Need miracle cure for acne
July 17, 2013 9:55 PM   Subscribe

I'm sick of my moderate adult acne. I feel like I've tried everything. I want to know what worked for you-- specific treatments/remedies but also lifestyle changes/diet/etc.

Growing up I had mild acne and went for long stretches of time with clear skin. Now I go to the dermatologist every 1-2 weeks to get cortisone injected into my zits and also just to generally bitch and moan. I'm in my early 20s and this has become a significant problem within the past year.

My current acne regime:

-Doxycycline 2x a day (oral antibiotic) -- worked very well at first, not anymore ~4 months in
-Wash face 2x a day with Cetaphil cleanser, follow with oil-free moisturizer
-Tazorac (retinoid gel) at night
-Acanya for spot treatment (which completely sucks but for some reason I continue to use it)
-Frequent cortisone injections

Other meds I'm on:
Wellbutrin, Vyvanse, occasional Klonopin, occasional Adderall (instant not XR)

Things I've tried:
Changing pillow cases often, doing nothing (i.e., just using water to wash face and doing nothing else), washing face with Dove bar soap, Epiduo cream, facials, toners, coconut oil, switching moisturizers

I don't really watch what I eat. I eat fruits but also a lot of carbs/sugars/dairy. My dermatologist has claimed that food has almost nothing to do with acne and that it's hormonal/out of my control. I find that hard to believe- they probably just want me to keep coming in.

I drink a lot of water and seltzer. Social drinker and non-smoker.

Please tell me what has worked for you. Diet changes? Exercise? Birth control? Other medicine? Laser treatments? I'm willing to try just about anything. I'm so fed up with these breakouts and it's driving me insane. I have to replace my concealer every 2 weeks because I literally won't leave the house without covering my zits. I'm generally happy with my looks but this is ruining my confidence. Lately my face is always shiny. I have to blot several times a day to keep it under control. I want to know if there's a way to fix this/if it could be contributing to the breakouts?

Thanks in advance
posted by DayTripper to Health & Fitness (55 answers total) 21 users marked this as a favorite
 
Nuke it from orbit: Accutane. The change in my SO's adult acne in a month was astounding.
posted by supercres at 10:02 PM on July 17, 2013 [10 favorites]


I cut sugar and wheat out of my diet for reasons completely unrelated to my skin, and haven't had a single acne breakout since.
posted by makonan at 10:02 PM on July 17, 2013 [4 favorites]


Stop using the concealer for awhile, it's likely just contributing to the problem. I wash my face once a day, at night, using Clean & Clear Deep Action cream cleanser or Neutrogena Oil Free Acne Wash Pink Grapefruit Facial Cleanser. The important thing for me is that it's a cream and not a gel wash, as these are more drying. To spot-treat I stick a q-tip under the tap and then dunk it into a little bottle of tea tree oil; I dab this onto the blemish once a day. For me I tend to break out on my body, and using Dial Gold Soap (anti-bacterial) in the shower keeps my back, shoulders, etc. clear. I really do believe that simple is best, and that our skin responds to an overload of drying or astringent things by producing excess oil. The important thing is to not let sweat dry on your skin, never go to sleep or even lay down with an unwashed face, and to use cream cleansers and the diluted tea tree oil.

I know it's controversial, but I also squeeze (non-cystic) acne to clear the infection. This works for me, especially with black-heads, but it may be counter-productive for others. I use clean hands on a clean face and allow the scab, if it was a white-head, to completely heal without picking at it.
posted by aspen1984 at 10:08 PM on July 17, 2013


Cutting dairy out worked for me but the most effective treatment was daily birth control pills.
posted by bq at 10:12 PM on July 17, 2013 [1 favorite]


Neosporin. Seriously.

Down a similar path, I suspect coconut oil might work.

My father had terribly acne as a young adult, and I take after him. I avoided years of acne with neosporin.

That's all I got.
posted by jbenben at 10:13 PM on July 17, 2013 [1 favorite]


Cutting out dairy, regular exercise that makes you break a sweat and switching to 100% mineral make up made a big difference for me. I still break out a week before my period, but the rest of the month I'm clear.
posted by tenaciousmoon at 10:15 PM on July 17, 2013


My dermatologist has claimed that food has almost nothing to do with acne and that it's hormonal/out of my control. I find that hard to believe- they probably just want me to keep coming in.


For many many people, acne is overwhelmingly hormonal. There's a reason so many women report much-improved skin when they begin hormonal birth control. Heck, there are birth control pills that advertise their ability to clear up your skin.

Since you say it is an option, and your derm considers your acne to be hormonal, why not give it a shot? Your OB/GYN will know which formulations of the pill are most associated with reducing acne.
posted by like_a_friend at 10:15 PM on July 17, 2013 [4 favorites]


Salicylic acid face wash, in it's various forms. Now I just get acne on other parts of my body.
posted by vaportrail at 10:22 PM on July 17, 2013


Rather than just shrugging and saying hormones, go to your gyn and get a full physical with bloodwork. All the birth control and accutane in the world isn't going to help much if you have a vitamin deficiency, systemic infection not affected by doxy, thyroid issue, etc.

And yeah, the makeup is making it worse. Among other things, unless you are using a fresh Qtip every time, you're incubating and smearing bacteria on your face every time you use it.
posted by Lyn Never at 10:26 PM on July 17, 2013


Make a pillowcase out of all-cotton terry cloth (towel fabric). Soaks up way more oil than regular pillowcases. Helps some. Bonus: no more embarrassing sleep drool spots.
posted by Eyebrows McGee at 10:28 PM on July 17, 2013


I've done Accutane, all the creams, steroids, antibiotics...basically anything that had any chance of changing it.

The Accutane worked, but caused some lasting health issues that weren't worth it. And the acne came back within a year.

I've tried every over-the-counter medication too, including Proactive. And frankly, nothing worked. But now, my skin is AWESOME because of Obagi. Using the three steps once a day is enough to clear up everything permanently. I now will have occasional breakouts or blackheads, but it clears up quickly and is barely noticeable. Every time I stop using it (like when I run out) it takes a few weeks for my skin to break out again.

I guess the secret is that it makes the product soluble so it gets into the pores in a way other products can't. It seriously changed my skin, and I'd recommend it in a heartbeat.
posted by guster4lovers at 10:33 PM on July 17, 2013 [1 favorite]


Birth control worked for me, but my Dr just informed me that they have banned this particular one in France due to potential blot clots. So yeah, maybe not the best option.

Paula Begoun of 'Don't go to the cosmetics counter without me' fame has her own acne line which could help. It's all fragrance/colour free with the good stuff like BHA's and other acne fighing ingredients. Could be worth a look. Here tis!
posted by Youremyworld at 10:45 PM on July 17, 2013


I suffered from acne through my teenage years and into my mid-twenties until I switched up nearly every product I was using on my face. I also take Adderall (I'm on XR, however I started taking it after my skin had cleared up and have found no changes since).

This "regime" has worked for myself and two other friends who also couldn't keep their face's blemish free, and is something that cleared up my skin while I was in makeup school and having things like morticians wax, latex, and greasepaint put on my face (and having it taken off) 2-3 times a day.

Cleanser- Avene micellar lotion (I used to use La Roche Posay, but switching to Avene made no difference)
Moisturizer- Nuxe 24hr soothing and moisturizing cream for sensitive skin
Primer- Smashbox photofinish
T m

Quite honestly, it's been the primer that's made me notice the biggest difference in the consistency of my breakouts. I can run out of the other products for a couple of days no problem, but if I try wearing foundation or concealer without a silicone primer to stop my pores from really gobbling it up.... bam. I look ten years younger for the wrong reasons.
posted by rideunicorns at 11:12 PM on July 17, 2013 [1 favorite]


I had terrible adult acne, and like you, the dermatologist's prescriptions didn't seem to be helping. My skin has always been oily, but I began breaking out really badly around a year or two ago. My dermatologist also gave me the "hormonal acne" line, and tried to get me on Accutane. I decided to try a few things before making that big of a commitment.

I started exfoliating a lot more, and using Dermalogica's microfoliant in conjunction with the Clarisonic Mia made all of the dermatologist prescribed creams and lotions actually work. I think the Mia really does help things penetrate skin better. My skin is oily though, so YMMV.

You can check out these products and see if you think they might work for you on Makeupalley.

Now I only get the occasional small pimple, and it goes away pretty fast.
posted by MFZ at 11:19 PM on July 17, 2013


Lifestyle changes that helped were spending more time outdoors in the sunlight, getting way more sleep and removing myself from stressful situations.

None of these things was a cure, but they were free to implement and definitely reduced the severity and frequency of the attacks.
posted by the latin mouse at 11:33 PM on July 17, 2013 [1 favorite]


I had severe acne up until about two years ago (I'm 26 now and only see the occasional spot).

It is my understanding that because every person's body chemistry is different, as are their potential allergies and irritants, one size will never fit all. I do know that food absolutely has 'something' to do with it though. What nonsense that your derm told you otherwise.

A book called The Clear Skin Diet saved my face. I had tried every topical treatment imaginable and decided a last ditch would be 'natural healing.' To my surprise, food ABSOLUTELY has everything to do with it.

In addition to changing my diet I did a series of chemical peels. That was brutal, but it worked wonders.

DO NOT TAKE ACCUTANE before trying a clean, proper diet. That stuff has killed people.

The hormones in dairy products are the culprit for many people, as is refined/processed food and sugar in general.

My skin is clear today. I eat a diet of whole foods- primarily organic vegetables, fruits, nuts, protein shakes, and leafy greens. I do eat the occasional organic egg and haven't found that I break out as a result.

I use a 10% benzoyl peroxide gel if I feel a small breakout coming on, (if I've been naughty- i.e., nachos, cakes, pastries.. guilty.) and it works wonders for me. But absolutely read up on that stuff if you decide to try it because it can cause a world of pain and destroy many towels and sheets if you don't handle it properly. There are many brands, just surf for the highly rated ones.

Good luck, my heart goes out to you I remember how frustrated I was.
posted by OneHermit at 11:45 PM on July 17, 2013 [1 favorite]


I can't pitch a clean diet loudly enough; if you don't read the book, absolutely try cutting out dairy, processed foods, and refined sugars for at least a month and see what happens before you harm your body with accutane.
posted by OneHermit at 11:49 PM on July 17, 2013 [1 favorite]


I feel that Accutane is a last resort.

My dermatologist has claimed that food has almost nothing to do with acne and that it's hormonal/out of my control.

It sucks, but it's true for many people. See if your derm is open to prescribing Spironolactone. This wipes out hormonal acne without a lot of the side effects of the pill, in my experience. I take 75-100mg/day (he prescribes 4x/day of the 25mg tablets which are covered under the $4 generic plans at most pharmacies in the US). Changed my life. I now leave the house with no makeup at all and don't even think about it.
posted by Bunglegirl at 12:04 AM on July 18, 2013 [4 favorites]


Instead of doxy, I found that a sulfa drug three times a week (bactrim, single strength) really worked for me.

Epiduo was semi-helpful, but doesn't really do the trick like the bactrim does.
posted by sockermom at 12:19 AM on July 18, 2013


If none of the above options work, try turmeric paste made from turmeric and plain Greek yogurt. Turmeric is an anti-inflammatory and I use it on any spot that pops up with great success.
posted by discopolo at 12:58 AM on July 18, 2013 [1 favorite]


I never had severe acne as a teenager, but in my mid-twenties began getting moderate-severe acne. I found that over the counter stuff dried my face out harshly without treating/affecting the acne.

I now use two prescriptions together: a retinoid gel, and Finacea. For me, the Finacea was the first thing that actually worked to treat my acne. It did get worse before it got better, but the Finacea actually helped bring the acne up to the surface so that it *could* be treated, rather than just suppressed, I guess, with over the counter treatments. The retinoid gel helps to prevent acne, in my case, but the Finacea is what really helps treat acne that is there presently. The Finacea is definitely more effective than the retinoid, in my opinion, but they are better together in my case.

I do believe that for some people there is a connection between food and acne as well. For me, when I eat too much sugar (and I can eat a lot of sugar), I break out in the very specific spot between my temple and cheekbones on each side. This happens about a 3 days to a week after a sugar binge, and only then. (I typically have a pimple or two on my chin, but the temple/cheekbone spot seems to come up only after eating too much sugar.)

If your doctor hasn't prescribed Finacea yet, I would ask about that.

I also have rosacea, and I have found that sulfur products work well to treat the redness and small bumps that can look like acne. Over the counter Prosacea is great, and metrogel is a prescription for it.
posted by shortyJBot at 1:08 AM on July 18, 2013 [2 favorites]


I'm so sorry that you're dealing with this. I've been there. For the last year and a half or so, I've been clear with the occasional spot. (There are even days that I rock absolutely no makeup IN PUBLIC, which feels really huge for me.) My two cents:

I strongly second the mineral makeup suggestion. (I use a bareMinerals powder foundation.) If you truly do not want to leave the house without some kind of concealer, and there aren't many days when staying in and unmade-up feels like an option, this may make a big difference.

Also re: makeup - do you use anything besides Cetaphil to remove it at the end of the day? I know that it shouldn't be necessary, but I've found it helps to take any foundation or concealer off with a special remover before doing the rest of my face-washing. (I use a very small amount of this one.) Washing any makeup brushes/applicators themselves regularly is important, too.

My skin care routine is currently this:

Morning: Cetaphil (rinse with a washcloth, to exfoliate a bit), followed by a small amount of this lotion and any makeup I'm wearing.

Night: Makeup remover, Cetaphil (again, getting gently scrubby with the washcloth), followed by this lotion, only as/where needed. I also add a layer of this serum underneath the lotion if I'm having an especially blemishy day/week.

The Murad products have been a godsend for me. If you have a Sephora near you, you might have them whip you up a sample of some of them. They are crazy-expensive, but as you only need a tiny, tiny amount, a bottle usually lasts me at least five or six months, and a Sephora-sized sample container can last a week or so.

While I've used topical meds in the past, I haven't in a long, long time. I primarily recall that they (and Proactiv, during my brief stint with it) made my usually-oily skin feel uncomfortably dry, and even flaky.

FWIW, I'm a vegetarian who consumes minimal dairy - cheese (delicious cheese...), but almond milk instead of milk, and not much else. Like you, I drink a lot of water. I also began taking vitamins and switched birth control pills around the time that I began the new skin care routine. While the combination of all of these things (and a bit more sleep) seems to have helped immensely, it's harder for me to put finger on one cause for the improvement. As far as birth control is concerned, though, no pill has ever made an enormous difference for me - they've made breakouts more predictable, is all. YMMV.
posted by Austenite at 1:20 AM on July 18, 2013


Being on birth control pills clears up my acne (and it has come back both times I've stopped taking them).

I definitely think diet can have an effect too, at least for some people/some types of acne, even though a lot dermatologists say otherwise. There's a difference between something not having been proven and it not actually being true.

For me, cutting out cheese from my diet and eating more whole grains had a big effect. I don't eat much meat or other dairy products, so I'm not sure if it was cutting out cheese specifically or dairy or saturated fat in general. With the whole grains, the change I made was basically just eating whole wheat bread or crackers instead of other types. I eat a fair amount of sugar and white rice and that never seems to make much difference one way or another, so I think the important thing was the adding more fiber part not the reducing refined carbs part.
posted by treese at 1:53 AM on July 18, 2013


I forgot to say, the one birth control prescription I was on actually initially made my skin a little worse in the first couple of months but after that cleared it up.
posted by treese at 2:14 AM on July 18, 2013


N'thing going on the pill and/or cutting out dairy.
posted by DestinationUnknown at 3:23 AM on July 18, 2013


When I go on birth control without taking the week of placebos, my acne pretty much disappears. My doctor was perfectly willing to write a note allowing me to do this when I went to her and explained how much it affected my health.
posted by chaiminda at 3:47 AM on July 18, 2013


I have been using the La Roche Posay Effaclar range that is formulated for acne and it is giving me very good results so far. Effaclar K is particularly good for the daytime as it keeps my skin from getting too oily. Prior to that I had been using glycerin soap and a mild moisturiser only, which kept cystic acne to a minimum but I was still getting a lot of blocked pores.

The other things that I find help are to drink more water, and take a good quality Vitamin D3 supplement (currently I'm on 3 months of 10,000iu) and avoid drinking much alcohol.
posted by veids at 3:57 AM on July 18, 2013


A bunch of people appear to have found Caroline Hirons' advice helpful. I think she'd say your cleanser was too harsh and too alkaline, and a bunch of other things besides.
posted by Acheman at 4:00 AM on July 18, 2013


Accutane is, at best, a bitch while you are on it. I, too, have had lasting effects.

I'm 55, had acne since around age 9, cystic acne from my teens into adulthood. Well into adulthood.

I've cut out virtually all wheat and animal products, and my skin has never looked better. If it weren't for the scars, you'd never know my skin had not always been great.
posted by jgirl at 4:29 AM on July 18, 2013


My son's skin was so clear after Accutane that other parents asked us about how he kept his skin so clear. It absolutely is the nuclear option of last resort, but under the supervision of a competent doctor, it is safe to use.
posted by COD at 4:58 AM on July 18, 2013 [1 favorite]


My dermatologist also told me my acne was hormonal, since it was mainly on my chin and got worse right before my period. She put me on a low dose of spironolactone, which reduces the amount of testosterone in your body. After the first couple of months, I haven't had any major breakouts, and the occasional pimple I get goes away quickly.

I also use Differin gel (a retinoid) at night, and Aczone in the morning (to reduce redness and inflammation because the Differin dries my skin out). However I think it's the spironolactone that has made the difference for me, since I was on those topical medications before starting the spiro and my breakouts didn't really stop until starting spiro.

I am a woman in my mid-30s. I've tried changing my diet before and it never helped at all.
posted by barnoley at 5:10 AM on July 18, 2013


(Oh also, I've been on many different birth control pills over the years, and even the ones that are supposed to help acne (Ortho Tri-cyclen, Yasmin) did not help me at all. In fact, I think they actually made it worse. So not everyone gets clear skin on birth control.)
posted by barnoley at 5:11 AM on July 18, 2013


My Clarisonic makes the biggest difference for me. My favorite cleanser was the blue acne one Clarisonic made, but they reformulated it, and the new one isn't it. I'm currently using the Juice Beauty blemish cleanser - I think it has gentler salicylic acid from willowbark - and it's doing pretty well. Sometimes I follow up with a stridex pad on my forehead and nose.

I have not had a cystic acne breakout in months now.
posted by Ms Vegetable at 5:54 AM on July 18, 2013


I came in to say Spironolactone as well. Nothing topical helped me, but Spironolactone cleared it up totally in about 5 months. I take it daily and I have never had such great skin.
posted by Lescha at 5:55 AM on July 18, 2013 [1 favorite]


A lot of people are anti-Accutane but I'm three months in and this morning I cried because for the first time since I was sixteen, my face is clear. Like, straight up clear. I wish I'd done this earlier rather than go through ten years of treatments (nearly everything else - a string of antibiotics, all the retinoids, everything they put you on before the retinoids...everything except laser treatment.) In the end, none of it worked, and this has.

The only side effect I've had is dry lips. Some people have had worse (significantly worse!) experiences with it. Talk to your doctor. The blood tests and lifestyle change required are annoying, but I'd happily do this forever if it meant my skin being so nice.

Birth control helped to some extent but not enough to, say, leave the house without makeup.
posted by punchtothehead at 5:59 AM on July 18, 2013 [2 favorites]


My skin was pretty troublesome for like a decade, starting in the late-teenage years. I tried out the stuff here -- http://www.acne.org -- and it has been totally clear (except for a very occasional minor pimple) for five years or so. It's just a regimen of putting on benzoyl peroxide (I think 2.5%?) twice a day, and gentle moisturizer, but it really works for me and apparently a lot of other people. (I just bought some benzoyl peroxide from the drugstore to try it out at first, but now I do buy it from the website because their stuff is cheaper and has a better consistency.)

I'd avoided benzoyl peroxide previously because it made my skin red and itchy, but it turned out that I just had to suck it up and go through two weeks or so of adjustment with flaky red unfortunate face, and then all of a sudden it was fine. I wear minimal makeup these days and just generally don't worry about my skin at all. Sometimes I remember how I used to get up in the morning and sort of cringe at the first look in the mirror -- anything better? worse? new and unexpected? -- but I haven't felt that way in ages.

Only downside is the stuff can bleach your pillowcases/sheets and clothing if you're not careful. I just stick with white towels and bedding, and it's pretty much fine.
posted by little cow make small moo at 6:29 AM on July 18, 2013 [1 favorite]


Recycling my own old comment, hope it helps:

Sulphur (MSM) supplement as recommended by my dermatologist has been a miracle for me. Per my doctor, you take a small half teaspoon daily for a month and then stop: it will either work for you or not; either way, taking it after a month doesn't add anything. I did it several times over the years (teenage acne, on/off the pill, and moving continents) and every time, it cleared everything up completely. I've always looked for pure sulphur, nothing added. It has no taste whatsoever so you can just put the powder on your tongue and wash down with water.
posted by rada at 6:29 AM on July 18, 2013


How long have you been on the Wellbutrin? Has your acne been worse since you've been on it? I ask because I had HORRIBLE acne while I was on Wellbutrin, and it went away almost entirely when I stopped taking it. So anecdotal, but it's possible that your Wellbutrin is causing your acne and switching to a different antidepressant could work.

I don't know about Vyvanse, but I took Ritalin and it also made me break out a bit, the theory was that it was drying me out so much that my skin was producing more oil to overcompensate.

Other than that, my skin is definitely clearer when I eat less processed foods, especially white flour and sugar, and just do plain old soap and water once a day, rinsing thoroughly.
posted by rabbitrabbit at 7:40 AM on July 18, 2013


OH! I also just remembered that I've heard several people recommend Preparation H for acne. I've never tried it myself, but several people I know swear by it.
posted by rabbitrabbit at 7:41 AM on July 18, 2013 [1 favorite]


I had cystic acne, occasional flares but often BIG ones. I did accutane (a different medication name, but similar) and it wasn't a big deal. If you're female, it's critical that you do not get pregnant. I'm a guy and I used extra chap stick and eye drops for a few months. And they make you do a blood test every month. Seriously, that was the extent of it for me.

It worked where nothing else did (I was 38 at the time, so many years of trying stuff), and 4 years later I'm still completely clear.
posted by jeff-o-matic at 7:58 AM on July 18, 2013


I have Papulopustular rosacea, which can be confused with acne. (Imagine the complexion of a 14 year old boy as a 39 year old woman.)

My dermatologist put me on spironolactone and it went away.
posted by Lucinda at 8:44 AM on July 18, 2013


I tried most of the stuff mentioned above for persistent moderate acne, including the Clear Skin Diet book, the Acne.org regimens, and years of dermatology treatment, lasting well into my late 20s. I never had scarring until I used some of the prescription retinol creams that cause high rates of skin-cell turnover. (Tretinoin? Differin? I don't remember them all.) I had years of various topical creams and years of high-powered antibiotics that were terrible for my digestion, all with very little effect.

What worked was accutane (under the Claravis brand name), and it worked instantly with no real side effects. My skin has been totally clear for years now.
posted by stopgap at 8:47 AM on July 18, 2013


As an aside: I found that acne treatments left me with oily skin so I would get products that claimed they helped reduce oiliness. But really, my skin was oily because the treatments were drying it out and my body was compensating by producing much more oil. My products targeted for oily skin were counterproductive, then, because they were even more drying. In fact, my skin was so dry I found that even just rinsing my face with water and not moisturizing immediately would leave it dry and red. Cetaphil is pretty mild, but you might try something like a cold cream or a moisturizing cleanser that you wipe off instead of rinsing with water. You could also look into the oil-cleansing method. For me, Cetaphil was actually slightly irritating because it has sodium lauryl sulfate and alcohol.
posted by stopgap at 8:57 AM on July 18, 2013


Check ALL your acne treatment products and makeup for ANY siliciones at all. I, like you, had done a ton of acne treatments (I only lasted 12 days on Accutane. It was brutal). What I finally figured out is that my skin is very sensitive to silicones in products and they are everywhere ... in every moisturizer, face wash, makeup product, etc. You have to be ninja-like in ridding them from your product pile.

Stuff I use now:

-- Acne.org face wash
-- Aczone (prescription)
-- Retin a cream
-- Peter Thomas Roth oil-free moisturizer.

The following companies also make 'cone free products: Coola, Boscia, REN, EmerginC, Juice Beauty. Some of Peter Thomas Roths' products are 'cone free. Try that. See what happens. Good luck.
posted by nubianinthedesert at 9:11 AM on July 18, 2013 [1 favorite]


I took accutane in college and it nuked my acne. I was happy. It returned when I was 26 though. It took me a year to figure out that I was having too much caffeine and when I limited my coffee, my skin would clear up. I also include eating spinach nowadays for some extra vitamin A. Beta-carotene supplements also helped.
posted by DetriusXii at 9:34 AM on July 18, 2013


My annoying adult acne vanished (in my late thirties) when I went on a low-carb diet. I don't think it was as severe as yours, but it was definitely present and annoying and quite painful at times. After 3 months eating "paleo" by however you define that term, it was gone and has not come back.
posted by KathrynT at 10:19 AM on July 18, 2013


Things that have worked for me:


-Avoiding all iodized salt and sea salt (which are in virtually all processed food, sigh)

-Evening primrose oil capsules, 1500 mg/day. The inexpensive brands never worked for me, but YMMV.

-I stopped getting acne on my back when I switched to a sulfate-free shampoo. It was a possible coincidence, but it might not hurt to cut sulfates out of things that touch your skin. I also found that I got horrible acne/rashes from color-depositing shampoos, FWIW.

-Finding a dermatologist who is willing to listen to my concerns and work with me. Easier said than done, I know.
posted by corey flood at 10:46 AM on July 18, 2013


I recently started on the acne.org "Regimen", and it seems to be working. That site also has tons of reviews/experience logs for other products and methods. I've also found cutting down on dairy and wheat products to be highly beneficial.

If you're considering the Accutane route, there's some recent research suggesting that taking a much lower dose of Accutane than is usually prescribed can be comparable in efficacy to the standard dosage, and without the gruesome side effects (google "low-dose Accutane").
posted by zeri at 12:27 PM on July 18, 2013


For me, no medication, antibiotic, or creme from the dermatologist ever worked completely.

Controlled the problem, but my acne never went away. I always had at least several bumps on my face, back, chest. So I finally just accepted I would have to deal with acne until I was elderly.

I also had a lot of allergies and constant sinus infections which were getting worse and worse, so when I turned 40 I became desperate, went to see a holistic doctor, and radically changed my diet.

And, not only did my allergies improve, but my acne cleared up completely.
I avoid gluten, anything made with milk or milk products, and sugar.

When I eat even the tiniest amount of milk (or cheese or yogurt or butter etc...) I break out in large cystic bumps and get whiteheads. Sugar does not help, but any products made with milk make my acne go bonkers. Butter is the worst.

Avoiding gluten caused my life-long (since age 3) eczema to vanish.
If I eat wheat now within a day or two my fingers and feet breakout with eczema.

Changing my diet has honestly been a miracle cure for me!
I still cheat, but my skin reminds me every single time (and so does Mr. bessiemae, who can tell when I've been cheating because my skin rats me out.)

No matter what your dermatologist says, I would encourage you to experiment and eliminate common allergy-causing food one by one. See if your skins looks better without it for a few weeks/ month, and see how you feel (and how your skin looks) when you add it back in.
posted by bessiemae at 1:11 PM on July 18, 2013 [1 favorite]


Another one for Accutane. I'm on it currently and my only real side effect for me is dry lips. I'm almost two months in and people are SHOCKED by how great my skin looks, and this is just the beginning. I've taken every antibiotic, every hormone treatment, every cream, and tried all the OTC stuff, too. Sometimes you just have to bring out the big guns and shut it down. I only wish it didn't take so long to get to this point!
posted by ancient star at 2:46 PM on July 18, 2013


Stridex Max strength is the best solution, worked like magic on stubborn decade old cystic acne.
posted by greta_01 at 6:01 PM on July 18, 2013


I'm late to the "I hate pimples" party, but thought I'd add my two (or more) pence while the thread is still open.

Acne SUCKS. It sucks more than anyone who doesn't have to deal with it can EVER understand. I know the frustration of looking at your face in the mirror in the morning and thinking "FFS!" and "WTF??!" (insert favourite expletive) and the shame/sadness/anger/etc. associated with acne. The depression that can coincide with it is too often minimised by friends, partners and the g-damn doctors that are supposed to help. It definitely has emotional and psychological consequences, in addition to the obvious physical ones. You are not alone!

/ rant over

Anyway....as you will have discerned from above, there does not appear to be a single solution/cure that works for everyone. I'll just tell you my little story and recommendations.

I went on accutane at about age 19/20, as my first year at Uni (lucky me!) I started to get horrendous cystic acne. The accutane helped take it down several notches, but didn't eradicate it. What worked for me next -- for years and years -- was that at about age 21/22 I went on the pill; ortho tri-cyclen in particular.

I didn't realise that the bc pill was suppressing my acne, though, until I went off it in my early 30s. I think I thought that I had just outgrown it. Then holy sh*t, about 6 months later, cystic acne came back with a vengeance. I tried OTC from the drugstore, topical stuff from the doctor, etc., but it got to a point where I could not -- emotionally -- take it anymore, so I went back on the pill. Fast forward a few years, and I tried to go off the pill again, thinking "surely I should have outgrown the acne by now!" Erm, nope! Boom, some number of months later, cystic acne came back. Back to the bc pill (but living in a different country, I couldn't get ortho tri-cyclen, so went through a slew of other types).

Fast forward a few years again, and I tried again to go off the pill. But this time, I tried to pre-empt the cystic acne's return by taking a boatload of vitamins for several months ahead of going off the pill (e.g., mega B5, zinc, vitamin C, d3, etc). And you know what? I *thought* I had finally solved it! I didn't have acne for month, after month, after month. Yay, me! Well, boo me, b/c almost exactly a year later, the cystic acne returned. Gaaaah! :(

That was about 2-3 years ago. I am now in my early 40s and remain off the bc pill and am still trying to manage my acne. I decided NOT to go back on the pill (at least for the time being) b/c I can't be on it my whole life, and need to figure out a way to control the acne without it. So since getting off the pill, I have tried a variety of lotions and potions and have been on a few rounds of antibiotics when the cystic acne has come on in a serious attack (e.g., new ones every damn day).

At the moment, I am getting over one of these serious attacks, and my skin is looking (no jinxing) pretty good (if one ignores the red marks). So in addition to taking antibiotics on an as-needed basis (I've been prescribed limecycline, for 2-4 months at a whack), I have also incorporated salicylic acid into my daily regimen. This has worked much better for my skin than BP (which I've also read is not good if you are concerned about ageing skin). In particular, this stuff has really helped the acne bumps (not cysts, but more like congestion) on my chest and it helps bring jawline cysts to the surface (so they don't just grow under the skin indefinitely). It also helps reduce the post-spot redness pretty darn well too.

I think exfoliation is highly important to those of us with acne, you just have to be careful how it is done. For a while, I was using a spinning brush thing (not clarisonic) and I swear that helped, but if you have active acne and you aren't careful with the product you use with the brush, you can make things worse by over-drying and irritating your skin. You have to strike a careful balance when you have acne, NOT to over-dry. I think that is what happened to me in the episode before last: I used drying stuff and it seemed to be working, so then I applied the drying stuff with greater zeal (in my excitement at seeing improvement), but then tipped my skin over the edge and irritated the hell out of it, making for a long, horrible cystic acne episode.

So I have moved somewhat away from manual exfoliation to 'chemical'. And my new regime relies heavily on Alpha Hydrox products. I use the face wash, which claims to leave your skin with the 'right' ph level, which important to reduce irritation/inflammation and, thus, acne. And I use the swipes maybe a couple of times a week; these really give your face a nice glow the next day and help get rid of dead skin/stuff (cut pads in half to make them go further). And finally, as a night treatment (since I use the salicylic treatment during the day), I've been using either the enhanced glycolic lotion or the souffle. Both of these help exfoliate without you having to rub your skin. I truly believe that these products (the clearasil + the alpha hydrox) have significantly improved my ability to manage my cystic acne alongside the use of antibiotics if/when they are called for (e.g., when I went overboard previously and over-dried my skin).


Things that don't work for me:

I've just realised that tea tree oil is very bad for me. I think that every time I used it (even diluted) to treat a couple of cysts underneath my jawline, the whole area got worse, and fast too. So be carefull with that stuff if you try it.

I thought black African soap was my holy grail a few months ago. Seriously, my skin looked amazing for a while when I started using this (alongside a black African soap lotion). I was feeling very cocky and proud of myself for having found something so simple and cheap! But alas, I think it can be over-drying, and this was the stuff I got over-excited/over-zealous about using, which resulted in a pretty bad episode. So I have stopped using it, but may go back to it at some point; just use it less often. For many people on makeupalley, it has been their holy grail, so it is something to look into. Just, as ever, be careful about not overdrying your skin.

Finally, I urge you to try your best to manage acne without accutane and bc pills if you can. I think that, although the bc pills helped while I was on them, coming off of them can be a mother-f-er for your skin, as you are caught in a vicious cycle whereby your skin needs the pill to look ok, or else you look like sh*t (i.e., it messes with your body's ability to regulate and produce its own hormones). And while accutane can help some people, it is serious stuff and a significant proportion of people have to do several cycles to get it to work.

OK, now that I have written a short book, I'll sign off. Best of luck in coming up with a routine that works for you!
posted by Halo in reverse at 5:55 AM on July 20, 2013


Seconding jbenben's Neosporin suggestion.

I realize it's probably not great for me to regularly use an antibiotic on my face, but it has really helped with my adult lady acne - that didn't start until my early 20s. Other things that have helped (and I've had alllll kinds of acne) were to find the right kind of birth control pill, exercise, drink loads of water, and get enough sleep. I wash my face with just water, and use a Burt's Bees Citrus Facial Scrub every other day or so to exfoliate (I have dry skin that is acne prone, and also sweaty prone - go figure). Then a couple of times a week, I'll spot treat with neosporin after washing my face, or thinly spread it as a mask.

In terms of exercise, it's critical that I rinse my face with water immediately after working out (or even once during, if it's a long workout). I sweat like a mofo when working out (sometimes not even when working out), and I need to rinse my face to get all the sweaty crap out ASAP.

I find that generally, my skin responds better to a "less is more" approach. Water, a burt's bees exfoliate, and neosporin help keep things under control most of the time.
posted by raztaj at 10:44 AM on July 20, 2013 [1 favorite]


P.S. Neosporin doesn't work for everyone. I've tried it and it made my (jawline) acne worse, perhaps b/c it contains petroleum jelly. If your acne is due, in any part, to clogged pores, then this could cause a problem for you. According to Wikipedia, Neosporin is known for causing contact dermatitis.
posted by Halo in reverse at 2:02 AM on July 22, 2013 [1 favorite]


i have had some issues with adult acne and then a few years ago i had a reaction to a product that gave me something that is similar to acne but even worse because the darn pimple-like things come back in the same spots over & over. it also spreads easily. i think the dermo said it is some sort of dermatitis and that there is no cure. she gave me some weird sulfur towelettes and they worked but made my clothes smell like sulfur so i stopped using them. smelling like rotten eggs was really not working for me!

anyway, very recently i've switched to burt's bees products, still trying out various samples, and my skin is almost completely cleared up. it may be that their naturally ageless moisturizer is making the huge difference, but either way i don't have those awful cyst-like things anymore and most of the pimple-like things are gone too. reading reviews on their site it seems their products, because they don't have all the gross chemicals of other products, do clear up a number of peoples' acne. they also have an acne line which i haven't tried. i'm probably going to try their sensitive skin line when i'm done with these samples.

Neosporin doesn't work for everyone. I've tried it and it made my (jawline) acne worse, perhaps b/c it contains petroleum jelly.

there is a cream version of neosporin. i don't think it has petroleum jelly, or if it does, it would be quite minimal. i think that is what people are referring to using on their acne.
posted by wildflower at 9:47 PM on July 23, 2013


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