Painful cystic acne, 28 y.o. female, HELP!

[Lizzie1980]

This is my first post on here. I just registered and got my account. I am hoping that the experience of the users here might help me evaluate my acne. Here is my story in a horribly-condensed nutshell:

28 y.o. female with painful, scarring cystic acne. Have been on Differin for 2.5 years - still using it but it doesn't seem to be making any difference.

As a teen, I had no acne or very little - I do not remember having trouble. Once I became sexually active around 17 y.o., I went on combined oral contraceptives. I stayed on oral contraceptives, changing brands to Yasmin sometime in 2003. I was on Yasmin approximately 2.5 years. While on Yasmin at around age 24, I began to have some mild cystic acne appear on my chin/jaw/cheeks occasionally. I also had no sex drive, apart from the period during which I was taking the sugar "break" pills to bleed.

Due to no sex drive and other stressors I stopped taking birth control pills in July 2005. I opt to monitor my own cycles and provide contraception for my relationship through natural family planning. I do not have and have no desire to have any kids. PROBLEMS START. Cystic acne lesions begin appearing 3/4 months after stopping oral contraceptives, and escalate quickly to alarming proportions. Multiple breakouts per cycle, highly oily skin, painful lumps and cysts under the skin, red scars and pock marks afterwards.

Family doctor prescribes me some oral antibiotics to see how that works. They do not help significantly.

I see a useless Dermatologist who is more interested in my Scottish heritage than he is in solving my acne. He prescribes me Differin and Evoclin to see how they do. I never use the Evoclin, but I do use the Differin. I progress through 2006 and 2007 with the same acne problems. The acne comes and goes in no particular order with no particular pattern. It is all concentrated around my chin, jaw and cheeks.

I have eliminated several things from my diet to try and control my acne, including cow's milk, peanut butter and chocolate, and for a while it seems to make a difference but then I get hit with another big breakout. I use only a Cetaphil-type cleanser, no scrubs, no harsh chemicals. The only things that get put on my face are Cetaphil, Differin and a light, water-based moisturiser. I have stopped wearing makeup.

The acne breakouts continue. They are extremely painful, red lumps which begin under the skin. They occasionally come to a head, occasionally I take a sterilized needle to them and pop them to get pain relief and allow the cyst to dry out and scab over. This seems to be the only way the lesions ever heal - if I do not pop them they stay under the skin as a lump for months.

I do have a sex drive and I am ovulating and menstruating regularly, with 26-28 day long cycles every cycle give or take. I have recently had a crop of black, thick hairs develop on my chin. Because of this, I ordered my GYN to order some hormone tests. We tested testosterone, FSH, LH, DHEAS, and one other thing I can't remember. All results came back in the "normal" range, although my DHEAS and testosterone levels (the male androgens) were on the high side of normal (but still normal).

I have noticed NO pattern in my acne breakouts. I can eat burgers and fries all week and have gorgeous skin, and then eat at home healthily and break out. I can break out on Days 1, 10, 15, 20, 25, 28 of my menstrual cycle randomly. I monitor my cycles and my acne like a hawk, and have been for three years. If I routinely broke out with PMS or ovulation - I think I would have noticed a pattern by now.

So whaddiya all think??? I would SOOOO appreciate some input here as I'm about sick to the back teeth of all this. I am 28 years old and embarassed to look like a teenager with spots, and I am sick of the way I look. I have a doting, loving husband who - bless him - doesn't care about any of this.

I also have prehypertension or stage 1 high blood pressure, which I will be seeking treatment for soon. Yes - I am aware of Spironolactone and it's anti-androgen effects. I would not mind trying it as it would treat my Bp problems too - but I am worried now about its effects on my menstrual cycle regularity. I really do not want to go back on birth control pills - mainly because of my high Bp. I would love to go on Spironolactone if I could still monitor my cycles regularly and evaluate when I ovulate in order to provide abstinence contraception for my husband and I.

HELP!!!!!!!!!!!!!!!!!!!!!!!!

L.1980

[AnnD]

Why keep using and paying for stuff that doesn't work. If you haven't been tried on Accutane then try it...it is very good on cystic acne and it works! Accutane is hard on the liver so you have to monitor your blood while you are on it but it all so worth it...it is regulated period of time you have to be on it but the effects of the drug lasts for years. good luck.

[Lizzie1980]

Thanks for the advice, but I am vehemently opposed to Accutane. Accutane is a high-risk drug that comes with high mental and physical risks attached to it. I am not prepared to put it into my body.

I'm not paying for Differin anyways - I have prescription drug coverage......but that's neither here nor there. I am more fixed on determining WHY I have this acne and what's CAUSING it, than I am about knocking it out of my system with a potent drug.

L.1980

[Monarch7]

I feel your pain! I'm a 36 year old female whose finally figured something out. I have tried everything except Accutane and was told that was my only hope. I have had cystic acne for a couple years and it was very embarrassing and painful. I've had to get a steroid shot because my eyelid was swollen from a cyst. The biggest thing that helped me was changing base makeup. I went to Merle Norman - they have a website - and got the delicate line. Their mineral powder has like 3 ingredients total and the coverage is great. I have used 3 other mineral powders and was very disappointed. They just didn't cover and it felt oily even though I have dry skin.

I have also used many face soaps and washes and fell in love with the Oil of Olay wash for sensitive skin. NO break outs.

I was desperate and ready to just fall over from the agony. I was willing to buy anything. I have not had ONE cyst since I switched just two products. Dermatologists, like any other doctors, don't know ALL about you and how your body works. Only WE know what works for us and what we have been through.

I've tried watching the foods and drinks and can also report that pizza breaks me out every time, but nothing else.

Peace to you and your new confidence...

[Lizzie1980]

Hey Monarch (love that name LOL!),

Thanks so much for the advice and support. Unfortunately - I do not wear makeup, so it is not makeup that is making me break out. I wish it were that simple! As for face wash - I use walmart's brand of Cetaphil cleanser which has basically nothing except water and steryl alcohol in it - so it's not that either.

In fact, here I am on day 5 of my cycle and I have just broken out with 3 new cystic pimples......I was thinking about stopping eating sweet stuff altogether and managed it for two weeks, but broke down last night and ate about ten cookies. I can't do that.

Anyways - just an update - my gynecologist called me last week after the results of my hormone blood tests came back. She wants me to come in next week for an ultrasound to screen me for PCOS!!!! I NEVER thought that I would be at risk of having PCOS - my cycles and periods are as regular as clockwork with every cycle being 26 days long give or take a day or two here or there. Anyways - according to her, my FSH and LH hormones are at an out-of-whack ratio and this could be a sign of the earlystages of PCOS.

So - next week it's off to the gynecologist - while drinking bottles of water! - to go get my ovaries checked out on ultrasound! NEVER had an ultrasound before and quite apprehensive!!!!

L.1980

Originally Posted by Monarch7

I feel your pain! I'm a 36 year old female whose finally figured something out. I have tried everything except Accutane and was told that was my only hope. I have had cystic acne for a couple years and it was very embarrassing and painful. I've had to get a steroid shot because my eyelid was swollen from a cyst. The biggest thing that helped me was changing base makeup. I went to Merle Norman - they have a website - and got the delicate line. Their mineral powder has like 3 ingredients total and the coverage is great. I have used 3 other mineral powders and was very disappointed. They just didn't cover and it felt oily even though I have dry skin.

I have also used many face soaps and washes and fell in love with the Oil of Olay wash for sensitive skin. NO break outs.

I was desperate and ready to just fall over from the agony. I was willing to buy anything. I have not had ONE cyst since I switched just two products. Dermatologists, like any other doctors, don't know ALL about you and how your body works. Only WE know what works for us and what we have been through.

I've tried watching the foods and drinks and can also report that pizza breaks me out every time, but nothing else.

Peace to you and your new confidence...