My Skin Battle: Dermatologist vs Estheticians

(Photo source)

This summer has wreaked havoc on my skin.  Hands down the worst summer for my skin in the last few years. 😦  I’ve been having bouts of breakouts with some calm in between, only to have another bout of break out.  And I don’t mean just a zit, I either get huge cystic acne or clusters of pimples (like 6 – 10 at a time).

It’s really putting a damper on my self esteem, and I feel pretty self conscious when I go out.  Although I’ve been using make-up and it’s not as noticeable, I notice it, and that’s enough for me.

It all started in April when my skin would get super oily during the day, and then it would feel super dry after I washed it.  It was a pretty unpleasant cycle, and my dermatologist just kept prescribing more drying lotions.   Then I read Fabulously Broke’s review on Pure and Simple spa and decided to give it a try.

I was really impressed with Pure and Simple’s philosophy and their approach and decided to splurge on a 5-package of facials ($695 + tax & various products $$$ later…), and my acne was also still in bouts.

It would get worse after my facial, and then better.  Even BF noticed!  But as soon as I stopped getting facials, it would act up again.  (When I say stop, I mean if I didn’t got for 2 months or so).  Or if I ate certain foods, my acne would just get out of control and the natural products that I was using couldn’t control it.  In fact, my acne seemed to get progressively worse, a bit better, and then worse. Now it’s in its “worse” stage. 😦

I’ve also tried the Oil Cleansing Method, as so many of your have sworn by in my last skin post.  Reader Sonia was so kind as to send me a mixture of her oil cleansing potion!  It was working great the 2 weeks or so, and then my bout of acne came (likely due to consumption of way too much cheese!), and I felt like it was doing more harm than good, and have gone off of it.  I would like to try it again, after my skin calms down.

During this time, I wanted to further educate myself on my skin since I was getting conflicting recommendations from my esthetician and my dermatologist. I’ve summarized the information I’ve gotten from each below.

Esthetician: Use natural products and instead of trying to dry out your skin – plump it up with lots of moisturizer products.  Natural products work best as it is more easily absorbed into the skin.  Come for facials often to regularly clean out your pores.

Dermatologist: Use the glycolic acid toner in the mornings to keep sloughing off dead skin cells and kill bacteria on the surface of your skin.  Use moisturizer only in dry areas – do not moisterize everywhere.  Use a retinoid and Vit A cream at night to control oil and treat active acne.

Further Readings

I’ve also read the “Skin Type Solution” by Leslie Baumman, M.D. (dermatologist), and Beauty Pure and Simple by Kristen Ma (co-founder of Pure and Simple holistic spas).  I will be doing a review on each of the books, so I don’t want to go into too much detail here.  They are both great reads, and I highly recommend them to anyone, but especially those of us who deal with acne and other skin problems.

There are a lot of similarity and overlap in the approach that both ladies take.  For instance, I have oily and sensitive skin.  In both books, I need to address the bacteria on my skin surface, and slough off dead skin cells so that they do not eventually clog more pores.  The difference is in the products and the types of treatments each recommend.


My dermatologist has prescribed a regime similar to that recommended by Dr. Baumman’s book, including the following. 

Glycolic acid (all over face and neck): check;
Retinoid (all over face neck): check;
Spot treatment: check;
Sunscreen and gentle cleanser: check and check.

Moisturize only in dry areas: check.  Chemical peels over abrasive exfoiliation.  No steaming of face. No fancy treatments required.  (Sidenote: Baumman does not shy away from recommending more intense treatments where she thinks it’s needed, such as botox and intense light treatments).


My esthetician approaches treating acne (and other skin problems) in a holistic manner.  Instead of using drying solutions, she recommends more moisturizing which she says will bring back the balance of oil in our skin. She argues that when there is balance in my skin, it will stop producing so much oil and blackheads.   She also recommends monthly facials to purge or clean my pores.

There is a part of me that wants to use more natural products – maybe it’s the hippie or romantic in me – being one with nature and whatnot.  Wanting to use products from our earth instead of chemically manufactured.

But then, I know it’s not all working because I keep getting breakouts, and it’s really getting to me.  And I always feel a little it’s a bit of a conflict of interest that an esthetician encourage their clients to do monthly (or more frequent) facials.  They are expensive – mine are ~$120 (+ tax + tip) each.  Of course, you’d want them to come back more often, right?

Finding my Medium

Maybe there can be a happy medium for me – things are never just black and white, right?

I’ve also read that dermotologsits should be consulted for more severe cases of acne or skin conditions and an esthetician can be consulted for more moderate cases since they do not have the same training or background as dermotologist.


I’m going back to using what my dermatologist prescribed to clear out my skin.

I find that when my skin is good, it’s really good, but when it starts to break out – the bacteria on my skin just grows exponentially and then everything is out of control.

However, I will also be moisturizing my skin with more natural products (I do find they are absorbed more easily into my skin).  And when my skin gets better, maybe I will go to using the glycolic acid and retinoid every other night instead of every night.

Le sigh.  Wish me luck!

Any tips, readers?  Do you prefer a dermatologist or esthetician?  Natural or chemical products?



Filed under Health

30 responses to “My Skin Battle: Dermatologist vs Estheticians

  1. My skin was terrible until I went on bc. It took over a year but now I get a few zits a month and that is it.

  2. Michelle

    I think you should treat your skin by the things you eat instead of what you put on your skin. Like you said, eating cheese caused you to break out a lot. Whenever I drink milk (and other things), I break out a lot. Right now, I am changing my diet, and it’s better than all the lotions and potions that I bought. I am curing from within, not just treating the problem.

    • I agree. I have also slowly been making life style changes – more veggies and legumes, less processed grains and fats. It’s helped quite a bit, so I try to combine eating well with products that work well for my skin.

  3. I’m super skeptical about advice from anyone who can benefit financially from the advice, so I would probably rely on the derm’s advice more. I also don’t think that all-natural products are all that they are cracked up to be – everything comes from the earth, so the fact that something is plant derived versus derived in a lab doesn’t resonate with me. Especially for medicinal type things, where a controlled lab environment would probably produce more stable, better tested products. But then, maybe I’m a little bitter after organic shampoo dried out my hair horribly…

    I don’t have much advice personally, but I’ve found advice from two online beauty personalities who have encountered adult acne that you may want to try out. One of them is by “Goosmakeupartist” on youtube, you can search for his acne video online and I really trust this man’s opinion. Another one is by a blogger at shopnowbloglater, she recommended a child-diaper rash cream for cystic acne around the chin, which apparently did wonders for her. My friend from high school has experienced good results with Proactive… sorry i do’nt have any personal advice, good luck and I’m sure your acne doesn’t appear as bad to others as they do to you!

  4. Maybe it’s dairy? I recently read the “feed your face diet” by Dr Jessica Wu and she claims dairy is the cause for most breakouts. Another thing is to change your pillowcase every few days and use a separate towel for your face, hair and body. I had a bad breakout 2 years ago that recently started to go away. I try to avoid dairy except for goat cheese and yogurt every now and then.

    • LC

      It wouldn’t surprise me if dairy was a major culprit. The minute I gave up cow’s milk, yogurt, and only ate cheese on pizza, my skin broke out one last time and then it all went away… forever! I’ve never had bad acne but I haven’t had a single breakout since giving up dairy. (I gave up meat at the same time though… might’ve helped.)

      • I think it’s the high fat content in dairy, or just dairy.

        I went on a weekend cheese spree and it wreaked havoc on my skin (but tasted sooooo good). So, I’ve got to indulge sparingly…. it’s hard to give up cheese… so yummmy!

  5. Oh boy, I’ve been here. Like you, I also suffered with cystic acne and tried several remedies. Seriously, I even went to a Chinese herbalist on a sketch looking side street who prescribed me with some nasty tasting teas (I drank them, it didn’t work). Like you, I was also being told by the esthetician to come in more frequently, but I found that their extractions actually ended up aggravating the cysts (and it was bloody expensive). I’m on the dermatologist side again, but I know that not all of them are created equal. He prescribed that I use a topical retinoid at night, a benzoyl peroxide spot treatment only as needed, and a pill to prevent hormone surges from wreaking havoc on my face. So far so good. I hope you find something that works soon.

  6. Chinty

    Hi, I have been lurking here for a long while without really commenting. Today you have spoken of something very close to my heart and just had to put in my two cents. I suffered from acne for about a year and half and did all that I could to get some relief. In the end, the only thing that worked for me…and I mean THE ONLY THING is a face cream, dead cheap that I got from an Asian store. I do hesitate to say it loud ’cause people usually use it as a fairness cream and I use it to combat acne. Try Fair & Lovely – any type would do (’cause they have a lot of versions under the same name). For me its been a life saver…

  7. ST

    You may not like this idea, but have you considered Accutane at all? I’ve had skin problems since I was 13, and after years of using products that would work temporarily via my derm, doctor, and estheticians, I had a major outbreak of cystic acne at the age of 25. I had said to myself, ‘enough’, time for a more permanent solution, because my scarring was getting unberable. That, and as you know, cystic acne can hurt. I went on it for 6 months. normally Accutane is taken for approx. 4 months at full dose (based on body weight). I reacted, so my doctor lowered it, and I was on it for 6 months. This reduced the scarring and now a year and a half later, my skin breaks out from time to time, but nothing major. I am so glad I did it. My cousin who had worse skin, and was adamant against it did the same thing, with great results as well. It’s something to look into. it took me 5 months to decide to do it, but glad I did.

    • I have a few friends who used accutane and it did wonders. It was strong, made their skin including their lips peel off, couldn’t wear contacts but it did the trick. All of them have perfect skin now! I guess the only big thing is you have to absolutely make sure you don’t accidentally get pregnant.

      • Kristy

        I also don’t comment on your posts but I too have had horrible skin since I was 13. When I was 17 I went on Accutane, it was hard, beacuse it totally dries eveything out, but my skin is great now! I hardley get any breakouts! The only thing is there have been studies about accutane and how it messes with your digestive system (intestines, bowels). So research it well, and way the risks. I have also tried skin id by Neutrogena (work has been stressful, so I have had a bit more breakouts) I found that it worked really well, but you can buy the stuff they give you at a drug store by Neutrogena. The stuff I use is the cream cleanser that has 2% salicylic acid. Good Luck, I know it is a hard process and sometimes really emabarassing!

      • ST

        That’s true, which is why if you go on a lower dose, you have less adverse reactions, such as the uber dry skin, and the cracking lips, but the derm should also be able to help you with this. You could also have a doctor prescribe it, they’re easier to book appointments into in my opinion, and that’s what I did. The monthly blood tests suck, but it really is worth it when you’re skin is done, and a few months after you see the results.

      • Thanks, girls, for the suggestion.

        I have gone on accutane when I was in high school. My acne was very bad. Much worse than it is now (despite my moans and groans). It was definitely really strong stuff and I’d much rather avoid, if I could get my acne under control with life style changes and topical products. It would be a very last resort.

  8. Hanah

    Have you considered Diane 35? It’s a birth control pill but it’s marketed as an acne medication, and it worked really well for me. Some people are sensitive to the pill, but if not then it’s a pretty low investment and it might work. Good luck!

    • Thanks, Diane. I have gone on BC (tricyclan) and it’s helped. I’ve taken bc for the last 7 years (on and off), and lately, it’s been affecting my mood swings so I went off of it. It’s probably partly to contribute to the acne, as well.

  9. i’m so sad the OCM method didn’t work out for you! i completely feel your pain though – my story was similar to yours in that i went in and out of dermatology offices, various prescriptions, dropped loads of money on facials (which always irritated my skin more) all from my teen years through college. in college i would buy expensive facewashes / creams, hoping that the expensive stuff would work better. what a waste. eventually i figured out that my skin just HATES chemicals. i would not describe my skin as super sensitive, but anytime it touches facewash / non-natural soap / synthetic moisturizers etc. i get nasty under-the-skin painful breakouts. it took me a lonnnggg time to figure out the correlation between the two! after switching to OCM, i had to try a couple of different formulations / mixes of oils before i found one that worked well (some of them even caused me to break out). now, as i stated before, i use straight up grapeseed oil in the summer when i’m oily, and jojoba in the winter when it’s dry. maybe at some point once your skin stabilizes you could try introducing OCM with a different oil again! i really do hope you find something that works because i totally feel your pain.

  10. Anonymous

    I’m 35 and having the same problem. I had the same reaction to facials (made me break out, then got better) but I realized, as someone said above, that my skin seemed to be getting worse overall, perhaps from spread of bacteria. So, I think I might continue to get facials but WITHOUT extractions. I feel like i have tried every cream and pill on the market with minimal success, both prescription and OTC. And BC, honestly, never helped me that much. (I’m not on it now.) I took Accutane years ago and my skin was perfect WHILE I WAS ON IT, but once I went off it, my skin was worse than ever, outside of now. I don’t really know what to do at this point, so I am looking forward to reading about your further skin adventures.

  11. Kay

    ummm… if diary is causing those, can you stay off dairy?

    IMHO, those pimples are just a symptom.. My ND says when food allergies / intolerance show up the skin, it’s deep. if you treat it topically now, what will you do when some other symptoms show up? [My food intolerances started very small and it is a serious issue now. So it my daughter’s.] I’m not trying to be condescending or patronizing, just giving facts on food intolerances.

    Acne or cheese/dairy, its really up to you to pick your battle.

  12. If you think certain foods trigger breakouts, experiment! I stopped eating peanut butter because it made me break out in massive cysts. Today it still results in scary whiteheads, but not nearly as bad – so I indulge every so often.

    When I had acne, natural remedies did not work. Chemicals all the way – benzoyl peroxide seemed to do the trick in the end. Now my main concern is my sensitivity, so I don’t use any face wash and I use natural eye creams/moisturisers – the fewer chemicals, the better.

  13. Pingback: New Skin Regime | fabulously fru-girl

  14. Pingback: Book Review: Pure + Simple – A Holistic Guide to Natural Beauty by Kristen Ma | fabulously fru-girl

  15. Pamela R.

    Hi Fru Girl,
    I’m 30 and have also struggled with “acne” issues in the past. I’ve tried Accutane, Diane 35, Differin, and every kind of lotion/pill prescribed by a dermotologist. I avoided going to spas for facials because this tended to make the situation worse! One year before my wedding, I had the worst breakout ever! Part of it was a reaction to the topical medication my doctor prescribed combined with my normal triggers. It was so bad, I even missed work and stayed at home for five days! I was referred to another dermo, this time at the UBC skin care clinic. There, I discovered that I didn’t even have acne! I had rosacea instead and that the acne treatments were making it worse. My new dermo prescribed her own “concoction”, an antibiotic cream. She also told me to stay away from coffee. My skin improved (it isn’t perfect however and I still get flare ups, which can be controlled). I take advice from rosacea blogs and it has helped keep things in check (things like: less sugar/spicy foods in diet, no coffee, lots of water, good sunscreen). I learned that a lot of the treatment for acne aggravates rosacea so that pretty much explained why none of the treatments lasted. Have you considered rosacea?

  16. M

    I had similar issues. You’d be surprised how cutting out dairy (& possibly wheat and sugar will clear it up). Also I highly recommend a naturopath who specializes in hormone balancing to do bloodwork. It’s more detailed than the regular md test. Naturopaths will get to the source that’s causing it. All the meds in the world won’t get to the bottom of it. Bacteria under your skin is just one symptom of a larger issue. Good luck!

  17. Alison

    First time I have read your blog and thought I’d quickly suggest something that noone else has mentioned. It is really common with Western lifestyles to get an imbalance of good and bad bacteria, or Candida. It is the same thing that causes thrush, however you can have Candida ( throughout your digestive system, skin etc. Often Western doctors prescribe rounds of antibiotics without warning of this, or suggesting remedies to counter the treatment. There are natural ways to ‘flush’ your system and to boost good bacteria, which you may find helps your skin.

    Also, I recently started taking 2 fish oil tablets a day and after a few months, my skin actually became less oily, softer and my pores literally halved in size. Not sure why, but it is the only change I made – so could be worth a shot 🙂

    • Hi Alison,

      Thanks so much for commenting and your suggestion. I checked out Lani’s blog, and I love her no-non-sense approach to treating our skin. There is a lot of good points she brings out that I’d like to incorporate in my day-to-day life. My acne has (again!) taken a turn for the worst and I need a permanent solution… It is SO frustrating.

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