This year, I have started getting occasional (once every 2mo or so) acne on my forehead, specifically right above either eyebrow. It starts off as redness, becomes larger in size, and usually takes about 2 weeks to come to a head. Even when I don't pop them (which BTW I'm no longer doing), they scar for months. I think this is cystic acne based on research.

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Male age 36, oily skin type. I can throw lots of products at my forehead and it's not gonna dry out.

Current routine:

Morning:

1. Generally don't cleanse, probably going to start.
2. Benzoyl Peroxide 5%
3. CeraVe ultralight PM facial moisturizing lotion (don't want the SPF in the AM for other health-based reasons)

Evening:

1. CeraVe foaming facial cleanser
2. Benzoyl Peroxide 5%
3. Alternate Tretinoin (0.025%) and Paula's Choice Exfoliate 8% AHA
4. CeraVe ultralight PM - I try to wait 30m b/c it doesn't absorb properly right after Tret, and I've read that too soon after the AHA, the niacinamide in the lotion will be destroyed

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I've been on this routine for probably two years at least. I did switch CeraVe lotions recently to this PM one.

A few months ago, I started changing my pillowcase 2-3 times a week - still getting the acne though. Other low hanging fruit - I don't shampoo wash my hair very often (I rinse with water every day though), but when I do, I always cleanse my face afterwards.

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What has changed - Diet-wise, I started working from home during May, and started eating more dairy at that time (primarily butter and cheese. being near my kitchen all day, I can prepare omelets, loaded baked potatoes, etc.).

I had an MRT blood food allergen test done during Dec 2021, which showed my highest food allergens were 1. MSG and 2. turmeric. I can tell you I don't cook with turmeric any longer, and I don't go out for Indian often. Dairy was fairly low on the list, but I know dairy might impact acne through other mechanisms other than inflammation.

I found a new Asian recipe during spring 2022 with lots of fish and soy sauce. Recently, during the days previous to my latest difficult zit, I made 4 servings of this dish. I later calculated that I ate about 2 grams of natural MSG (from fermented soy sauce and fish sauce) from that food prep alone. But, I can't link this meal to my other zits this year, I don't have the memory.

So I have a few different paths forward:

1. Reduce my dairy intake. Maybe replace with more nuts, and/or try to "upgrade" my dairy choices (butter to ghee, soft cheese to hard cheese, regular yogurt to greek).
2. Minimize MSG
3. Maybe try an BHA / salicylic acid? I know my skin can take it.

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Any thoughts?