Can someone help my spotty face?

[taybert]

I have acne. I’ve basically had it since I was 11 (37 now). I’ve had times when it’s been better (on the pill, various medications) and worse (pregnancy). I’ve had 2 course of roaccutane as an adult, the last one finished about a year ago. I’ve been on Epiduo (benzoyl peroxide and adapalene) with spironolactone for maintenance since but for about the last month, it’s back. My head is an oil slick, I get rid of the breakout I have and another one pops up. It’s a familiar tale and I know I’m probably heading for the return of painful cystic spots soon.

I’m a doctor so I know all about the different meds and I’ve either had them and they haven’t worked or or I can’t have them now (eg OCP). I don’t have the strength to do another 6 months of roaccutane for the sake of a year off spots.

So please wise women help me! Having spent thousands on miracle cures for acne over the years I’ve pretty much given up on complicated skincare regimes beyond cleansing and an oil free moisturiser in the morning. But there are so many more products around now with active ingredients and I wonder if there’s something that could help a bit. Even just to reduce the oil.

Ideas very much appreciated! Thank you.

[Fluffycloudland77]

You know there is no miracle cure for women like us, there’s only roaccutane & I didn’t like it anymore than you.

Best I can think of is dianette if you can get another dr to prescribe it.

[Fedup21]

Can you go back on the pill? That’s the only thing that worked for me.

[taybert]

I can’t have the combined pill at all now because I have migraines with aura unfortunately. If I could I’d be golden, it was perfectly manageable on Yasmin which also helped periods and didn’t make me too fat. But then I developed migraines and I don’t fancy having a stroke. Rubbish innit?

[Fluffycloudland77]

Yep that’s the same reason I can’t take dianette. It is indeed rubbish.

I wish they’d just make the cyprotene acetate part available for acne.

When you took the isotretonoin did they give you a low dose over a longer time frame? Because I’ve read that makes it less likely to work because it never really stamps down on oil production.

My derm nurse had it three times but she had the loveliest skin.

[QueenJulian]

Although not scientifically backed (as far as I’m aware), have you thought about changing your diet? I did the whole 30 a while ago and my frequently spotty, often flushed skin was clear and glowy. You’re supposed to then reintroduce foods to see if you have any reaction and decide whether to cut any out permanently. It takes some organisation but it’s only 30 days and doesn’t involve any medication. Well worth it if it works!

[taybert]

First time I had 1mg/kg (so maximum) second time just less than that because my skin everywhere else was tearing and cracking so couldn’t tolerate a higher dose (acne on head, eczema elsewhere. Seriously) My dermatologist is a bit of an acne expert and is involved in a lot of research, she reckons it shouldn’t make a difference having a lower dose and it’s often more successful because people end up stopping too quickly with the higher doses. She’d probably give me another course but she’s over an hour’s drive away and I just don’t feel at the point where I want to take on the hassle and the side effects for another 6 months, especially if it’ll only last a year.

[5LeafPenguin]

Diet...no refined sugar and no caffeine made a huge difference to me in my 30s ( it was hard because I loved tea and cake, but it was worth it).

Sudocreme masks at night can be like magic on some skin types.

Good luck. No

[5LeafPenguin]

Ignore random 'no' ..

[Fluffycloudland77]

Is it true dermatology can prescribe higher doses of lymecycline? Maybe that would work.

Eczema and isotretonoin must be quite a trial..would you risk a long low course?.

[taybert]

Might need to do long and low isotretinoin. Need to gear myself up for it though! To be honest one of the biggest considerations is just the travel to get there to monthly appointments and the hassle it involves (I’m a bit remote so no one nearer).

I dislike the suggestions about sugar and caffeine. I really like cake. Maybe you’re right but not sure how my family and colleagues would feel if I was withdrawing from caffeine

[taybert]

I’ve never seen higher doses of lymecycline used, that doesn’t mean it doesn’t exist though. I keep hoping it’s just a bad patch and it’ll settle down. Might give it another month or so then email the dermatologist for a bit of advice....

[Fluffycloudland77]

😂

It works for some people though. Before I turned 40 (43 now) I thought people who went on health kicks in middle age terribly sad trying to recapture youth but now I realise it’s what some of us need to do just to feel healthy day to day.

The prescribing rules are harsh but what’s the alternative 🤷🏻‍♀️

[lemorella]

You really have my sympathy, my sister has developed cystic acne in her 20's and has tried different contraceptive pills, antibiotic creams and all sorts of lotions and potions.

From a non medical perspective what about some holistic things like booking yourself in for a facial every month (just for a deep clean and to feel fresher) and investing in some good coverage foundation.

I had terrible skin for about ten years and one summer it just completely cleared up and I rarely get spots now, even if I do the spots are different, I can pop it and it's gone the next day it doesn't linger all swollen for weeks. So I keep repeating to my sister hers may do the same and to keep hope, it's very disheartening.

[BridgetJonesDaiquiri]

I could have written your post. I'm 35 and suffered with acne since age 12. Had glorious skin while on the pill but came off due to developing migraines with auras exactly like you. Skin has been worse and better at random times over the years. Worse in 1st pregnancy, then randomly no spots in 2nd pregnancy. No rhyme or reason but it's obviously hormonal based acne.

Having had lovely skin for the last 18 months, I'm now 10 months post partum from having DD2 and my skin has been awful the past 2 months. Loads of spots round my chin. Could be stress as well as hormones I suppose (Covid, house move) but it's getting me down.
Surely by mid-late 30s we should be over the acne - or does it just continue until menopause?!

I'm trying Alpha-H liquid gold at the moment as I've heard v good reviews generally and in particular for cystic spots. I'm still getting the spots but this stuff seems to stop them in their tracks and the red marks from last months spots are fading quicker than usual. Worth a try maybe?

[MilkshakeandFries]

Mine was cleared up by lymecycline, cutting out dairy and skin care wise I used la Roche posay and nothing else - a light cleanser and moisturiser.

What I have found aggravates it is anything that dries me out - fake tan causes huge painful spots, as does salicylic acid although I know for others this works well.

I had been using Beauty Pie plantastic drops which loads of people swear by for acne but I found started mine up again just as I felt I had a hold on it, so that's gone out of my routine now and I'm kicking myself for trying something new!

[itistiime]

Cutting out diary. I know it shouldn't make a difference but it does- too much diary equals acne for me.

[EoinMcLovesCakeJumper]

Unfortunately a lot of it is to do with your hormones and no amount of topical lotions and cleansers are going to help. Having said that, I recently started swiping my face with a bit of TCP in lieu of toner, and I no longer get nearly as many breakouts as I used to. I think if you kill the acne-causing bacteria, it really helps to keep it under control. I still get some, though, and I expect I will until I'm on the other side of the menopause!

[Sootikinstew]

What's wrong with roactuane? I have been hearing myself up to ask my doctor for this as I heard it's a magic cure?

[DontAskIDontKnow]

As long as you’re not vulnerable to eating disorders, I’d recommend fasting. It’s worked wonders for my skin. It’s simpler than trying different diets. Insulin is a hormone too.

[taybert]

@DontAskIDontKnow I already do intermittent fasting, usually 16-18 hours fast a day. I don’t really want to do any more than that and my weight is good.

@Sootikinstew roaccutane is ok. In fact it’s very good. But you do have to go for appointments monthly, frequent blood tests and it does have side effects like dry lips and eyes, aching joints and skin fragility. My face is testament to the fact that it’s not a cure for everyone (though it is for a lot of people) I recommend it all the time because if it works it’s amazing. But for me, having done it twice, 6 months of hassle isn’t really worth a year of reward, especially at the moment.

[Fluffycloudland77]

@Sootikinstew Some young men have committed suicide and the families have blamed the roaccutane.

It does make you bone tired. Your skins dry on your body, your lips need constant reapplications of nipple cream, your eyes get dry, your hairs dull because your scalps dry. But for me it was 4 months out of a hopefully 80yr life & I don’t check my face for spots every morning anymore.

Month 3 was hard. Then it’s over & you might get a couple of spots in that first month but they aren’t awful.

I’d do it all again but I’d had acne 16-41 & I was pissed off with it.

[user1486723488]

Have you tried CBD cream?

[user1486723488]

www.bestcbdoils.org/best-cbd-acne/

[taybert]

@Fluffycloudland77 - that’s it exactly, if it’s one course and you’re done it’s amazing. Even two courses. But by course number 3 it’s looking less likely to be a cure. Don’t get me wrong, I might do it again, I just don’t feel I want to go through it all just at the moment.

[Lpeach1]

If you're not looking to take medication I would highly recommend PHFormula Acne Kit.

I have acne but don't want to take tablets to deal with it. I've been using the PHFormula Acne Kit for 4 months now and I haven't had a cystic spot the whole time. I still get spots but nothing like it was and my face is much less oily now!