Obagi Update Part III

So I came back to the United States, went to the Open House at the local medical spa, got tons more information and encouragement from the Obagi rep (Nota Bene: Do not take what a sales representative says about his/her product as gospel. Ever. Do your own research, or proceed at your own peril.)

Anyhoo, so I thought, what the heck, I'll try it. I paid a lot of money for it, might as well check it out. Plus, I had a more stable schedule and could devote the time necessary to do the whole procedure, both A.M. and P.M. Also, my work schedule is limited to 1 day a week, and while my freelancing requires me some out-of-the-house time for interviews, those are fairly minimal, so I could schedule those at more convenient times when my face wasn't so sensitive. Easy peasy, right?

Whatever.

I did the P.M. routine the night after I returned home from the Open House, a Thursday. It took about fifteen minutes to do the whole routine:

• Foaming Gel cleanser for Normal/Oily Skin
• Toner
• 1/2 gm of Clear
• 1/2 gm of Blender mixed with 1/2 gm Age Defying Cream (the .1% Tretinoin)
• Triseryl Eye serum
  

I waited about 5 minutes between the Clear step and the Blender/Tretinoin step. Also, my Belo derm had prescribed 1 gm of Clear and Blender, but I cut it in half not only to save on the product (did I mention that this was super-expensive) but also because the sales rep and the aesthetician at the local medi-spa had suggested to use it sparingly. If this kit is gonna last me 4-6 months (as the sales rep said it should), I'll have to be conservative with dispensing the stuff.

The next morning, I went through the A.M. routine:

• Foaming Gel Cleanser
• 1/2 gm Clear
  
• 1/2 gm Exfoderm
• Triseryl Eye serum
• Healthy Skin Protection SPF 35

Again, I cut the original prescribed "dose" of 1 gram for both the Clear and Exfoderm in half, dispensing only half a gram for each. Also, I was pretty liberal with the sunblock, slathering it on my face. I only got a small tube of it, but sunblock is something you should never ever ever skimp on, especially when your skincare regimen involves products that will increase your skin's sun sensitivity.

I did the treatment through Saturday evening, faithfully following each step and making sure that I had plenty of sunblock each day.

As early as Friday afternoon, I noticed that my skin had become noticeably drier, and the familiar redness had returned. I knew that I was going to be at work on Monday, but I figured I could just apply makeup to cover up the ruddiness if it hadn't dissipated yet. By Saturday, however, the flaking and peeling had increased considerably, and the redness had only intensified. The flaking was concentrated on my chin and around my mouth, but the redness was all over my face.

By Sunday morning, the flaking had migrated to the lower part of my cheeks. In the meantime, I had done more research on the Internet, searching out message boards on skincare and finding posters who shared their own experiences with Obagi. One had written that he (? she?) had experienced severe flaking and drying in cycles -- every six weeks, I think -- the whole time they were on Obagi. Most of the posters had similar experiences to mine -- some not as severe -- but just about everyone said that they had to endure the intense exfoliation for weeks during the initial phase.

I had to make a decision and realized that, no matter what the result, there was no way that I could go through even one more week of what was going on on my face, much less 6-8 (as the brochure said). So on Sunday morning, I stopped cold turkey and started washing my face with Cetaphil cleanser. I followed that up with the Obagi sunblock, really slathering it on like there's no tomorrow. On Sunday evening, I did the same, only skipping the sunblock and letting my skin breathe and recover. I went to bed praying that I would wake up on Monday morning -- the one day I would actually have to be at work -- with my face calmer and the irritation eased.

No such luck. It looked like I was going to have to go to work with my face not just beet-red, but with the entire bottom half of it -- my nose, upper lip, chin, and cheeks up to my cheekbones -- flaking in sheets.

I tried applying makeup, but it only made the flaking more obvious. I realized I would have to go to work with my face in such a state, or call in sick. Since I only go to the office once a week, it seemed a ridiculous move to skip work, so I desperately tried to arrange my short bob so that it would cover as much of my face as I could get away with, and marched off to work.

As it turned out, very few people asked me about my face, but their politeness only increased my self-consciousness. I mean, you know what they're thinking, right? What the hell happened to your face, girl? I was able to get through the day only because I forced myself to rarely look in the mirror. The two times I did, I was horrified by how much worse it had gotten. At one point, I had to peel off a five-inch sheet of flaking skin off my right cheek. Fortunately, my hair had covered it up nicely.

Monday night was more of the same, but at least I was at home. My skin continued to flake and peel, shedding in layers on my clothes, sheets, on my husband's dark scrubs. It was disgusting, to say the least, and I vowed to stay indoors the rest of the week until my skin healed.

It took several days, but it finally calmed down and returned to normal. In the meantime, I had to be extremely careful with sun exposure, making sure that I applied sunblock even though I was indoors (we have a lot of windows). Nearly a week after I stopped using the Obagi products, my skin was finally back to normal.

My theory is that, if I had switched to a lower-dose Tretinoin (i.e., .05% instead of .1%), my skin might have tolerated it better. But the sales rep and aesthetician weren't kidding when they said that I would need to "push through" the initial phase, because the side effects can be dramatic, not to mention traumatic. My skin, however, isn't so bad that it needed such powerful ammunition, and my lifestyle just cannot accommodate such a high-maintenance regimen, particularly given the side effects and their duration.

I'm back to doing my normal wash-moisturize-sunblock routine, although I continue to use Cetaphil and will do so for another week or so, until I can be sure that the inflammation has really died down. Also, I had Dermasweep done yesterday, which I'll write about another time. That requires a mild skincare routine a day or two after treatment as well.

If you do decide that Obagi is for you, my advice is to proceed with caution, and make sure your dermatologist is aware of every medication you're currently on. Ask lots of questions, and make sure you schedule a follow-up a week or two after you begin so that he/she can evaluate its progress on your skin condition. And don't forget to use tons of sunscreen while you're on this regimen. As you can see, it exfoliates your skin like mad, and that means that the very sensitive new skin that's created will be very vulnerable to any sun exposure. Especially if you're a person of color, you're going to want to head off any hyper- or hypopigmentation by being vigilant with the sunblock.

It's a very expensive regimen (about $400 or so for the entire full-sized kit, which supposedly will last 4-6 months). You'll also need to get a Tretinoin prescription (such as Retin-A or Renova), and will likely need to refill your sunblock tube several times. Because of its high price tag, complicated steps and significant side effects, make sure that this is the right regimen for you before you commit to it. The good news is that, according to the aesthetician, Obagi will give you a refund if you decide to return it. But make sure that you confirm that information with your own dermatologist so that you can make a well-informed decision.

I've heard lots of great things about Obagi, and I'm sure that it's helped plenty of people with various skin conditions develop the smooth skin they've always wanted. But it's definitely not for everyone, and if your skin problems are relatively minor, you might want to seek other options before opting for this one. If you think that it could benefit you, however, I highly recommend talking to your doctor at length about it, and then doing your own research. It could save you lots of money and, more importantly, lots of frustration.