DH still dealing with acne in his 40s?

[Owlsartisan]

DH is 43 and has suffered with acne all his life since his teen years. It was so bad as a teenager that there are hardly any photos of him because he hated his skin so much. The ones I have seen, it’s horrible sore looking cystic acne. He took antibiotics for a time and that helped clear them somewhat.
When we met and he was in his 30s, they were not so noticeable, just a couple here and there. But they were still present, he’s now 43 and gets outbreaks regularly, still quite big cystic looking ones and they can be very sore.
His skin and hair is very oily and he has to shower once or twice in 24 hours at times. He’s also a cyclist and fell runner so needs showers after those activities anyway.

I just didn’t imagine that a man in his 40s would still be dealing with acne and oily skin/hair. He doesn’t want to take antibiotics long term - he uses benzoyl peroxide cream on the worst spots.

I’m also selfishly worried about our 5 year old son and whether he’ll inherit this bad skin as a teen/adult. It really effected my DH’s self confidence and even now he gets embarrassed by it.

Has he never considered roaccutane? The side effects can be a bit crap when you're taking it but it is really the most effective thing to clear it up long term.

Showering so frequently won’t be helping, especially if he’s using soap each time: skin compensates for being stripped by producing more oil. I have oily skin - though not acne, but previously had a lot of blocked pores - and hands down the best thing I’ve ever done for it is to stop using soaps and shower gel. It’s made such an improvement. If he exercises a lot he needs to look into doing the same.

He needs a referral to dermatology. I did a course of isotretinoin (accutane) in my 30's. It really is the only long term solution for lifelong acne.

He’s probably drying his skin out too much. I had horrible acne until my late 20’s - it wasn’t until a lady on the clarins counter explained to me that over dry skin creates more acne that I got it sorted. Good face cream twice a day and it’s stopped for me.

Would he consider skincare? I'm a guy and I had breakouts of cystic acne right into my 30's. I used to buy tretinoin from abroad because it's prescription only in the UK but they were quite thick formulations and my skin didn't love it - although it did get rid of the acne. Now you can get online dermatologists in the UK. I use Demartica and their custom formulations are really effective - also great for anti-ageing since tretionion is essentially weapons grade retinol.

It's £25 per month. They might offer adapeline which is another alternative but I would ask to try tretinion first.

I've been using it for 7 years and haven't had a breakout since.

He might want to look into some other products to complement it and deal with the oilyness but skincare is definitely the thing to explore.

Be warned, when you start to use something like tretinoin, it can take 1-2 months to be fully effective but it can purge your skin to start with i.e. he'll get a massive breakout as it draws out all of the crap.

Adult acne was covered in medical Monday on Jeremy Vine this lunchtime.

He needs to see his GP and get referred to a dermatologist.

I get bad hormonal acne & have recently tried ‘47 skin’ which has made a bid difference. Maybe worth a shot- think you can get it in Boots now.

https://47skin.com/

I took would say he needs roacutane

Adult acne is real and your husband should not hesitate to get a referral to dermatology; benzoyl peroxide won't really help with cystic acne. Deep sympathy for his misery, incidentally; I had moderately bad acne on my shoulders and back that was not quite bad enough for anybody to suggest roaccuatane but kept me off the beach for decades; my perverse miracle was the chemo I had for cancer which also cleared my acne permanently. A rather radical cure.

Agree this needs a dermatology referral.

I don't think it's selfish to worry about your son either, far from it. But on the positive side, acne treatment has come a long way since your DH was teenager so if your son needs help you will be prepared and things are better now.

Roaccutane. Topical stuff will do fuck all.

The trouble with asking for advice on a forum like this is that you’ll get all sorts of comments from people who are well-meaning but don’t necessarily know the difference between few spots that can be fixed with a skincare routine, and chronic acne that needs a proper diagnosis and bespoke advice from an expert (and that means a dermatologist, not someone on a skincare counter who is there to sell a product line).

I have naturally oily skin which is acne-prone. No, it isn’t producing oil because of ‘too much washing’ or ‘harsh products’ - some people simply have oilier skin than others, and I am one of them. I’ve got my skin pretty much under control now but honestly, your husband really should see a dermatologist for proper advice that’s bespoke to him, his skin type and his particular form of acne.

Can I ask what you do actually use when you have a shower or is it just water?

Also get the GP to do a blood test to check his vitamin levels.

Has he tried an elimination diet? I had awful acne from the age of 5 right through to my 20s, I was on antibiotics for years and they still didn’t clear it completely. Eventually I moved abroad and cut out dairy (not deliberate, it was expensive so just stopped eating it) and my acne cleared up completely. Really weird as when I was young I was told to drink milk as it would be good for my skin! For me it’s actually the milk protein that sets it off so I can have milk occasionally but no yoghurt or I immediately break out. It may not be the same for your DH but I wish I’d tried it years sooner.

No idea if true or not, but I've heard that washing your face in anti-dandruff shampoo can help for certain types of acne.

A friend had acne in their twenties and washed his face so often because of it, but it was counterproductive and made things worse. He started using e45 cream to moisturise his face and it helped a lot.

Roaccutane is the only thing that got rid of my adult acne. Amazing stuff!

Roaccutane. Nasty but effective. It cleared my DH’s chronic cystic acne.