Adult acne - cystic - one spot at a time - advice?

[user1498990621]

Hi everyone,

For the last 4 years since I turned 25 I have been dealing with adult acne. I went to bed with totally clear skin and woke up to a cluster of large inflamed cysts the following morning and have had these problems since. It is mainly localised to my chin and I usually only have one or two at a time. I have had a few months of no cysts but will then go through a period of having one every 6 months. I have tried the following:

6 months of antibiotics
Epiduo
Differin
Benzoyl Peroxide
Vitamins
Diet changes (including elimination)

I think it is hormonal as skin seems to be worse about 10 days into my cycle. I don't have any children and not currently TTC.

I have just had another term appointment and they suggest Lymecyline for 4 months with differing and, if successful, a further 6 month course. They said this is often all it takes, as although I have cystic acne, it is localised and only one at a time (leaves marks that take 6-12 months to fade though so my skin looks like I have loads of acne on it because of these marks as well as any new or current cysts).

I have been reading up about antibiotics and it seems they either do work but stop once you take them or don't work at all. I am wondering whether it is worth bothering?

My wedding is at the end of August and I am so terrified of having a massive cyst on the day. I currently organise my social calendar around my skin, trying to schedule things in when my skin is most likely to be behaving during the month (usually I get a week where I have nothing active). My confidence and self-esteem is very low because of my skin issues.

A bit of background:

Clear skin until aged of 25 - maybe had 5 spots my entire life before then. Had normal skin, not oily

Skin now gets slightly oily in t-zone but not too bad.

I use Cetaphil cleanser AM and PM and Epiduo at night. No moisturiser as derm said to stop putting on my face as it isn't dry so I shouldn't add anything.

Diet wise - very little dairy, low sugar, lots of veggies and organic meat. I cook from scratch every day, don't eat processed foods. I drink at least 2 litres of water every day. Usually have one coffee in a morning (black, no milk). Drink alcohol moderately - usually wine at a weekend.

Came off the pill 8 years ago and was diagnosed with PCOS a year later following a scan and hormone tests. Skin was clear and remained so for further 3 years. Slowly my periods returned to normal (28 days) and tests showed hormone levels back to normal, scan showed cysts had gone. However, since the PCOS disappeared, I have got acne. Seems to be the wrong way around!

I take oral vitamin b12 for a deficiency. I can absorb b12 fine but don't get enough, despite a diet rich in foods which have high levels of b12!

Advice very much appreciated. I am considering Accutane at the moment but term says to try antibiotics first.

Thanks :)

Tinty I would definitely go the EPO\ starflower oil route with your daughter . The book by Liz Earle which gives the reasons. Also look at the Weleda cream. for her.

If you can get accutane, take it. It changed dds life.

I didn't realise your wedding was only 7 weeks away! Exciting! I know it's easier said than done, but please try to enjoy it rather than stressing about your skin... (very easy for me to say but honestly I hope you manage to enjoy the run up to the big day!)

The rest of your skin is lovely, way better than mine! I have 2 thoughts:

1. do you have your makeup sorted for your wedding, have you had a trial and do you trust them to be able to cover up any spots OK? I had 1 spot on my wedding day (very annoying as the rest had gone by then) but it wasn't too bad really as they covered it quite nicely. Also you could ask your photographer to edit some of the pics if you want to.
2. can you get hold of some over the counter benzoyl peroxide (possibly from the US as they have different formulations - I tried quinoderm here but never got on with the cream texture - prefer gel) and you just dab some on when a spot starts coming up, with a cotton bud? That's what I'm meant to do now when I get a spot these days... it's worth a try if you only have 7 weeks unless you do decide to go to a private derm.

If you are going to take the antibiotics, I'd recommend taking some strong probiotics at the same time (tmi but they stopped my recurring thrush when I was on Lymecycline). I used these.

This is my before and after. Before was January 2015, I got married at the start of April 2015. My skin must have been great after that as I didn't think to take the after photo until September 2015 :)

About to rush out so haven't got time to reply properly until later but this year I made an amazing discovery of a product by Mario Badescu. It's called Buffering Lotion and I've suffered from one-at-a-time cystic spots for 25+yes and nothing hasn't worked like this stuff does.

It really reduces the spot, overnight, and instead of it hanging round for 2 weeks it is gone within a few days. I don't just use it when I have a spot. I use it all over my chin and jawline every night. I haven't had a cystic spot for months and months now and I got at leads one every month.

It's amazing stuff I promise you.

Definitely try the theraclear ( or any other light therapy) as it will get rid of those spots almost immediately. Antibiotics, creams, medication helped but never got rid. Dianette did nothing for me

I get cystic hormonal acne at various points of my cycle - premenopausal so they can be quite random but every month I will get at least 3-4 spots either on my chin or forehead.

I've found evening primrose oil makes them much worse - I only realised this after I ran out after taking it consistently for 6 months. Had a spot free month and then when I remembered to buy some more and started again, I had the worst huge, cystic spots that I have ever had. I stopped again and although I still get the spots, they are not as bad as on the evening primrose oil.

I get huge, solitary spots on my cheeks and chin the marks last for months and months. I have been using a strong glycolic acid pad every night and Liz earle hot cleanser. Touch wood I haven't had one for about four months now. Your skin looks beautiful btw

Thanks again for all the replies - seems different things work for different people and I guess that is partly the issue for me, as I have tried loads already and feel fed up at the thought of years more trial and error. I am really loathe to go on the pill or antibiotics as it is such a short term fix and with the pill I worry spots would get worse when I came off. Like a few others have said, the rest of my skin is actually quite good, just need to stop these monsters on my chin forming!

I am tempted to give light therapy a go before the wedding and used isotrex to see if that helps.

It is nice to know I am not alone but sorry for everyone else who has/is going through this too!

BlairWaldorfLovesShopping - did you alternate duac and isotrex? different one each evening?

Spironolactone changed my skin and therefore my life.

I took a course of it and noticed a difference in my skin immediately. I now don't take it all the time (I could if I wanted to, but there are side effects like breast pain) but if I have a flare up I only need to take a low dose for a couple of days for it to clear up again. I don't know quite how it works, but it brings those huge nasty ones to a head (that then can be popped) within the same day and the smaller ones just disappear on their own

A retinol gel will help reduce the scarring

Roaccutane was the only thing which worked for my cystic acne. And it doesn't just slight reduce it - it made it permanently vanish.

Not a drug to go on lightly - but it sounds like it is affecting your self esteem and life decisions so if consider it.

Worst side effects for me was dry skin and can't touch alcohol on it, I've not heard of the hair loss side effect and definitely didn't experience it.

I am 47 and have suffered with hormonal spots on my chin for my whole adult life. When I was younger I was on Dianette & that really cleared them up & then on various other hormonal contraception. Since stopping this the spots on my chin have come back. I was recommended to try Silver Serum by the Skin Shop (www.skinshop.co.uk). It has really worked for me & doesn't dry my skin out like some other products. If I feel a spot developing I put it on & it doesn't get any bigger. Might be worth a try.

DD is on her second course of Roaccutane and her skin has got better before improving. It's absolutely critical not to get pregnant whilst taking it, or for a certain period afterwards though.

*did get worse!

Heard good things about spiro but side effects can be as bad as Accutane so I think I would rather go on that and be done.

How long were you on Accutane for @Bovneydazzlers?

I had my graduation last Friday and spent the whole day trying to avoid looking at anyone, including the photographer. So sad how this has ruined every special occasion for me over the last 4 years.

My OH is making pizza tonight and I keep making excuses not to eat it in case it is wheat/gluten. Literally every decision about what I do, wear, eat etc. is governed by my skin. Such a shame.

I have made GP appointment for next Monday to discuss what term says - might ask for private referral back to get accutane ready for as soon as we are back from honeymoon. In the meantime I am going to take the antibiotics, even though I don't want to, as it is only for 7 weeks and who knows, they might just do the trick and save me having to go on accutane :(

Just coming on to echo other PP's suggestion that you try Duac.

I had terrible skin pre pregnancy after coming off the pill. It took about eight weeks but it really worked.

Post pregnancy I had a break out after going on the coil. Weirdly obsessive use of Micellar water and La Roche Posay moisturiser kept it all at bay.

In the end I just stopped putting extra hormones in me and my skin looks great (finally! At thirty seven!)

I also NEVER use foundation and rarely concealer.

Good luck OP - adult acne is miserable.

Ooh, and nothing I did in the way of diet changes made the slightest difference. Maybe a little bit when I drank less, but think that was more about wearing 'going out' make up rather than the drinking whilst out.

I think it was 4 months, maybe 5 months I was on roaccutane for, when I was about 23. Just started my first professional job, felt like a spotty teenager with all my spots!

I was so obsessed with my spots when I had them, I knew exactly where each spot was at any time, would obsessively count how many I had at each time, it really affected my self confidence.

I spent about 2 years in total going through various pills and different antibiotics, only roaccutane did anything. But yours may be different, some people do have positive effects through other antibiotics (but I have to say that they may not offer a permanent cure to all spots like roaccutane) [disclaimer that I have no medical training in saying this!]

Thanks - amousehaseatenmypaddlingpool. Is duac all you used or did you go back on pill/have antibiotics?

I have been prescribed differin but don't want to use it as I already use Epiduo which has both adapalene and BP in it, so differin is basically the same but with less helpful stuff.

I am tempted to get duac and the retin-a stuff and alternate, see if that helps.

I haven't been on the pill for more than 6 years and definitely don't want to go back on it!

I don't think diet has anything to do with mine either, I think it is hormones, triggered by my post-pill PCOS resolving itself, meaning I actually ovulate and have a normal cycle now (which I didn't have been 14-22 because was on pill and then 22-25 had no period/very irregular and PCOS diagnosis).

When you say obsessive use, what do you mean?

I don't wear make-up often, only a few times per month if I have a bad breakout (so basically I breakout before I use the make-up, so it definitely doesn't cause it!)

It's a pain because we all respond differently to different medics remedies. etc. thinking about this , do you eat meat OP? I say that because some people are intolerant to chicken, some to steak etc. dd2 has terrible skin reactions to chicken. Also I can't touch some shellfish.

Acne has nothing to do with diet

We are what we eat.

Hi @ppeatfruit

Yes I eat meat, although not loads. I have kept a food diary for 6-7 weeks and didn't notice any patterns unfortunately. I really only have any issue day 10 of my cycle to day 21-22 - after that things heal up and tend to be OK for a week or so (but obviously lots of red marks meaning things don't look great, but nothing is active). I don't eat fish as don't like it and I am severely allergic to nuts. Never been tested for shellfish but had a nasty rash after touching some crab that someone had been eating so have stayed away from trying it.

For me I do think it is hormone based, as per previous posts, with the whole ovulating stuff, but honestly who can ever be sure unless there is a very clear link or pattern? It is a frustrating condition to have! :(

I'm sorry peat but there is a lot of nonsense spouted about acne and diet. In your case you are talking about an allergic skin reaction I think. Meat particularly chicken is one of the least allergenic foods out there.