This going to be long. Sorry!
I am a woman in my early 40's and have weird skin. All of my life, it was oily and very prone to acne, but not to the cystic stage. For about 7 years in my late 20s-early 30s I used Retin-A gel (orange tube) and took several rather broad-spectrum abx (one at a time) internally to treat my never-ending symptoms. Success never was anything to write home about. Eventually dermatologists wanted me to quit the abx due to generalized abx tolerances, when they're used for non-critical applications.
My skin still is oily to the point of having no real wrinkles, except the very surface layer of skin just will not peel off without serious exfoliation. It's dry outside of this top layer and starts looking like flakes that stay connected with tiny, dry boundary lines. This feels dry from underneath, and any foundation make-up that I wear starts caking up on these edges. It looks dreadful. Particularly the central area of my face (nose, chin, center forehead) is affected by this, and it lessens toward the edges of my face.
This layer of skin just will not peel off unless there has been a pimple nearby, and then the whole surrounding area will peel for days. These pimples either are deep, or else they are lots of widespread, fairly surface blackheads and a few basic whiteheads.
About a year ago I started exfoliating my face with a foot scrub. I remembered using Aapri face scrub as a teen, so looked for natural ingredients such as ground apricot seeds and walnut shells, so found the foot scrub. Something new happened. For the first time in what seemed ages, my face would peel in the shower, after I gently rub this stuff into my face with my fingertips. After rinsing it off, I can gently scrape my skin with my fingernails, and rolls of dead skin come off, which I rinse away. Then and after my shower is through, my skin feels so good! It feels like it can breathe. It's soft, supple, and flexible, and the cracked-looking landscape is gone. I love how this feels. However, after a couple of days, the dead, dry, stuck skin flakes reappear. I get nervous exfoliating too often, and besides, something else is happening, two things, actually.
First, my acne seems to have returned. I would have thought that with my skin being able to breathe again, it might flare up, but eventually abate. It has been a year now. It hasn't abated. I'm 41 and still get acne like a 15 year-old!
Second, my face tends to redden and look blotchy in the afternoon. While the skin may feel good and no longer look like a desert, the coloring fluctuates. My face warms, too. So again, I'm hesitant to overdo exfoliating, but after a while I have to, to get rid of the awful peely look.
And the skin still is quite oily, despite those stupid stuck flakes.
When I'm not exfoliating, typically I wash with a soft washcloth and nothing more than warm water. I don't want to use soap, as it just dries the outer layer.
Any ideas how to get rid of this peely/not-peely problem? At my age, a dermatologist will be reluctant to prescribe Retin-A again, as this already was a problem when I was in my mid-30s. The insurance is going to assume I'm a wrinkly old person who just wants a face lift per the "other" use of Retin-A.
Thank you for any advice you may have.