Dealing with post-inflammatory hyperpigmentation (PIH) and scars

[NothingMuch]

After finally conquering my long battle with acne (for the most part anyway), I find myself with a scarred wasteland that is my face and back. My next fight is preventing and clearing my hyperpigmentation problem. It was something that felt achievable compared to my deep pitted scars. I’m not going to take any pictures of myself (it’s embarrassing to look at even if it’s done anonymously), so I stole a picture from the internet to represent what I’m dealing with. This person’s skin tone and dark spots are about the same as mine.



I have to be extra careful with what I chose to help solve this problem. One wrong move and I could suffer with the aftermath for months or years (or forever). I came across mandelic acid to speed up exfoliation and fade the dark marks quicker. On the upside, it’s a very gentle alpha hydroxy acid (AHA) compared to something like glycolic acid. It's also sold at a fairly cheap price. On the downside, the gentleness means it takes much longer to see results.

I’ve been using mandelic acid 10% + HA from The Ordinary for 4 weeks now. I think the improvements must be too subtle to notice at the moment. Since the really dark spots can take up to a year or more to fade completely on their own, I'm not sure how quickly I can expect the mandelic acid to fade them out. Three months? Six? For the first two weeks I had a slight uptick in the number of whiteheads around my chin and cheeks. I'm guessing that was just a purge because my skin calmed back down after that. It also got rid of a stubborn blackhead.

Here's my nightly routine so far. I do this daily and at least an hour before bed.

• Wash my hands
• Wash my face with a gentle, fragrance free soap.
  • If I'm wearing make-up, I use my normal body wash because my facial soap doesn't remove it very well. Hopefully I'll be able to find a better body wash and ditch the expenisve facial stuff.
• Put moisturizer on my eyelids
  • Helps protect them from the acid
• Apply 2-3 drops of mandelic acid to both sides of my face
  • I do wonder if I'm putting too much on because The Ordinary has no specific directions.
  • Never put this acid on the eyelids!
• Apply moisturizer to the rest of my face

Here's my morning routine.

• Wash hands
• Rinse face with warm water
• Apply moisturizer
• I really need to find a facial sunscreen! For now I mostly avoid the sun, esp. during high UV hours.

I'm still battling my skin picking OCD which plays a major role in the severity of my dark spots and scars. I'll be hopping over to the Mental Health Disorders forum sometime soon.

 

[NothingMuch]

Hummm. I'm not sure if this post should stay here or be better placed into the Appearance and Body Image forum.

 

[NothingMuch]

Yesterday was day 60 (2 months) of using mandelic acid nightly.

I can tell I need to stop using it for awhile because I'm starting to get irritation and breakouts on my chin from what I assume is over-exfoliation. Mandelic acid may be gentle, but you can still do too much of a good thing!

I had been doing so well too despite my carb slips. My face is still clear save for two new, medium sized bumps on my chin. After they go away, I'll wait another week, then cut down my acid use to once a week.

 

[NothingMuch]

After a three week hiatus, I've returned to using mandelic acid on my face. I think I'm going to stick with using it once a week from now on. I don't want to risk more irritation and dark spots. I've been spot treating with mandelic daily on the rest of my body though. There are old acne spots that I wouldn't let heal due my skin picking problem, resulting in constant scabbing. I finally healed one bad ruff patch that I'm pretty sure has been there for at least a year. I've now turned my focus onto two more bad spots on my chest and arm. They're getting progressively better and hopefully I can stop using the mandelic on them soon. The worst of the worst is on my upper back (the places I can reach of course). I'll take care of those last. The reason I'm doing all this healing in baby steps is because I noticed I get overwhelmed when I try to heal every spot at the same time.

I other news, I finally found a facial sunscreen that I can put on my face during the day. It's a SPF 45 ultra sheer, so it does a better job of blending into my skin tone. Nothing is worse than spending money on something that gives your skin that awful white cast.

I'm also looking into adding vitamin C (or some other type of tyrosinase inhibitor) to my routine, but I don't want something too pricey. I want my acne and dark spot routine to be as budget friendly as possible without being outrageously expensive...but not so cheap that it's a useless waste of money.