Why has my acne become so much more potent, painful, and permanent?
June 24, 2012 11:37 AM   Subscribe

YANMD: (Almost) all of a sudden, my acne has become more cystic, leaving deeper and darker scars, and when broken stinging more. Have I been doing terrible harm to my body?

For the last approximately two years, I've been taking antibiotic Augmentin to assuage my acne. Combined with a probiotic, it worked well to clean up my face and help keep it reasonably clear.

In the last month or two, I've been getting these deeper "cystic" type zits. Additionally any zits that come to a pus head and I open become deep cuts which sting, and eventually leave very dark, slow-fading scars. (see a photo here.)

Has my long-time use of Augmentin done some terrible damage? Any insight appreciated.
posted by ptsampras14 to Clothing, Beauty, & Fashion (8 answers total) 1 user marked this as a favorite
I don't think you should be popping them.

Are you taking antibiotics under your doctor's supervision? Have you discussed this issue with your doctor? Are you using topical medicated face wash or anything like that?
posted by J. Wilson at 12:25 PM on June 24, 2012 [1 favorite]

If you're a women I would recommend ortho tri cyclen (name brand - not generic). It's the only thing that worked for me after trying a million other things.

If you're a man then you shouldn't try extracting the cysts yourself. If you must have them extracted have it done by a dermatologist. They can do it with minimal scarring. Spironolactone (sp?) worked well but isn't a great long term solution. Benzaclin can help fade out the scars after a cyst's come out, but doesn't do anything to prevent the cystic acne itself.

Cystic acne really sucks so you have my sympathy.
posted by side effect at 12:46 PM on June 24, 2012 [1 favorite]

What kind of face wash do you use? I got a rash of cystic acne when I started using Noxema to wash my face. When I switched to gentler soap (Cetaphil, etc.) it disappeared and never came back.
posted by Jess the Mess at 12:48 PM on June 24, 2012

If you are a woman, please consider getting your hormones checked. Nothing topical will help hormonal acne. You'll have to consider birth control pills or something else internal.

You should also be meticulous in checking ingredients in the products you use ... even those specifically formulated for acne. A good place to start is zerozits.com. Cosdna.com is good for checking the comedogenecity of cosmetics.
posted by nubianinthedesert at 1:10 PM on June 24, 2012 [2 favorites]

Seconding getting your hormones checked if you are a woman. Polycystic ovary syndrome might be a possibility. Also, get your blood sugar checked as - believe it or not - there can be issues of acne and weight gain tied in with insulin resistance.

Some people have had good luck with eliminating either dairy or refined starchy carbs. I know a woman who solved both her weight AND her skin issues with a low-carb diet. YMMV - it works for some people but not for others; every body has its quirks.

I had a similar experience as Jess the Mess when I used a creamy face wash (not Noxzema). Use a gel, or use makeup remover towelettes (Neutrogena from the drugstore or Korres from Sephora) followed by something super-gentle like Cetaphil.

Are you using a new freshly laundered/clean pillowcase every single night? Try that. I find that is very important to keep my own skin clear (and so I buy tons of extra pillowcases from Overstock.com).

Finally - don't pop those zits no matter how tempting it is. It's easy to do it wrong and get what you are getting, dark marks/scars. Dab the zit with a benzoyl peroxide solution or tea tree oil to dry it up instead, and, if you absolutely have to have it popped, see a dermatologist or at least an esthetician.
posted by Rosie M. Banks at 2:46 PM on June 24, 2012 [1 favorite]

Who is prescribing the Augmentin? If it's not a dermatologist, see one. If it is a dermatologist, find one who has some other ideas for solving the problem.

And you should probably get swabbed for MRSA. That may be why you're experiencing a change in the nature of your acne.
posted by Lyn Never at 4:43 PM on June 24, 2012 [2 favorites]

If you can't stop getting them, try alpha hydroxy acid (glycolic acid) to speed up the depigmentation process. The stuff from Dan Kern is quality stuff without bs or too much of a markup.

I've also seen some general complexion improvement after using it chronically - opens up some pores a little and reduces redness.

I've started using blue light and it *might* be helping with the cystic stuff, but it seems to make everything else work better. It's expensive, though.

Conversely, it's possible that the antibiotic that you're taking is (relatively more effective at) killing off the beneficial commensal skin bacteria that competes with the other inflammation-causing bacterial strains.
posted by porpoise at 7:30 PM on June 24, 2012

This is a question only a dermatologist can answer for you. If a dermatologist prescribed the Augmentin, get a second opinion.

Also, if you are female (obviously IANAD or anything) then try ortho-tricyclen, Yasmin, or any other acne-fighting BCP. Give it up to nine months to work (a lady on a now-defunct advice line told me that when I was frustrated, and I've never seen that information anywhere else but in my case it was dead-on accurate; my cysts got worse and worse for nine months whereupon they suddenly vanished).

Try, also, the following. Get some 2.5% benzoyl peroxide (this is hard to find but PanOxyl makes it). Carefully apply it in the morning and give it 30 minutes to bind to your skin before you allow *anything* else to touch your face. Do the same in the evening, after washing. There are other steps you can do, but start with the uncomplicated stuff. If your skin gets dry, try Cetaphil Daily Advance Ultra Hydrating Lotion.

Topical treatments usually aren't enough for cystic acne though. However, the benzoyl peroxide will almost certainly help. It's a matter of building up a system of treatments each of which makes a contribution to 99-100% clear skin.

But yeah, dermatologist.
posted by tel3path at 7:54 AM on June 25, 2012

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