DD Skin issues

[Helpwithbeauty]

I wondered if there was anyone here who is aesthetically trained or into dermatology? My teen is unfortunately struggling with acne and has been for about 20 months now. It is definitely hormonal and worst around her monthly cycles. We have tried every lotion and potion from the GP and the next stage was a referral to a consultant and the GP said this would probably lead to a prescription for Roccutaine (which DD didn't want to take).

We have resorted to a private Aesthetic specialist and have been seeing her now for 4 months. We have been set straight on a lot of bad practices that we were in - only using a pillow once, turn and then change, use one side of the towel once on one side, turn and then change, changing make up to be mineral based products so her skin can breathe and then lots of lotions and potions. The problem is the cost of these. Apparently DD's skin was very damaged from the products she was using before, she used to pick her spots which is apparently a cardinal sin and had off the shelf products like toners and cleansers purporting to be for acne and breakouts of the like of Biore, Clean and Clear, Clearisil, someone recommended Acnecide, we've tried that too. Our specialist has advised that these products are awful and have added to the damage to DD's skin.

We have now got a multitude of products pre-cleanse, cleanser, serum, moisturiser and sun block. But each of these is costing anywhere between £35.00 to £60.00 per bottle. There are also tablets which are a small fortune and I just don't think I can carry on paying out all this money - it is costing me hundreds of pounds per month. She needs to go nearly every 2 weeks and the specialist will "extract" any large, angry or infected spots (I think that it is basically picking and squeezing in a clean environment with sharp sterile things), LED light therapy and chemical peels. She has mentioned when her skin is better she will need additional treatment for her scarring - micro-needling, another small fortune. If her skin was fantastically better, I would not begrudge paying it all - but it isn't. The tablets I know say they they will need 16 weeks minimum usage to work and I have committed that I will pay for 6 months in total so have another couple of months yet, but I am wondering what we do if we decide not to proceed with these products in the long term. Do we just go back to using the high street products that have apparently damaged her skin terribly. It is all so confusing.

Are expensive products the only way forward?

It sounds rough for your DD and you’ve been very supportive and generous. I’m not an expert on the slightest, but I’ve had acne for… a long time! So I’ve been through various treatments, products etc.

Personally, a diet change helped a lot (diet didn’t change specifically for acne, but it was an unexpected and very welcome bonus). In particular I found sugar to be a trigger. I eat low carb.

Products - there is so much out there, but as a general rule avoid fragrances, essential oils and drying alcohols. The derm/aesthetician you’re seeing may be talking about a damaged skin barrier, and these ingredients are major culprits. Some ingredients are easy to spot, but to take the headache out of it use Inci Decoder.

For some reasonably priced (not super budget, but not £££) products, I really like both Geek and Gorgeous and Facetheory. Salicylic acid (1-2%) is great for acne-prone skin, as is niacinamide, and you don’t need to go super harsh or stripping. I also rate Dr Sam’s Flawless Cleanser for an all-in-one gentle cleanser that will remove sunscreen and makeup (you need a separate eye make up remover, Boots do some good gentle pads in their essentials range in the blue packaging, I use Eucerin as I have very sensitive eyes).

Sunscreen is important especially when using acids, I use Altruist face fluid which is about £9/bottle so way more reasonable then many good facial sunscreens.

Ill stop there as otherwise I’ll be waffling for ages

my daughter had terrible skin and like your daughter we had tried every lotion and potion, our next step was the doctor to discuss what else could be done and then someone recommended the witch hazel stick. It’s £4 approx from Superdrug and it’s amazing. DD’s skin has drastically cleared up.

we have recommended it to a few others who can’t believe something so cheap has changed their skin, their mental health regarding their skin and made them more confident too.

…that was my roundabout way of saying, no, seeing a specialist is not the only way. I’m sure it can be great and really helpful if you can afford it, but there are other options to work with too and go from there.

Your poor DD I feel for her, I was that girl once!
Not sure how old she is but I went on the pill aged 15 due to horrendous periods but it also cleared up my skin perfectly. Years later I still get a few spots with my incredibly oily skin but absolutely swear by Carbon Theroy products which you can get in Boots. There's a bar of soap looking cleanser which is £6 and the moisturiser is £13. (There are scrubs and masks too if you want them). The products are charcoal and tea tree based and work absolute wonders xx

hormonal acne will remain a problem for so long as the hormonal imbalance is there.
Has anyone suggested a contraceptive pill? Once the active acne is controlled you can work on restoring the skin. Resolving scarring etc but otherwise it’s an ongoing battle.
Are you using ZO or Obagi? Both are brilliant but won’t resolve hormonal imbalance. That’s an inside job so to speak.

A dermatologist is more likely to prescribe spironolactone than roaccutane for young, hormonal acne. My consultant dermatologist told me that whilst explaining that I should have roaccutane for my older, non-hormonal acne.

Thank you so much for your replies.

She did go on the pill early in 2021, but came off it at Christmas as she was still suffering with her skin but found that the pill put quite a lot of weight on her (which dragged her confidence down even further).

Thanks for the suggestions so far, I will definitely look into them.

I had the pill Dianette at 15 it worked absolute wonders but it all came back when I stopped.
My brother had roaccutane and has been stop free since, he was also 15.
I know your daughter doesn't want to try it so I sincerely hope something can be done for her poor thing

Spot*

Are the products she's using at the moment having any positive effect? Perhaps people can suggest budget equivalents with the same active ingredients.

She should see the dermatologist instead of spending money you don't have.

Roaccutane is not the only treatment available, and even if she didn't want to take it she would have been discussing her concerns with an expert.

That all sounds really difficult for your daughter. I have had hormonal cystic acne since I was ~18 years old, but not to the same extent as you describe for your DD. I have found topical retinoids helpful, although they haven't completely "cured" me but I have a level of spots that I am now happy with and can feel confident without makeup. I buy this privately as a monthly prescription from SkinandMe. I don't know how old your DD is but I would be surprised if they prescribe to under 18s, but do check if she is interested. Most literature suggests that topical retinoid use is unlikely to be teratogenic, but any sensible doctor will probably still want a patient on very good contraception.

Also, side note about the combined pill. It may be worth trying a different combined pill as many women report different side effects between pills.

OP, your DD needs to see a Dr (either GP or referral to dermatologist) even if you have to pay for an appt it will work out both cheaper and more effective longer term.

What even are the tablets? And what brand is the rest of the stuff?

I'm a registered nurse who has an aesthetic clinic with lots of skin experience. My own and other peoples.
It makes my blood boil when other practitioners see vulnerable clients and don't look after them.
I would escalate to a GP. They will follow NICE guidelines initially then perhaps offer a dermatologist referral. I've had acne - I still do occasionally, now I'm in my 40's. It's demoralising and frustrating. I get it totally.
Two prong attack; Systemic solutions- so the contraceptive route or an antibiotic route. I was on and off antibiotics for the best part of two years.
Look to more affordable brands - I favour Cerave and Eucerin. Keep it simple. Cleanse, non oily moisturiser and SPF. Consistency is key here. No picking, but this is a psychological shift in thinking and takes time for your brain to switch and control the urge. Agree with pillows and towels, but don't over complicate things. Keep her own towel and change pillow slip every couple of days. Get a Foreo. It's a cleansing tool. Forget hot cloth method - the skin barrier has been compromised, so it needs to repair.
When the active acne is controlled, work on the scarring. Chemical peels are great. Glycolic toners are also good. Retinol is fabulous for scarring. But for now, keep it simple.

I would expect to be seeing results by now from the private specialist. The advice seems a little odd. I’ve been learning about skincare for years due to having bad skin and some of that sounds very extreme. There are plenty of plain, non irritating and cheaper skincare products available in the high street. Cerave, Cetaphil, Superdrug do very basic own brand moisturiser. I never want to be in a situation where only expensive products will do.

What the specialist seems to be saying is your daughter’s skin barrier is damaged from all the harsh products. The temptation is to dry out spotty skin but that can just make things worse and make the skin produce more oil. This will just take time of using good simple products like LRP’s cicaplast balm. I’d also recommend a gentle anti bacterial spray like Clinisept+.

I am not a medical expert but I’d probably try

• Cerave hydrating cleanser (not foaming)


• A hyaluronic serum


• Cerave moisturiser

And to treat the spots a subscription from Dermatica with clindamycin and tretinoin, built up gradually and buffered with moisturiser if skin seems sore or dry.

I think diet plays a small part, less sugar, dairy helps.

To echo a couple of other posters, I think you should see a dermatologist, rather than an aesthetic specialist (which strikes me as being someone more 'beauty' trained than medical).
I went down the private dermatologist route a number of years ago. Yes, it did cost money, but nowhere near what you're paying out. Consultation fee and prescription, and that was it.
I can't help feeling (and I could be wrong!!) that the person you're seeing isn't medically trained/qualified, and is relying on aesthetics rather than medical treatments.
There are so many medical treatments out there. For what it's worth, I had a low dose and longer period of on roaccutane with immediate effects and no side effects bar some rather dry bogies in my nose!!
All the best to your daughter. My teenage years and twenties were so badly impacted with acne. The best thing I ever did was go to a private (properly medically qualified!) dermatologist in my 30s.
By the way, you sound like a wonderfully supportive and compassionate mum 😊

I have had bad skin all my life, a couple of months ago someone recommended a book called 'skin care, the new edit' by Caroline Hirons and I've found it brilliant. It's great for teaching about skin generally getting a better understanding of acne and spots. She recommends routines and products for a whole price range. I have been doing a new routine for about 6 weeks and my skin is not perfect, but so so much better. I'm not getting too excited yet incase it's a lucky fluke but just the knowledge alone is worth the read, I finally feel like I have some direction with it all.

If it’s hormonal then getting back on the pill should help. Then look at diet and exercise.
I think she should see the dermatologist rather than keep paying out for these lotions and pills. It sounds like a lot of chemicals on her skin.
Is her skin better if she goes on a holiday to the sun ?

Have a watch of Cassandra bankson on YouTube, she had terrible acne and she's really good at assessing products

Dermatica is an online private dermatologist. Use them. They're cheap as chips but give you access to prescription products. Combine that with an antibiotic of some kind. Then use mild cleansers etc like curel, cerave, cetaphil. Please don't listen to people recommending witch hazel and any other number of off the shelf products. Also, be careful about ascribing any blame to her with diet. It's hormonal and diet will play a very small role in this. It's not because she ate cheese or some crisps. I hope she stays positive. It WILL clear up once she's goes on some meds and the right skincare.

Me too. I recommend a prescription skin service such as Dermatica or Skin+Me which will have tretonoin or other things in that will very much help. It's about £20/month but the first is about £3.50.

Avoid roacuttane it's dangerous.

What helped me as a teen was the pill, Dianette, not sure they still do it and unsure it's medical name so just look that up, she can ask for it. It cured my acne completely and I only came off it when I got pregnant (it's a shit contraceptive)

I haven't taken it since I was 34 now but the Dermatica keeps my acne at bay. I still get spots but like I say I use that skincare which helps a lot. Before that GP gave me EpiDuo which also very much helped but I chose to pay for the other one instead. EpiDuo is very good also.

I have no idea if my diet helps, I think it does. I've been a very healthy eating vegan for 6 years.

My skin is now actually looking really, really good.

Other things I think would help: silk pillow (avoid bacteria on face at night), use kitchen towel to pat face dry after washing (avoids bacteria on face).

Good luck. Acne is debilitating.

Don't start using antibiotics. Messing up your gut microbiome will not help long-term. Avoid them where possible as gut health has a lot to do with overall health, especially immunity. They also don't usually work for acne.

Oxytetracyclin absolutely does work for acne. Plus, acne can destroy your mental health and life. Horrendous for a teenager. Much harder to unpick.

I’ve had acne since a teenager and nothing helps. I did have good results with epiduo but after a while it stopped working. Has she tried that? You don’t need to be spending that much money every month. Try watching some beauty YouTubers that will recommend high street products.

They absolutely do. Lymecycline saved my self confidence by reducing the spots. And then after a few years I was ready for the isotretinoin.