I'm nearly 50 and my skin is awful. Scary photo included

[Crusoe]

Just that really. I am nearly 50 and my skin has been shite since the age of 11.
I have always suffered with big sometimes painful spots that take weeks and weeks to go only to be replaced by more.
Alcohol makes them so much worse. I am guaranteed weeks of awful skin after a glass or 2 of wine so I hardly ever drink.
I do drink lots of water which does help a bit but it really shows in my skin if I have a day where I don't manage so much water.
I have a healthy diet with fruit and veg, although I could probably eat more. I have tried cutting sugar but struggling a bit with that.
I use a vitamin e face wash & moisturiser and a bit of e45 on very dry flakey patches.
I saw the GP last year for what might have been eczema or possibly a ringworm type infection. It finally went with steroid treatment. GP suggested I might have rosacea but declined any treatment as it wasn't bad enough. She couldn't have been less interested if she tried.
In reality at the moment my skin is not nearly as bad as it has been. I can cover the blemishes easily with make up and I haven't had to take a day off work for years because I am so embarrassed about my it.
I am just so fed up though with never having clear nice skin, of never feeling confident about it and always worrying about.
I don't have much money to buy expensive products and I can't face the GP again.
Anyone, can you help? What can I do to improve my skin?

Insist on a referral to a dermatologist and insist on roacutane.

I'm a big fan of "getting it sorted by someone who knows" - faffing around with different cleansers etc is very trial and error and IMO rarely leads to a step change, which I think is what you need.

I was in a very similar position about 18 months ago and went to a specialist skin clinic. I had some (blue light?) laser therapy. I think I had 2 sessions (they said I was at the mild end of the scale, I would say my skin looked pretty similar to yours) and I think the science was that it killed off the lurking bacteria. It was coupled with a scrupulous skincare regime (which introduced glycolic acid but actually was less about what I used than what I did, including using a LOT less product than I had been). It really really worked, and I've probably had maybe 2 spots since then and they have been v minor. My skin had always made me feel fed up and now I really don't think about it.

Also I took my somewhat spotty 14 yo DS to the dr about 6 months ago for something unrelated and mentioned in passing that his skin wasn't great (DS could cheerfully have murdered me ) at that point) and the dr was super-nice. V matter of fact, said, oh mate, its not too bad but why put up with it when you don't have to, prescribed some Duac and within 10 days DS's skin looked great and has mostly done so since.

I know both he and I have felt SO much better since we got it sorted so I am evangelical about telling people to try and get some proper advice from someone kind. Good luck!

Your skin looks dry and taut, like you're over-treating it and have a damaged moisture barrier. I too think you should see a derm if you can. (I have problems too and I should take my own advice ...) I suspect that you're doing harsh things to your skin which means it's reacting and giving you more acne, might that be right? Try being gentle and kind to your skin. A gentle low-pH cleanser, hydrating toner, hydrating sheet masks, a gentle occlusive cream, maybe a face oil. Moisture and hydration. And a doctor. :)

Thank-you everyone that replied.
I have made a dr's appointment (a different dr so hopefully a different result!)
I have also ditched my old cleanser and moisturiser in favour of Cetaphil and I think it is helping. One nasty red scaly patch has almost gone and my skin just feels more comfortable.
Thanks for all your suggestions - lots to think about.

I had similar problems post partum. I was prescribed oral antibiotics and used Differin every other day (and lots of heavy moisturizer as it dried my skin awfully). It took about three weeks to clear my skin, but I was quite lucky not to end up with permanent scars, only purplish spots but they healed over time.

Zineryt is AMAZING. It's a mixture of the antibiotic Erythromicin, and Zinc. Has completely transformed my skin. Go back and see another GP.

I'm another zineryt user. I had horrible lumps all over my arms and shoulders. Oral antibiotics didn't work. The zineryt did!

I had a bit of improvement with Zineryt but one week on oral antibiotics (doxycycline i think) and my skin's better than it's been in years. Definitely go back to your doctor, life's too short to faff around with cleansers etc! (She says, after being miserable and spotty for years after coming off the pill)

Yoy van have dry skin which is oily OP.

After a wash my face is tight but the oil was then quickly produced. The dermatologist can do a tape test to see how quickly the sebum appears.

DUAC on prescription from the Dr is brilliant.
I tried dozens of different products but in the end using this for a few short weeks did the trick
If I get a breakout now I use this or some Clinique products for spot prone skin and it's mostly fine now
Ask the Dr, I'm sure you won't be disappointed

Another one saying you should insist that your GP refers you to a dermatologist: the correct medical advice could change your life.
Hope you will let us know how you get on.

My face is also very dry after a shower and feels sore unless I put on moisturiser. I was diagnosed recently with facial eczema. The GP prescribed steroid creams which worked well. I've also been using soft white petroleum based creams to keep it under control and am trying to wean off the steroid cream. I only mention it because the spots around my mouth look like the ones in your photo. Coconut oil also feels nice on my skin.