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.

I’ve had acne since age 12 (32 now) and it’s been almost clear with a few minor flare ups the last few years. It really started to clear for me when I switched from a vegetarian diet to eating more meat and fish. Lots of salad. I realised that nut butters, nuts, seeds and flax seed trigger breakouts for me (I don’t know if that’s allergy/ intolerance related although no previous allergies, or if it’s the high omega 6 in these products). I also have to be careful not to have too much Olive oil as this can break me out too so I do think It’s triggered by foods high in Omega 6. Oily fish like Tuna and Salmon really clear it up though.

Have you heard of “Fungal” acne? I don’t think it’s medically recognised, worth a read though. Sone people who’ve been previously unable to cure their acne with conventional means have cured it with antifungal products. Linked to yeast overgrowth and sometimes eczema/ Seb Derm I think. simpleskincarescience.com/pityrosporum-folliculitis-treatment-malassezia-cure/

Also what helped, is leaving my skin alone as much as possible and not over cleansing. I wash with warm water only in the morning. In the evening the same if I haven’t put any creams/ make up on. If I've worn make up then I use the La Roche posay effaclar wash in the squirty blue bottle (this stuff is brilliant) and the nip/ fab glycolic acid exfoliating pads. Sometimes I put Nivea sensitive moisturising night cream on (in the dark blue box) as this is the only moisturiser that doesn’t break me out.

Honestly, leave your skin the fuck alone as much as possible because over cleansing will just make it produce more oil and break down it protective barrier. It needs to find its own balance.

I have PCOS so know my spots are hormonal. They are nearly always on my chin, another giveaway for hormones. Previously I controlled them with Dianette then Yasmin.

I am experimenting with seed cycling, in particular sunflower and sesame in the two weeks before my period which seems to be quite promising. It’s taken me twenty years to learn of seed cycling. I swear it’s helping my mood too and other PMS type stuff.

I am also using a prescription from Dermatica which contains niacinamide for oil control and tretinoin and an antibiotic but feel like nothing topical will work on it’s own.

Does anyone have any tips for Rosasea?

I have what I think is rosasea all over both cheeks. It's stress related I think, but I have never had anything like this before. It's horrendous, all multiple lumpy and red.

My GP has seen a photo and prescribed antibiotic cream, but I was expecting an oral prescription.

I have ordered honey, some really mild products aimed at rosasea and a silk pillow case as I sleep on my front and everything is so sore 😔

I am feeling so miserable about it.

My son has acne. He’s starting using a product called SkinKissed Serum. It is expensive but they often have 3 for 2 and other offers on. It has taken the redness out of his spots and is in no way harsh (like the products his GP prescribed). He was on long term low dose antibiotics for some time but couldn’t cope with the effect on his digestion.

I think, after three weeks use, it’s the best thing we’ve tried so far. He’s 20.

I found that Doctor Sam Bunting on YouTube really helped me understand my skin; might be worth a little scroll, I learnt a lot and realised I was succumbing to a lot of marketing before!

Even with oily skin I now moisturise morning and night (which felt so counter intuitive at the start!), otherwise my skin starts to create more oil to help any dry patches and I end up in a bad cycle.

I'm another vote for Azelaic acid. I'm very sensitive to almost all other actives, including niacinamide which is supposed to help with tolerance so go figure. But AA I can use day and night and it has been the only thing that has helped. Bonus points as it helps with scarring too.

Treeactive face cream (available on Amazon) has worked wonders for my tween DD.

She had tried a whole load of other face creams, washes etc without success.

Treeactiv works.

Have you tried ‘the ordinary’ products? niacinamide 10% combined with zinc 1% And a retinol treatment at night fully controls my PCOS acne. removing milk (mainly from tea and coffee) makes a noticeable difference for me too. I know this isn’t medical grade stuff, but it has really really helped me.

I’m at my wits end with it too. Dianette worked like a dream for me and I came off it and my face exploded with acne. I tried a different pill as they wouldnt px me dianette again and it was OK but wasn’t the same and I still had a few breakouts.

I’m off the pill now and went to a facialist who recommended me skin accumax supplements and Environ products which can only be purchased after a skin consultation . Very expensive but aside from the spots my skin has never been in better shape generally. The skin accumax contains ‘DIM’ which is supposed to balance hormones and I’ve also started taking zinc and spearmint tea which also are supposed to balance hormones. Woke up today with something developing on my chin though but I’m going to give this new routine some time. Also going to cut out sugar and see if that works