Acne Help

[Acnehelpplease]

I'm absolutely at the end of my rope now, I've suffered with acne for the best part of 20 years at this point (I have PCOS). I'm hoping someone here has a miracle cure.

Unfortunately I can't take roaccutane as it started to affect my kidney function relatively early in treatment. I feel people think I look dirty, I wear makeup when out beyond the park with the kids etc but of course it's still visible and affecting my confidence.

My current treatment is Dianette (although the doctors are getting increasingly worried about prescribing this, meant to be 2 years max and I've been on it more than off for the last 16 years) as well as differin gel every other night. I also use an led light mask nightly.

Other than this I shower twice a day, double cleansing my face if wearing makeup/sun cream (curel so gentle as my skin can become dehydrated), use acids nightly, eye cream, sebamed moisturiser or the light version of weleda skin food if very dry. I try to limit make up use, and remove it as soon as I'm home. I change my towel and pillowcase daily, wash my pillow weekly and change them every 3 months. Drink 3 litres of water a day, eat relatively healthily too. What else can I do?! I'm so sick of never feeling happy in my appearance, not to mention the pain and bleeding.

It sounds like you are using too many products on your face, all that cleansing and using acids etc will really dry your skin out and cause your skin to over produce oils I believe?
I have heard taking myo-insotol can help but not sure it's scientifically proven...

Are you using acids too much? I'd drop the acids and use differin every day personally.

Are you under a dermatologist? If not, it sounds like you need another referral really. The other option is to go private - either IRL or via an online doctor. If you get on with adapalene (differin) I think dermatica/skin and me type places can do the 0.3% because they compound their own formulas - I don't think this strength is available ready-made for a GP to prescribe.

Only thing which worked permanently for me was long term prescription antibiotics- one of the tetracyclines.

NHS wouldn't prescribe them. Private GP did. Private GP thought risks were over- stated and the benefits far outweighed the risks.

I had a similar journey to you. I’ve had PCOS related acne for years and tried everything. I used Adapalene (Differin) for a few years (the 10% one) and it was ok but not great. Then I moved onto Tretinoin from Dermatica. It’s colpletely cleared me and hardly get a pimple now. This has been 4 years.

I’d give Dermatica or one of the other similar companies (Skin & Me and Monderma (I think)) a try. The first treatment usually just costs postage. I only use the second lowest strength of the Tret still and it will probably stay that way as any stronger makes me peel - but it could be different for you. I use it every 2/3 nights and it lasts me ages. It does usually take a while to build up tolerance but if you’ve used Differin for a long time, it probably won’t take too long at all as that’s a retinoid too.

Also, there’s nothing wrong with double cleansing, especially if you’ve been wearing SPF. I use The Ordinary Squalane for my first cleanse and a Rovectin gentle cleanser for my actual cleaning cleanse.

Even if you don’t go for the Dermatica etc, I’d cut back on all the actives for now until your skin has recovered, in case they are aggravating things, which could be possible if your skin barrier is damaged.

Before starting Tret, I discovered I couldn’t tolerate silicones, dimethicone in particular, as they caused me to break out all the time. I had a spreadsheet with all the ingredients of different products and that’s how I came to the silicone conclusion. The other thing that really affected me was an ingredient called Bismuth Oxychloride which is found in Bare Minerals powder foundation - that I’d tried as it was supposed to be good for acne. It made me break out horribly!

You sound like you’ve got your hygiene good with the pillow and towel change..just a reminder to clean your makeup brushes and things regularly, too, if you don’t already.

Good luck - I know how soul destroying it can be. ❤️

Do you have oily skin?
I think you need to go back to basics and try and restore your Ph levels. Over cleaning/striping your skin causes it to produce more oil.
I was on dianette for years which worked well. I am no longer ok to take it but a private dermatologist has prescribed Spironolactone which reduces oil production. I then use cerave products and tret every few days (daily spf).

Duac worked for me, but that’s quite low on the list of treatments and way before roaccutane so I assume you’ve tried it already.

the washing / pillow case changing etc etc did fuck all. Took years before I tried duac and my skin was transformed within 6 weeks. It’s never returned despite being plagued for 2-3 years.

What is your skin care routine?
Sounds like you need some acids to add in to it.

Did you bother to read the OP?!

when reading your post, I had these thoughts- maybe ask the Gp to retry roaccutane- you might respond differently this time.
it sounds like there’s way too much going on -
acids; make up, spf, eye cream, moisturiser- I feel dizzy just reading. Have you considered a prescription of tailored product from Skin & Me, I had grumbling acne as an adult. Now use a script from skin & me (25-£30 a month, pricey but my only ‘treat’). Use simple face wash, simple toner and then the nightly cream. It’s really good. Also, salysilic soap from Amazon really helped too.

After trying everything the GP recommended, Spironolactone is the best for mine and dd skin.

I found that the tret in skin and me is a game changer too. My skin is far from perfect but about 80% better than it was.

I also came to realize that I'd damaged my skin barrier. I switched to Dr Sam's cleanser and moisturizer and my skin can actually tolerate both without drying. Absolute rarity. I don't like to recommend products as I know I've wasted £££ chasing the holy grail but these have genuinely worked for me.

I wish you well OP I know only too well how much acne and associated sore skin can get you down

Thanks everyone for the suggestions, unfortunately nothing I haven't already tried been suggested as yet.

I get it sounds a lot of use of acids but 20 years of trial and error and this is the absolute best I can get my skin to be. I've tried stripping my skin care back, this is the combination that has it least irritated. The non-acneic skin on my face is perfect, I have no irritation, dryness etc.

Dianette worked to a huge extent for years but since having children it just isn't doing anything.
Tried the antibiotics, skin and me and dermatica (tret in any strength does not agree with me no matter how I try to build it up or persevere it makes my skin inflamed and angry). The NHS derm couldn't do anything else for me when roaccutane became a no go.
At this point the only thing I haven't tried is laser treatment as the cost is a barrier.

I think this was avoided after the kidney function issues with roaccutane but I'll ask the question again. Thank you.

I've been on Lymecycline for acne for 3 years now, still get the odd zit but only during TOTM, I was covered prior to this.

Not particularly oily with my current skin care routine, my skin is not dry/dehydrated or red or irritated. I think it sounds a lot in one post but my product routine is as follows:

AM:

• Cleanse (curel gentle foaming cleanser)
• Mosituriser (Sebamed clear skin gel)
• Eye cream (I have some fine lines that appear worse without one)

PM

• Cleanse (approx 3x a week double cleanse, more in summer due to spf)
• Glycolic Acid on a cotton pad swept gently over face
• Alternate differin/moisturiser.

So I essentially follow a fairly typical cleanse/tone/moisturise routine at night and Cleanse and moisturise in the morning. Make up is probably 2-3x a week between office days/weekend outings.

@Acnehelpplease have you already tried Tret?

What's your diet like? High diary and sugar can affect lots of skin conditions.

Yes, that does irritate my skin and damage my barrier no matter how slowly I introduce it and persevere.

Relatively healthy, I can struggle to shift weight when it's on so I try keep it off in the first place.
Breakfast is either Greek yoghurt, berries, milled chia and flaxseed or scrambled egg, mushrooms and tomato.

Lunch is usually lentil and vegetable soup or chicken salad.

Dinner a bit more varied, spag bol, chicken chasseur and broccoli, stir fry, chickpea curry have all been things I've ate in the last week. I try to eat half the recommended portion of carbs and wholewheat where possible.

Of course I'll have the odd treat outside of this, glass of wine, chocolate, takeaway but not a daily or even weekly occurrence.

It feels like acne rules my life at this point, the time and effort to look after my skin, considering what I eat, the amount of laundry. God I even cringe at my husband kissing me goodnight at times in case he somehow transfers dirt on to my skin! I wear contact lenses so I don't accidentally touch my face adjusting my glasses or have potentially dirty glasses against my skin.

I had acne for years. Had roaccutane 3 times and it helped a lot but never truly went away. I then read about fungal acne and started putting Nizoral shampoo on my face like a face mask for 20 minutes every morning. It has ketokonazole in it which is am anti-fungal. It went away in about 3 weeks and has never come back.
It's cheap so might be worth a try?

Combine tretinoin or adapalene with clindamycin. It will almost certainly clear it. Monderma do it in a vegan base cream. Dermatica are also good. You are wise to steer clear of oral treatment.

I took minacin (tetracycline) for 20 years. They really helped. I managed to stop the antibiotics with 30mg zinc daily and cut out dairy completely. The dairy is huge for me. If I eat cheese or chocolate now I get breakout within a few hours. Dairy is a major trigger for my acne

I had an acne flare up in my early 40s. Zineryt from the GP (topical antibiotic applied to the face) cleared it up completely. From googling I can see its discontinued but you can get a generic version.

Instead of Tretinoin, would a low dose retinol be worth trying? I had mild acne all my teen/adult life until I started using retinol a few years ago for the anti-aging benefits. I now rarely get a spot and when I do it’s a small unproblematic one.

I've had acne since my teens and I'm now 48. Currently Epiduo is keeping things under control. Things that have helped me over the years (aside from the roaccutane x3) are:

Low/no dairy and an anti inflammatory diet
Zinc supplements (plus a good multivit)
Spironolactone
NLite laser (I think they now have even better ones. Yes, it's pricey but it really worked for me)
Benzoyl peroxide. For me this is the most effective otc topical.

I've just started using Slynd (drospirenone) as the progestogen part of my hrt but it's too early to say if it's working.