Dehydrated skin/eyelids

[VAL422]

Starting at age 16 I began using Retin-A (Tretinoin cream) to treat my acne scars, however, I did not use it improperly and feel that I still suffer from misuse. Throughout my teenage years I continued to mindlessly use it in very large amounts, even on my eyelids, and I noticed that it did cause a significant change to my facial skin altogether. I never did anything to treat it, but now thinking about it, it was probably severe cutaneous dryness. I stopped using it for a while and never moisturized as compensation. I also developed a bad habit of heavily washing with soap, which only exacerbated the dryness. I didn't think much about it, but I did realize that my skin had reached a level of dryness that was somewhat severe, since I noticed that my skin was very intolerant to everything, even makeup. After much research on this issue, I attribute this to a weakened skin barrier.
      Last summer I developed a bad habit of abrasively scrubbing my skin with soap and basically just continued to wash the life out of my face. I never stopped to think about the damage I was causing my skin; I guess it just became an obsession. Nonetheless, I soon began to notice the effects. I felt that my skin barrier was completely destroyed; I did not even look normal anymore.Regardless of the weather,my face would quickly turn red and I would develop really deep noticeable lines around my eyes. My skin became sensitive even to water. Although I stopped the excessive washing at this point, I did not feel any improvements in my skin.
     I contacted a dermatologist and explained my symptoms, he told me that I suffered from hypersensitive skin and that I should treat it by moisturizing 2-3 times a day and at night. I really wanted to solve this issue so I purchased skin barrier repair cream (Ducray Ictyane HD cream with hydroxydecine) and religiously used it throughout the past 6 months. Thankfully, these past 6 months of rigorous moisturizing have definitely helped, now I can just apply a few pumps of the cream in the morning (and occasionally at night), with some sunblock and my skin looks fine throughout the day, even in very hot weather. However, I'm still having a few skin issues that I haven't been able to get answered, and that is why I am seeking help.
    For one thing, I assumed my skin would have completely healed by now, however I've noticed that my skin barrier is still on the weak side because 1)  My skin is still a bit sensitive to water; I have to wash very lightly or i'll notice that my skin becomes less elastic, and 2) I have to apply makeup in a very thin layer, otherwise it just looks disastrous. I'm assuming this is because there is still a lot of underlying dryness as well. However, my biggest problem now is with my eyelids. I'm guessing the heavy use of retinoids on this very delicate area has stripped the area of its lipids, ceramides, fatty acids and cholesterol and that is why the emollient cream has not sufficed, even in large quantities. I've noticed that the skin is so irresilient that it doesn't bounce back if i was to just rub the area. Even the heat from the shower leaves it the way too, and it is very intolerant to water. I'm sure it sounds like I'm exaggerating, but I really aren't.
     Although I deeply regret using the retinoids so mindlessly on my eyelids, now I am 20 years old and looking for a solution. I've found that moisturizers containing niacinamide,lipids, ceramides, and hyaluronic acid do "plump up" the area, however, I do have to use copious amounts, and I've found that it's very irritating to my eyes, so I am obligated to use it only at bedtime. They're also quite expensive and I can't afford to try various kinds; and it also leaves the area very puffy. I've found that Cerave eye repair cream works well. Ultimately, my main questions are, which products/ regimen would you recommend for me to return my eyelids to normal (used for how long) and, as far as my facial skin goes, should I just continue with my regimen of moisturizer and sunblock in the morning, and how long will that take to fully heal?

[thisredeyeaintfly]

Your skin may be allergic to the sunscreen you are using.  I have to be very careful about what sunscreen I use.  For everyday use I wear Clinique City Block Sheer SPF 25, and when I run I use Vanicream Sunscreen for Sensitive Skin SPF 30.  Both have only titanium dioxide and zinc oxide as active ingredients.

I would also keep a log of everything you put on your skin.  If I were you, I would hold off on the cremes etc. on the eyelids for awhile and just use the barrier creme as that seemed to be working for you.  

Also be careful with what you use to wash your face.  Use something very gentle.  I use Restoraderm skin restoring body wash.  

From one person with very sensitive skin to another, I feel your pain, and  I hope everything heals soon for you!

[Bhupinder Kaur, MD]

Hello,
You should continue with the regimen of cleansing, toning and moisturising and use sun blocks at least half an hour before going out in the sun.  However for the delicate eye area, avoid caffeine, because it promotes water retention and leads to the dryness of the eye. You should also apply almond oil or skin creams containing vit C or K,alpha hydroxyl acids and kinetin.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.