Cystic acne in 40s

[peepingbomb]

I'm 41, keep waking up to huge inflamed red spots. Do suffer with night sweats which prob isn't helping. Changed my skin care a month ago to all non comodogenic stuff, seemed to work really well but after a few weeks then these crops of spots. No whiteheads, just massive enlarged pores and red. Not hormonal, as it's forehead then right cheek then left cheek etc. Is it purging? I use I key list fulvic acid wash, no7 renewal serum and salicylic acid neutrogena moisturizer.
FML, I'm fed up of it. Do I see a private go through my work healthcare and get something prescribed? I'm putting salicylic acid spot gel on which calms them down and they go after a few days but my skin is getting scared as it's so often and as soon as a few disappear, more appear somewhere bloody else ( and I don't pick or touch them).

Have you tried tretinoin? I never got lots of spots but when I did they were angry painful cystic acne spots. I haven't had any since using tretinoin.

@3WildOnes
No but I'm considering it, I don't have any wrinkles at all due to my oily skin, it's like an oil slick all the time and I've heard it can be good for this. It's slightly clogged but jeez these big red spots, like a pore is swollen!
I assume the gp can prescribe this?

Rugby acne benzoyl peroxide 10% works wonders.

Also Niacinamide is a great help.

I had acne on and off until my 30s,
I couldn't use neutrogena as it made it worse so did simple range.
I use tretinoin too and have clear skin now, you do have the red flaky skin for a while, but it's definitely worth it.

There are lots of things GP can prescribe, including tretinoin - definitely worth a visit.

I was prescribed differin by my GP which is meant to be a gentler form of tretinoin but it made my skin considerably worse.

Thanks all. I'll arrange a video call with gp.
I don't know why I feel nervous etc about trying something from the gp. I guess making my skin age? I'm pretty crap at wearing spf, as it all brings me out in more spots even la roche posay effaclar ones. I've heard hello Sunday serum spf is good for oily skin.
I vividly remember seeing an Estée Lauder sales person at boots in my early twenties and she told me I'd be glad of my oily skin twenty years later. Nope, not yet!

I went to a dermatologist at 40 for acne- I figured I wasn't going to grow out of it! I had roaccutane, it was life changing, no spots since.

I wish I'd done it 30 years ago tbh.

@cathyandclaire
Any side effects? There are some nasty ones listed.

I had very dry skin and peeling lips but nothing unmanageable. Both my kids had it too ( thanks to my dodgy genetic heritage) and they were very similar. DD1 had serious depression previously at 18 so I was very worried about her going into Roaccutane but she was fine, we just monitored her closely.

I went on roaccutane at 46 and was an absolute game changer for my skin.

This is perimenopause. I had the same at 42. HRT sorted it out in 2-3 weeks. Complete freedom from a lifelong battle with cystic acne ever since.

I was waking up to 3-4 new acne everyday all over my face. It was HORRENDOUS! I could not go out of the house due to 10-12 acne at the same time. And they all took 2 weeks to go away. Absolutely NOTHING helped.

I considered accutane but then combined with night sweats decided to try HRT first. It's been a game changer!
I also use a benzoyl peroxide + niacinamide prescription from Dermatica couple of times a week just to make sure there is no chance of the buggers returning.

Exactly the same here 🙋🏼‍♀️ - 3 kids assumed I'd 'grow out of it' but here I am with acne nearly 30 years on - early 40s on long term antibiotics and seriously considering roaccutane which I've put off for years but now seems like the only option...

Perimenopause

@SoftPillowAllNight
Tried hrt and it made me unwell and my night sweats only happen in winter, made my skin worse too and dreadful insomnia.
I've never had good skin, always spots, the spots have changed from black heads and whiteheads to more cystic acne

@peepingbomb - sorry to hear that. It's such an awful problem to have - even more so in your 40s when it's just embarrassing all around. Really brings you down.

In the short term you might need antibiotics - lymecycline.

If you haven't tried it Accutane might be the final answer. I researched it and very nearly started myself. Good luck!

Roaccutane seems to get great results. I paid to see a dermatologist privately when I was about 40 after two decades of acne misery. He suggested Roaccutane but I didn’t want to risk it (slightly wobbly MH history) so he prescribed Spironolactone instead which worked wonders. It isn’t actually an acne drug- it’s primarily used in people with heart failure or kidney disease and also used as a hormone treatment for transwomen. I think it reduces testosterone and it can be used off label to treat acne. It completely transformed my skin, I came off it after about 6 months and have barely had a spot since. To be fair I have now entered perimenopause so my natural testosterone has probably decreased now too, making acne less likely.

Other things I have found really helpful are La Roche Posay effaclar duo- I’m usually quite sceptical about pricey skincare but this product honestly made a really big difference. I don’t use that anymore as don’t feel I need it as I hardly ever get spots now, but I now use tretinoin which treats fine lines and acne as well as acne scarring. It’s a great product if you can get through the super sensitivity phase at the start!

If it isn't getting better being treated as spots consider inflamatory rosacea
https://www.rosacea.org/patients/faces-of-rosacea

I had this and was only diagnosed when I went to a private dermatologist after years of to and fro with the gp.

If it appears quickly (mine could come up in hours) and you're particularly stressed or eating badly it could be it.

Easy to get rid of it with a low dose antibiotic (because it's anti inflamatory, not because it's bacterial) but to keep it away you either stay on the antibiotic or reduce things that trigger inflammation - stress, poor sleep, certain foods.

I think it sounds like you are overcleansing and getting rid of your protective layer.
I'd recommend a blue and red light pen or mask.