DD20 hormone spots

[BastardtheCat]

DD is awaiting an ultrasound to investigate why her periods are so erratic and painful. She can go months without one then get one that lasts for two to three weeks.

GP has tried to regulate her cycle with various contraceptive pills.

Her skin is really troubling her. She is pale skinned with normal to dry skin but has been, for the past 2 years, struggling with large cystic breakouts on her t zone. It isn’t acne - she doesn’t have clusters of blackheads or white heads- these are large sore lumps and bumps deep under her skin. She’s extremely conscious bless her. I saw her yesterday (visited her in Uni) and they’re particularly sore and she gets about 8 at a time, nearly constantly so no respite. The alter the shape of her profile - they’re so huge and so, so painful.😥

She eats well and gets plenty of fresh air and exercise. She has a good skin care routine (The Ordinary) but nothing is helping.

I’d love to help her. Can anyone recommend any products or lend any advice please?

I thought acne was deep under the skin? Pretty sure it was for my brother? I think she should ask the go for a referral to a dermatologist.

Second getting her to see a dermatologist, I think the placement of spots can suggest possible causes for the acne. I've had awful skin since being a teenager, it's settled a bit now I'm in my 40s, but I'm sure the menopause will cause me to get breakouts again! I've found tretinoin effective, but you need to be on top of moisturising otherwise it can damage the skin barrier and cause more issues. I use a face oil and then moisturiser . I'm not sure if this is would be suitable for younger skin and I think it needs to be prescribed by a dermatologist, so they'll be able to advise.

One product I've found particularly soothing is the Aromatherapy Associates rose and pink clay mask. I use it a couple of times a week and it does seem to help the spots heal a bit quicker.

Thank you. I think I’ll encourage her back to the Gp to ask for a dermatology referral. Thank you.

Get a proper dermatologist appointment. Not an aesthetician. They must be a licensed qualified dermatologist and I’m saying this because some high-end beauty clinics might use the word doctor in their title but aren’t actually a dermatologist. That said I think cystic acne is always hormonal - it’s clearly related to her cycle somehow. It might be worthwhile waiting for the ultrasound or any hormonal imbalance tests 1st to treat the root cause not the end result. Poor girl.

It look it might be a cystic acne, so referral to dermatologist,

has her thyroid been checked?
has she been screen towards PCOS?

Pore Favour, which used to be called Anti Acne Club, make supplements that cured my adult hormonal acne. I think they do a money back guarantee if they don’t work.

This sounds like more than a topical treatment can help with.

I'd suggest spearmint tea and reduce dairy and sugar.

It could be as a result to the various contraceptives she has been trialling.

a couple years ago (I’m mid twenties) I started really getting deep, painful hormonal spots all around my chin every month - having had relatively clear skin from my teens / early twenties it was a bit of a stinger! Tried lots of topical products and diet changes, like spearmint tea etc but nothing particularly made much of a difference.

earlier this year I saw on TikTok someone having great success with Azaelic acid so bought the Anua serum - had previously found the Ordinary cream didn’t do much for me. Now very occasionally get the spots but nowhere near angry and they calm down a lot faster. I’ve been trialling a few more Kbeauty products and they seem to be far more effective in general, the Anua serum is relatively gentle yet seems to be doing so much heavy lifting!

She needs to go to a dermatologist. Acne needs medical treatment (e.g. antibiotics, tretinoin, roaccutane) not just skincare.

There is a hormonal acne cream called Winlevi that helps with this type of acne. I got some online from the independent pharmacy after completing an online assessment and sending photos. I had very painful, deep cystic spots and noticed a positive difference within days of using it.

Thanks for your help everyone. We went back with the GP and asked for a Dermatologist referral and frustratingly, the GP said that they had to try certain options before referring. This was all online and we were unable to reply and say “but we’ve already tried these tablets and cream!!!” So, 5 days in and despite giving them another go, DD’s skin is now dry and taut (thanks to the cream), but her spots are angrier than ever and I can see that she has a ton clustered around her mouth and some large sore cystic ones on her jawline. She is in pain and really down. She’s been with me all week - Uni reading week - she eats healthily, drinks plenty of water and is getting enough sleep. She doesn’t smoke/vape.

I’m going to see if I can afford her to see a Dermatologist privately but a google search in my area doesn’t fill me with confidence. At the risk of sounding very naive, how do I go about this?

Bump

I got fed up with my GP so booked an appointment with Bupa for my daughter - it wasn’t covered on our private health 🙄 seems nothing ever is! Anyway, she was given Roacutane and it cleared up in weeks, although she was on the drug for a year I think? It was over 10 years ago. She did need regular blood tests as they worry about pregnancy whilst on it, but it was the only thing that worked.

My dd tried everything from the gp but it dodnt work. They refused to refer her to a dermatologist sober went privately.

Spent neatly £800 & her skin is now perfect.

First consultation was £180, 2 follow ups were £80 each. Actual monthly cost of roaccutane was £50 & she was on it for 9 months total.

It was worth every penny!!

I also had roaccutane twice in my life - once at 14 & again at 30 when I developed cystic acne. These were both through the nhs but I think they've tightened up their referral criteria as they wouldn't even refer dd.

We were lucky in that the dermatologist who treated me on the nhs both times now works privately out of an aesthetic clinic so we could use him. But you need to ensure that you use an actual dermatologist as only they can prescribe roaccutane which is the treatment your dd needs.

Good luck

Thank you both.
I’ll contact my nearest BUPA hospital today - I have one in my local city about 6 miles away.

It cost about £250 back then for the consultation and then we had to pay for the medication as that was a private prescription. Our consultant was very good though and got my doctor to do the blood tests, so that saved us a bit. I think we went back 3 more times, came to about £1000 in total but I’d more than spent that on Dermalogica and other premium skin care brands over the years, in the end I just wanted her well and happy, I’d have paid anything. It’s sad that the NHS doesn’t see it as urgent, it can easily lead to mental health problems which could be with them for life, no joined up thinking.

Are you still using this? I’m wanting to try it. I’m in Cornwall and apparently it can’t be prescribed on NHS here (postcode lottery) but I’m not even finding good reviews?

@BastardtheCat I hope you find a remedy soon. As a life long sufferer of cystic acne (1-2 each month pre period) I never addressed the issue as it wasn’t so bad. Now in my late 40s my skin is so dimpled due to the acne scars. The slow aging and wrinkling really shows the scars like never before. Also menopause caused a massive flare up which HRT has helped. Just wondering if you could adjust the contraceptives such that the estrogen is a bit more to balance out the acne causing progesterone. I’ve learnt this using HRT and balancing these has helped.

I bought the Winlevi cream and she used that instead of what the GP prescribed. I’ve seen a definite improvement in her skin overall but she still gets the large angry painful spots near her mouth or on her forehead. She currently has two of these and although they aren’t many, they’re so large and angry that they really bother her.

We didn’t proceed with BUPA as we didn’t have the funds and we were going to give the cream a chance.

She has signs of being polycystic (bloods, ultrasound results) but her GP won’t investigate further until she’s a bit older.

She’s a red-head and since she reached puberty, despite having lovely skin, she’s always had clusters of small red spots around her nostrils too - we wonder whether there’s a gene connection too here.

@BastardtheCat just wondering how winlevi is going for your daughter, or if she tried anything else? I hope she's seeing improvements.

I think my daughter discovered it was a fungal thing see if you can find something online
Just looked and fungal acne is a thing which antibiotics don’t help