Cystic acne

(61 Posts)
ILoveSparklers Wed 21-Nov-12 19:45:38

I had a few cysts in my chin the last couple of months. Really hurt, used to get tem occasionally but now one constantly. Anyone else suffer? What treatment do you recommend?

lurkingaround Wed 21-Nov-12 21:30:17

I used to have cystic acne. You can spend a fortune on various products with only sometimes good results, or you can go the medical route. Which, having spent 20 years, and a bloody fortune on cosmetics products, is what I recommend. I wouldn't waste too much time on cosmetic stuff. Go to your GP and see what they think. Ask about referral to a dermatologist.

Cysts cause short-term problems -they are painful, unsightly- and long term problems -scars-, neither of which you want. I went on Roaccutane (finally) at 40, a low dose and I haven't looked back. It was fantastic.

ILoveSparklers Wed 21-Nov-12 22:04:36

Thanks, worried about side effects. Was on diannette which contained it. But don't want to be on pill forever.

squoosh Wed 21-Nov-12 22:09:35

I used to get these on my jaw line a lot. Not sure if this is what cured them but I now cleanse by massaging in a rich cream cleanser and then gently rubbing off with a hot flannel. Haven't had any in months.

AddictedToGin Wed 21-Nov-12 22:15:41

I eventually went on Roaccuatane when everything else failed, including multiple antibiotics, moisturisers, cleansers, facials... It was brilliant (although takes a while to work). Cystic acne made my life a misery but after the Roaccutane I haven't had a spot since and I can slap on £2.99 moisturiser now instead of importing various potions from the States!

lurkingaround Wed 21-Nov-12 22:27:44

I can understand your concern re side effects of Roaccutane. So was I. Hence the 40 before I took. It's worth talking to a derm and investigating for yourself but it was fantastic for me. And like AddictedToGin, I can slap on any old moisturiser, saves me a fortune!

ILoveSparklers Wed 21-Nov-12 22:55:59

Thank you guys... I'm looking like one big spot sad. Oh well. Used to it and now in my 30's affects me less confidence wise thankfully.

Pinot Thu 22-Nov-12 09:53:43

Ohhhhh sad Another sufferer signing in.

I've been on dianette for 5 years - I'm 37. I really don't want to be on this bloody pill much longer - do any of you think I should go down the Roaccutane route? sad

Sorry OP I have no words of advice, just massive empathy!!

saggybaps Thu 22-Nov-12 10:03:43

Had to post as I suffered from this for years. I tried every lotion & potion on the market, long courses of antibiotics & ended up spending years on dianette.

Finally I had a sympathetic doctor who referred me to a dermatologist (tony chu's clinic) They prescribed two creams & I had the n-lite laser treatment. That was 6-7 years ago & I've never looked back. It truly was life-changing, as when you've a chin full of painful cysts it does batter your confidence talking to people. I highly recommend.

lurkingaround Thu 22-Nov-12 10:07:19

You should get referred to a decent dermatologist Pinot, but I think you should seriously consider Roaccutane. I used to be on Dianette, and it controlled things, but when I came off it, the acne returned. My derm said that I would probably never (yes, never) get rid of my acne without Roaccutane. Once I finished babies, and breastfeeding, I went on it. My only regret is that I didn't do it years ago. A small 20mg dose did it for me. Really really fantastic. The relief of no spots is wonderful.

Pinot Thu 22-Nov-12 10:35:33

I'm going to do it. Thank you - just the push I needed. thanks

Everlong Thu 22-Nov-12 12:23:17

I had this horrible weird outbreak this time last year, really big, sore cysts just on one side of my chin from nowhere.

I felt really self conscious and embarrassed and very low about it.

I was on antibiotic for acne for 8 weeks which cleared it but as soon as I stopped they came back. I've been on tetralysal ever since plus tretinoin gel, which is a retin a gel you put on all over your face. It's a bit like a peel and makes your skin look quite youthful.

Don't suffer in silence ladies thanks

shrimponastick Thu 22-Nov-12 12:32:10

Annoying isn't it.

I have suffered acne since early teens. took the pill throughout most of my adult life, Dianette being the wonder pill. Even when the GP refused to prescribe it for me due to a blood disorder I bought it over the counter on my trips to Spain rather than suffer spotty face, neck, back, chest.

It was never cystic acne, but a lot of spots.

However in Jan this year I stopped taking it andwent to GP for a referral to Dermatology. typically when I went the spots weren't that bad. I think I have 'grown out' of it, a bit. Still very oily. Also my diet is 100% better than it used to be. And I don't smoke now. So maybe that helped?

Anyway - the Dermatologist was quite helpful. He prescribed me Differin Gel to use for awhile in the first instance. Very good. It basically increases cel turnover, prventing blockagesin the pores. He did say that if I was still not totally happy then to go to the GP and ask for Trimethoprim anti biotics. He said that these give the best results in all anti biotics. And if they don't work then he prescribes Roaccutane.

so I have been taking the anti bs for a month or so now, and using the Differin gel each evening. And all is well. Still get the very occasinal small pimple, but not the big hard welts that take three weeks to go away.

My opinion is that if you have true acne, any cosmetic product won't touch it.

p.s. The Differin Gel makes my skin look much better in general tone too, saves on the acid peel stuff smile

ILoveSparklers Thu 22-Nov-12 13:28:11

I have booked an appointment with gp smile.

cathyandclaire Thu 22-Nov-12 18:00:50

Good luck with GP...I'm another ex-acne sufferer. I had roaccutane at 40, I decided I wasn't going to grow out of my spots, and it transformed my life. The freedom of not thinking about your skin/concealing spots all the time is amazing. I wish I'd taken it 30 years ago.
In fact, my little DD really suffers from spots and she's on Roaccutane already at 14, the side effects are manageable at the moment and it's so lovely to have my happy little daughter back. I know Roaccutane has been associated with depression and shouldn't be taken lightly but for us the benefits have WAY outweighed the risks.

SantyClaws Thu 22-Nov-12 18:06:08

i started getting this a year ago (i'm 36) after always having good skin - i had no idea the pill was keeping the zits away till i stopped taking it sad

The doc gave me Differin gel too, and a water retention tablet that seems to do the trick. (water tablet has a mild hormonal effect, apparently, that i was missing since going from pill to coil)

mummyinthemiddle Thu 22-Nov-12 18:15:56

I have also suffered with this in the past. Then it calmed down while I was pg and bf. They came back worse than ever about 6 months ago and I thought I was just going to have to put up with it. However, I then went on a paelo / low carb diet (except for a few glasses of wine at the weekend). The affect on my skin has been significant. I can't say I don't get any spots now (I get the blind kind that never get a head and take months to heal) but it has really imrpoved and no I just get the odd spot. I think it is probably cutting out wheat that has made the biggest difference. I don't know if there is any evidence that a paleo diet helps with this problem but I think it is what has made a difference for me!

SantyClaws Thu 22-Nov-12 18:23:38

(I get the blind kind that never get a head and take months to heal)

^^yeah those are the buggers grrr

Charliefox Thu 22-Nov-12 18:43:33

I suffered with it terribly and was on oxytetracyclin for 10 years, which kept it under control but it would come back with a vengeance if I ever tried to come off the medication. I had a breast reduction, came off the tablets before and after the op and the acne has never come back. My tinpot theory is that it was hormone related and the breast reduction reduced the amount of hormones, thereby 'curing' the acne.

ILoveSparklers Thu 22-Nov-12 19:37:30

I get the blind kind too... I think mine is resulted to levels of testosterone being quite high.

ILoveSparklers Thu 22-Nov-12 19:37:58

Related even...

LtheWife Thu 22-Nov-12 19:49:27

I'm 31 and have suffered since my teens. Tried everything my GP could give me, was on antibiotics for 3 years but nothing helped. Really wanted to try roaccutane but always said I'd wait until after having a family. The starting a family has been put on hold for a year or two so I'm wondering if I should try roaccutane now. A difficult decision as I really don't get on with hormonal contraceptives (hence no longer taking dianette which didn't help anyway) and I know you need to double up for iPLEDGE, but I'd prefer not to screw up my cycle before TTC and I don't know how long after taking roaccutane you have to wait before TTC.

ILoveSparklers Thu 22-Nov-12 19:51:31

It's annoying isn't it. My preschooler hit me on the chin earlier by accident and I nearly wept! Plus people probably think its contagious!

Chicksy Thu 22-Nov-12 20:32:19

Suffered for years as GP wouldn't help. Eventually I saw Dermatologist and now take tetralysal and use differin gel. It has completely turned my life around. For the first time in years I have clear skin, and in my case it worked so quickly. Cant believe I suffered so long it was so unnecessary.

ILoveSparklers Thu 22-Nov-12 20:37:07

That seems to be a common theme chicksy...

shrimponastick Fri 23-Nov-12 08:54:24

Some GPs are more sympathetic than others.

When I went to see mine (female go if that makes any difference)I had a clear skin as had only just stopped the Dianette. She took me at my word, and understood that I didn't want to wait for a severe breakout to prove my need for a referral.

PragmaticWench Fri 23-Nov-12 09:20:32

I had years of different antibiotics, dianette, creams, gels and even liquid antibiotics that smelled of vinegar from the GP! Whilst they worked to some extent, nothing shifted the acne completely and I had it on my face, neck, shoulders and chest. The impact on my self-esteem and relationships can't be underestimated. I was eventually referred to a dermatologist and took two courses of Roaccutane in my mid twenties. The difference was incredible!! Yes, there were side effects but I honestly didn't care once my skin cleared, and stayed clear afterwards. Low cut tops were a revelation, in lots of ways!

However, I'm now in my early thirties and the acne on my chest and on the back of my neck has crept back (I had to have a high-necked wedding dress). I'm not taking anything as I'm pregnant and am really worried about people seeing my chest when I breastfeed. I think that I'll ask for another low-dose course of Roaccutane once I'm done with breastfeeding.

Good luck with your GP OP, I think everyone has the right to request a referral to a consultant? It is definitely worth explaining the impact it has on you emotionally and that it hurts.

cathyandclaire Fri 23-Nov-12 09:24:20

I think it's a good idea to take pics on your phone of all the bad days...then you can show the doc because sod's law says your skin will be fab on the day of the appointment!

LtheWife Fri 23-Nov-12 10:07:38

If your GP is hesitant to refer you ask them to have a look at the map of medicine. Anyone who suffers with painful nodules or cysts should be referred to a dermatologist to be seen soon (not as an urgent case, but quicker than someone without nodules or cysts). They should do a blood test first however. You can see the flow chart they should be working from on the nhs website

FairPhyllis Fri 23-Nov-12 20:58:11

Worth trying Roaccutane. NB - it doesn't work for everyone. It didn't work for me, but I'm happy it's helped so many other people. What helped for me was laser treatment.

ILoveSparklers Fri 23-Nov-12 21:37:48

Pics on phone is a brilliant idea smile

PragmaticWench Sat 24-Nov-12 11:57:53

I just asked my sister (she's a pharmacist) and apparently there is a topical version of Roaccutane, a gel I think, that can be used instead. Might do some research.

ILoveSparklers Sat 24-Nov-12 19:50:17

On the plus side... Generally if you have acne, you are less susceptible to wrinkles? Please tell me there's a benefit there somewhere?

lurkingaround Sat 24-Nov-12 20:03:21

There is a topical version of Roaccutane, P-Witch. It's called Retin A. It's good, but can be hard to use as it can cause a lot of redness and peeling. It's probably on a par with Duac or Differin (more so Differin). Depends how bad your acne is, I suppose. Having been there done that (repeating myself) I'm all for going for a cure with Roaccutane for cystic acne.

ILoveSparklers I love your optimism! I know one of the reasons I went on Roaccutane at 40 was that I just couldn't bear the thought of still having spots AND getting wrinkles (sad to say they were starting). Whatever about having one or other, both was just NOT FAIR!!! grin

lurkingaround Sat 24-Nov-12 20:04:20

P-Wench! Sorry got the name wrong!

Speedos Sat 24-Nov-12 22:05:25

I had laser treatment combined with a glycolic peel and even after one session my skin was so much better, well a week later anyway.

I've had 2 follow up peels only and my forehead is completely smooth.

I've never tried Roaccutane so can't comment on that.

MrawMraw Sat 24-Nov-12 23:11:23

I have cystic acne, caused by hormones (PCOS). I sympathize, it is actually painful and I have scarring. I wish more HCP's would take it seriously.

I started treatment with Benzol Peroxide gel, which does help a bit but doesn't stop my cysts from actually forming.

GP offered antibiotics but I refused as I get stomach problems on Antibiotics (strips the good bacteria, and the acne is causing pain but not internal probs).

Eventually a blood test for other issues found the underlying cause - hormonal acne due to PCOS, so I was referred to a specialist, who told me the only ways to really shift acne caused by hormone imbalance are -

1) Dianette
2) Roaccutane
3) Anti-Androgens such as Spironolactone, Furosemide, or Cyprotene Acetate.

However, all of the above have side effects which could maybe outweigh the benefits of using them.

Dianette has all the usual side effects and risks of the pill, and then some!

Roaccutane the liver risks and other associated risks , Cyprotene has this risk also.

Spironolactone is a diuretic and will make you pee A LOT at the doses needed to make a difference, can have the problem of raising potassium blood levels too much which is possibly dangerous, and has been linked to cancer in rats (but not proven).

All need monitoring.

Spironolactone (what I was given) has completely solved my acne altogether. However it will stop working as soon as you stop taking it, so if I stop taking it I will consider Roaccutane.

I put up with the acne for years just as a fact of life, wore heavy concealer, hid my face a lot in public, but it has been great to be rid of it.

FairPhyllis Sun 25-Nov-12 02:16:06

Mraw is right that if it is hormonal you have to do the drugz. Mine is hormonal in that I have "normal" levels of testosterone, but my body for some reason is very sensitive to even very low levels of it, so I have some PCOS symptoms without actually having it.

Roaccutane and Dianette didn't do much for me, but Yaz (think it is called Yasmin in UK) has pretty much stopped any breakouts, and I had laser treatment for scarring and redness. Since then I've been able to keep things more or less under control with clindamycin and Differin.

I'm not sure that acne and oily skin (hence fewer wrinkles) inevitably go together - I am becoming increasingly convinced that I actually have quite dry skin.

However if you haven't had Roaccutane then I would strongly recommend giving it a shot, especially for cystic acne, because so many people do get really good results with it. It is so frustrating and demoralising to still have it as an adult - I always thought there would be a day when it magically cleared up by itself, but that hasn't happened yet.

ILoveSparklers Sun 25-Nov-12 20:41:12

Thanks everyone. I was on diannette for 10 years... It worked but you know it may sound silly... But I feel more emotionally stable and capable when I'm off it.

LtheWife Sun 25-Nov-12 21:03:34

Doesn't sound silly at all Sparklers, whilst taking dianette I was very emotionally unstable. I went from almost homicidal rages to suicidal depression and everything inbetween. Very unpleasant and it didn't even help my acne.

ILoveSparklers Sun 25-Nov-12 21:10:52

Messing with your hormones does have an impact doesn't it. I feel much more confident off it. Like it somehow "dumbs" me down... Can't explain it. Would rather put up with the cysts than go back on it... Might see if the differin gel helps.

dontmixthecolours Sun 25-Nov-12 21:26:32

I'm in the same boat. Saw GP this week who told me I need to be on antibiotics for 9 months before she'll consider anything else. She says this is because my body has been through a lot recently (3 miscarriages in 14 months). Dianette worked brilliantly for me but I can't have it now because of an increased risk of stroke.

I know it sounds silly but i can't get anything I like to wear for Christmas that'll cover me up enough and it's getting me down

Sorry, that was a pointless post

ILoveSparklers Sun 25-Nov-12 22:51:16

Not a pointless post at all. I have a blue lace dress that covers everything...and I love it... Will see if I can find a link.

ILoveSparklers Sun 25-Nov-12 22:53:46

Phase 8 do loads of dresses that cover well smile

AlreadyScone Sun 25-Nov-12 23:02:59

Could be perioral dermatitis? My new GP took one look at my chin and diagnosed it about a month ago. Antibiotics prescribed, working so far...

dontmixthecolours Mon 26-Nov-12 07:05:47

Thanks so much sparklers, you may have saved the day

msrisotto Mon 26-Nov-12 08:19:30

MrawMraw Thanks for that post, very informative.

I've been on Dianette for about 10 years, I still take it....I reckon i've fallen through a net somewhere by staying with my GP and just getting repeats from the pharmacy. I haven't been able to move GPs because no one else will prescribe it to me! So I have to travel back to my parents home to pick up prescriptions. Nevermind. I don't plan on coming off it for now (you can also buy it over the counter abroad) but when I do, I will seek an appointment with a dermatologist. I have come off it in the past in favour of Microgynon and Yasmin but they didn't work and the acne came back. Interested to hear about anti-androgens. I am concerned about the risks of roaccutane although hopefully with lower doses it is better?

lurkingaround Mon 26-Nov-12 10:06:10

mrsrisotto Would you consider going on Roaccutane while on Diannette? You have to be on contraception while on Roaccutane so you could go on it and get it over and done with? Like I said before, but I can't say it often enough, my only regret with Roaccutane is that I didn't do it earlier. I only needed 20mg, (usually dose is approx 60mg I think) and I did get dry lips, and slightly dry skin (oh the joy, fantastic), but that was all.

Tough time dontmix, sympathies, it's awful isn't it. I had a vicious outbreak after one of my mc. I disagree with your GP, I would be asking for a referral to discuss, can't see the point in waiting, only leaves you with more marks.
Cystic acne is cystic acne, whatever the reason.

msrisotto Mon 26-Nov-12 11:36:51

Gosh, i've never even thought of that. How would I be able to tell that it was working though? I have good skin whilst on Dianette but it deteriorates whilst off it so if I was to take roaccutane whilst still on the Pill, you wouldn't see any results.... Also, a GP may not refer me whilst my skin is good. Did your GP refer you to a specialist for the roaccutane Lurking?

lurkingaround Mon 26-Nov-12 11:53:48

Yes, mrsr GP referred me. My skin wasn't awful (I thought) at the time, but derm was horrified I hadn't been treated sooner with Roaccutane. She (derm) considers scars from acne to be unacceptable. Most dermatologists are very clued in, so while I get what you say about your skin being fine on dianette, I think they would know from you skin, scars etc, whether you need Roaccutane. Maybe I'm wrong, worth a consultation tho. Nothing to lose. And a consultation would give you a chance to ask about dose and side effects and all of that.

I told my derm I was fine on Dianette, but she still tut-tutted the fact I hadn't been treated with Roaccutane.

msrisotto Mon 26-Nov-12 12:34:14

Thanks for your advice Lurking. It's certainly given me a lot to think about.

litquot Mon 26-Nov-12 18:20:31

I was put on Duac at the beginning of the year and it was a marvellous revelation, finally after 25 years I had clear skin. I totally loved its drying effects. However, my GP told me that I couldn't keep using it because it was an antibiotic and gave me Differin to try. I've had it for nearly 3 months and it is nowhere near as good. I have been told to persevere for 3 months to give it a full try but I'm hating it. So the alternative would be....

msrisotto Mon 26-Nov-12 18:26:07

Yeah antibiotics never worked for me either litquot. Have a read upthread, there are plenty of alternatives.

litquot Mon 26-Nov-12 19:26:12

Yes, but antibiotics DID work for me but GP says they are not a long term solution. Roaccutane seems to be the main alternative.

Speedos Mon 26-Nov-12 21:03:44

Programme on bbc3 now on acne!

MrawMraw Mon 26-Nov-12 21:46:11

Pretty much anything which is properly effective for cystic / severe acne will have unpleasant side effects.

Antibiotics strip your body of good bacteria and can cause digestive probs, candida overgrowth, resistance and all sorts of other problems, and are incredibly over-prescribed so much so it's seriously worrying.

Roaccutane has liver risks yes, and is teratogenic but if carefully monitored and no chance of pregnancy I'd say it's a good bet for the chance of a cure. Does cause peeling of skin and sun reactions too I believe. Derm will prescribe.

Anti-Androgens are good for some people (totally worked on me) , however are also teratogenic to the male fetus and some studies have suggested a link with Spiro and cancer (lab rats given Spiro showed a higher incidence of tumours, however they were given a HUGE dosage to body weight compared to humans). Spiro is actually a heart failure / blood pressure medication but has the side effect of reducing androgens. For effective treatment you need 100mg - 400mg a day, which is a high dose and will almost certainly cause symptoms such as constant visits to the loo, dizziness etc. I take 100mg only because I am quite small with low blood pressure as it is and I certainly feel the diuretic effects and have to follow a low potassium diet. An Endocrinologist or PCOS specialist (repro medicine) will prescribe this, but a GP will look at you as if you are crazy if you request it (been there done that grin). The pill Yasmin has an ingredient which is an analogue of Spiro (equiv to about 25-50 mg Spiro a day) , that's why it is known for no bloating , no weight gain etc.

I also take Gedarel 20/150 (Mercilon) pill which seems to help too. Marvelon it's big sister pill in terms of oestrogen helped better but I had oestrogen withdrawal syptoms in the break week which were hellish even if tricycled the packs. But different pills suit different people. Popular acne pills are Dianette (I decided to try the safer pills first), Yasmin (my PCT won't prescribe as too expensive), Marvelon, Cilest. Worst theoretically are the mini pills (Cerazette in particular), Microgynon, Brevinor. But again, everyone is different.

The herbal remedies Agnus Castus and Black Cohosh are very very good for regulating hormones (Agnus Castus if you have too frequent periods or for conception, Black Cohosh if too few periods and menopause) but not good to take along with the pill as they work against it's action (ie they promote fertility rather than suppress it)


lovestotalk Wed 19-Nov-14 13:23:40

Hi everyone,

I have suffered from acne since I was about 12 (I'm now 19). My doctor began by telling me the usual things to try such as a healthy diet, more sleep, more water etc, which didn't help me at all. Obviously being so young they were reluctant to start me on any birth control, so i tried and tested about every topical product that was available. I had special face washes, creams, lotions etc all with varying effects but nothing that actually got rid of my acne. Being so young and growing up with other girls that didn't seem to have this problem- it really got me down and my doctor started to prescribe me medication. I took various strengths of anti biotics, and a tablet that wasn't birth control but was specifically for acne (I think it was Tetralysal?). Eventually when I was 14 I was put onto birth control (Microgynon) which helped somewhat but didn't prevent the acne breakouts. I was then prescribed with Dianette which was a miracle lifesaver! I had clear skin throughout the whole time I took that pill (apart from the odd spot here and there). However a month ago my doctor took me off Dianette as he said I needed a break from it because I had been on it for so long. I am now on Gedarel but my spots have come back just as bad as before. I know this is because Gedarel is not as strong as Dianette. The return of the spots is really bringing me down, especially since I have now been so used to clear skin, and going back to having spots seems to be a step-back.
I still drink 2 litres of water a day, get a minimum of 8 hours sleep and try to eat well; however they are just not shifting.

Is the return of the spots just because my hormones are all up in the air and they will settle down soon with the new pill? Or should I go back to my GP and request to be put back on Dianette soon?

After reading your previous messages I'm concerned as to how the pill might affect me in the future (not what I'm thinking about now, but having children etc), so might ask my doctor about that too. Another implication is that I am currently at university which means I am registered with a different doctor now than the one I have been registered with throughout this process- I'm worried that they won't understand the whole process that I've been through and how much it gets me down. Please help! sad xo

Nabootique Wed 19-Nov-14 13:32:25

As I understand it, Dianette contains Roaccutane, or similar ingredients (I think) which is why it helps acne. I never went on it myself. I did go on Microgynon and that didn't help my spots. I've had really good chats with the family planning nurse lately and was told that Microgynon is progesterone-led, which can actually make spots worse. Being on an oestrogen-led pill really helped me. Do you know if your pill is more one than the other?

avagosling Wed 19-Nov-14 13:57:56

It's an internal issue, no skin products will help.
Try evening primrose oil and chaste three tincture, get the good quality ones as high street ones are not effective

lurkingaround Wed 19-Nov-14 14:55:15

When you've had clear skin it's awful to go back to spotty skin! The OCP you're on is not bad but obviously not as 'skin-friendly' as Dianette. If acne is your issue, Yasmin (another OCP) is a very skin-friendly option, (more so than your current OCP) and is often used to treat acne, so I'd suggest maybe giving it a month or 2, but if it's not settling, then ask about Yasmin.

RonaldMcDonald Wed 19-Nov-14 15:39:16

I use a v gentle ff rinse off wash, tepid water, no scrubbing, pat dry
a bha

over time this was the only thing that made the difference and i do it without fail
i've been given the whole shebang of anti bs and pills over the years
i know cystic is supposed to be only controlled internally but a simple routine and no arsing about was the only thing that actually made a difference in the end

once under control I have had a series of peels and microderm which i think has made a massive difference to my skin and obvs its appearance

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