La Roche-Posay Effaclar Duo+ Unifiant Tinted Moisturiser review, and an update on papal passings and parallel pustules

Source: Wikimedia Commons ~ Bekstet (author)

Topic advisory: I promise this post is not remotely anti-religious, but it does contain coverage of "dermatological derangement" against a backdrop of ecclesiastical turmoil.

Back in 2016 I wrote a post on a couple of skin issues, namely dark circles under my eyes (I don't remember ever having them in fact!) and acne. In those days I used a multi-faceted approach to subdue the spots, including antibiotics, probiotics, fish oil (to tamp down inflammation generally), and a suite of La Roche-Posay products: Effaclar Duo (a spot zapping cream), plus an astringent exfoliant of theirs and a spray called Serozinc, and finally, jojoba oil. 

For anyone who doesn't remember the original post - which I am guessing is more or less everyone reading! (otherwise skip down to "The antibiotic remedy I was given") - here are some extracts from it again (it's 52 rather than 43 years now...):

"...I have suffered from acne continuously for 43 years. A GP once described me, with perhaps a little more candour than was indicated, as, technically speaking - from a hormonal perspective - 60% man. Another breezily remarked that in my case, puberty might well segue seamlessly into the menopause and beyond. And blow me, but he was right too. I don't know what percentage of the population experience uninterrupted skin eruptions well into middle age, but I know that acne in adults, especially women, is more common than you might think. Spots tend to be confined to the jawline and chin in adulthood at least - when I was 18 I had them all over my face - topping out at 64 in total during the 'acme' of my acne, as it were. It is hard for non-sufferers to imagine the extent of pain and discomfort involved, not to mention the blow to one's self-confidence - even now, it isn't easy to socialise when I get major breakouts, as for one thing having acne seems downright incongruous at this time of life.

One unexpected upside of my problem skin was the fact that it turned out to be my passport to a year spent as a teaching 'assistante' in a school on the Riviera. At an interview to decide whereabouts in France I was to be deployed, I had a chance to defend my top choice of the Cote d'Azur. I think my reason surprised the judging panel, for instead of mentioning the usual suspects of a chance to 'swan about on yachts' or 'go celeb spotting at the Cannes Film Festival', I piped up: 'The sun will be good for my acne', and that was that.

...Oh, and following an overnight explosion of some 30 pustules(!) the day the Pope died in 2005, I managed to secure an emergency appointment with a German pharmacist, who - using only an enormous encyclopaedia and a winning smile - knocked up a wonder blend of two antibiotics in cream form, that had the rash subdued within a week or so. Meanwhile, I kept my back to the window in meetings at all times, and cupped my erupting chin pensively in my hand."

The antibiotic remedy I was given was really quite ingenious, and my doctor back in Britain said he would never think to make a paste out of two antibiotics, or even use antibiotics in cream form to start with. The handwriting was so sketchy on the red and white plastic "sippy cup"-style receptacle the mixture came in that it was several years before the doctor twigged definitively to what it said, and he made a point of telling me at my next appointment: erythromicin and metronidazole.  

Around that time I happened to be working in Germany near the town where the pharmacy had been, so I made a detour to go back and thank the lady concerned. She really was a star, even though the first couple of days were still cringe-makingly embarrassing while the cream got to work.

These days, at the age of nearly 66, my complexion is much better on the whole, and Effaclar Duo+ Unifiant is the only skincare product I use for breakouts now. It is a foundation-coloured cream that stings a bit and dries the spot out very effectively - often overnight or in a couple of nights at most. It can also be layered quite easily with foundation - it blends in well, and even on its own the colour happens to work with my skin tone. It is a little drying, so you need to keep your skin hydrated the rest of the time, but I tend not to moisturise that area at night when treating the spot, so as not to dilute the product's drying efficacy. It is worth experimenting to find the way to apply Effaclar Duo that looks unobtrusive by day, while allowing it to work optimally at night. Unless a spot is really bad, I tend to only treat it at night when I don't mind what I look like. The other great thing about the product, apart from how well it works, is that the tube has a very finely tapered top, so you can dispense minute amounts just where you want them.

As you may have inferred, the trigger for this post was the recent passing of Pope Francis. Since the death of John Paul II, which coincided with my original outbreak, there was Benedict XVI, though he retired of course rather than died, so I don't count him. Meaning that Francis is the only pope to die in office since that fateful day in 2005.

Well, you can imagine that on the day the news was announced I peered anxiously in the mirror to see what mayhem might have appeared on my chin overnight. There was one lone but quite red and angry spot that had yet to come to a head, so I'd got away lightly this time. ;) And let's hope the next pope is pretty young (as they go), such that when he finally joins the Holy See in the sky, I will at last be well past puberty in dermatological terms. 

Oh, and I can thoroughly recommend the film "Conclave"...!

1903 Conclave ~ Source: Wikimedia Commons (unknown author)

Editor's note

The timing of this post is in no way a predictor of future posting frequency, but I ran with it on account of its being "topical", plus my last post was only really an announcement of something in the press...

Photo at the top is of the cathedral in Xanten, where the original incident occurred.

Quick (and slow!) skincare fixes: Part 1 - squaring dark circles and my acne 'hack'

Source: Wikimedia Commons

Topic(al) advisory - readers with perfect skin may wish to skip this post - something more conventionally scented will be along presently...;)

Now they do say that the eyes are the window of the soul. Well, that's as maybe, but chronic skin issues as well as sudden onset dermatological disasters (and I am no stranger to both!) can trigger a dark night of the soul in even the most mentally resilient person.

Squaring dark circles

I have been lucky up till now to have dodged problems such as bags or dark shadows under my eyes. It has all been kicking off lately in the upper eyelid area, mind you(!), but I will save that particular 'rag bag' of bother and doom for Part 2.

Then just recently I noticed dark circles appearing under my eyes for the first time. Having googled them - as you do! - I was pleased to learn that none of the myriad probable causes were fatal, as is of course the way of even the most minor of ailments on the morbidly inclined Interwebs.

But pretty much all of the reasons I found could have applied to me, barring eczema and being a 'person of colour', people of colour apparently being a little more prone to 'periorbital hyperpigmentation'. Yes, I could take my pick really from allergies (like hay fever, which I now have!), fatigue, rubbing or scratching my eyes - me and Truffle both - sun exposure (where do I start?), contact dermatitis (see Part 2!), and loss of fat and collagen due to age (which is rampant pretty much everywhere except my skull, knuckles, and Achilles tendons).

NB Only turn upside down for brief photo opportunities!

The problem was, though, that I noticed the dark shadows right before the gig in Preston documented here. That was one of the 'dermatological disasters' to which I obliquely allude in that post. And even though gigs are by definition held at night, I am sufficiently vain to not even want to run the risk of someone spotting my dark circles in the near pitch darkness of the beer garden. So instead of having a pre-gig lie down, as is my wont, I legged it to Debenhams in the pouring rain. Well, after a quick two minutes spent googling 'Sali Hughes best thing dark shadows' and seeing what that fetched up.

The answer is a ringing endorsement of Clarins Instant Concealer. I went for shade No 2, which is actually quite pale compared to the 110 Honey foundation of theirs that I also use, but seemingly that is the whole thing with concealer ie that you need it to be lighter in order to conceal the offending darkness. (I am a bit slow on the uptake, I know. ;) ) Then  in order to qualify for four free items of skincare and cosmetics worth about £50 in total, I was persuaded to spring for another product from the Clarins range, which had to be skincare. I went with a make up remover which will feature in my upper eyelid tale of woe, so I shan't do a spoiler on that here...

The lady at the Clarins counter applied a tiny blob of the concealer either side of my nose in small, patting movements, gradually building up coverage. You really don't need much, so caution is advised when squeezing the tube, especially in hot weather, as it seems to be bursting to come out of the nozzle! (I am in fact planning a separate post on tube-related issues.)

This way up at all times!

For anyone who would like a budget alternative to the Clarins concealer, Laura Davis of The Independent singles out Bourjois Healthy Mix concealer in this article as her top pick for the under-eye area. And would you believe, I had a similar pre-gig dark shadow incident some weeks later, and of course I had forgotten to bring my newly acquired Clarins remedy (makes a change from my usual hair gunk crisis!), so instead had recourse to a couple of testers in a big branch of Boots. I would have gladly bought a tube as back up, but they had run out of my shades except in tester form. There were at least two (one pale, one medium) that did a very decent job at only £7.99 a pop compared with £21 for the Clarins.

My acne 'hack'

Full disclosure - I have suffered from acne continuously for 43 years. A GP once described me, with perhaps a little more candour than was indicated, as, technically speaking - from a hormonal perspective - 60% man. Another breezily remarked that in my case, puberty might well segue seamlessly into the menopause and beyond. And blow me, but he was right too. I don't know what percentage of the population experience uninterrupted skin eruptions well into middle age, but I know that acne in adults, especially women, is more common than you might think. Spots tend to be confined to the jawline and chin in adulthood at least - when I was 18 I had them all over my face - topping out at 64 in total during the 'acme' of my acne, as it were. It is hard for non-sufferers to imagine the extent of pain and discomfort involved, not to mention the blow to one's self-confidence - even now, it isn't easy to socialise when I get major breakouts, as for one thing having acne seems downright incongruous at this time of life.

One unexpected upside of my problem skin was the fact that it turned out to be my passport to a year spent as a teaching 'assistante' in a school on the Riviera. At an interview to decide whereabouts in France I was to be deployed, I had a chance to defend my top choice of the Cote d'Azur. I think my reason surprised the judging panel, for instead of mentioning the usual suspects of a chance to 'swan about on yachts' or 'go celeb spotting at the Cannes Film Festival', I piped up: 'The sun will be good for my acne', and that was that.

As you can see, I did manage some yacht-swanning after all!

Now in my 40+ zit busting years, I wouldn't say I have tested every single remedy out there - I shied away from Roaccutane, for instance, the heavy artillery of acne treatment, though it was offered - and I also didn't try the specialist range of skincare by Proactiv, with which some people reportedly get good results. Over that time, however, I did try umpteen formulations of the contraceptive pill, of which Dianette was the (relative!) gold standard for the condition, as well as umpteen kinds of antibiotic, Dalacin T (a salicylic acid preparation in roll-on form), benzoyl chloride in various strengths, witch hazel, tea tree oil, all manner of toners and cleansers and astringent gels from Guerlain to Clearasil and everything in between - plus a weird calamine lotion that dried like white plaster on my face, such that I had to stay home for three days.  Luckily I was revising for my A-Levels at the time. Oh, and following an overnight explosion of some 30 pustules(!) the day the Pope died in 2005, I managed to secure an emergency appointment with a German pharmacist, who - using only an enormous encyclopaedia and a winning smile - knocked up a wonder blend of two antibiotics in cream form, that had the rash subdued within a week or so. Meanwhile, I kept my back to the window in meetings at all times, and cupped my erupting chin pensively in my hand.

Then lately I would say I have had a few breakthroughs - and fewer breakouts - and my current regime is working pretty well. I still get spots - why, only yesterday I found a whitehead in the middle of my cheek, which was most irregular! - but they do feel more under control. I cannot say that anything that works for me will necessarily do the biz for you, as everyone is different, but I can certainly recommend giving some of these things a go. And no, I am not happy about being on antibiotics, but they still really seem to work, as I discovered to my cost when I went cold turkey for two months a few years ago.

My acne armoury:

Oxytetracycline - 250mg x 2 once daily (have got down to half the daily dose at least!)

Nature's Best Acidophilus Extra 4 or 10 Billion - (just take a lot of the beggars, basically, and it does pay to go for a decent brand,  I have no idea if probiotics are any good for acne in themselves, but I feel it is important to offset the damage being wreaked to my 'microbiome' by the antibiotics!)

Nature's Best High Strength Fish Oil - 1 capsule of 1100mg a day, though you can take up to 3. It is specifically since starting on the fish oil - I found a bit of science on it here - that I have been able to knock back the antibiotics. The fish oil supposedly has anti-inflammatory properties, which I can well believe.

La Roche-Posay Effaclar Astringent Lotion Micro-Exfoliant - it contains salicylic acid which is good for tackling spots, albeit its alcohol-based formula isn't ideal. For though it may seem counter-intuitive, drying the skin out too much with alcohol-containing lotions stimulates it to produce more sebum, whereupon you get locked into a sort of vicious cycle of oily secretions. ;)

La Roche-Posay Effaclar Duo - the best spot zapping gel I know, and goodness knows I've tried a few!

La Roche-Posay Serozinc - an aerosol spray containing zinc, which is good for calming angry complexions. Thanks to Louise Woollam of Get Lippie for the tip off.

Artnaturals Jojoba Oil - I use this at night to counteract any over-drying from the astringent lotion above. It felt very strange putting oil on my oily skin, but I genuinely think it is helping my overall skin condition, and since this...er...lubricious epiphany(!) I truly haven't looked back. ;)

PS I have historically squeezed and picked my spots - hey, it is one of the few pleasures associated with the whole wretched business! - but luckily my bad behaviour has not led to significant scarring - well, aside from a permanently discoloured area on my chin, maybe. I do, however, have quite a few brown spots on my cheeks that are doubtless due to the combination of antibiotics and/or Dianette AND sun exposure down the years. But for longest time - rightly or wrongly - I thought the drying effects of the sun would be good for my skin, and even now I am a big believer in the morale-boosting benefits of sunshine, enjoyed in moderation, with appropriate sunscreen applied!

PPS I have never tried excluding dairy from my diet, but if anyone thinks this might really help, I'd consider giving it a go.


Do you suffer from either dark circles under your eyes or acne (anywhere?!) 

If so, I would be most interested in learning any good fixes you have come up with - whether instant or longer term...

Perfume And Rosacea: A List Of Trigger Factors To Make You See Red

I am not blessed with good skin. Since the age of 15 or so, I have suffered from some sort of dermatological disturbance or other. For many years the doctors just called it acne: "teenage acne" first, then, as I approached my 40s and it became untenable to construe 36 as the new 16, my condition was promptly renamed "adult acne". I wondered how long these skin eruptions would persist - would my dispiriting ailment ever be relabelled "geriatric acne"? As the years passed with no remission in sight, it seemed a very real possibility.

On turning 50, I entered a brief phase of "menopausal acne", before a new hospital consultant pronounced my condition to be...drum roll..."perioral dermatitis". I quite liked this name, because "dermatitis" sounded reassuringly non-specific, even when qualified by its location ("around the mouth"). This was clearly not something I could have brought upon myself by eating lots of sticky buns and chocolate. But as it turned out I didn't suffer from perioral dermatitis for long, because at my next six monthly consultation, a new consultant took over, who was adamant that I was in fact suffering from rosacea.

Rosacea - it has a pleasing ring to it, possibly because it sounds a bit like "rose", but appearances are deceptive. Rosacea is in fact a ruddy nuisance. Your skin is prone to angry red patches, topped off with painful lumps and bumps that rise and fall with the precision choreography of a pus-propelled Mexican wave.

The first line treatment is antibiotics - both oral and topical - but in my reading around the subject, I was shocked to come across a long list of possible trigger factors compiled from patient histories. Here are the ones that sounded most relevant to my own lifestyle and diet

Foods

•Cheese (except cottage cheese)
•Chocolate
•Vanilla
•Soy sauce
•Yeast extract
•Vinegar
•Avocados
•Spinach
•Broad-leaf beans and pods, including lima, navy or pea
•Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
•Spicy and thermally hot foods

Temperature-related

•Saunas
•Hot baths
•Simple overheating
•Excessively warm environments

Weather

•Sun
•Strong winds
•Cold
•Humidity

Beverages

•Alcohol, especially red wine, beer, bourbon, gin, vodka or champagne
•Hot drinks, including hot cider, hot chocolate, coffee or tea

Medical conditions

•Frequent flushing
•Menopause

Emotional influences

•Stress
•Anxiety

Physical exertion

•Exercise
•"Lift and load" jobs

Skin care products

•Some cosmetics and hair sprays, especially those containing alcohol, witch hazel or fragrances
•Hydro-alcoholic or acetone substances
•Any substance that causes redness or stinging

Hello? That is my life right there that the Rosacea Organisation has described. Indeed it is pretty much the life of any middle-aged working woman. Well, speaking for myself it is, give or take the lima and navy beans. What are navy beans, anyway? Oh, and I am not a fan of Bourbon. But otherwise that is me to a "T".

So I am supposed to avoid sun...and cold...and wind? And humidity? That would also include rain, I take it, which tends to be jolly humid. That means I can only venture out on a mild, dry cloudy day, and must remain confined to barracks during all other types of weather. Which will doubtless increase my stress levels (another trigger), and prompt me to seek refuge from the stress of multiple weather constraints in a nice relaxing bath with a glass of wine (a double whammy of triggers!).

Though I must say that it has been no hardship at all to avoid exercise - gentle Pilates once a week (when I am in the country) can't surely do me any harm. I don't have a "lift and load" type job either, unless you count mauling my briefcase and luggage in and out of the boot of the car on work trips. And as a concession I have given up witch hazel spot zapping sticks, along with facial toners containing astringent, alcohol-based formulae (which is most of them!).

Even so, there were enough prohibitions on that list to put the wind up me good and proper (it's that wind trigger again!), so at my last hospital appointment I levelled with the consultant.

"Okay, so what's the deal with all these supposed triggers in the leaflet I've been given? If I followed that list to the letter I would end up like those poor kids you see on the Discovery Channel who live in a bubble - you know, where their parents can't hug them or their skin would fall off? What is a person really supposed to do?"

"Ah", replied the consultant. "I shouldn't worry in your case. You have some redness, but your rosacea manifests itself for the most part as papules and pustules rather than spontaneous flushing."

Hearing my face linked to such distasteful terms as "papules and pustules", I blushed deeply. But at the same time I was relieved that I could crank up the radiator and enjoy a G & T or two. And most importantly, I could carry on wearing perfume on a daily basis...

For in my case the trigger list proved to be a red herring more or less. And for everything else, there's Revlon ColorStay. Yes, for a foundation with light but forgiving coverage, it simply cannot be beaten.




Picture of rosacea sufferer from acnetreatmentforum.com, photo of girl with "face mask" from rosaceaworld.com, photo of windswept woman from nj.com, cartoon of man lifting load from safework.sa.gov.au, cartoon of spotty face from glamouredited.com, photo of mugs from myrosaceacure.com, phot of Revlon ColorStay from zimbio.com