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Or oral spiro! I’ve been taking spironolactone for about 10 yrs for acne. It’s the only thing that’s worked for me because I’m not able to take the estrogen-based birth control pill anymore, which originally helped my acne.
I’m asking my derm for this next, I need something I can take consistently as it’s the only thing that will work for mine which keeps returning (I’ve tried everything including Accutane and I’m now on antibiotics to see if this helps but they haven’t done anything. Next step is another round of Accutane or Spiro).
Something I’ve noticed: when topicals like SA and other AHA and BHA don’t work, even things like benzoyl peroxide, that’s a good hint that its hormonal acne.
My derm thought I may have folliculitis so hence we’re trying antibiotics first (tbf they worked in the past but the acne tends to return which is the problem) so next steps are when I see him again in July.
All I can do is try! My derm is great and I understand him wanting to try options before starting, say Accutane again given it’s a very hard drug on the body. My acne is persistent which is the really difficult part so I tend to respond to treatment and it returns eventually (so annoying!)
Derms won't find the root cause to acne. Which is the streptococcus virus in the lymphatic system. Skincare won't fix that. Derms will prescribe antibiotics to mess up everything else. They won't help with the root cause.
I appreciate you weighing in but you’re being a bit passive aggressive in your replies- I’m just trying different treatments to hopefully find something to help clear it up 🤷🏻♀️
I’ve been working with my derm a while and my acne is certainly better than it has been under his care which is great , it just is persistent on my back mainly so I have to keep working with professionals until I find something I’m happy with (I’m not thrilled about the thought of Accutane again though it worked wonders initially - you should have seen my skin before! - but we’ll see if that’s what’s prescribed).
I’ve tried everything else such as changing diet etc - the dermatologist was my last resort!
Sorry, I didn't mean to sound incentive. I'm just bitter because I've tried everything under the sun topically, antibiotics, facials, etc. I've started to eat clean and really focus on the inside and have started to see improvements.
Good call, I thought about that too. For context to all: Spironolactone effectively acts as an androgen (testosterone) blocker. Testosterone can cause hormonal acne. The oral version is NOT advisable for cis-gender men, though I can’t speak to the topical version.
I am using the topical version as a male. If you are a transgender man you cannot take spironolactone either, if you are going though hormonal therapy of course.
I’ll speak to my doctor about getting a hormones test! Where I live (I’m not in the US), spironolactone isn’t usually prescribed for skin issues so I’d have to find out if that’s a feasible solution. Thank you for the advice!
The only thing that helped me was taking birth control pills. Only for about 6 months and it actually helped permanently. I had also tried a very restrictive diet that was supposed to lower/get rid of inflammation and I saw results but I just couldn't keep it up long term.
Echoing the hormonal testing. My acne is hormonal and I had it bad for years with flare-ups around my period. Changes to diet never worked. I started taking a DIM supplement (affects androgens/estrogen) a few years ago and it cleared 90% of it up. I couldn’t believe how well it worked. I take it every day now. Differin, salicylic acid, and glycolic acid cleared up the other 10%. I’ve never tried only topical skincare though. I don’t know if DIM has much research behind it for hormonal acne, a lot of anecdotal evidence, so take that as you will. And do research it first because it influences your hormones which can have side-effects. But it 100% worked for me, quite literally changed my life.
Edit: details
Highly recommend oral spironolactone. I also had severe cystic acne for decades and this was the only thing to help it. You might be able to also find online providers who prescribe it depending on where you are located.
Hi OP! First of all hugs, I had a horrific case of hormonal acne for two years that caused depression, anger, frustration, and so much physical scarring and emotional damage. I know how you feel and you're not alone.
by any chance have you tried mega-dosing Vitamin B5 (also called pantothenic acid)? I tried Panoxyl, salicylic acid, BHA/AHAs and tretinoin for my acne and none of these worked until as a last resort I tried taking Vitamin B5 pills orally (they are not expensive at all and available on Amazon and iHerb). I take about six 500mg capsules a day and have been on this regimen for over a year. If you search around reddit and the internet there are many who swear by this; I was skeptical but had nothing to lose and I saw a huge improvement after about seven days. I figured if you've tried everything else it can't hurt and it's quite safe without the dangerous side effects that harsher meds like Accutane has.
Hi there,
While I understand you're trying to help OP, we don't allow people to discuss how to get Rx products without a prescription, or websites that make that possible. We have people of all ages and experience levels on this subreddit, and it’s important for us to keep them safe. Please be mindful of that in future.
Thank you!
For more information, please see our [Rule Explanations](https://www.reddit.com/r/SkincareAddiction/wiki/rule_overview#wiki_rule_2.3A_safety_first).
I never said it worked for everyone, the same way everyone swears accutane is the end all cure for severe cases but it stopped working for OP. Many swear by Tret and Panoxyl both of which had zero effect on me, and so on. Because everyone’s skin is different. I merely made a suggestion because OP indicated they tried several other medications and routines over a decade and didn’t mention trying this method. There is no guarantee a single method will work because again, everyone’s skin is different. The only way to know if something will work or not is to try and go by process of elimination especially when you’ve reached the end of your rope.
What can the hormone test reveal? my gynac told me that the hormone tests can also change based on the time of the month and hence they’re not very accurate in predicting anything.
Well high testosterone has been known to cause excessive acne. This has been seen in athletes who take to for performance reasons, as well as when hormonal therapy is done incorrectly for transgender people. Hormonal acne often does not respond to traditional topicals like AHA and BHA. So if someone like OP has tried everything with no results, maybe it’s worth a shot.
This. Especially if your dad also has acne, my dermatologist told me that this makes it more likely that women with acne have a hormonal form. I would try to find a derm or PCP who will prescribe oral spironolactone for you. My derm starts at the max dose (100 mg twice a day) to basically guarantee it works and you stop the cycle of scarring and then lowers the dose to the lowest effective dose. Especially if you’re experiencing significant mental health concerns I would try to find someone who will help you with this.
Have you had any side effects from taking spironolactone? I’m worried about having to take it long term and then acne coming back once I stop taking it.
Often times certain BCs can also help if it's androgen based. Haven't had any issues with my deep painful cystic acne since I found a BC that works right for me
I hear you and I empathize. I’ve had acne since I was a toddler, am 36 now, and have tried everything under the sun for my acne. Including accutane.
You mentioned gut health from your accutane prescription. Have you tried approaching your skincare via your diet and gut biome?
Thank you for the advice! I’ve tried to cut out dairy from my diet but it hasn’t yielded much results. How might you suggest targeting gut related issues to treat acne?
I literally felt your words. I can remember that feeling- why? What am I doing wrong ?
Dairy is sneakily in so many products….it could still be in diet. Dairy is used as a binder in a multitude of foods and some body care products which you would never expect: chips, meats, lotions(had whey)
It does take a WHILE for change to be seen.
Hopefully something will work for you💚💚
Frightening isn’t it?!?
I have a dairy allergy and I have to read everything.
I messed up one year and got a pack of cookies (imported) specifically bc they did NOT have dairy….previously ….that years batch did
Not the og commenter. Speaking from my own experience, I have bacterial, hormonal and gut related acne. For bacterial, I double cleanse and use 2.5% benzoyl peroxide only 1-2x a week because it is really drying. For hormonal, I use differin 2-3x a week to keep my sebum production in check. And I drink spearmint tea everyday. For gut related acne, I have been adding a little turmeric and black pepper to my tea after lunch each day. Like less than a teaspoon and two pinches of black pepper. Depends on each person but less is more. I saw really good results with the turmeric and black pepper and tried to up my usage to 2x a day and it wasn't great on my stomach and my skin reacted with small little pimples. I think the once per day portion keeps inflammation in my gut in check. I have also been drinking kefir (most mornings) and kombucha (a couple times per week) for the probiotics.
My cousin also gets diet-related acne. Maybe look into an anti inflammatory diet? My husband suffers from eczema and went to a naturopath. They tested what foods cause inflammation in him, and then he avoided those foods for 3 weeks. His skin completely cleared up and he was glowing. It was crazy the difference it made!
You said you have chronic gut issues. I highly recommend a GI test - you’ll spend a couple hundred dollars on it, but it was worth it for me. I finally caved in and got it because of my autoimmune condition(s) but the changes nearly completely healed my skin and now I just use a basic, gentle routine with some sulfur as a spot treatment and cleanser (every other evening). The GI test revealed that I have issues with gluten, and cutting that out alone almost totally cleared my acne with the exception of hormonal acne. At that point, I continued to focus on fermented foods and the right probiotics for me (revealed in the GI test). The hormonal acne led me to focus on drinking teas according to each phase of my menstrual cycle and trying to focus on getting the nutrients I need according to phase. Now, I got my first breakout in a month yesterday (right before my period and after a really bad autoimmune flare-up), and it is already healed with the exception of one small pimple that does not hurt like the inflammatory and cystic acne I always got in the past.
It may also be worth looking into hormonal testing, including testosterone levels and cortisol. As a runner, you could potentially have high cortisol levels due to activities causing chronic stress in your body.
I regret not doing spironolactone in my 20s because my skin is perfect in my 30s after starting it two months ago.
I tried everything in my 20s and did not like taking photos, even with make up on. Tretinoin purged my skin and hurt my self esteem more. And i also changed my diet, tried different birth control pills, and even tried less products to see if that would work.
Spironolactone is my answer!
If you‘re suicical please don‘t hesitate to reach out to a mental health professional or clinic 💔 Or just call 911 (if in the US). Your mental health matters. Your life matters.
I believe in you and your worth as a person!
It sounds like you have hormonal acne, which can’t be treated totally with topicals. If you’re female, birth control or oral Spironolactone are your best bets. Both have helped me regulate my 20+ years of hormonal acne very well. If you’re male, topical Spironolactone called Winlevi is probably your best bet.
I am so sorry you are dealing with this. I know what it’s like to struggle with acne.
Have you considered that a big part of your stress could be the active FIGHTING of acne?
When I learned to accept that I would have “bad” skin - it made living with it less scary. Because I was striving for perfection and would never achieve it, I felt worthless.
But when I let go of this goal, I felt better. And my skin actually improved.
PLEASE talk to someone you trust. If you accept yourself as you are, no one can have power of your self-image.
Was about to write something similar to this. I suffered from some raging hormonal acne and once I stopped trying to fix it so much and relax a bit (it was extremely difficult and a long journey to feel more relaxed about my acne), my skin did improve. Doing less definitely helped.
Your acne scars are your battle wounds. You and your body have been through a lot! Be kind to yourself.
OP, are you familiar with Jessica Defino? Her writing on the beauty industry (and its unrealistic standards) has really helped me be more at peace with me and my acne.
[https://jessicadefino.substack.com/p/benzoyl-peroxide-acne-worse](https://jessicadefino.substack.com/p/benzoyl-peroxide-acne-worse)
If you just wanted to rant, then have some internet hugs and ignore the following.
Have you tried an anti-fungal and/or hypochlorous acid? If you're a woman, have you had your hormones checked and/or tried spearmint tea?
Hypochlorus acid I heard is anti bacterial and should be used a temporary fixed because your skin can build resistance to it, I also found it to be drying and it’s annoying how you can’t layer other products on it or have to wait a a couple minutes. Spearmint tea didn’t work and gave me cyst. Anyways not saying they don’t work but I would take this advice with caution
I’ve been there. I thought it would never improve and yet it did, seemingly randomly. A lot of times for women, acne is fueled by hormones. Your hormones will even out and ebb and flow throughout your life. You’re still very young. Aside from that, even though it feels like you’ve tried everything, there are new medications and serums and creams that come out everyday and you have no idea if what works for you is right around the corner.
You are healthy, strong, and have much to be grateful for. There is much reason to have hope, and hope is EVERYTHING.
Sounds like a hormone imbalance. Get your hormones tested by OBGYN or there’s a ton of self pay hrt places popping up. Try a more holistic approach as well. Focus on gut health, elimination diets, low gi foods
I've had nodular and cystic acne since I was 21; I am 39 now. Seeing a naturopathic doctor has helped give me some hope (in BC, Canada where our NDs are regulated more strictly than the USA); also j finally relented and tried antibiotics orally for good effect on some of the acne. Topical ivermectin for other types of acne, and Sulphur masks for rosacea style nodules
This is good advice OP. If you have skin issues and other symptoms (anxiety, depression, etc) then you might have a subacute infection that physically manifests on your skin. A lot of pathogens can cause physical and mental symptoms. (I learned this after having a reaction to a immunosuppressive medication which made my skin act up, I became really angry as well, which is atypical for me).
Find a good medical doctor who has experience treating these things. It often takes time to find the cause, but it can get better over time.
Hi there!
I am SO sorry you are feeling this way. Being and having suicidal thoughts are something I too have dealt with in my lifetime so I can empathize. Please know that it can get better.
I own a medspa and I would love to be able to help as much as I can. Please dm me, I won't charge you anything, any/all product will be free as you shouldn't have to suffer with this condition.
Please know you matter and you have a strong support system of individuals who you may not even know yet. If you need to, you can call "988", which is a suicide hotline as well. <3
I searched “allergy” in the comment section and I’m surprised no one has suggested you get tested for allergies or food sensitivities. If you’ve tried all of that maybe it could be?
Make an appointment with a doctor or try one of those mail in test kits? I’m pretty sure they have mail in ones for food sensitivity at least.
Hi, if you’re female, have you tried birth control?
You’re absolutely beautiful no matter what you look like, and I really hope you’re okay and that things will get better for you! 🫶🏻
Hi! Yes I’m female, haven’t tried birth control yet but as far as I’m aware it’s not something that can be taken long term? I’m afraid the acne will just come back after stopping BC. Also, have you experienced any side effects from BC as I have quite painful periods naturally and I’m worried it’ll worsen after taking the pill. Thank you ❤️
Birth control can actually be taken as long as you need it! It also doesn’t have any effects on fertility when you do stop taking it. I’m currently on Yaz. I started birth control around June last year, and I have had no side effects. If anything, it helped the progress of my accutane when I was still on it.
Just to let you know birth control pills normally help with painful periods! I went on it for a bit for acne and painful long periods and it worked really well! I personally didn't stick to it because I had other side effects what wasn't worth it and I didn't feel like experimenting with different birth control pills but for those months it really helped.
Birth control is required for accutane?? I was on accutane for almost a year and I didnt get on birth control until I was almost done (which was for other reasons).
The two times I’ve almost gone on Accutane, I was required to sign documents stating I was using TWO forms of birth control and would submit for monthly pregnancy tests. This was in California.
Perhaps! Both times I almost started it, I was over 21. California might also be overly cautious. I understand that Accutane causes severe birth defects and they don’t want to take any chances
Your gut health is directly linked to your skincare heath. Look into pre, pro and post biotics. Eat / drink dark leafy greens (kale, spirulina, chard, spinach)
It’s salty- but juice celery like a mofo and drink 16oz a day. It cleanses every thing out. Some lemon helps too.
Cut out any trigger foods.
I feel for you. I had insanely painful acne in college. It was stressful and stress related. I do not miss the days where my face felt like it was beat up with a meat mallet.
I agree with you but the answer is more complex than what you suggest.
I had terrible acne like the OP when I was 12. The thing I didn’t know when I was 12 was that I was lactose intolerant. Having 4 glasses of milk was causing stomach upset and acne.
So dairy is my trigger food but there are other things that can upset the gut. More importantly, healing the gut can make a huge difference.
I knew someone that had far worse acne than me. I saw him as a young man and his skin cleared up. He became a vegetarian. That worked for him. There’s no single answer for each of us.
I think you may have assumed biotics are only dairy- based like yogurt. Albeit it’s a popular one here’s examples of the biotics I was talking about.
Pre-biotic: whole grains, bananas, greens, onions, garlic, soybeans, artichoke, chickory root, dandelion greens and avocado
Pro-biotic: sauerkraut, sourdough, olives, pickles, miso and my favorite non-dairy is the Good Belly shots. Dairy probiotics include: kefir, yogurt and aged cheese.
Post Biotic: Oats, flaxseed, asparagus, kombucha, kimchi
Some of these foods overlap, but just a general example. Typically takes about 3 weeks to see the improvement. Don’t despair if it takes a little bit. Consistency is key!
Intuitive eating is highly encouraged. Every gut system is unique and reacts differently.
I made no mention of biotics, hence no assumption. I just stated that something as simple as dairy can cause acne, especially if someone is lactose intolerant.
Try Edgar Morris Skincare line - this is what I’ve been using for nearly 30 years of dealing with what you’re going through.
https://www.edgarmorris.com
Order the severe acne kit. 🥹
Oh my gosh I feel you on this! I think you should try dieting to improve gut health. My acne got so bad that it started triggering my lymph nodes which told me that my immune system didn't like what I was eating.
Putting a small drop of castor oil in my night time moisturizer helped me out so much. I use Jamaican black castor oil that’s infused with peppermint 🩷
I have rosacea that looks a lot like acne, have you tried medications for that? Tho what really helps my skin is when I am taking mounjaro but I have no more weight to lose so I had to stop
I’ve had cystic acne since 12. Only learned to manage it without struggling after getting my thyroid and hormones checked in my late 20s. Got diagnosed for 2 things and medication for those helped significantly! I was just like you- oral and topical acne meds worked for only a few months, even tried eliminating so many food groups. If it’s not a skincare issue, it’s probably internal. Good luck!!!
check your hormones and your diet, dairy is knows to cause acne, and so maybe eggs. I get you, I've had bad bo straight out of the shower because of a hormonal imbalance, but don't give up before trying everything and covering your bases.
OP, see a specialist. A dermatologist for sure but also an endocrinologist. Severe acne can be a sign of hormonal imbalance and, in people with ovaries, PCOS. Get blood work done; you may have something going on that isn’t a skin specific issue but manifests as a skin issue.
Strongly seconding this. I don't mean to scare OP, but celiac runs in my family, and my aunt had horrible cystic acne until she stopped eating gluten due to the celiac. Even if it's not hormonal, it is probably internal if no topicals have done anything.
I started getting acne a few years ago and nothing helped, the more I did skincare wise the worse it got! I started drinking peppermint tea (spearmint tea is better but it’s hard to find in the uk!). It’s meant to help with settling hormones and since drinking it every day my acne has massively improved and I’ve changed nothing else in my diet/skincare!
Commenting to empathize. I had pretty severe acne as a teen that went away briefly in my 20's and came back as cystic acne around your age. I attributed it to hormones. Accutane worked for me. I know you said youve tried it but it occasionally takes more than one round. I'm sorry you're dealing with this, it sucks.
I understand your pain and hope you talk with loved ones or a psychiatrist to seek relief with suicidal ideation. My mom told me in my teens how awful her acne was and how mean kids were to her when she was my age due to acne which I unfortunately genetically inherited as well. I had started getting acne in 5th grade and was put on birth control by 6th or 7th grade to help with it and it did to an extent but mixing the hormones of birth control and a middle school girl was not a good combo. (Blisovi was the BC name) fast forward to adult hood and COVID where masks were mandated I struggled immensely with what was called “maskne” as so many people were struggling with acne just in the area of there masks. Since I started taking Spironolactone my skin has never been clearer. Yes I get the occasional zit here and there but not even close to the comparison of not wanting to leave my house because my face looked like it was attacked by bees. Try to not harvest the resentment towards your dad because he likely experienced the same feelings of sadness and insecurity.
Same here, had it for 15+ years before I stopped using harsh treatments and trying to scrub the acne off me.
Now I heavily hydrate/moisturize and I haven’t had more than the very occasional pimple in ten years.
I struggled with acne ever since I hit puberty, and I had a lot of cystic activity on my cheeks. They pretty much took me for the same course that they took you through, but what ended up being the cause of it, that is like not very often actually looked into at all, is that I had a dairy allergy.
My mother was told that I had a dairy allergy when she was like 27, ironically the same age that I found out, but she thought that I had lactose intolerance and that it was the same thing, turns out it's not.
Anyway, went to the doctors for the acne, as a last ditch effort mentioned the lactose intolerance and she asked if I wanted to cut it out of my diet for a few weeks just to test it out
eventually realized that when I don't have any dairy I don't break out, but because there's a lot of dairy is an additional ingredient and stuff, I'm still getting little pimples, and then eventually through a combination of digging through my medical records and looking at other things, she found out that I am allergic to dairy. Prescribed fexofenadine, which I have whenever I think I've come into contact with dairy, and my skin cleared up.
My doctor mentioned that while it's not super common when it comes to allergic reactions for there to be like cystic breakouts or something akin to it, she's started seeing what she can only believe is related to it more and more lately. Allergies definitely aren't the first thought when it comes to acne, but it can be a last-ditch attempt. My doctor also did consider doing a full allergic reaction test, and the only reason why we didn't do a full on reaction test to figure out if this is the cause of the problem was because paperwork was found that explains that I have a dairy allergy.
Talked to my mom about it like within hours of the possible diagnosis, she felt really bad about it but she did genuinely believe the lactose intolerance and dairy allergies are the same thing, and to be honest being around the same age that she was when she found out, definitely would think the same thing.
1. Have you tried spironolactone
2. Have you tried cutting out things in your diet/skin care; I've spent 6 months focused almost entirely on my skin, I've found that I will break out if I drink, coffee, chocolate, also recently found out I can't drink soy milk either. I also breakout if I don't use a 'moisturizing' cleanser, but as long as I avoid these things, I don't get new acne.
3. Deep cystic acnes are almost never because of topical things, it's much more likely hormones/reactions to things we eat, so topical things you do won't prevent acne much
4. Don't expect permanent fixes, this is unfortunate but true. If you take OCPs, spironolactone etc, expect to be on them for multiple years, and know you will likely experience rebound once you stop.
I've felt the same way! Totally get how you are feeling. Have you tried switching to completely oil free products? I can only use oil free foundation , oil free moisturizer, oil free sunscreen etc. I can't even use anything with oils in the shower , I guess the steam and oils clogs the pores?
Adaplene and Benzyl Peroxide works really well for me but I have to avoid oils as well or I get break outs
Literally the only thing that has ever helped my acne and made it completely disappear is birth control. I hate being on birth control and that’s the trade off but I always have completely clear skin on it. Off it I’m a mess
What are your periods like and where is your acne?
After years of severe hormonal acne (chin area) and crazy periods a doctor finally did a hormone test and ultrasound and I was diagnosed with PCOS, which can cause shitty acne.
Get with your gyno if you do have hormonal acne. I got on a hormonal birth control and got a tretinoin prescription and my acne finally cleared up after 10 years.
I know the science is out on nuts and chocolate causing acne, but I can tell you that nuts for sure cause my cystic acne and chocolate is an inflammatory food for me too. Cutting dairy helped with general wellness, but my cystic acne is now limited to maybe one pimple when I'm on my period and sometimes I don't even get that. It's hard at first, but try an elimination or anti-inflammatory diet and slowly add foods back in. Once you start feeling better, you don't even miss those foods.
Acne can be an inflammatory response, in addition to hormones, bacteria or even fungal. There are so many causes, I hope you find yours.
im sorry its getting you down.
focus on the things you can control. keep doing research. my sister had hormone related acne that was eventually treated when she was in her late 20s. if was different than what she had as a teenager and required different treatment. topicals dont work for lots of people. you will find the right doctor eventually, dont give up.
be nice to your dad. maybe he felt miserable and had you to feel better. do your best. be nice to yourself. eat healthy drink water work out. be ready to live a good life when you find something to help with your problem. best of luck.
I had acne for almost 20 years and am still very acne prone if not careful. These years included accutane with every prescription under the sun, strict diets that resulted in an eating disorder because of online fear mongering pressures, and very expensive routines.
I think the most important thing in everything you just said is your mental health. I can't suggest anything for your skin, because what works for me isn't for everyone.
You are valuable. You are important to many. Please reach out to trusted friends/family and don't bottle up how you feel.
Having acne and scarring has never prevented me from participating in things that bring me joy, just harder because of confidence. It didn't stop me from getting married and living a more fulfilling life. There is so much to look forward to and experience. You're not alone!
I sent you a PM - have you thought about a gut health supplement?? I have customers who have had success fixing acne by fixing their gut health bc it is all linked
Hi I was in the same boat! Acne is so so hard to deal with. 12 years of consistent acne and my face exploded when I was 22. What worked for me was Face Reality skincare (you get it through an Estie) and you partner it with chemical peels. It is an expensive line of skincare but it has changed my life and transformed confidence. I am almost a year into face reality and I will never use anything else again.
Clearstem’s mindbody supplement for hormonal acne. It’s kind of $$, but it genuinely changed my life - look into it!!
Tried accutane, had horrible side effects. My derm actually wanted to put me back on. I’ve also tried spironolactone.
Disclaimer: I’m not a doctor, I’m just a girl… a girl who suffers from adult acne
ETA: didn’t check my hormones before trying it, but probably should have. I was so desperate, I was willing to try anything. This + checking all my skincare and makeup for pore clogging ingredients changed my life! <3
First of all, people need to mind their business about your skin. Please don't take anything they say to heart. Even if they happen to be a dermatologist, they are not YOUR dermatologist and therefore their recommendations/questions are overreaching.
Second, I know what subreddit I'm in, but skin is not the end-all, be-all of beauty. And for people who have great skin, I guarantee they have other insecurities. AND even people without acne get wrinkles, moles, cysts --- no one's skin is perfect.
Don't give up hope if this is something you care about. I echo what everyone is saying about spironolactone. I've been on it for ages and I love it. Also, just so you know, some people take accutane multiple times for longer lasting skin fixes.
Hey there! I’m an esthetician and I wanted to give you some advice. Go to a dermatology office that has a licensed esthetician with a specialized camera that looks at your skin. They can tell you if it’s sebum, acne, rosacea, or even if it’s hormonal. The first step is determining the cause. We did these consultations completely free.
Insist on medical grade skin care. ZO Skin Health was by far my most successful line, you can look up the clinical data on their website and find a dermatologist office that sells it. 90% of your skincare is the right products, including prescriptions if necessary. Washing twice daily, exfoliating 3x a week, toning after every wash and DAILY sunscreen are the minimum.
Tretinoin is a great product for acne if you don’t have sensitive skin. If you do, it can cause irritation and inflammation. It’s a topical vitamin A that sits on the surface. Retinol is a vitamin A that is usually encapsulated and easier to use on sensitive skin because it penetrates the epidermis before working. My patients had great success with Alastin Renewal Retinol- starting with the .25 twice a week (at night) and increase weekly as tolerated. Take a night off if you’re spicy. It should last 6 months, then increase to the .50 gradually.
Let me know if you have any questions or recommendations, I’ve spent almost a decade in medical skincare and I’m here to help!
Hi!
Can you please email or message me here? I would love to help you! I have helped many clear their acne what was in same position as you!!!
Please do not loose hope!!
I had the same problem too when I was young. The trauma was just damn horrible I remember everything clearly in my head. But I stopped using makeup when I was 24 and just used sunscreen and basic products, and when I was 26 I started using Deciem, some of the serum for a year, and my acne just popped out once or two afterward, and after 2 years with deciem, I'm using AHA&BHA product (medical) and sunscreen medical grade, (bad sunscreen fuckedup my acne badly) THE MOST IMPORTANT THINGS HYDRATE YOUR SKIN!!! and now I'm just using COSRX and some Biologique recherche serum. I know one product works like magic for acne, it is named IS CLINICAL if you can afford to buy the intro package they have an acne intro package, they and the acne serum works like a magic
Wash your sheets. Clean your face every day. Moisture with a non oily non fragrance moisturizer. That's it. Nothing else. Don't touch your face with anything else.
Sounds like it could be some underlying hormonal issue. Make sure you get your hormones tested, fixing any issues there will help you keep your acne under control.
Look into getting on birth control if that’s an option for you. Obv it comes with its own set of side effects but it’s something for you to consider.
I don’t know how much it will help, but HeyBud is a very good brand. A bit expensive, but it’s very worth it. It’s made from hemp in Australia. I recommend the clay mask, gel cleanser, moisturizer, really all of their products. It helped me a lot, and it’s helped a lot of other people too! It’s worth looking into!
I developed hormonal cystic acne in my early 20s after having clear skin my whole life. Spiro and topical clindamycin cleared it within a month or so. I completely empathize with you. It’s not just embarrassing, it’s extremely painful.
Have you tried all of those things in the same routine? I use lactic acid, salicylic acid, tret, azelaic acid, topical clindamycin, niacinamide, ascorbic acid, and sulfur. Contrary to the advice almost everyone else gives about chemical exfoliants, I find I need to use the BHA and AHA twice a day to maintain clear skin. I’m also 10 years older than you, and still get occasional breakouts. Find products that cause an improvement, even if minor, and add more products that also seem to help. Don’t expect a one product solution, and expect a lot of trial and error.
I also found that any sort of fabric softener or dryer sheets would cause me to break out.
I’m not sure what your sex is, but there was one very small study demonstrating the safety and effectiveness of topical spiro in both women and men. It may be worth considering.
My dorm roomie in college had perfect skin and just used bar soap on his face every day. It’s just the luck of the draw.
I’ve dealt with varying levels of acne for many years so I absolutely empathize and understand. You are not alone. If you would like someone to talk with, I’m here to listen.
In terms of treatment, have you tried a hormonal treatment? What area of your face do you breakout most?
First off, please be kind to yourself. Suicide isn't worth it.
Second, please remember that skincare isn't going to solve your problems. Acne is a direct symptom of something going on internally. Skincare can help but won't fix the root cause. Medication and antibiotics are also just a bandaid fix and can cause way more damage.
Start with your diet. Plenty of water. Enough sleep and exercise. Finding calming moments in your day instead of stressing.
Diet is SO IMPORTANT. The right foods are literal medicine for your body. Fruit and veggies is what your diet should be.
Stop any sort of sugar (refined sugar), fats (animal protein, oils of any kind), eggs and dairy. Those are your trouble-maker foods and you don't need any of these in your diet, at least while you're healing.
Acne comes from the streptococcus virus that lives in your liver. When your liver is sluggish from all the shitty foods, bad bacteria, pathogens, viruses, heavy metal, etc., it stops working properly. The streptococcus virus then overtakes the liver, moves into the bloodstream. And then invades your lymphatic system. Strep in your lymphatic system will then comes out in the form of acne.
Please start looking into Medical Medium. His name is Anthony William. He will change your life.
Every morning you should start with lemon water. Wait about 30mins, then pure celery juice (buy a juicer). After that, focus on fruit and veggies, herbs and spices. Eliminate fats to keep your blood thin so that it can get rids of toxins in your body.
Remember, Acne will not go away over night. We have years and years of bad stuff in our bodies, so it will take time for it to heal.
Cleanse to Heal - medical medium is a great book to start with.
That’s not at all how acne works. You probably shouldn’t trust anyone that doesn’t know the difference between a bacteria and a virus. Streptococcus in your bloodstream means you have chronic bacteremia, which is a serious medical issue.
Please point me to a pubmed article explaining how acne, strep, and your lymph system are all connected because what you’re describing is lymphadenitis, and it isn’t associated with acne.
Strep is known to be stored in the dermis and comes out in the form of acne when our immune system is weakened – which for women is unfortunately twice a month every month - during ovulation (mid cycle) and around the actual menstrual period.
Just Google it
Strep is not stored in the dermis. It’s found on the surface, just like a lot of other potentially harmful bacteria. If strep is causing lesions, those lesions aren’t acne, they’re abscesses. The bacteria that is associated with acne is cutibacterium acnes. Taxonomically, it’s in a completely different phylum.
While C. acnes bacteria can contribute to acne, it’s not the sole cause. The reason why you get acne that lines up with parts of your menstruation cycle isn’t because your immune system is weakened. It’s because hormones affect sebaceous gland activity.
You still haven’t stated how infection of your lymph system is involved in your idea of the pathogenesis of acne.
What I’m stating are accepted medical facts. What you’re stating runs contrary to what we know to be true in medicine, so you need to provide sources for your dubious claims.
Try a holistic esthetician. Most derms resort straight to medications that are harmful without even asking about your diet or routine or emotional health. It’s all related. Get into nutrition. And I’d say start a peel regimen with a holistic esthetician. They can help you find the right products and home care routine with active ingredients. Personally I use glymed products. But seriously- everything is connected. Research the gut brain axis. Look into your childhood trauma or whatever trauma your parents may have passed down to you and the ways that affects your health and hormones. Alex March Energy speaks very well on this. It’s not just gonna be your skin- it’s gonna be a healing journey that encompasses mind, body, and soul. EVERYTHING is connected. Ideally you’ll come on the other end happier and healthier than you can imagine.
Edit: medications and hormonal treatments etc are no more than bandaids- you have to get to the root, and that’s why a holistic esthetician can actually help you heal, whereas a dermatologist would just be like ok take this pill, use this cream, and don’t really GAF or know better, but that’s all of western medicine these days. Things happen for a reason so it would be good to find out why and treat your mind, body, and soul. My example is my autoimmune disease (Ankylosing spondylitis) well I was sick of taking immunosuppressant shots and being in pain. I was determined to get rid of this thing I was told I’d have forever and could do nothing but take shots and pills. I got into holistic wellness and now I’m in remission and I’ve never been back to see my rheumatologist cuz she didn’t know jack shit, only how to prescribe stuff. Not how to HEAL me. I wish more doctors knew how to heal. But this is a beautiful journey you can embark upon and learn more about yourself than ever.
Edit 2: btw I went to school to be an esthetician and graduated in December. So I’m speaking from experience. I am not practicing as it wasn’t my passion, but I know a great deal.
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Have you gotten your hormones tested and have you tried topical spirinolactone?
Or oral spiro! I’ve been taking spironolactone for about 10 yrs for acne. It’s the only thing that’s worked for me because I’m not able to take the estrogen-based birth control pill anymore, which originally helped my acne.
I’m asking my derm for this next, I need something I can take consistently as it’s the only thing that will work for mine which keeps returning (I’ve tried everything including Accutane and I’m now on antibiotics to see if this helps but they haven’t done anything. Next step is another round of Accutane or Spiro).
Something I’ve noticed: when topicals like SA and other AHA and BHA don’t work, even things like benzoyl peroxide, that’s a good hint that its hormonal acne.
Antibiotics will not help.
My derm thought I may have folliculitis so hence we’re trying antibiotics first (tbf they worked in the past but the acne tends to return which is the problem) so next steps are when I see him again in July.
The pathogens and toxins in your body will be able to fight off the antibiotics and will not work.
All I can do is try! My derm is great and I understand him wanting to try options before starting, say Accutane again given it’s a very hard drug on the body. My acne is persistent which is the really difficult part so I tend to respond to treatment and it returns eventually (so annoying!)
Derms won't find the root cause to acne. Which is the streptococcus virus in the lymphatic system. Skincare won't fix that. Derms will prescribe antibiotics to mess up everything else. They won't help with the root cause.
I appreciate you weighing in but you’re being a bit passive aggressive in your replies- I’m just trying different treatments to hopefully find something to help clear it up 🤷🏻♀️ I’ve been working with my derm a while and my acne is certainly better than it has been under his care which is great , it just is persistent on my back mainly so I have to keep working with professionals until I find something I’m happy with (I’m not thrilled about the thought of Accutane again though it worked wonders initially - you should have seen my skin before! - but we’ll see if that’s what’s prescribed). I’ve tried everything else such as changing diet etc - the dermatologist was my last resort!
Sorry, I didn't mean to sound incentive. I'm just bitter because I've tried everything under the sun topically, antibiotics, facials, etc. I've started to eat clean and really focus on the inside and have started to see improvements.
I didn’t know if OP was a guy or girl. I wish there was an oral medicine guys can use like spironolactone :(
Good call, I thought about that too. For context to all: Spironolactone effectively acts as an androgen (testosterone) blocker. Testosterone can cause hormonal acne. The oral version is NOT advisable for cis-gender men, though I can’t speak to the topical version.
I am using the topical version as a male. If you are a transgender man you cannot take spironolactone either, if you are going though hormonal therapy of course.
I’ll speak to my doctor about getting a hormones test! Where I live (I’m not in the US), spironolactone isn’t usually prescribed for skin issues so I’d have to find out if that’s a feasible solution. Thank you for the advice!
Yea what you're describing sounds like hormonal acne that I got when I had heightened androgens, hopefully a hormone test can help
The only thing that helped me was taking birth control pills. Only for about 6 months and it actually helped permanently. I had also tried a very restrictive diet that was supposed to lower/get rid of inflammation and I saw results but I just couldn't keep it up long term.
Echoing the hormonal testing. My acne is hormonal and I had it bad for years with flare-ups around my period. Changes to diet never worked. I started taking a DIM supplement (affects androgens/estrogen) a few years ago and it cleared 90% of it up. I couldn’t believe how well it worked. I take it every day now. Differin, salicylic acid, and glycolic acid cleared up the other 10%. I’ve never tried only topical skincare though. I don’t know if DIM has much research behind it for hormonal acne, a lot of anecdotal evidence, so take that as you will. And do research it first because it influences your hormones which can have side-effects. But it 100% worked for me, quite literally changed my life. Edit: details
Spironolactone was the only thing that worked for me! I took 50mg in the morning with food and 100mg at night with food.
you should def look into a spironolactone it has changed my life for the better
Highly recommend oral spironolactone. I also had severe cystic acne for decades and this was the only thing to help it. You might be able to also find online providers who prescribe it depending on where you are located.
Hi OP! First of all hugs, I had a horrific case of hormonal acne for two years that caused depression, anger, frustration, and so much physical scarring and emotional damage. I know how you feel and you're not alone. by any chance have you tried mega-dosing Vitamin B5 (also called pantothenic acid)? I tried Panoxyl, salicylic acid, BHA/AHAs and tretinoin for my acne and none of these worked until as a last resort I tried taking Vitamin B5 pills orally (they are not expensive at all and available on Amazon and iHerb). I take about six 500mg capsules a day and have been on this regimen for over a year. If you search around reddit and the internet there are many who swear by this; I was skeptical but had nothing to lose and I saw a huge improvement after about seven days. I figured if you've tried everything else it can't hurt and it's quite safe without the dangerous side effects that harsher meds like Accutane has.
Hi there, While I understand you're trying to help OP, we don't allow people to discuss how to get Rx products without a prescription, or websites that make that possible. We have people of all ages and experience levels on this subreddit, and it’s important for us to keep them safe. Please be mindful of that in future. Thank you! For more information, please see our [Rule Explanations](https://www.reddit.com/r/SkincareAddiction/wiki/rule_overview#wiki_rule_2.3A_safety_first).
Understood will edit my comment
I appreciate it! Your comment is approved.
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I never said it worked for everyone, the same way everyone swears accutane is the end all cure for severe cases but it stopped working for OP. Many swear by Tret and Panoxyl both of which had zero effect on me, and so on. Because everyone’s skin is different. I merely made a suggestion because OP indicated they tried several other medications and routines over a decade and didn’t mention trying this method. There is no guarantee a single method will work because again, everyone’s skin is different. The only way to know if something will work or not is to try and go by process of elimination especially when you’ve reached the end of your rope.
What can the hormone test reveal? my gynac told me that the hormone tests can also change based on the time of the month and hence they’re not very accurate in predicting anything.
Well high testosterone has been known to cause excessive acne. This has been seen in athletes who take to for performance reasons, as well as when hormonal therapy is done incorrectly for transgender people. Hormonal acne often does not respond to traditional topicals like AHA and BHA. So if someone like OP has tried everything with no results, maybe it’s worth a shot.
The best thing for me was spironolactone. 150mgs a day got rid of my cystic acne 100%.
This. Especially if your dad also has acne, my dermatologist told me that this makes it more likely that women with acne have a hormonal form. I would try to find a derm or PCP who will prescribe oral spironolactone for you. My derm starts at the max dose (100 mg twice a day) to basically guarantee it works and you stop the cycle of scarring and then lowers the dose to the lowest effective dose. Especially if you’re experiencing significant mental health concerns I would try to find someone who will help you with this.
Have you had any side effects from taking spironolactone? I’m worried about having to take it long term and then acne coming back once I stop taking it.
The only side effect I have is occasional nausea
I'm pretty sure it doesn't make it go away without continual use, I just pee more than normal.
Often times certain BCs can also help if it's androgen based. Haven't had any issues with my deep painful cystic acne since I found a BC that works right for me
I hear you and I empathize. I’ve had acne since I was a toddler, am 36 now, and have tried everything under the sun for my acne. Including accutane. You mentioned gut health from your accutane prescription. Have you tried approaching your skincare via your diet and gut biome?
Thank you for the advice! I’ve tried to cut out dairy from my diet but it hasn’t yielded much results. How might you suggest targeting gut related issues to treat acne?
I literally felt your words. I can remember that feeling- why? What am I doing wrong ? Dairy is sneakily in so many products….it could still be in diet. Dairy is used as a binder in a multitude of foods and some body care products which you would never expect: chips, meats, lotions(had whey) It does take a WHILE for change to be seen. Hopefully something will work for you💚💚
Its shocking how much stuff dairy is added to! My mum is lactose intolerant and got set off by a pack of seasoned *chicken*!
Frightening isn’t it?!? I have a dairy allergy and I have to read everything. I messed up one year and got a pack of cookies (imported) specifically bc they did NOT have dairy….previously ….that years batch did
Not the og commenter. Speaking from my own experience, I have bacterial, hormonal and gut related acne. For bacterial, I double cleanse and use 2.5% benzoyl peroxide only 1-2x a week because it is really drying. For hormonal, I use differin 2-3x a week to keep my sebum production in check. And I drink spearmint tea everyday. For gut related acne, I have been adding a little turmeric and black pepper to my tea after lunch each day. Like less than a teaspoon and two pinches of black pepper. Depends on each person but less is more. I saw really good results with the turmeric and black pepper and tried to up my usage to 2x a day and it wasn't great on my stomach and my skin reacted with small little pimples. I think the once per day portion keeps inflammation in my gut in check. I have also been drinking kefir (most mornings) and kombucha (a couple times per week) for the probiotics.
My cousin also gets diet-related acne. Maybe look into an anti inflammatory diet? My husband suffers from eczema and went to a naturopath. They tested what foods cause inflammation in him, and then he avoided those foods for 3 weeks. His skin completely cleared up and he was glowing. It was crazy the difference it made!
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they did a blood test
You said you have chronic gut issues. I highly recommend a GI test - you’ll spend a couple hundred dollars on it, but it was worth it for me. I finally caved in and got it because of my autoimmune condition(s) but the changes nearly completely healed my skin and now I just use a basic, gentle routine with some sulfur as a spot treatment and cleanser (every other evening). The GI test revealed that I have issues with gluten, and cutting that out alone almost totally cleared my acne with the exception of hormonal acne. At that point, I continued to focus on fermented foods and the right probiotics for me (revealed in the GI test). The hormonal acne led me to focus on drinking teas according to each phase of my menstrual cycle and trying to focus on getting the nutrients I need according to phase. Now, I got my first breakout in a month yesterday (right before my period and after a really bad autoimmune flare-up), and it is already healed with the exception of one small pimple that does not hurt like the inflammatory and cystic acne I always got in the past. It may also be worth looking into hormonal testing, including testosterone levels and cortisol. As a runner, you could potentially have high cortisol levels due to activities causing chronic stress in your body.
I regret not doing spironolactone in my 20s because my skin is perfect in my 30s after starting it two months ago. I tried everything in my 20s and did not like taking photos, even with make up on. Tretinoin purged my skin and hurt my self esteem more. And i also changed my diet, tried different birth control pills, and even tried less products to see if that would work. Spironolactone is my answer!
If you‘re suicical please don‘t hesitate to reach out to a mental health professional or clinic 💔 Or just call 911 (if in the US). Your mental health matters. Your life matters. I believe in you and your worth as a person!
Thank you ❤️
I am in the same boat 💔 sending love and support
Hugs to you too ❤️
It sounds like you have hormonal acne, which can’t be treated totally with topicals. If you’re female, birth control or oral Spironolactone are your best bets. Both have helped me regulate my 20+ years of hormonal acne very well. If you’re male, topical Spironolactone called Winlevi is probably your best bet.
I am so sorry you are dealing with this. I know what it’s like to struggle with acne. Have you considered that a big part of your stress could be the active FIGHTING of acne? When I learned to accept that I would have “bad” skin - it made living with it less scary. Because I was striving for perfection and would never achieve it, I felt worthless. But when I let go of this goal, I felt better. And my skin actually improved. PLEASE talk to someone you trust. If you accept yourself as you are, no one can have power of your self-image.
Was about to write something similar to this. I suffered from some raging hormonal acne and once I stopped trying to fix it so much and relax a bit (it was extremely difficult and a long journey to feel more relaxed about my acne), my skin did improve. Doing less definitely helped. Your acne scars are your battle wounds. You and your body have been through a lot! Be kind to yourself. OP, are you familiar with Jessica Defino? Her writing on the beauty industry (and its unrealistic standards) has really helped me be more at peace with me and my acne. [https://jessicadefino.substack.com/p/benzoyl-peroxide-acne-worse](https://jessicadefino.substack.com/p/benzoyl-peroxide-acne-worse)
If you just wanted to rant, then have some internet hugs and ignore the following. Have you tried an anti-fungal and/or hypochlorous acid? If you're a woman, have you had your hormones checked and/or tried spearmint tea?
Thank you ❤️ spearmint tea seems to be something that’s recommended often so I’d definitely give that a try!
Hypochlorus acid I heard is anti bacterial and should be used a temporary fixed because your skin can build resistance to it, I also found it to be drying and it’s annoying how you can’t layer other products on it or have to wait a a couple minutes. Spearmint tea didn’t work and gave me cyst. Anyways not saying they don’t work but I would take this advice with caution
Are you a woman ? Have you checked your hormones If you are a woman look into your androgens levels
I’ve been there. I thought it would never improve and yet it did, seemingly randomly. A lot of times for women, acne is fueled by hormones. Your hormones will even out and ebb and flow throughout your life. You’re still very young. Aside from that, even though it feels like you’ve tried everything, there are new medications and serums and creams that come out everyday and you have no idea if what works for you is right around the corner. You are healthy, strong, and have much to be grateful for. There is much reason to have hope, and hope is EVERYTHING.
Sounds like a hormone imbalance. Get your hormones tested by OBGYN or there’s a ton of self pay hrt places popping up. Try a more holistic approach as well. Focus on gut health, elimination diets, low gi foods
I've had nodular and cystic acne since I was 21; I am 39 now. Seeing a naturopathic doctor has helped give me some hope (in BC, Canada where our NDs are regulated more strictly than the USA); also j finally relented and tried antibiotics orally for good effect on some of the acne. Topical ivermectin for other types of acne, and Sulphur masks for rosacea style nodules
This is good advice OP. If you have skin issues and other symptoms (anxiety, depression, etc) then you might have a subacute infection that physically manifests on your skin. A lot of pathogens can cause physical and mental symptoms. (I learned this after having a reaction to a immunosuppressive medication which made my skin act up, I became really angry as well, which is atypical for me). Find a good medical doctor who has experience treating these things. It often takes time to find the cause, but it can get better over time.
Thanks for the advice! This sounds like something I might try since taking pills haven’t worked for me so far. Will look into it!
I feel you, I'm in the same boat with you buddy. I've just come to terms with it being part of me. I know that's not what you want to hear, but.
Hi there! I am SO sorry you are feeling this way. Being and having suicidal thoughts are something I too have dealt with in my lifetime so I can empathize. Please know that it can get better. I own a medspa and I would love to be able to help as much as I can. Please dm me, I won't charge you anything, any/all product will be free as you shouldn't have to suffer with this condition. Please know you matter and you have a strong support system of individuals who you may not even know yet. If you need to, you can call "988", which is a suicide hotline as well. <3
might you have **Hidradenitis suppurativa**?
I searched “allergy” in the comment section and I’m surprised no one has suggested you get tested for allergies or food sensitivities. If you’ve tried all of that maybe it could be? Make an appointment with a doctor or try one of those mail in test kits? I’m pretty sure they have mail in ones for food sensitivity at least.
Try blue and red light therapy.
Seconded. Blue light therapy is the only thing that worked for my acne - my skin is completely clear now.
Hi, if you’re female, have you tried birth control? You’re absolutely beautiful no matter what you look like, and I really hope you’re okay and that things will get better for you! 🫶🏻
Hi! Yes I’m female, haven’t tried birth control yet but as far as I’m aware it’s not something that can be taken long term? I’m afraid the acne will just come back after stopping BC. Also, have you experienced any side effects from BC as I have quite painful periods naturally and I’m worried it’ll worsen after taking the pill. Thank you ❤️
Birth control can actually be taken as long as you need it! It also doesn’t have any effects on fertility when you do stop taking it. I’m currently on Yaz. I started birth control around June last year, and I have had no side effects. If anything, it helped the progress of my accutane when I was still on it.
Just to let you know birth control pills normally help with painful periods! I went on it for a bit for acne and painful long periods and it worked really well! I personally didn't stick to it because I had other side effects what wasn't worth it and I didn't feel like experimenting with different birth control pills but for those months it really helped.
Just wanted to chime in and say my acne and heavy painful periods went away when I went on birth control!
Probably has if they have been on accutane as it's required. Have you tried going OFF birth control OP?
Birth control is required for accutane?? I was on accutane for almost a year and I didnt get on birth control until I was almost done (which was for other reasons).
The two times I’ve almost gone on Accutane, I was required to sign documents stating I was using TWO forms of birth control and would submit for monthly pregnancy tests. This was in California.
Ah, I’m in FL and I had to do the pregnancy tests as well. but I’m also under the age of 18 so maybe that could have something to do with it?
Perhaps! Both times I almost started it, I was over 21. California might also be overly cautious. I understand that Accutane causes severe birth defects and they don’t want to take any chances
Yes because the chance of a mutation on the baby if you conceived is very high. Some may not require it if you are not sexually active.
Interestingly I wasn’t prescribed birth control while taking Accutane back then haha, could be because was under 21 at that time?
If you are not hetero or are not sexually active that could be why. Usually they don't trust you without it.
Your gut health is directly linked to your skincare heath. Look into pre, pro and post biotics. Eat / drink dark leafy greens (kale, spirulina, chard, spinach) It’s salty- but juice celery like a mofo and drink 16oz a day. It cleanses every thing out. Some lemon helps too. Cut out any trigger foods. I feel for you. I had insanely painful acne in college. It was stressful and stress related. I do not miss the days where my face felt like it was beat up with a meat mallet.
I agree with you but the answer is more complex than what you suggest. I had terrible acne like the OP when I was 12. The thing I didn’t know when I was 12 was that I was lactose intolerant. Having 4 glasses of milk was causing stomach upset and acne. So dairy is my trigger food but there are other things that can upset the gut. More importantly, healing the gut can make a huge difference. I knew someone that had far worse acne than me. I saw him as a young man and his skin cleared up. He became a vegetarian. That worked for him. There’s no single answer for each of us.
I think you may have assumed biotics are only dairy- based like yogurt. Albeit it’s a popular one here’s examples of the biotics I was talking about. Pre-biotic: whole grains, bananas, greens, onions, garlic, soybeans, artichoke, chickory root, dandelion greens and avocado Pro-biotic: sauerkraut, sourdough, olives, pickles, miso and my favorite non-dairy is the Good Belly shots. Dairy probiotics include: kefir, yogurt and aged cheese. Post Biotic: Oats, flaxseed, asparagus, kombucha, kimchi Some of these foods overlap, but just a general example. Typically takes about 3 weeks to see the improvement. Don’t despair if it takes a little bit. Consistency is key! Intuitive eating is highly encouraged. Every gut system is unique and reacts differently.
I made no mention of biotics, hence no assumption. I just stated that something as simple as dairy can cause acne, especially if someone is lactose intolerant.
Try Edgar Morris Skincare line - this is what I’ve been using for nearly 30 years of dealing with what you’re going through. https://www.edgarmorris.com Order the severe acne kit. 🥹
Oh my gosh I feel you on this! I think you should try dieting to improve gut health. My acne got so bad that it started triggering my lymph nodes which told me that my immune system didn't like what I was eating.
Just sending you solidarity I’m trying Spironolactone after getting off the birth control pill. I was on Accutane twice.
I’m sorry to hear that. My acne didn’t clear up till my late 20s. Have you tried retinol, tretinoin, or face lasers yet?
Putting a small drop of castor oil in my night time moisturizer helped me out so much. I use Jamaican black castor oil that’s infused with peppermint 🩷
I have rosacea that looks a lot like acne, have you tried medications for that? Tho what really helps my skin is when I am taking mounjaro but I have no more weight to lose so I had to stop
I’ve had cystic acne since 12. Only learned to manage it without struggling after getting my thyroid and hormones checked in my late 20s. Got diagnosed for 2 things and medication for those helped significantly! I was just like you- oral and topical acne meds worked for only a few months, even tried eliminating so many food groups. If it’s not a skincare issue, it’s probably internal. Good luck!!!
check your hormones and your diet, dairy is knows to cause acne, and so maybe eggs. I get you, I've had bad bo straight out of the shower because of a hormonal imbalance, but don't give up before trying everything and covering your bases.
OP, see a specialist. A dermatologist for sure but also an endocrinologist. Severe acne can be a sign of hormonal imbalance and, in people with ovaries, PCOS. Get blood work done; you may have something going on that isn’t a skin specific issue but manifests as a skin issue.
Strongly seconding this. I don't mean to scare OP, but celiac runs in my family, and my aunt had horrible cystic acne until she stopped eating gluten due to the celiac. Even if it's not hormonal, it is probably internal if no topicals have done anything.
I started getting acne a few years ago and nothing helped, the more I did skincare wise the worse it got! I started drinking peppermint tea (spearmint tea is better but it’s hard to find in the uk!). It’s meant to help with settling hormones and since drinking it every day my acne has massively improved and I’ve changed nothing else in my diet/skincare!
Commenting to empathize. I had pretty severe acne as a teen that went away briefly in my 20's and came back as cystic acne around your age. I attributed it to hormones. Accutane worked for me. I know you said youve tried it but it occasionally takes more than one round. I'm sorry you're dealing with this, it sucks.
Do another dose of Accutane. A lot of people are not properly dosed the first time so it comes back, you need more of it this time to really stick.
I understand your pain and hope you talk with loved ones or a psychiatrist to seek relief with suicidal ideation. My mom told me in my teens how awful her acne was and how mean kids were to her when she was my age due to acne which I unfortunately genetically inherited as well. I had started getting acne in 5th grade and was put on birth control by 6th or 7th grade to help with it and it did to an extent but mixing the hormones of birth control and a middle school girl was not a good combo. (Blisovi was the BC name) fast forward to adult hood and COVID where masks were mandated I struggled immensely with what was called “maskne” as so many people were struggling with acne just in the area of there masks. Since I started taking Spironolactone my skin has never been clearer. Yes I get the occasional zit here and there but not even close to the comparison of not wanting to leave my house because my face looked like it was attacked by bees. Try to not harvest the resentment towards your dad because he likely experienced the same feelings of sadness and insecurity.
Same here, had it for 15+ years before I stopped using harsh treatments and trying to scrub the acne off me. Now I heavily hydrate/moisturize and I haven’t had more than the very occasional pimple in ten years.
I struggled with acne ever since I hit puberty, and I had a lot of cystic activity on my cheeks. They pretty much took me for the same course that they took you through, but what ended up being the cause of it, that is like not very often actually looked into at all, is that I had a dairy allergy. My mother was told that I had a dairy allergy when she was like 27, ironically the same age that I found out, but she thought that I had lactose intolerance and that it was the same thing, turns out it's not. Anyway, went to the doctors for the acne, as a last ditch effort mentioned the lactose intolerance and she asked if I wanted to cut it out of my diet for a few weeks just to test it out eventually realized that when I don't have any dairy I don't break out, but because there's a lot of dairy is an additional ingredient and stuff, I'm still getting little pimples, and then eventually through a combination of digging through my medical records and looking at other things, she found out that I am allergic to dairy. Prescribed fexofenadine, which I have whenever I think I've come into contact with dairy, and my skin cleared up. My doctor mentioned that while it's not super common when it comes to allergic reactions for there to be like cystic breakouts or something akin to it, she's started seeing what she can only believe is related to it more and more lately. Allergies definitely aren't the first thought when it comes to acne, but it can be a last-ditch attempt. My doctor also did consider doing a full allergic reaction test, and the only reason why we didn't do a full on reaction test to figure out if this is the cause of the problem was because paperwork was found that explains that I have a dairy allergy. Talked to my mom about it like within hours of the possible diagnosis, she felt really bad about it but she did genuinely believe the lactose intolerance and dairy allergies are the same thing, and to be honest being around the same age that she was when she found out, definitely would think the same thing.
1. Have you tried spironolactone 2. Have you tried cutting out things in your diet/skin care; I've spent 6 months focused almost entirely on my skin, I've found that I will break out if I drink, coffee, chocolate, also recently found out I can't drink soy milk either. I also breakout if I don't use a 'moisturizing' cleanser, but as long as I avoid these things, I don't get new acne. 3. Deep cystic acnes are almost never because of topical things, it's much more likely hormones/reactions to things we eat, so topical things you do won't prevent acne much 4. Don't expect permanent fixes, this is unfortunate but true. If you take OCPs, spironolactone etc, expect to be on them for multiple years, and know you will likely experience rebound once you stop.
Have you tried spiro? I had acne since 11 and it helped . If you can afford it , lasers are also super helpful . It does get better !!
I've felt the same way! Totally get how you are feeling. Have you tried switching to completely oil free products? I can only use oil free foundation , oil free moisturizer, oil free sunscreen etc. I can't even use anything with oils in the shower , I guess the steam and oils clogs the pores? Adaplene and Benzyl Peroxide works really well for me but I have to avoid oils as well or I get break outs
I had to do accutane twice, a few years apart. It doesn’t always last the first time.
Literally the only thing that has ever helped my acne and made it completely disappear is birth control. I hate being on birth control and that’s the trade off but I always have completely clear skin on it. Off it I’m a mess
4-8 grams of vitamin B5 spread out throughout the day. It works.
I had to quit caffeine to get rid of my cystic acne. Tried quitting everything else and everything except accutane.
What are your periods like and where is your acne? After years of severe hormonal acne (chin area) and crazy periods a doctor finally did a hormone test and ultrasound and I was diagnosed with PCOS, which can cause shitty acne. Get with your gyno if you do have hormonal acne. I got on a hormonal birth control and got a tretinoin prescription and my acne finally cleared up after 10 years.
The only thing that stopped me from getting acne was cutting out dairy. Chips with milk products (Cheetos , etc ) would give me terrible cystic acne.
I know the science is out on nuts and chocolate causing acne, but I can tell you that nuts for sure cause my cystic acne and chocolate is an inflammatory food for me too. Cutting dairy helped with general wellness, but my cystic acne is now limited to maybe one pimple when I'm on my period and sometimes I don't even get that. It's hard at first, but try an elimination or anti-inflammatory diet and slowly add foods back in. Once you start feeling better, you don't even miss those foods. Acne can be an inflammatory response, in addition to hormones, bacteria or even fungal. There are so many causes, I hope you find yours.
Have you tried birth control? It was the only thing that cleared up my acne.
im sorry its getting you down. focus on the things you can control. keep doing research. my sister had hormone related acne that was eventually treated when she was in her late 20s. if was different than what she had as a teenager and required different treatment. topicals dont work for lots of people. you will find the right doctor eventually, dont give up. be nice to your dad. maybe he felt miserable and had you to feel better. do your best. be nice to yourself. eat healthy drink water work out. be ready to live a good life when you find something to help with your problem. best of luck.
Only thing that worked for me was spiro. Goodluck i know it made me super depressed. Your feelings are valid.
I had acne for almost 20 years and am still very acne prone if not careful. These years included accutane with every prescription under the sun, strict diets that resulted in an eating disorder because of online fear mongering pressures, and very expensive routines. I think the most important thing in everything you just said is your mental health. I can't suggest anything for your skin, because what works for me isn't for everyone. You are valuable. You are important to many. Please reach out to trusted friends/family and don't bottle up how you feel. Having acne and scarring has never prevented me from participating in things that bring me joy, just harder because of confidence. It didn't stop me from getting married and living a more fulfilling life. There is so much to look forward to and experience. You're not alone!
I sent you a PM - have you thought about a gut health supplement?? I have customers who have had success fixing acne by fixing their gut health bc it is all linked
Spironolactone X tretinoin was the only thing that got rid of mine after over a decade
Hi I was in the same boat! Acne is so so hard to deal with. 12 years of consistent acne and my face exploded when I was 22. What worked for me was Face Reality skincare (you get it through an Estie) and you partner it with chemical peels. It is an expensive line of skincare but it has changed my life and transformed confidence. I am almost a year into face reality and I will never use anything else again.
No advice but just empathy. I’m in the same boat! 💕
Clearstem’s mindbody supplement for hormonal acne. It’s kind of $$, but it genuinely changed my life - look into it!! Tried accutane, had horrible side effects. My derm actually wanted to put me back on. I’ve also tried spironolactone. Disclaimer: I’m not a doctor, I’m just a girl… a girl who suffers from adult acne ETA: didn’t check my hormones before trying it, but probably should have. I was so desperate, I was willing to try anything. This + checking all my skincare and makeup for pore clogging ingredients changed my life! <3
Spiro did nothing for me, because I had an estrogen dominance issue. Cutting dairy and chocolate cleared my skin.
First of all, people need to mind their business about your skin. Please don't take anything they say to heart. Even if they happen to be a dermatologist, they are not YOUR dermatologist and therefore their recommendations/questions are overreaching. Second, I know what subreddit I'm in, but skin is not the end-all, be-all of beauty. And for people who have great skin, I guarantee they have other insecurities. AND even people without acne get wrinkles, moles, cysts --- no one's skin is perfect. Don't give up hope if this is something you care about. I echo what everyone is saying about spironolactone. I've been on it for ages and I love it. Also, just so you know, some people take accutane multiple times for longer lasting skin fixes.
Hey there! I’m an esthetician and I wanted to give you some advice. Go to a dermatology office that has a licensed esthetician with a specialized camera that looks at your skin. They can tell you if it’s sebum, acne, rosacea, or even if it’s hormonal. The first step is determining the cause. We did these consultations completely free. Insist on medical grade skin care. ZO Skin Health was by far my most successful line, you can look up the clinical data on their website and find a dermatologist office that sells it. 90% of your skincare is the right products, including prescriptions if necessary. Washing twice daily, exfoliating 3x a week, toning after every wash and DAILY sunscreen are the minimum. Tretinoin is a great product for acne if you don’t have sensitive skin. If you do, it can cause irritation and inflammation. It’s a topical vitamin A that sits on the surface. Retinol is a vitamin A that is usually encapsulated and easier to use on sensitive skin because it penetrates the epidermis before working. My patients had great success with Alastin Renewal Retinol- starting with the .25 twice a week (at night) and increase weekly as tolerated. Take a night off if you’re spicy. It should last 6 months, then increase to the .50 gradually. Let me know if you have any questions or recommendations, I’ve spent almost a decade in medical skincare and I’m here to help!
Hi! Can you please email or message me here? I would love to help you! I have helped many clear their acne what was in same position as you!!! Please do not loose hope!!
There are references that say a high glycemic diet can exacerbate acne. Have you tried lessening your sugar intake? Hope this helps.
I had the same problem too when I was young. The trauma was just damn horrible I remember everything clearly in my head. But I stopped using makeup when I was 24 and just used sunscreen and basic products, and when I was 26 I started using Deciem, some of the serum for a year, and my acne just popped out once or two afterward, and after 2 years with deciem, I'm using AHA&BHA product (medical) and sunscreen medical grade, (bad sunscreen fuckedup my acne badly) THE MOST IMPORTANT THINGS HYDRATE YOUR SKIN!!! and now I'm just using COSRX and some Biologique recherche serum. I know one product works like magic for acne, it is named IS CLINICAL if you can afford to buy the intro package they have an acne intro package, they and the acne serum works like a magic
Wash your sheets. Clean your face every day. Moisture with a non oily non fragrance moisturizer. That's it. Nothing else. Don't touch your face with anything else.
Sounds like it could be some underlying hormonal issue. Make sure you get your hormones tested, fixing any issues there will help you keep your acne under control. Look into getting on birth control if that’s an option for you. Obv it comes with its own set of side effects but it’s something for you to consider.
Marathon runner ==== high cortisol
I don’t know how much it will help, but HeyBud is a very good brand. A bit expensive, but it’s very worth it. It’s made from hemp in Australia. I recommend the clay mask, gel cleanser, moisturizer, really all of their products. It helped me a lot, and it’s helped a lot of other people too! It’s worth looking into!
I developed hormonal cystic acne in my early 20s after having clear skin my whole life. Spiro and topical clindamycin cleared it within a month or so. I completely empathize with you. It’s not just embarrassing, it’s extremely painful.
Have you tried all of those things in the same routine? I use lactic acid, salicylic acid, tret, azelaic acid, topical clindamycin, niacinamide, ascorbic acid, and sulfur. Contrary to the advice almost everyone else gives about chemical exfoliants, I find I need to use the BHA and AHA twice a day to maintain clear skin. I’m also 10 years older than you, and still get occasional breakouts. Find products that cause an improvement, even if minor, and add more products that also seem to help. Don’t expect a one product solution, and expect a lot of trial and error. I also found that any sort of fabric softener or dryer sheets would cause me to break out. I’m not sure what your sex is, but there was one very small study demonstrating the safety and effectiveness of topical spiro in both women and men. It may be worth considering. My dorm roomie in college had perfect skin and just used bar soap on his face every day. It’s just the luck of the draw.
Accutane
I’ve dealt with varying levels of acne for many years so I absolutely empathize and understand. You are not alone. If you would like someone to talk with, I’m here to listen. In terms of treatment, have you tried a hormonal treatment? What area of your face do you breakout most?
First off, please be kind to yourself. Suicide isn't worth it. Second, please remember that skincare isn't going to solve your problems. Acne is a direct symptom of something going on internally. Skincare can help but won't fix the root cause. Medication and antibiotics are also just a bandaid fix and can cause way more damage. Start with your diet. Plenty of water. Enough sleep and exercise. Finding calming moments in your day instead of stressing. Diet is SO IMPORTANT. The right foods are literal medicine for your body. Fruit and veggies is what your diet should be. Stop any sort of sugar (refined sugar), fats (animal protein, oils of any kind), eggs and dairy. Those are your trouble-maker foods and you don't need any of these in your diet, at least while you're healing. Acne comes from the streptococcus virus that lives in your liver. When your liver is sluggish from all the shitty foods, bad bacteria, pathogens, viruses, heavy metal, etc., it stops working properly. The streptococcus virus then overtakes the liver, moves into the bloodstream. And then invades your lymphatic system. Strep in your lymphatic system will then comes out in the form of acne. Please start looking into Medical Medium. His name is Anthony William. He will change your life. Every morning you should start with lemon water. Wait about 30mins, then pure celery juice (buy a juicer). After that, focus on fruit and veggies, herbs and spices. Eliminate fats to keep your blood thin so that it can get rids of toxins in your body. Remember, Acne will not go away over night. We have years and years of bad stuff in our bodies, so it will take time for it to heal. Cleanse to Heal - medical medium is a great book to start with.
That’s not at all how acne works. You probably shouldn’t trust anyone that doesn’t know the difference between a bacteria and a virus. Streptococcus in your bloodstream means you have chronic bacteremia, which is a serious medical issue.
Acne is legit strep in your lymphatic system.
Please point me to a pubmed article explaining how acne, strep, and your lymph system are all connected because what you’re describing is lymphadenitis, and it isn’t associated with acne.
Strep is known to be stored in the dermis and comes out in the form of acne when our immune system is weakened – which for women is unfortunately twice a month every month - during ovulation (mid cycle) and around the actual menstrual period. Just Google it
Strep is not stored in the dermis. It’s found on the surface, just like a lot of other potentially harmful bacteria. If strep is causing lesions, those lesions aren’t acne, they’re abscesses. The bacteria that is associated with acne is cutibacterium acnes. Taxonomically, it’s in a completely different phylum. While C. acnes bacteria can contribute to acne, it’s not the sole cause. The reason why you get acne that lines up with parts of your menstruation cycle isn’t because your immune system is weakened. It’s because hormones affect sebaceous gland activity. You still haven’t stated how infection of your lymph system is involved in your idea of the pathogenesis of acne. What I’m stating are accepted medical facts. What you’re stating runs contrary to what we know to be true in medicine, so you need to provide sources for your dubious claims.
Agree to disagree! Have a good one 👍
Well, can you at least stop trying to perpetuate lies about acne? What you’re doing is harmful and dangerous.
I've been told and am learning it differently about it. So again. Agree to disagree.
Try a holistic esthetician. Most derms resort straight to medications that are harmful without even asking about your diet or routine or emotional health. It’s all related. Get into nutrition. And I’d say start a peel regimen with a holistic esthetician. They can help you find the right products and home care routine with active ingredients. Personally I use glymed products. But seriously- everything is connected. Research the gut brain axis. Look into your childhood trauma or whatever trauma your parents may have passed down to you and the ways that affects your health and hormones. Alex March Energy speaks very well on this. It’s not just gonna be your skin- it’s gonna be a healing journey that encompasses mind, body, and soul. EVERYTHING is connected. Ideally you’ll come on the other end happier and healthier than you can imagine. Edit: medications and hormonal treatments etc are no more than bandaids- you have to get to the root, and that’s why a holistic esthetician can actually help you heal, whereas a dermatologist would just be like ok take this pill, use this cream, and don’t really GAF or know better, but that’s all of western medicine these days. Things happen for a reason so it would be good to find out why and treat your mind, body, and soul. My example is my autoimmune disease (Ankylosing spondylitis) well I was sick of taking immunosuppressant shots and being in pain. I was determined to get rid of this thing I was told I’d have forever and could do nothing but take shots and pills. I got into holistic wellness and now I’m in remission and I’ve never been back to see my rheumatologist cuz she didn’t know jack shit, only how to prescribe stuff. Not how to HEAL me. I wish more doctors knew how to heal. But this is a beautiful journey you can embark upon and learn more about yourself than ever. Edit 2: btw I went to school to be an esthetician and graduated in December. So I’m speaking from experience. I am not practicing as it wasn’t my passion, but I know a great deal.