Sudden Cystic Acne in 40s - hormonal?

[Cheeseandonioncrisp]

Hi, I'm looking for some advice and/or experience of a similar skin situation.

Long story short, since I turned forty about 8 months ago I've started getting cystic acne on my forehead and nose. I'm wondering whether it's hormonal or an infection? I haven't used any new skincare or make-up. I've got a GP appointment in two weeks and, as my experience with skin and GPs hasn't been great in the past, I want to go in with a rough idea of the kind of treatment I'm after. Should I ask for birth control (never been on any before)? And if so, which? Yasmin? Dianette? Or should I ask for spironolactone? Or antibiotics? Something else?

Bit of background about my skin...I have sensitive, oily skin with easily clogged pores and have rosacea too. In my early twenties I suffered with small whiteheads on my nose and cheeks but through trial and error I discovered products that work for me which are simple, lightweight, oil and fragrance free and they cleared up my skin totally alongside Soolantra for the rosacea. However 8 months ago I suddenly got a cluster of three large, deep spots that feel like hard peas under the skin and take weeks, sometimes months to come to a head. I'm getting them one after the other. They are inflamed and painful and it's really getting me down.

My usual spot treatments (azaleic acid, retinol, and benzol peroxide) don't touch the sides. I've got Differin too which helps speed up the process a bit but it's not preventing them.

At first I tried to squeeze them which left pock marks so I now use a hot compress on them twice a day which speeds the process up. I usually have two or three at any given time.

My gut is telling me it's hormonal as my skin does feel oilier I think, and my periods have gone haywire.

Thanks for reading, any suggestions? X

Mine began in my early 40’s when peri hit. The GP prescribed Duac cream which was brilliant. Very drying though so I only used every other night on the actual spots.
As I have a prescription for duac, I’ve been able to order Skinoren from an online pharmacy. It’s keeping my skin amazing, OTC azelaic isn’t really strong enough.

Definitely hormonal. I’m on spironolactone and it’s a game changer.

I had clear skin until I hit mid forties. I was diagnosed with rosacea. After a few YEARS of sore and unslightly skin, I was prescribed Soolantra. Skin cleared up within two days.

Hope you get sorted. X

You won’t get Dianette at your age. They don’t prescribe it. They will give you oral antibiotics and topical stuff which did nothing for mine. Don’t let them put you on any other contraceptive pills because most will make it worse. I was referred to dermatology but they wouldn’t do spiro as it wasn’t licenced for acne. Couldn’t have roaccutane because of a history of anxiety and depression. Luckily I read about dim supplements and they totally transformed my skin. I would give them a go before any type of drugs

That's interesting to hear that higher strength azaleic might help...I'm worried about using anything too harsh on my sensitive skin though 😬

This is good to hear, I think this is what I'm going to push for...how long are you on it for? Will it come back when you stop using it? 😨

I have used Soolantra for years and totally agree it's amazing and completely cleared up my rosacea...however this cystic acne seems quite different in how it presents and Soolantra does nothing for it 🥲

My sympathies. I have alway had problem skin but after years of trial and error finally found a routine and products that work but in the past few months I’ve had more spots than when I was a teenager and rosacea flare ups all the time.

Oh really? I was hoping for maybe a combo of contraceptive and spiro...They want to put me on a coil for my heavy periods but I've read they can cause acne. I also have a history of depression and am on antidepressants so I assumed that ruled me out for accurate too. What are dim supplements - they sound interesting?

Sorry to hear that, I feel the same 🥲 It's so disheartening when your skin just changes seemingly out of nowhere and you have to rethink everything you're doing AGAIN...and on top of that dealing with wrinkles and just looking knackered 🫠🫠