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Cystic Complexion Crisis

By Amalah

Hi there Amalah!

Love your blogs, love your advice at the Smackdown, which is why I’m writing. Back in November, I got some zits on my right temple. No big deal, really, but they were the nasty bright red and sort of oozy grossness kind. About five of them, in a Cluster of Ew. So, I figured, what the heck. My parents have money, and they love me a lot, and they were asking what I wanted for Christmas. I requested the Philosophy gift set you listed in the Holiday Gift Guide. I opened it December 25 and began using it that very night. I started with once a day–previously that had been enough to maintain the status quo for my face since I very rarely wear make-up. Then I started using Purity twice a day about a week later.

Fast-forward a month, and… my face has freaked the hell out. Yes, I am among that lucky 10% of the female population for whom, apparently, these products do not work AT ALL. I’ve even had to add a benzoyl peroxide topical acne treatment–first time since my teens–just to keep the pimples under pseudo-control, which really just means stop many more from appearing since the ones I have had SINCE THANKSGIVING are still there. I woke up this morning and I had two new lovelies on my chin, where I haven’t broken out since my mid-twenties (I’m thirty-two, if that means anything). That isn’t even counting the fact that my facial lines are more obvious since I started using Hope in a Tube. No, really. My exceptionally unobservant husband squinted at me this morning and asked, “Did you always have those lines from your nose to your mouth? And that one on your forehead?” Not till the past two weeks, buddy.

So. Aside from donating the face wash, and line cream, and serum, to my best friend with the naturally clear and lovely skin, which is next on my agenda, what the heck is wrong with my skin? I can’t afford to drop a bunch of money testing products on my face with four kids and one-and-a-half incomes, so I’d like to know: is there a common factor among those of us for whom Philosophy just is not effective at all? And is there one thing that does work for us? At this point I’m ready to go back to Neutrogena but if you tell me there actually is something that will eliminate the Final Five constantly being reborn on my right temple, I might be willing to try it.
Thanks in advance!



It sounds like your skin is going through a transition — some fundamental change in body chemistry or hormonal shift. It could be age related or a reaction to stress or even something in your diet. Maybe salicylic acid is your nemesis. It can be really, really difficult to pinpoint the reason your skin “freaks out” and starts behaving like it did in high school again, and unfortunately, no, there is no “universal” reason Philosophy doesn’t work for some people and no guaranteed Option B I can recommend. Your skin sounds STRESSED OUT and a bit wild-cardish, so I’m not really inclined to start rattling off expensive alternate brands right off the bat.

In fact, I’m going the “get thee to a dermatologist” route, because of the Final Five. They sound possibly like cystic acne — the toughest and most persistent form of acne out there. If they are cystic (red, pus-filled, painful), a slap from the drugstore and Sephora are not likely to do very much, and too much messing around with them yourself can lead to scarring. Tell your doctor you’ve had the same five nodules since November and OTC products are making things worse. A dermatologist might recommend cortisone injections or prescription-strength treatments. (If you get Retin-A for your zits, go ahead and use it on those fine lines in place of a wrinkle cream.)

If your doctor doesn’t give you a specific regimen besides the shots or a topical treatment, head over to and start reading all the articles under “Get Clear.” I like the regimen this site lays out because it’s possible to implement it fairly cheaply, using inexpensive products so it’s not quite the blow to the wallet like when a four-piece kit from Philosophy or Murad or Dr. Perricone doesn’t work for you. It’s also much gentler to 30-something skin than something like Proactiv.

You’ve already got the Benzoyl Peroxide treatment — recommends a 2.5% formulation — so now you just need a gentle face wash and a moisturizer. If Neutrogena served you well in the past, Neutrogena it is. Think of the Final Five as a separate freak occurrence — your former skin care routine probably didn’t cause them. A hormonal imbalance or some other underlying problem probably did. Were the holidays a particularly stressful time for you last year? Did you notice any change in your cycle? Change something in your diet? Eating a lot of candy or processed foods with partially hydrogenated oils or high-fructose corn syrup? These are all things that I’ve been able to nail down as causes for skin-related freak-outs in the past.

So. Dermatologist to check out the Five. 2.5% benzoyl peroxide (or other dr-recommended treatment), gentle (non-acne-specific) face wash, moisturizer. Don’t pick or squeeze or touch. And next year: Ask for cash.

Photo by gagilas

Published March 22, 2010. Last updated July 23, 2017.
About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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