Formula Adjustment for Steroid-Dependent Skin and Acne Breakout

Question

I have a friend with steroid-dependent skin who developed redness and sun sensitivity. I created a formula that helped improve these symptoms within 11 days, but now she is experiencing a sudden acne breakout after stopping steroid use.

My initial formula included:

Water
Ceramide Complex
Licochalcone A
Vitamin B12
Pro Vitamin B5
Matte Silica
Light Cream Maker
LipidSoft
Phenoxyethanol

I have the following questions:

Can I increase the concentration of Licochalcone A, Vitamin B12, and Pro Vitamin B5 in the formula?
Can I use a BHA toner all over her face to treat the acne?
Based on the acne breakout after stopping steroids, what adjustments should be made to the formula to help control the acne while considering her skin is still sensitive from steroid withdrawal?

MySkinRecipes Expert · Accepted Answer

Subject: Advice for Steroid-Dependent Skin and Acne

Thank you for sharing your friend's situation and the formula you created. It's good to hear that the initial formula helped improve the redness and sun sensitivity after just 11 days.

The sudden acne breakout is a common symptom during steroid withdrawal, as the skin's natural balance is disrupted.

Regarding your questions:

Increasing Licochalcone A, Vitamin B12, Pro Vitamin B5: The staff advises that Licochalcone A at 2% is already a high concentration and should not be increased further. While increasing B12 and B5 might offer more hydration/soothing, the staff's recommendation focuses on addressing the acne directly with other ingredients.
Using BHA Toner: As the skin is still sensitive from steroid use, using exfoliating acids like BHA or AHA all over the face is not recommended as it can cause irritation. The staff suggests that if you must use BHA, it should only be for spot treatment on clogged pores (สิวอุดตัน) and avoided completely on inflamed acne (สิวอักเสบ).

Based on the community feedback and the staff's recommendation, here is an adjusted approach focusing on strengthening the skin barrier and controlling acne gently:

Remove LipidSoft: Both community feedback and staff recommend removing LipidSoft (or any oil/ester) from the formula, as it might be contributing to the acne.
Consider Beta Glucan and Egg Enzyme: Community members have found Beta Glucan helpful for steroid-dependent skin. Egg Enzyme (Lysozyme Acne) was also suggested for its anti-inflammatory properties which could help with acne.
Add Safe-B3 and Zinc PCA: The staff specifically recommends adding Safe-B3 (Vitamin B3 / Niacinamide) at 3% and Zinc PCA at 1%. These ingredients are known for their ability to strengthen the skin barrier, reduce inflammation, control oil production, and help with acne.

An adjusted formula based on the staff's recommendation could look like this (adjusting water percentage accordingly after removing LipidSoft and adding Safe-B3/Zinc PCA):

Water: 70.5%
Ceramide Complex: 10%
Licochalcone A: 2%
Vitamin B12: 5%
Pro Vitamin B5: 3%
Matte Silica: 3%
Light Cream Maker: 2%
Safe-B3 (Vitamin B3 / Niacinamide): 3%
Zinc PCA: 1%
Phenoxyethanol: 0.5%

Total: 100%

Advise your friend to try this adjusted formula for at least 15 days and observe the skin's response, especially regarding the acne. Continue to avoid harsh treatments and sun exposure.