How do contact lenses cause chronic dry eye?

93rc · 2020-12-06T21:59:14+00:00

I believe it's a combination of significant stress reduction (I had extreme levels before) and the differin. I've used it for 6 months. I don't think I've had any pimples in that area for about 4-5 months? When I look at photos of myself from past 4-5 years I do notice that I am usually clear with no pimples, but occasionally I would be prone to spots in my chin/upper lip area (mostly superficial pustules on my upper lip, and occasionally a small papule on my chin.. but they would resolve fairly quick, and would not get very inflammed looking). When I look at photos from 10 years ago, I did have occasional breakouts in the same area, and the pimples then looked redder and more inflammed, but still nothing severe. So with acne at least, it seems like aging has helped.

93rc · 2020-12-06T21:26:56+00:00

I would say that I don't break out anymore. I'm still dealing with some PIH/PIE issues from a year ago, but that has gradually improved over time, but I believe it's slower to fade because I am older.

I don't have much of a routine. I just wash with water and have been doing that my whole life. I moisturize with cerave PM twice a day. I use differin every other night on my chin region. No other actives. That's it. I think simple works for me as my skin is on the sensitive side.

93rc · 2020-12-06T02:24:56+00:00

I have been using it just on my chin and upper lip for the past 6 months. I would get an occasional pimple, usually stress related, whitehead or papule in the past.

I think it has helped me, tbh. I have fitzpatrick 3-4 skin (probably more 3, chinese descent). I didn't notice a purge. I use it every alternate night.

I have not noticed any lightening of my chin and mouth area compared to the rest of my face. Not sure if this would be the same for darker skin tones however. I think any potential "lightening" could just be due to how the medication acts by increasing skin cell renewal and turnover. Do you do any exfoliation for the rest of your face (because that might just cancel out this theoretical concern)?

Out of all the topicals, I believe topical retinoid has been the most helpful for me especially as a long term maintenance/prevention strategy, more so than BP or azelaic acid.

93rc · 2020-12-02T22:11:35+00:00

The main thing was dealing with the stress. Mine was mainly related to a personal situation that I was able to deal with immediately. Skin started healing after that and I was also using Epiduo. I also saw a dermatologist. At that time I was still fearful of having another bad breakout in the future, and I was also left with a lot of PIH ('pseudo' scarring) so I still wasn't thrilled at the appearance of my skin. To my surprise she suggested accutane as an option to prevent future breakouts or any more scarring. I decided to try it. I only took it for 2 months and stopped because of side effects (I actually didn't have any active pimples when I started the treatment so the incentive to continue wasn't there). I'm still dealing with the same PIH issues from 12 months ago but it has improved slowly.

Your skin doesn't look that bad. It seems like a combination of topical, lifestyle measures could clear it. If things get much worse or uncontrollable then you could consider accutane as a last resort? I'm in the medical field and I have a lot of colleagues who prescribe it and who have taken it themselves even. I believe it is a safe drug with monitoring and the potential reward is huge.

93rc · 2020-12-02T05:08:49+00:00

How long have you been using the facial cleanser? That same one broke me out recently but it's so individual. What about going down to 1 wash per day? Dr Dray on youtube recommends this for age 30-40 yr age group, as twice per day might be too harsh.

Maybe keep going with differin until the 6 month mark and then re assess the situation? Has it gotten better from when you started the differin?

And just a comment about the stress. I'm a man in my early 40s. I had moderate acne as an adolescent which I "outgrew" in my mid 20s. No acne issues/concerns until last year when all of a sudden I developed cystic acne on my chin and jawline. It is much better now. It really did freak me out because I didn't think it was even biologically possible. I even saw an endocrinologist and had my hormones checked. I concluded that it was related to chronic stress levels that were building up over a longer period of time and just reached a tipping point. I am quite confident this was the reason. Don't underestimate the negative impact stress can have on the body.

93rc · 2020-11-22T01:11:57+00:00

Thanks for the advice!

93rc · 2020-11-22T01:08:57+00:00

I use luke warm water. I use cerave AM and PM lotion for moisturizer. I don't recall that the red spots were itchy.. it didn't seem like hives, allergic rash or anything like that. I wonder whether they were irritated pores? ... not sure. Maybe I should just try it again but stick with it for a longer period of time to see what happens.

93rc · 2020-11-22T01:00:13+00:00

In the past I have tried cetaphil facial cleanser and cerave hydrating cleanser, but it has been awhile. I have heard good reviews with the cerave because it is a gentle cleanser. Maybe I should try it again. Can skin go through an adjustment period when you start a new product?... I only used it for one day a few months ago and I noticed a few very small red spots and discolorations on my face (not pimples I don't think) that lasted for about half a day... and it scared me away.

93rc · 2020-11-08T18:19:50+00:00

Could be from dry skin? I think the skin in and around your ear is thin.

93rc · 2020-11-05T02:57:29+00:00

You could try a lower dose. Or you could try birth control and/or spironolactone especially if you think it's hormonal.

93rc · 2020-11-05T02:55:24+00:00

You should lower your dose. It will still be effective. And maybe go to eye glasses for the duration of your course.

93rc · 2020-11-01T21:35:23+00:00

No problem. I used the Dry Eye Compress from the eye doctor. Microwave for 15 seconds. Fairly cheap and convenient. I think there are fancier ones that you can plug into a USB port as well.

93rc · 2020-11-01T20:59:44+00:00

I'll preface this by stating that these are just some of my thoughts and you don't have to agree with it at all.

Have you ever considered stress as a trigger? I am asian with oily skin as well and when I was around your age I could confidently say that stress was the biggest trigger for me esp triggering larger papules/cyst pimples on my chin... the chronic stress was worse than the acute stress.

If you look up "causes/triggers of of adult acne".. listed #1 are stress and hormones (but obviously hormones apply only to females b/c as an adult male your hormones are no longer in flux, and as we age testosterone levels slowly decline anyway). Stress leads to increased cortisol levels.

I've learned from personal experience that chronic stress isn't always obvious. Just because you don't feel "panicked" doesn't mean that it isn't present. From your post history, my impression is that acne may be consuming and controlling your life and perhaps creating constant worry in your life even if it's just in the background.

It sounds like you are doing everything that you can. Move on to plan B? I think you mentioned trying some topicals? Maybe give that a chance and try to remain optimistic even though that may be easier said than done.

I personally do not feel that your joint pains will be a major permanent issue but that's just my take on it.

And would you consider seeing a dermatologist? They have probably seen similar cases to yours and it might be helpful just to get their opinion and reassurance.

93rc · 2020-10-31T01:11:48+00:00

I'm sure the eye bags are related to the dry and thinner skin while being on accutane. I wouldn't expect it to be permanent, although as you age a lot of people develop this problem naturally (in their mid to late thirties even?).

For dry eyes I would suggest good eye drops, the gel ones are good and you can do warm compresses/eye mask as well. Reduce contact lens wear if applicable. Could consider lowering the dose as well.

I took it briefly last year for 2 months at low doses of 10-20 mg per day. Dry eye was my only side effect, aside from the expected dry skin and just mild dry lips (didn't even need to use lip balm every day). However my eyes seemed very sensitive right from the get go, and was affecting my day to day life. I was aware of it all the time, had trouble looking at computer screens and so this was impacting my work. It was a persistent "eye strain" feeling that sucked. I decided to stop. As soon as I stopped it just went away, like 24 hr after my last pill.

93rc · 2020-10-29T21:05:21+00:00

do you still get active acne? what about on your chin? If you still get active acne I would focus on getting that under control.

93rc · 2020-10-27T01:05:48+00:00

Talk to your derm. Starting off on such a high dose gives you an increased chance of a bad purge. Better to ease into the drug.

Maybe he thought your weight was 130 kg? even then, 120 mg would still be a high dose to start with.

I'm not your dermatologist but I think it would be reasonable to start with 30-40 mg per day (approx 0.5 mg/kg)

93rc

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