Acne: too old for this shit. Real talk.... what works?

[SteveArnottsCodeine]

Hello fellow spotty Mumsnetters!

I was a spotty teenager and from around 14-16 tried everything topical imaginable, ending up on Retinoids (I think- the strong drugs you can’t get pregnant on!) until I was 17. After that my skin was perfect until.....

..... I got pregnant with DD1 at 29. I am now a decade and another kid on and my skin is as bad- if not worse- than when I was a teenager. I saw my doctor about it around 5yrs ago who referred me to a dermatologist. The dermatologist said it wasn’t bad enough to warrant oral drugs and gave me a topical cream (that did nothing) and discharged me. Went back to GP after that didn’t work and he said it was what it was- if dermatologist said it wasn’t bad enough for anything but the topical cream then he couldn’t do anything else.

My skin is very oily- my forehead in particular is a grease pool- and I’ve not yet found anything to really deal with that. I use those little papers to mop it up throughout the day and use an anti grease primer before putting on make up but these are obviously not treating the cause. My forehead is the main area that’s an issue but I also get them on my chin and around my jaw line, with the occasional one on my cheeks.

I’ve had some success with a couple of creams/lotions but neither are perfect. Lumene Gel dries my spots up but doesn’t seem to prevent them. Acquel Anti Acne Cream has kept my forehead clear for a couple of weeks now, but has seemingly pushed the issue elsewhere so I’ve now got painful whiteheads full of puss in my hairline and eyebrows (very weirdly!)

The big hormonal ones will only dry out with ibuprofen gel on - which also dulls the pain of these big buggers. But my spots in general are a mix of these, headless ones and white head, puss-filled beauties.

My mensural cycle seems to not really have any effect on it- it’s bad all month. I have a Mirena coil as the pill made my migraines worse. I do cleanse, tone and then use an acne friendly moisturiser twice a day and wash my face in the shower with a generic face wash for spot prone skin and dedicated (regularly laundered) face scrubby thing. In the past I used Hibiscrub on my face as I read it could be good for acne but it did nothing for me.

I don’t have polycystic ovaries or anything like that, I am a bit overweight but not hugely. My diet is pretty good, I eat fish but no other meat. I wear make up but always take it off before bed and regular clean my brushes and stuff.

I have diagnosed fibromyalgia and am being investigated for lupus. I take a lot of codeine, naproxen and tramadol as well as regular amitriptilyne for nerve pain and sumitriptan for migraines. I take Sertraline for anxiety.

So wise Mumsnetters.... what works? I’ll spend anything within reason. I shouldn’t be approaching 40 with the skin of a 14yr old!

Thanks in advance for your advice.

I got the strong drugs you aren't allowed to get pregnant on aged 40. I think it's called roaccitane. It's the only thing that's worked and I've spent thousands over the years. The only thing that slightly worked was pro activ but even then I'd still get spots. I hardly get spots at all these days and they did say if they came back I could potentially get another course of roaccitane. I'd be back for roaccitane if I was you. It's made such a difference to my confidence and I wish I had done it years ago.

I found taking a daily folic acid tablet cleared my horrible cystic type acne from my jaw line.

I came on to say Roacutane when you’ve tried all else (or before I’d risk of scaring) but I don’t know how it would react with your other meds.

If you are able to pay privately, last month I paid £200 for private dermatologist for teenage child. That was a 30 minute consultation. Extremely thorough.
Requested they write to our NHS gp, request the blood tests. We had the blood tests and thereafter consultation with NHS gp, received prescription.

There was a bit of a wait to get the private appointment and then again a wait for gp to arrange blood tests etc. Almost 2 months in total from calling for private consultation to getting prescription.

I used omnilux blue light to kill the bacteria. It was years back though and I got it via a Transform clinic

I had roaccutane too at 41.

Can you remember the name of the consultant? They may have moved on by now. I was helped by my gp straight away but she’s well groomed herself and said she wouldn’t put up with it either.

Some drs are less than helpful but don’t waste time trying otc products, go private if you have to.

It makes me so cross when drs don’t help, there’s NICE guidelines on acne so they should be more helpful.

I don't have a lot of advice, but I sympathise. I'm 42 and thought I was past this shit.

I don't wear much make up and I suspect mine probably is hormonal. But like you said, I think if I went to the docs, they would say it isn't bad enough to treat. I also have a Mirena coil, and the thing that cleared mine when when I was a teenager was the pill (Diane 35) which they don't prescribe anymore. I'm considering getting the coil removed to see if that helps, but it might get even worse!

I just went to the GP about persistent cystic acne at 37 (I am on my second Mirena). She told me to try the la Roche posay Effaclar 3 step system for two months (ie through 2 hormonal cycles) - if no improvement then come back and we would talk roaccutane or other medications or even removing the Mirena.

I've been using the Effaclar system for 2 weeks and I've seen a huge improvement already - I never would've tried it as I didn't think of myself as having oily skin but it's working really well and also fading the scars that the cystic acne left behind - I never squeezed them as they never came up as whiteheads, just angry undergrounders, but they still managed to leave dark red scars behind which are now fading nicely.

I hope it lasts, it was worth a try before the super strong stuff (which I will go back and insist upon if this face stuff stops working). It's not too expensive either!

Also a word to say I'm on my second mirena - I got spots the first time too but they died down after the first couple of months on their own. Then I got my second Mirena and I guess there was suddenly a new flood of hormones and I got the spots again but this time they didn't go away. I assume my skin is changing with age as well.

I have cystic acne on the back of my neck & going up into my hairline. The only thing that has ever worked is Clinisoothe Skin Purifier. I apply it twice a day with a cotton pad, also use it on my face as I do get a few breakouts here & there. It’s changed my life, the few breakouts I get on the back of my neck are much smaller and much less painful.

@SnoozyBoozy Progesterone increases oil production.

I was great on dianette but the implant made me cystic.

My DD was prescribed Lymocycline which is an antibiotic now commonly prescribed by GPs specifically for acne / bad spots.

After 3 months it had pretty much cleared up. You could see the positive effect after 3 / 4 weeks already. She was also prescribed acnecide as a topical cream.

I find the following definitely helps dry up oily bits:

Gentle cleanser. Inkey list oat one for me, but the salicylic might work on the little spots. I'm definitely a lumpy hormone based cystic spot girl.
Glycolic toner to help shift the skin cells that cause bunged up pores. Superdrug own in the green bottle is great.
Niacinamide serum. I use the inkey list one from boots. This definitely dries up the oil production.

I use facetheory retinol oil for scarring after moisturiser. Sounds counterintuitive but it actually really helps.

During the day swapped foundation for la Roche posay effaclar tinted cream. Absolute winner.

If the dr and dermatologist don’t think it’s bad enough for anything medical I would give another vote for the la Roche posay effaclar range the duo in particular, maybe a niacinimide serum (the ordinary is cheap enough for a try) and maybe paulas choice bha treatment. You need to give these things time to work, like 4 weeks ish. Sorry you are struggling with this and tbh I honestly think you shouldn’t give up on the more medical route but maybe try some of the options here while you are trying?

There are some good suggestions here for products but please don't forget about diet. I only need to look at a packet of crisps to break out in spots.

The only cream I found worked when I got mild acne was benzoyl peroxide. You can buy it online for about £7. I found it really effective

Have you tried duac? I had terrible jawline acne afew years ago and went within around a week! Think it's good for oily skin as it really dries it out! The GP prescribed it x

Not all dermatologists are good though, my first one was rubbish and told me to stop wearing sunblock every day. He was lovely to my mum when she saw him on Bupa for pre cancerous moles but I was on the NHS.

Personally I would book a consultation at a sk:n clinic. I have seen dermatologists there for a couple of different things - not specifically acne. I have always been impressed by the consultants and nurses and other staff I have seen there and they really see to understand the impact having skin problems can have on self confidence and wellbeing. www.sknclinics.co.uk/treatments-and-pricing/acne-treatment

@Kjr33

If the dr and dermatologist don’t think it’s bad enough for anything medical I would give another vote for the la Roche posay effaclar range the duo in particular, maybe a niacinimide serum (the ordinary is cheap enough for a try) and maybe paulas choice bha treatment. You need to give these things time to work, like 4 weeks ish. Sorry you are struggling with this and tbh I honestly think you shouldn’t give up on the more medical route but maybe try some of the options here while you are trying?

I agree with this and was going to suggest LRP Effaclar as well. I especially think you need a glycolic acid which is what the toner in that range is. And I would suggest not using any kind of scrubby things on your face too, these can make it worse.

My skin is very similar to yours and the spots are coming out at all times of the month now, not just before my period. I'm 43 and have exactly the same thought that it shouldn't be as bad now as when I was a teenager surely! I have been very lax with my skincare recently though, but the LRP stuff really makes a difference so am back on it again. Oh I also realised after trying a million and one different things that less is more for my skin. It's very much trial and error though, good luck I hope you find something that works for you soon!

Same, same, same @SteveArnottsCodeine

Things that have helped, in order of how much they have helped-

Vitamin B complex in a strong formula (Solgar do a good one). Finding out how much difference this makes was life changing. It can give indigestion, I find it's easiest taken with largest meal of the day rather than an empty stomach. When I forget for a few days, my skin gets oiler and I soon get cysts again. Lots of people swear by ultra high dose b5 on it's own (pantothenic acid) but it's not a good idea to take B vits selectively.

Low carb, low sugar diet with plenty of "orange" coloured food -salmon, cantaloupe melon. I know that sounds nuts. I'm a doctor and can't bear quackery. But it really helps.

Skin+Me is going quite well for me. It's one cream you use at bedtime between washing and moisturising.

Daytime, Vichy blemish range helps. I also use The Ordinary Niacinamide and Zinc after washing, before moisturising.
www.boots.com/vichy-skincare/vichy-normaderm

I double cleanse -first with Vichy above and then with Tropic Clear Skies powder. My skin is significantly less oily when I use this.

Overall I find that when I'm on top of the vitamins and the diet, I can get away with slacking on everything else. But the reverse isn't true, so I think the vitamins and diet must be most important.

I use tropic clear skies powder and blue lagoon serum. I developed a strange acne type rash last year and nothing worked (including cream from my GP) until I used these products and my skin has been so clear ever since.
You can but it online with a 30 day money back guarantee.

I had been on roaccutane twice and it always came back.
What cured mine:
DIM supplement - life changing
No dairy
No sugar
No particular topical - I had tried them all but acne is an internal inflammatory disease - it's all about hormonal balance. Lifestyle and diet is everything.
I would ask for Mirena to be removed and see if that helps too.

Watch all of Dr Sam Bunting's Youtube videos on acne. I followed her advice and it totally cleared my skin.

My acne came back years after taking roaccutane. It was affected in part by my hormones, but I could break out at any time of the month. All at the same time, I cut out dairy, took vitamin D, drank spearmint tea and used Boots clearing paste. My skin drastically improved. I’m now using Skin+Me and have reintroduced dairy. My skin looks good. I know different things work for different people, but I also know how awful acne is and if what I say is of any help, then great. I really hope you get your skin sorted.

@Beeeeeeeeeeeeeep

The only cream I found worked when I got mild acne was benzoyl peroxide. You can buy it online for about £7. I found it really effective

I second this. I used acnecide.