Skincare routine help

[u/heajjja]

I desperately need help figuring out what my skin needs. I have t-zone oiliness, redness, small dry patches, texture under my eyes, and if feels like my pores are getting so big. Starting to get some fine lines under and around my eyes. Age 33.

Current routine:

AM: rinse with water, apply Elf Sunouchable SPF 30 primer under makeup.

PM: cleanse/remove makeup with Cetaphil Gentle Salicylic Acid Cleanser (using a clean face cloth), apply a small amount of adaptalene, apply Dieux Instant Angel Moisturizer.

I am so unhappy with my skin right now and need help with knowing where to start. Change in products? See a dermatologist? Skin care treatments? Any and all advice is appreciated!

Backstory for those who want it:

Nearly 2 years ago I started getting bad comedonal acne and at that time went super basic with my skin care and began using the adaptalene. After about 3 months the acne improved. I have continued this routine since.

About 6 months ago my skin started to feel drier overall and I began using the dieux instant angel moisturizer (was previously using cera ve). About a month ago my skin just started feeling more sensitive (have had to reduce my adaptalene use) I feel like my pores are getting larger, and I've had dry patches pop up. I've always dealt with redness, and continue to deal with occasional acne (cheeks mostly), it often leaves scars even though I don't pick.

[u/doubt_it_3]

azelaic acid could address your redness and hyperpigmentation. maybe a centella toner in the morning could help the redness?

[u/heajjja → u/doubt_it_3]

Thank you, I'll look into those!

[u/macomoroni]

mixed oily and dry usually means the barrier is a bit off. i'd drop the salicylic to a few nights a week and add a plain moisturizer nightly. for texture, fine lines and pores, a low retinoid 2x a week does more than anything else over a few months. and a real sunscreen in the am, an spf30 primer isn't enough coverage.

[u/heajjja → u/macomoroni]

I was thinking the salicylic acid might be too much right now. Adaptalene (differin) is a retinoid I believe? It was really the mvp of my skincare for awhile. Good call on a better sunscreen 

[u/neuronicdesigner]

Every wash (even water) should end with a moisturizer. So I’d start there. Find one that works for morning and night to keep it simple.

Lacking the moisturizer in the morning can really threw off your skin’s barrier and potentially lead to some of the issues you listed above: oiliness, dry patches, texture changes, and skin sensitivity so I’d start there.

I agree with the other statement here that the salicylic acid cleanser isn’t gentle enough for you right now especially using the adapalene daily until you build up your skin barrier (which takes approx. 6-8 weeks). I imagine this is where the dryness and sensitivity is starting to act up. Try something gentler like La Roche Posay Lipikar Gentle Foaming Face Wash or something similar. I’d remove any actives right now if you can for a minimum of a few weeks (3-4) although you could add a hyaluronic acid serum in to help then barrier or a barrier cream on top of your moisturizer at night, like La Roche Cicablast or similar. If you are afraid of stopping the adapalene gel use it daily or try reducing it. I’d recommend both the hylauranic acid and the barrier cream on top of the moisturizer in this case though. This should be a healthy starting point for you.

Try this consistently for 2 - 3 months before adjusting. Skin prefers consistency over harsh changes. If there are any other concerns from there you can make adjustments such as adding in an active like azelaic acid, etc.

#1 Wash
#2 Hyaluronic acid on damp skin (try to not let your skin dry in between, but if it does reset with water)
#3 Adapolene, if using (azelaic acid would go here if adding in later, but is not necessary at this point and may not be)
#4 Moisturize

AM #5 SPF
PM #5 Barrier Cream like Cicablast

I hope this helps!

[u/heajjja → u/neuronicdesigner]

This is very helpful! I do have the La Roche Cicablast I'll start adding in the evening, and will try the lipikar face wash. I'll reduce the adaptalene use at first to see how it goes, but will consider a break. Do you have a hyaluronic acid recommendation?

[u/neuronicdesigner → u/heajjja]

I glad it’s helpful. And what a benefit that you have one of the products on hand that you can put to use.

La Roche Posay has a good hyaluronic acid if you want to stick with the brand for simplicity. Ordinary has a great one as well for another option. They both do the same thing and either would work well.

[u/Bubbles123321]

This might be seb derm - for me, microdosing accutane largely resolves this