Acne

[Mol1628]

So mid 30s and I’m going back on the pill for severe acne. Scarring , cysts etc all over face back chest. I’ve been off all contraception for a year to see if my skin finally sorted itself out , it’s been a problem since I was about 14, but it’s worse than ever.

Will I ever NOT need acne treatment?! As soon as I’m back on the pill it’s a full cure so it’s definitely hormonal.

Ive been told I can try Roaccutane but that’s really only if the pill doesn’t work and I’m not sure I could put up with the side effects.

It’s horrible isn’t it? I was on the pill for several years from my late 20s to mid 30s for acne (having suffered with it since I was 16 and nobody telling me it was possible to treat it before that). I came off once in my early 30s and it came back. I think I came off a second time when I was about 36 and it finally seemed to have gone. (Although still present a bit on my back). I think I would have stayed on the pill forever if it had come back but I think they start to hassle you after a while to come off it don’t they?

Yes they told me to come off it in my early 20s and I went to the mini pill which was ok but didn’t completely clear it. But the doctor I saw yesterday said I could go straight back onto Dianette because of how bad it’s now got.

I was on nexplanon implant but that’s what started the cystic acne up and it’s just not stopped coming up since then so that’s really messed me up even more!

I know how you feel as I suffered with cystic acne for many years from my early twenties.
I had every cream and antibiotic you can name and also took the pill just to control the outbreaks but eventually I was referred to a dermatologist and was put on Roaccutane and to be honest with you it changed my life as after about 3 weeks of taking it the spots started to dry up and I wasn’t getting anymore.

I was lucky as I didn’t have any serious side effects and I actually felt happier as my skin was looking so much better and I didn’t feel self conscious.
You are monitored regularly whilst on Roaccutane so my advice would be to think about it and get referred to a dermatologist whilst your thinking about it.

Good Luck and if you need anymore information just let me know.

I'd say you ought to try Roaccutane. I have Rosacea - when very bad, it resembles Acne, and the treatments are the same.

About 15 years ago (in my mid-40s), my skin was terrible, all spotty and lumpy, as well as bright red and sore. I was prescribed Roaccutane, as a last resort. I couldn't believe the difference in days! Honestly, my skin was clear in a matter of about 2 weeks. The results were astonishing. The side-effects were minimal - I had a dry mouth, throat and eyes, so I drank more water, used more moisturiser.

Glad the roaccutane worked for you. I’m concerned it wouldn’t be a cure for me as my acne is definitely hormonal.

The doctor said if the pill and a topical treatment doesn’t help then I will be referred to dermatology for roaccutane.

My main concern is that if I took roaccutane it would work but as soon as I stop the acne would come straight back. Like it did with everything else I’ve tried.

Roaccutane doesn’t always cause bad side effects. I have a relative that has just finished a 6/7 month course. He was a bit achy, slight low mood at times and had dry skin and lips but that was all. His skin looks so good now. I think it’s worth considering if you’re not happy with the pill.

I'd say stop messing around with other treatments and push to get Roaccutane. Six months will change your life, honestly. I spent years trying this, that and the other and nothing worked. Roaccutane gave me a permanent solution. That was 10 years ago and I still have an acne-free face and back. The side effects had pros and cons, I could go for days without needing to wash my hair, which was brilliant. The dry lips were a pain but Lansinoh (yes, nipple cream) was amazing for that. I don't actually remember having any other negative side effects though.

No, once you have taken Roaccutane nothing is coming back trust me .

If your happy with the pill and it’s working for you then stick with it.

I took Roaccutane as a last resort when everything else failed and I was so miserable and self conscious that I didn’t want to leave the house without covering my face in so much foundation that it actually made my spots look worse.

I should have added that although I still have Rosacea (always flushed-looking, have tiny broken veins etc), since having Roaccutane, I've never had a problem with spots and lumps, never had any other treatments since the Roaccutane - 15 years ago. I hope you find something to work.

Yes it kills those spots for good .

Wow that’s interesting. Even hormonal acne?

Yes everything trust me .

Oh I do like the idea of that!

I took Roaccutane and it was great.. totally clear skin for a few years, then the spots did start coming back a bit but much milder than before (a few spots here and there rather than huge amounts of acne) so is totally manageable with creams etc.. No real side effects for me apart from slightly dry eyes and lips while I was on it.

thanks everyone. I have differin cream and Dianette at the moment to try and quickly get rid of what I have as it’s so sore. Then will re evaluate. Totally not fair dealing with this in my 30s!

Yikes a few days on the cream/pill and my skin is so sore I have lots of new cystic spots 🙄 I suppose this is the ‘purging’ phase. Least I hope so!

What is the root cause of all this, has anyone ever tried to determine the cause properly other than "hormonal"?. Some women with polycystic ovarian syndrome (PCOS) can develop such long standing skin problems.

I note too you've been given Dianette; that has anti androgenic qualities. Its also often been prescribed to PCOS patients.

If your periods are very irregular in nature then I would investigate PCOS a lot further. A dermatologist should send you for an ultrasound scan to assess if there are polycystic ovaries.

Roaccutane was amazing for me! I was on it for 9 months and 18 months after coming off it, I've only had 2 spots! My face used to be absolutely covered in acne! Side effects were dry skin, lips and nostrils but that was it.

Don’t think I have PCOS. Very regular periods. No other symptoms of it.

My brother and sister also suffer with acne so I guess it’s just genetic. I don’t know.

You have my sympathies OP. I suffered awful, painful cystic acne from about the age of 20 onwards. Some contraceptive pills helped but I never really went back on them after having my kids because I was worried about cancer risks as my Mum had breast cancer, as did some other women in my family.

I paid to see a dermatologist privately who wanted me to try Roaccutane but I just wasn’t brave enough to try it as I’d read about possible mental health side effects and already had a history of mental illness so didn’t want to go there.

The dermatologist prescribed Sprionolactone which is actually liscensed for completely different conditions (heart failure, liver scarring, high blood pressure and is even used in hormone therapy for transwomen, I believe) but it can be used to treat acne and excessive hair growth in women. It made a huge difference for me and cleared my skin up really well. I also stopped using any products containing sulphates, which I had read online might exacerbate cystic acne.
I had noticed that the cystic acne on my back fell exactly within a triangular zone where my hair falls when I wash it. It might just be a coincidence, but my back is now completely clear 99% of the time. I still get the occasional one but I can cope with that compared to how it used to be.

I stopped taking Spironolactone after 6 months or so as I was concerned about possible side effects and I don’t really like being on any medication long-term if I can avoid it. I thought I’d just see how things went with the option to go back on the drug if I needed to, but my skin has been pretty clear ever since.

I am mid-40s now so I wonder if a peri-menopausal hormone shift has actually done me a favour with regards to acne. It’s great to not have it dominating my thoughts any longer. The bad news is that acne seems to have finally cleared for me just in time for me to have lots of lines and wrinkles. It seems I was destined to never enjoy completely smooth, clear skin at any point in my life 😂

Anyway, sounds like you might be considering Roaccutane which I have heard great things about- it was just too much of a risk for me personally with my history. If you decide not to try it, you could ask about Spironolactone and see whether they think that might work for you. Good luck!

Just to clarify re the back acne specifically, I stopped using shampoo which contains sulphates and wonder whether that helped clear up my back spots.

Thanks waterlego I’ll look into that other drug. I hope I find the same thing as I get older. I don’t know how long they’ll let me take the pill for but I can’t carry on with my skin as it is so I’ll just have to take the risks!

I was just in the shower and I was trying to work out why my chest looked weird. Realised it’s not covered in little red spots! It’s clearing up already. The cysts will take longer to go but I’m seeing a change already after 5 days on the pill. Hopefully my face will follow.