itoshi rin
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The New Ultimate Acne Guide: From Root Cause to Clear Skin
Table of Contents
- 1. Why You Have Acne (Root Causes)
- 2. External Treatments (Topicals)
- 2.1 Tretinoin
- 2.2 Azelaic Acid
- 2.3 Clindamycin
- 2.4 Benzoyl Peroxide (BPO)
- 2.5 Adapalene
- 2.6 Niacinamide
- 3. Internal Treatments (Orals)
- 3.1 Isotretinoin
- 3.2 Antibiotics
- 3.3 Spironolactone
- 3.4 Zinc, Vitamin A, Omega-3
- 4. Fixing the Root Cause
- 5. Skin Barrier & Routine
- 6. Timeline & Realistic Expectations
- 7. Final Words
1. Why You Have Acne (Root Causes)
Acne isn't bad luck. It's your body's response to deeper imbalances:- Excess androgens → more sebum → clogged pores
- High insulin / IGF-1 from sugar, dairy, whey
- C. acnes bacteria trapped under dead skin
- Inflammation and oxidative stress
- Harsh products stripping your skin barrier
- Gut-liver axis dysregulation (food intolerances, dysbiosis)
2. External Treatments (Topicals)
2.1 Tretinoin
Effectiveness: ★★★★★Mechanism: Retinoid that speeds cell turnover, reduces microcomedones, boosts collagen.
Why it works:
- Clears dead skin before it clogs pores
- Fades pigmentation & fine lines
- Long-term prevention of new acne
- Started too aggressively → barrier damage
- No moisturizer or sunscreen → irritation
- Quit too early (needs 8–12+ weeks for results)
2.2 Azelaic Acid (15–20%)
Effectiveness: ★★★☆☆Mechanism: Anti-inflammatory, antibacterial, keratolytic.
Best for:
- Redness, rosacea-type acne, pigmentation
- Darker skin tones (safe for melanin)
- Most effective medication used for acne scarring
- Not used consistently (works best AM/PM)
- Combined with irritating actives (like BPO or harsh exfoliants)
2.3 Clindamycin (topical antibiotic)
Effectiveness: ★★☆☆☆ (only in combination)Mechanism: Inhibits bacterial protein synthesis (kills C. acnes)
Why it works:
- Effective short-term bacteria control
- Used alone → bacteria develops resistance
- Not combined with retinoid or BPO
2.4 Benzoyl Peroxide (BPO)
Effectiveness: ★★★★☆Mechanism: Releases oxygen into pores → kills bacteria
Use case:
- Inflammatory acne
- Paired with antibiotics to prevent resistance
- Using too much → irritation, over-drying
- Bleaches clothing/towels — use carefully
2.5 Adapalene
Effectiveness: ★★★★☆OTC retinoid: Less irritating than tretinoin, similar benefits
Good for: Beginners, sensitive skin types
2.6 Niacinamide
Effectiveness: ★★☆☆☆ (supportive)Function: Regulates sebum, anti-inflammatory, brightens skin
Why include it:
- Supports barrier repair
- Pairs well with most actives (AM use preferred)
- Doesn’t fix acne alone but helps overall skin health
3. Internal Treatments (Orals)
3.1 Isotretinoin (Accutane)
Effectiveness: ★★★★★Mechanism: Shrinks sebaceous glands, alters keratinization
Works when:
- Severe, nodulocystic acne
- Refractory to topicals
- Poor compliance (daily use mandatory)
- No support (hydration, lip balm, liver monitoring)
3.2 Oral Antibiotics (Doxycycline, Minocycline)
Effectiveness: ★★★☆☆ (short-term only)Mechanism: Anti-inflammatory + antibacterial
Use case:
- Moderate acne (short-term only: 8–12 weeks)
3.3 Spironolactone
Effectiveness: ★★★★☆ (in women)Anti-androgen: Blocks androgen receptors
Best for:
- Hormonal acne in women (esp. jawline, cycle-related)
3.4 Supplements: Zinc, Omega-3, Vitamin A
Effectiveness: ★★☆☆☆ (supportive)Zinc Picolinate (30–50mg): Regulates sebum, lowers DHT
Omega-3 (EPA focus): Anti-inflammatory
Vitamin A: Helps keratinocyte turnover (low dose; do not combine with Accutane)
4. Fixing the Root Cause
Hormonal Support:
- Lower dairy/sugar → ↓ insulin / IGF-1
- Zinc, green tea extract → ↓ DHT
- Sleep, stress control → ↓ cortisol
Diet:
- Eliminate: seed oils, high-GI carbs, whey
- Add: liver, oily fish, cruciferous veg, probiotic foods
Gut & Liver:
- NAC, digestive enzymes, probiotics
- Avoid alcohol & processed food
5. Skin Barrier & Routine (AM/PM)
AM:- Gentle cleanser
- Niacinamide or azelaic acid
- Moisturizer
- SPF 50+
- Cleanser
- Tretinoin or Adapalene (2–3x/week, not with BPO or clinda same night)
- Clindamycin or BPO (alternate with tretinoin)
- Moisturizer
- Vaseline on dry spots
6. Timeline & Realistic Expectations
| Week | What Happens |
|---|---|
| 1–2 | Irritation, purging begins |
| 3–6 | Texture improves slowly |
| 6–10 | Oil lessens, breakouts drop |
| 12+ | Pigmentation fades, glow |
7. Final Words
Acne is the signal — not the root issue.You need to:
- Address systemic factors (hormones, gut, diet)
- Support your skin barrier
- Be religiously consistent
Be aware: Most dermatologists will try to prescribe you oral antibiotics like minocycline or topical clindamycin. You should avoid using them as a standalone treatment — they don't fix the root cause and can lead to resistance.
Instead, ask for Adapalene (Differin) or ideally Tretinoin. Those actually work long-term and address the problem at its core.
With the right tools, acne is beatable.
Don’t quit after 2 weeks. Quit when you win.
If u have tips to improve my post or have something additional to say from experience or knowledge about acne, please do so.
