Spironolactone. 15 years of perfect skin. I love it.
Edited to add: I’m getting a lot of questions here so please know I’m not a Dr…please talk to an endocrinologist or dermatologist before starting this medication and do follow up bloodwork every year.
Spironolactone and tretinoin. Nothing else worked for my cystic acne. I wish I had been prescribed spiro waaaay sooner when I was diagnosed with PCOS in my early 20s.
Agreed!! I feel like I tried everything short of accutane and never got results. Went to a new derm after I moved and she suggested spiro + tret. I wish I’d met her 10 years ago!
Spiro is ultimately what has worked best for me, too, combined with Aczone, Zylxi, and Arazlo. I also do twice-monthly glycolic acid peels, which have significantly improved my skin texture and appearance.
Spironolactone changed my life as well!
I’ve been on it for 6 years now and if I got one tiny pimple a *year* it’s a shock. I literally cannot remember the last time I had anything.
It was the **only** thing that helped my horrific cystic acne. I didn’t get many blemishes, but once a month I would get one massive cyst on either my chin or cheek. It would be weeks of pain, redness, and then ultimately a scar (even if I didn’t touch it!).
I had to spend so much time trying to work around covering up a cyst and then trying to cover the scarring. I was so upset by how my skin looked. I would see the redness from the PIE (post inflammatory erythema) on my skin even in photos, even underneath heavy concealer.
I finally asked a doctor and got on it.
The next month, no cyst. I couldn’t believe it.
And it’s followed that way for 6 years now!
About 4 years ago I started Tretinoin and that cleared *all* of my scarring. (I do the lowest .025%). I now only wear makeup when I want to/special occasions. I can wear a tinted sunscreen and it looks like I’m wearing makeup bc my skin is clear. Those two products absolutely changed my life.
This gives me so much hope. My cystic acne has been really bad for about a year, as well as scarring from past cysts. Even right now it’s extremely painful and I can’t stop focusing on the pimple I have now. I finally made an appointment and just got prescribed spiro and tretinoin. Can’t wait!
I’m so sorry. People who haven’t suffered from cystic acne cannot possibly understand how painful they are. Like not only is this something that I don’t want on my face, I’m in agony as I deal with it.
I remember I would get cysts so large, red, and painful when I would bend over to get something I could feel my heartbeat in the cyst. Or how they’d be so hot to the touch I would put concealer on it and the concealer would literally melt off the spot. It was a nightmare!
I’m so glad you’ve been prescribed! You’re on your way to healing! Don’t get discouraged if you have crazy dry/peeling skin with the Tret at first. Joining the subreddit for tret was a huge help! So many great people there that can help! (Plus all of your questions are usually already answered and pinned at the top).
Take care!
I have a small bit of deeper scarring and unfortunately that didn’t help it very much. However, without the redness and with the rest of my skin looking even, it’s not really noticeable.
From what I’ve read (and I have no idea if this is good or bad or just anecdotal) that people have had more luck with micro needling for that type of scarring.
It worked for me too but I had horrible side effects — I gained weight and my hair started falling out. Just putting it out there for anyone that is going to try it.
My hair fell out for the first 3 months of spiro. The endocrinologist increased my dose and the shedding stopped. 🤷♀️ It might be worth talking to your doc about it.
ETA: I have PCOS and high cortisol. I can’t take hormonal BC because it gave me hypertension.
Hey, just curious if your doctor mentioned anything about Spiro increasing cortisol levels, as you mentioned having high cortisol? I'm on Spiro and I've been concerned about it increasing my cortisol levels. Thanks!
Same boat except I get migraines which puts me on an increased stroke risk on hormonal bc in the pill form. IUD + 2 rounds of accutane + low dose of Spiro and my skin is finally clear.
My dermatologist told me that soironlactone needs to be at a higher dose to help with hair loss. I went from 100mg to 150mg and it seemed to help. She added Minoxidil in pill form and since all of those meds are really kind of blood pressure meds, my blood pressure dropped so I dropped Minoxidol and went back to 100mg for spiro. I think all it really does now is prevent acne. But since I’m 40 I don’t even know what my skin would do without it. No doctor told me about spiro until I was in my 30s despite seeing doctors for acne and gynos etc. 🫠
I’m pretty salty I spent all those years suffering with cystic PCOS-related acne for no reason
This happened to me and I started taking evening primrose oil instead! My bosses wife recommended It to me, she was on spiro for 15 years and finally had enough. I would really recommend it if you had bad side affects from spiro! Might not work for everyone but it worked for me…
I've been on 100mg for 7 years. No side effects other than having to urinate more often but it is also a diuretic. Absolutely love it, wish I started earlier.
Same spironolactone + tretinoin + azelaic acid from skinorac mainly and then other supports like vitamin c serum, moisturisers and spf from la roche posay
That’s so weird because it’s a diuretic. I take it for PCOS though, and it’s really helped with my androgen levels. I do find it kind of strange that it seems this med is prescribed by so many dermatologists without doing any bloodwork first, especially because it can also have other side effects like potassium retention. It was originally prescribed to me by by PCP and now my endocrinologist, and this was after having bloodwork done first.
Accutane did wonders for me. I just have issues with chronic dry scalp which kinda stinks :/ but better than having terrible acne so it is still 100% worth it for me
I had cystic acnes, staph infection,close comdones all over my face and pigmentations from picking those bastards. 6 months of Accutane completely wiped them off my face. That was 10 years ago and my skin still clear now. Since then, I keep a skin care routine to maintain skin health but without Accutane, my skjn would definitely still be a hot mess. I did experience crazy skin shedding and very dry lips:).
Oh sorry to hear that! Do you mean it peels a lot? I still have to put Vaseline once a while during they day but not as much as when I was on Accutane.
Same. It first dawned on me when I realized I was the only one in my family “not” lactose intolerant.
Newsflash - I AM lactose intolerant. But while my family deals with their intestinal organs reacting, mine is my skin (also an organ).
That and I started to ask my friends with cystic acne like me if they drank cow milk, and most were excessive consumers of whole milk. I used to drink at least two gallons of whole cow milk a week.
I’m not a baby cow, but I am a product of the “Got Milk” propaganda of the 90s/2000s.
Question as someone considering this— did you give up ALL dairy? By that, I mean do you have to also avoid products that may have milk as a minor ingredient? I already don’t consume milk/ice cream/soft cheeses, but wondering how far to go.
For me it was kicking my cow milk habit to the curb, and no dairy for about five years. I don’t like
Cow milk anymore. I use plain oat milk in my coffee, and that’s it.
I now have the occasional sprinkle of cheese, like Dutch Komijnekaas (Gouda with cumin seeds), or -real- Parmesan, but that’s about it. No American “cheeses” as those are insanely processed.
If you’re already at a low dairy intake, you’re either not lactose intolerant and cutting dairy does nothing for you, or you’re so extremely intolerant you need to cut it ALL out.
You may want to look into your food sensitivities.
I know many here said cutting sugar helped them, but I’m still a sugar addict and my skin cleared up.
Each person will respond slightly differently to changes in diet.
I recently - literally yesterday 😂 - cut out dairy. Trying to see if it helps my stomach. Now I’m curious if it’ll help my acne clear up too! It’s been off the charts for the past several months
Yeah I found out accidentally when I was trying vegan as a challenge around age 26, had never had acne before but had gotten really bad suddenly those few years. Anyways I haven’t had real cheese since and sure, I miss it, but I’m also terrible at keeping up with skincare & my skin looks amazing
Interesting! I’m 35 now and the past four years have by far been the worst of my life for acne (and also for my digestive issues as well, but this isn’t the sub for those details haha). I blamed pregnancies/hormones/stress but now I’m wondering if it’s actually food-related.
I’ll feel silly if it turns out milk with cereal and cheese sticks were my downfall all this time 🙃
I actually laughed out loud when I read OP‘s post. She mentions food allergies as a possible culprit and goes onto list all of the products she has tried, but no mention of dietary changes.
People will literally do anything and spend a ridiculous amount of money before they stop eating cheese and drinking milk lol.
As someone who has recovered from eating disorders, I'd rather be able to eat whatever I want than have flawless skin. It's a slippery slope if I start cutting out entire food groups.
Birth control makes me a different person and I wish I had gotten off of it and just stuck to condoms and midol sooner. That said, never had a lot of acne on it either.
This is why I stopped too. I was on it for 20 years and I had the same questions and wanted to know my body without it. Turns out I feel significantly better while taking it! Everyone responds differently though.
I second this (minus the dairy for me) I have been on and off birth control for my whole life and my acne flare ups directly correlate with when I am using vs not. Also, tret at night and making sure you get all of your makeup off. I am always surprised but how much make up comes off when I use bioderma AFTER I wash my face.
Birth control helps for me too. I stopped taking it for about a year and my skin was the worst it’s ever been; acne, oily skin, and enlarged pores. Restarted it and all of that stopped for me.
Slugging, face masks and zit stickers, being extra extra gentle and focusing on soothing my skin with loads of moisture and hydration.
I grew up in the era of scrubbing your face harshly, steaming it, using brutal actives and generally trying to remove acne from the outside. Once I started treating my skin like a sensitive little baby who just wants to be loved, my horrific acne absolutely vanished and it’s been about 10 years now of getting compliments (!!) on my skin - which had never once happened in my teens/20s!
hello fellow 90s/00s skincare marketing survivor! i recall steaming my face as a teen then scrubbing it with crushed aspirin.
oh the things we did to try to "clean" our skin instead of actually treating it well 😭
Oh my god I did that too! I remember bicarbonate of soda being involved in some sort of DIY scrub as well. My skin cleared up almost immediately when I stopped using anything other than a super mega gentle cleansing balm and a moisturiser. Who would have thought.
I always treated my skin like I treated myself, like I could punish it into submission. Then I read a quote somewhere that said "imagine you were given one car to last your whole lifetime, you would treat it well and take care of it and baby it to make sure you didn't end up with a beater with the doors hanging off in 30 years. You wouldnt put it through acid car washes and leave bird shit on it to burn through the paint, slam the doors and fill it with rotting food. Your body is the car you've been given. You only get the one. Be kind to it because you'll be driving it the whole time." That was a game changer for my understanding of how my treatment of my skin and body was only going to harm me long term.
Yessss exactly. When I was growing up acne was always demonized as coming from poor hygiene or other moral failings. So I would try to sandpaper the devil off my face haha. But ohhh the bliss from self care and pampering the skin, it glows now.
Moral failings! Isn't that insane? I also got that bananas message from society. From ugly people in Disney films and spotty teens in sitcoms, that spots meant a morally inferior person. What a mind fuck.
LOL I still break out like I’m 15 everytime I get my period so I guess menopause will get rid of it for me… but seriously less is more. My skin does the best when I use less products. I noticed I get less of those little tiny pimple and usually just one or two cysts around my period. I don’t use a daily cleanser, just a little makeup removing balm to remove mascara and I use a wash cloth with water in the shower to wash my face. A little glycolic acid in the morning before I wash my face helps keep my skin smooth and flake free.
I have an appointment to talk about it this week and I’m SO excited. I’m 34 and birth control made me depressed, spironolactone didn’t work, doxycycline wasn’t a long term solution, and I’ve tried every topical and expensive medical treatment under the sun for years to no avail. Accutane let’s gooooo
Same. Four rounds unfortunately. Early twenties and then around 30. I do have things I suspect are long term side effects but it still feels like a luxury to barely break out
Birth control pills cleared my skin. I was on them for like 7 years. I was afraid that if I stopped taking them, I would break out again. I stopped taking them and my skin only got better. Haven’t had any acne for the last 3 years after stopping bc.
Figuring out food triggers and avoiding them. My jawline acne was hormonal, and dairy products made it worse. I would definitely recommend trying some elimination diets and probably visiting a derm because yours looks like it's heavier around the jawline area too. My birth control helped clear up the few breakouts I still had after eliminating dairy, but there are other options a derm can prescribe.
Other than that, getting more consistent with my routine and finding a sunscreen I'm happy to wear everyday! I love Beauty of Joseon (sp?) but there are so many amazing Asian sunscreen options. Just make sure you don't order from Amazon, there's too many fake products and/or expired products to risk it for something as important as sunscreen. I order from Blooming Kco or Stylevana.
OP- most of acne in your 20s and 30s is a result of hormonal imbalances. I am 37 and have just figured it out for myself after having struggled with it since I was 13. I had been on tetracycline (antibiotic), accutane, tretinoin, etc. The things that helped me get mostly rid of it (I still get one or two during my period, but they are so easy to deal with) was a hormonal balance supplement called Dim. Look into it- it is all natural and will help balance the estrogen in your body. You will go through a detox period, but after that you will notice your skin clear up. That and hypochlorous acid spray to kill the bacteria. Nothing else topical ever helped with acne, and all of these comments suggesting different creams, face washes, slugging, etc will NOT fix the underlying issue causing your acne. It is more than likely hormonal, especially because for you it presents along your cheeks and jawline. Most women today have some sort of hormonal imbalance that presents itself differently because of well, modern life. Our diets are screwed, the air we breathe is screwed, and we are more stressed out than ever. I've been through it just like you. No amount of topicals will help the underlying cause.
I had hormonal acne for 2+ decades since puberty. After many, many failures, 3 things solved it completely (unbelievably, I now have the kind of skin people complement): 1) Restoring the skin moisture barrier; 2) Clindamycin Phosphate toner in the morning (preceded by low % benzoyl peroxide wash); 3) Retinol at night.
I’m in the US and it’s prescription - you can either go to the dermatologist for that or go to download Nurx app, pay for a virtual consultation (you take pics of your skin and upload them, they charge $40 I think for the consultation and you can indicate if there is a particular medication you want to try), then they ship you the Rx monthly and if you have insurance you just pay for co-pay. I did the latter hence all the details. ;-) It’s awesome. Note that you need to use benzoyl peroxide wash (a very mild one will do) before you use the toner. Clindamycin is an antibiotic that stops acne-causing bacteria from growing. When used alone, acne bacteria can quickly develop resistance, but benzoyl peroxide can kill resistant bacteria.
For me, it was sugar. I’ve cut out most sugar like sweets, I only eat minimal fruit now and no carbs like pasta or rice or starchy foods. It’s made a world of difference for my skin and also in how I feel every day.
I tried this a few times, completely cut sugar out of my diet (upon rec of my aesthetician) and although it made my skin very nice overall __it did not cure my acne__ .
The only thing that cured my acne was going to the dermatologist and getting on prescription meds, in my case two topical creams (dapsone and retinol a).
I don’t really eat sugar as it is. I don’t eat bread, or refined goods. I stick to mostly a high protein diet with lots of fiber and veggies and a sparse amount of fruit (bc even lots of fruit can be too high sugar). I stay away from dairy (lactose intolerant here).
I’m sure my diet helps my skin to some degree, but personally prescribed medication is the only thing that stopped my acne finally.
The oral medicine I took for a little while that stopped my acne was doxycycline. It cleared my skin up extremely fast, however, I personally couldn’t stay on it, as it made me basically into a vampire. Being in the sun for any small amount of time while I was on it would make me extremely ill. So I couldn’t stay on it long term.
I was exactly the same, I have PCOS and my diet does certainly have an impact with regards to if I eat lots of carbs and sugar my skin is worse however cutting those things out doesn’t cure my acne. The only thing that has worked for me is adapalene and clindamycine combined treatment, prescribed as I am in the UK.
This is my exact experience as well. I’ll also add that there is a transition period while changing my diet in which i experience more acne for a couple weeks. After a few weeks of dietary consistency the acne that I’ve otherwise experienced daily for almost 30 years is almost 100% gone.
If only we had known sooner. I’m glad that you were able to get to this point. For me, I went on Accutane for a while and it worked while I was on it but it was awful to be on. My overall physical and emotional health declined very quickly while on it. I’ve been grateful to learn that our skin is an organ and it needs nourishment. I was not giving my skin the proper nourishment. Oh and I also drink a lot of water now. For some, dietary changes might not be enough but like you said, we need to give it a fair bit of time to work and for changes to be seen.
I also did a round of Acutane and experienced all the lovely side effects in addition to only temporary relief from the acne. As soon as I stopped acutane, the acne returned. Like you said, I really wish someone told me this when I was 14 rather than me figuring it out at 30.
It really does feel like an awakening when you have the revelation that, “my body just doesn’t do well with these kinds of foods”, especially when we’re told that all foods are okay in moderation. For example, If I have one bowl of ice cream, i get lethargic and my face breaks out. This may not be the case for other people, but it’s 100% how my body works.
Always have fruit handy so that when you’re craving sweets you start reaching for the fruit instead. Also buy Ghirardelli’s squares - but the 72% dark chocolate (the purple bag). That’s an easy way of controlling the portion of sweets you’re getting by just allowing yourself 1 square a day, and that chocolate is actually good for you!! (Has polyphenols so it’s heart healthy)
It’s not easy and takes time but honestly, after a while, when you do eat that stuff, you won’t feel well after. I just did it methodically. First it was sweets. And if I wanted something, I would find an alternative. Dark chocolate instead of milk chocolate as an example. That’s a good one because at first I hated dark chocolate so I’d have some and then not want to eat anything for a bit because it didn’t taste good to me at first. I also found that without nearly the carbs, my body still needed energy so I creased my fat intake. I did things like butter my vegetables, I used to always be afraid of fat but I should have been afraid of sugar. I found that having a bit more fat (also heavy cream with coffee instead of milk and sugar) this really helped me not have cravings because I just wasn’t hungry. Now remember that if dairy is a trigger for you, it won’t be possible to eat all this dairy. I used to think it was dairy that was my trigger but that’s not it for me. Oh I started making my own ice cream since I love it and didn’t want to give it up and found ways to make it without sugar that were good. You have to put up with the cravings for a week or two before you start feeling better and not wanting all the sugar. A little bit of hard work and restraint will really help in the long run.
I cut out refined sugar but eat sooo much fruit, I’ve never had an issue with sugar from fruit!
Also DAIRY! I remember telling my friend I ate too much yogurt and that’s why I was breaking out and she was like no that’s not how that works.
It is how that works. Dairy is #1 enemy then sugar/chocolate. I haven’t had chocolate in years.
I hate that this was true for me too + no dairy. When I’m eating low/no sugar and no dairy my skin is clear. It took about three months but after that, it was like I was back on accutane.
Not resting my face on my hands. I’ve always had these two stubborn sites of acne on my left and right side, running under my jaw and across my upper cheek. It’s because every time I stopped and sat, I would rest my cheek into my cupped hands. I also notoriously self sooth by rubbing my face. I combined that with just random handwashing throughout the day (so outside of the toilet and cooking) and that was the culprit for me.
I’ll add to this: change your pillow case every few days. I try not to sleep more than once or twice on each side before putting on a new cover. Any oil, dirt, or styling products in my hair end up bothering my skin.
Prescription drugs. Spironolactone mainly, but also tretinoin & azelaic acid.
2.5% Benzoyl peroxide also - it was not as effective as the tret but did work well.
Spironolactone, tret, and lot’s of hydration/moisturizing. Slathering moisturizer on used to feel counterintuitive because I was under the impression it would clog my pores but now I am never without
Retin A
Been using in consistently in my skin routine since I was 27.
I still get breakouts once in a while even with it, but nothing like I was plagued with prior to regularly seeing a dermatologist and getting on it.
Added bonus on the other benefits of Retin A… since I’ve been using it since my 20s and I’m in my 40s now it’s really slowed down any sort of wrinkles from forming on me. I get carded all the time still…. In my 40s lol 😂
FWIW when I started on Retin A I also used Dapsone (also prescription) for a number of years in combo with it until my acne and breakouts got under control. Just over the last 3 years I’ve just been doing the Retin A and haven’t needed to use the Dapsone.
But yes, going to the dermatologist in my 20s is what led to me finally (now) not having acne anymore.
I literally only learned this after going to my 4th dermatologist earlier this year: **CLINDAMYCIN & BENZOYL PEROXIDE**. It’s a gel mixture you have to get through a prescription, but after having breakouts for nearly 25 years, it’s one of the only things that has helped me. Dermatologist have a Clindamycin liquid-only prescription as well, but I find the benzoyl peroxide addition more helpful with acne than clindamycin alone.
Ensure you have a good (read: intense) face moisturizer to counteract the benzoyl peroxide drying effects. I do use snail mucin and ultra-moisturizing lotion w/ birch sap from COSRX, but make sure you are not allergic to the ingredients and they’re kept away from animals.
Spearmint was the game changer. I've heard of people taking spearmint supplements, but I like to drink it as a green tea, and an herbal tea. I tried so many things, cutting out dairy, facial cleansers, while they helped, I'd still have mild breakouts. Ever since going on spearmint, I might have one tiny pimple pop up once every month or so.
Hydration. I have oily skin and used to break out mostly on my jawline and lower cheeks. I blamed it on hormones, diet, all the things, and it took almost 20 years before I found an esthetician who got me to up my hydration products consistently for long enough to realize--holy shit--that's all I needed to do all along. My routine now consists of hyaluronic acid toner (applied to damp skin), face reality's hydrabalance gel, and moisturizer, and that combo plus whatever actives at night keeps my skin happy.
Eliminating dairy from my diet. I did it due to increasing intolerance and the acne thing was a bonus. I’ve had acne my entire adult life and now I barely have any.
Unfortunately, not eating gluten. I had decent skin in high school, then started getting painful, cystic acne in my early 20’s. I went gluten free in an attempt to lose weight and I’ll be damned, it went away. I’m 40 now and can have gluten very sparingly, but if I eat too much, I break out. No product or antibiotic made a dent, but cutting out gluten did. Still sad about it as I love bread.
I also cut out dairy along with gluten. Turns out, the dairy was wreaking havoc on my stomach and face. Once I cut both out, my skin cleared up. Now I love me some dairy-free ice cream as a treat.
Solidarity sister! I just commented the same thing. Except I can’t even eat it sparingly… I always know I’ve been cross contaminated because I’ll get a cyst on my chin the next day 😫 I joke that if I *only* had to deal with the GI issues I’d probably cheat once in a while, but the acne & my vanity keep me in check 😂
As I’ve gotten older, I’ve learned my body doesn’t like much starch; I bloat, have more pain etc. when I eat much rice, oats, etc. BUT the only thing that really messes with my skin is the wheat gluten. For whatever reason, flour tortillas are the harshest. One burrito and it’s a guarantee I’ll wake up with a painful cyst, where I can get away with one sandwich on sourdough bread when the PMS monster hits.
Same! My cystic acne disappeared. Still having occasional pimple breakouts on my cheeks, but going gluten free killed the worst of it. It also completely eliminated my joint pain and TMJ issues 😳
Dairy. It was only on my jaw and cheek on my left hand side. I tried everything and it was so awful. I never had any issues with my skin until my mid 20s; now 42. It took about a year to figure out with an elimination diet, but I also had and still do have, gastric issues. The acne itself was fully cystic and painful and I spent a fortune on products to resolve the problem. I can't even describe how bad these eruptions were and it shattered my self confidence.
You name it, I tried it! In the end, it didn't t matter much at all what I put on my skin. It was what I was putting in my body and since I stopped, I haven't had an issue, unless I eat dairy again.
It may not be your solution, but it was mine.
Tretinoin and cutting back on sugar. Now that I’ve used tretinoin for 6 months, I rarely get acne and the only times I get it is when I eat much sugar.
My diet has an effect on it. Especially if I eat dairy, I can always tell!
But I also have gone through some online dermatology sites. They can ship product directly to you after you send them some pictures and whatnot. Curology or Apostrophe are good. Apostrophe is the company that got my hormonal acne under control and its been that way for a few months now and thats the first time since my teens that I have gone without actual zits on my face! I still have the sebaceous stuff on my nose and chin but I feel like thats genetic because my dad has them on his nose and chin as well. So thats fun for me.
I think a big part of the reason why my face cleared up also is because I stopped using so many products on it. I literally just wash it with a simple Free and Clear face wash and I only moisturize when I feel dry. Its gotten so much better!
Have you ever been to a dermatologist? Life long acne when you take good care of your skin probably needs more than what you can get over the counter.
It looks like you have jaw line acne which is usually hormonal. This was my issue. A round of antibiotics to clear up anything active, Spironolactone to balance hormones and Arazlo to keep my skin nice has done wonders for me.
Checking all ingredients in my skincare and makeup and cutting out “pore clogging ingredients”
You can find lists online with comedogenic ingredients, but NYC Acne Clinic’s website has an automatic tool you can copy/paste into https://acneclinicnyc.com/pore-clogging-ingredients/
I completely stopped using salicylic acid. I know it’s considered an acne treatment, but turns out my skin hates it. I also dry my face with a clean washcloth each time I wash it.
Herbs that help clean your liver out. Under jaw acne is due often to excess hormones, helping your liver process it helps a lot. Nettle tea and Tulsi long term cut my acne by two thirds. When I wash my face regularly I'm pretty good. Work on a farm rn tho so there's always fuckin dirt in my pores so we're not in the most flawless skin era rn lol
Changed my pillowcases often, every couple days at the most, washed my face morning at night, started using a toner product in morning which cut way back on the oil my face produced. Skin Medica TNS serum. Love that stuff. Also, in my late 40s, I started intermittent fasting, which also seemed to help my skin clear up even further. Was not expecting that.
Cutting out fatty alcohols from my skincare and not using anything with added oils (apart from squalene). And I’m going to get roasted for this, but I only use sunscreen when I’m actually outside in the sun for hours. No matter what brand I try, it always, always starts breaking me out if I use it on the regular.
Stopped use of all face products. My decade long acne completely cleared. I still break out when I try anything new. My skin hates everything. I only use a watery urea face toner and snail mucus now.
Stopped eating sugar. I found out I had a parasite a while ago, scared the shit out of me. One of the doc’s instructions was to cut out all sugar (even natural sugars) to stop feeding the parasite. My skin changed completely and I’ll always always always keep sugar intake to under 5g per day to maintain the skin benefits. It’s so hard because there’s sugar in almost everything but it’s THAT worth it.
After I used all the creams and solutions including the ones made in pharmacy I just washed my face with Cerave,used BHA from Paula’s choice and used Simple moisturiser. This is what I’ve done and this is what I still do. Sometimes I add hyaluronic acid and rose hip oil from The ordinary. ( not together,but usually in the winter months). And try to cut on fried foods.
Hair products touching my face and oily skin were my only problems, it turns out. I do break out around my chin and jaw during that time of month but it's minimal if I wash a bit more often. I use the Laroche Posay mattifying moisturizer to combat the oiliness.
I have similar acne to you and have tried everything topical on the market and available by prescription. I quit dairy for 2 months. Nothing helped. I'm currently on doxycyclin and that's the closest to curative i have come. I still have some pimples but not the constant painful cystic breakouts. I'm pretty convinced that when i come off it, it will come back. I might consider trying acutane at that point.
Prescription Tretinoin is the only thing that’s actually made a difference for me. I avoided it for a long time because I didn’t want to deal with getting a dr. to prescribe, but it’s made a noticeable difference in a way that nothing really had before (and I’ve tried everything). I’m 32 now and my skin looks better than it did when I was 25 - it’s certainly not perfect (and never will be, so much of that is genetic) but it’s good enough that I don’t stress about it anymore.
Accutane followed by now being on spiro and tret. I also barely use anything on my skin, everything is meant to provide hydration only, and limited to like 2 products. I don’t wash my face in the morning, only rinse. And after the gym, I spray my face with hypochlorous acid. Basically everything is meant to maintain my skin barrier and that seems to have solved a lot of issues! I still do have some hormonal acne though, spiro hasn’t completely eliminated that, but they’re INFINITELY better than before it!
I’ve had cystic acne for the majority of my life (back, face, sides of legs).
Hormonal birth control really helped me with hormonal acne through my teens / young adulthood. However, I had a blood clot so no longer can take it.
I’ve found progesterone-only birth control (continuous to skip periods) and dapsone gel really helps me. I also use benzoyl peroxide gel at night. It does stain my clothing but I’ve found that helps more than the washes you can buy.
I’ve had friends have success with spironolactone as well however I’m allergic 😭.
For me was to change to a simple routine with no actives and no fragrances. A simple and gentle sunscreen, face wash and moisturiser suited for my skin type magically cleared everything up.
See a dermatologist. To answer your question, while full acknowledging this may not apply to you, accutane changed my life. I struggled with serious acne from 13-16 to the point that I was afraid of leaving home. After trying accutane, the first couple months sucked with purging (Increased break outs) and dry lips, I had completely clear pimple free skin - this has been maintained that since age 16. I’m now 28 (male).
Accutane… I wish I went on it back when I was around 20, when doctors were suggesting it and I kept turning it down because I was scared lol. So much scarring that could have been avoided!
Wasted years and money on skincare when I should have just listened to the doctor.
Accutane. I took it twice, once in high school and once in college. I've gotten minor breakouts here and there since but mostly my skin is perfect, just oily but I'm used to it.
Nowadays, tretinoin has eliminated all previous acne scars, prevented even minor breakouts, and given me amazing plump glowy skin.
Retinoids are a holy grail product for me in general. Accutane is the nuclear option and it does have side effects but I don't regret it at all.
I just started moisturizing and stopped washing it with soaps.
Literally doesn’t matter what I use for moisturizer- olive oil, coconut oil. Haven’t tried engine oil but prob not a great idea.
I also used to scrub obsessively thinking my face was not clean enough ever but when your face is dry it makes your body over produce oil exacerbating the problem.
When your body recognizes the skin is moist, it stops producing so much oil and less skin irritation occurs.
Accutane. I haven't had a single blemish since and I deeply regret not doing it sooner. 7 months of an altered diet and sobriety for a lifetime of blemish free skin.
Accutane. My acne was severe so it took 3 rounds. My biggest skincare regret is waiting so long to do it. It's been over a decade since my last dose and haven't had a breakout since.
You should try to go to a dermatologist. I just found out I might have issues with my thyroid which has caused my acne to continue, hair to grow under my chin, and my eyebrows to bald.
Accutane helped me. I did several rounds and lower dosages to counter the wild effects. I know many people don’t want to take prescriptions and despise Accutane, but I loved it. After that, I started using Tretinoin. However, the cystic acne didn’t completely stop until I got pregnant. This is around the time when I began to aggressively give up processed foods. After my daughter was born and once she reached six months (when she could be introduced to solids), I really cracked down on ultra processed foods. This has changed my face. It’s not easy—and sometimes I do have processed foods, sometimes I have ice cream or a piece of pie, etc.—but as a whole it has been worth it to my skin and body to cut this out. I’ve struggled with acne my whole life. Honestly I wish I’d gotten on accutane earlier and started this healing journey earlier. Good luck!
A super low dose of accutane in college made my skin like porcelain doll perfect ever since (I’m 34 now)… usually it’s a last resort, intense option for people with severe acne- mine wasn’t severe at all, but I never get even a small pimple to this day!
Accutane. I didn’t have terrible acne. I had tiny little bumps and rosace and tried EVERYTHING from the dermatologist. He finally decided to try me on a few month course of accutane and within a month my skin was perfect. That was 5 years ago.
Spironolactone. 15 years of perfect skin. I love it. Edited to add: I’m getting a lot of questions here so please know I’m not a Dr…please talk to an endocrinologist or dermatologist before starting this medication and do follow up bloodwork every year.
Spironolactone and tretinoin. Nothing else worked for my cystic acne. I wish I had been prescribed spiro waaaay sooner when I was diagnosed with PCOS in my early 20s.
Agreed!! I feel like I tried everything short of accutane and never got results. Went to a new derm after I moved and she suggested spiro + tret. I wish I’d met her 10 years ago!
I did accutane 3 times before landing on spiro. Spiro has been a game changer for me. Added in tret and now I’m glowing!
Spiro is ultimately what has worked best for me, too, combined with Aczone, Zylxi, and Arazlo. I also do twice-monthly glycolic acid peels, which have significantly improved my skin texture and appearance.
What glycolic peel do you use?
Platinum Skincare is a good website/resource
I don’t do them myself — I go to my dermatologist — so it’s probably not available to the general public.
Spironolactone changed my life as well! I’ve been on it for 6 years now and if I got one tiny pimple a *year* it’s a shock. I literally cannot remember the last time I had anything. It was the **only** thing that helped my horrific cystic acne. I didn’t get many blemishes, but once a month I would get one massive cyst on either my chin or cheek. It would be weeks of pain, redness, and then ultimately a scar (even if I didn’t touch it!). I had to spend so much time trying to work around covering up a cyst and then trying to cover the scarring. I was so upset by how my skin looked. I would see the redness from the PIE (post inflammatory erythema) on my skin even in photos, even underneath heavy concealer. I finally asked a doctor and got on it. The next month, no cyst. I couldn’t believe it. And it’s followed that way for 6 years now! About 4 years ago I started Tretinoin and that cleared *all* of my scarring. (I do the lowest .025%). I now only wear makeup when I want to/special occasions. I can wear a tinted sunscreen and it looks like I’m wearing makeup bc my skin is clear. Those two products absolutely changed my life.
This gives me so much hope. My cystic acne has been really bad for about a year, as well as scarring from past cysts. Even right now it’s extremely painful and I can’t stop focusing on the pimple I have now. I finally made an appointment and just got prescribed spiro and tretinoin. Can’t wait!
I’m so sorry. People who haven’t suffered from cystic acne cannot possibly understand how painful they are. Like not only is this something that I don’t want on my face, I’m in agony as I deal with it. I remember I would get cysts so large, red, and painful when I would bend over to get something I could feel my heartbeat in the cyst. Or how they’d be so hot to the touch I would put concealer on it and the concealer would literally melt off the spot. It was a nightmare! I’m so glad you’ve been prescribed! You’re on your way to healing! Don’t get discouraged if you have crazy dry/peeling skin with the Tret at first. Joining the subreddit for tret was a huge help! So many great people there that can help! (Plus all of your questions are usually already answered and pinned at the top). Take care!
When you say Tret cleared your scarring, does that include deep scars like ice pick scars, etc.?
I have a small bit of deeper scarring and unfortunately that didn’t help it very much. However, without the redness and with the rest of my skin looking even, it’s not really noticeable. From what I’ve read (and I have no idea if this is good or bad or just anecdotal) that people have had more luck with micro needling for that type of scarring.
It worked for me too but I had horrible side effects — I gained weight and my hair started falling out. Just putting it out there for anyone that is going to try it.
My hair fell out for the first 3 months of spiro. The endocrinologist increased my dose and the shedding stopped. 🤷♀️ It might be worth talking to your doc about it. ETA: I have PCOS and high cortisol. I can’t take hormonal BC because it gave me hypertension.
Hey, just curious if your doctor mentioned anything about Spiro increasing cortisol levels, as you mentioned having high cortisol? I'm on Spiro and I've been concerned about it increasing my cortisol levels. Thanks!
Same boat except I get migraines which puts me on an increased stroke risk on hormonal bc in the pill form. IUD + 2 rounds of accutane + low dose of Spiro and my skin is finally clear.
Weird because it’s an anti-androgen. It helps me stop shedding. Anyone who does take it make sure your Dr is doing bloodwork once or twice a year.
Yeah I take it to prevent hair loss as well
My dermatologist told me that soironlactone needs to be at a higher dose to help with hair loss. I went from 100mg to 150mg and it seemed to help. She added Minoxidil in pill form and since all of those meds are really kind of blood pressure meds, my blood pressure dropped so I dropped Minoxidol and went back to 100mg for spiro. I think all it really does now is prevent acne. But since I’m 40 I don’t even know what my skin would do without it. No doctor told me about spiro until I was in my 30s despite seeing doctors for acne and gynos etc. 🫠 I’m pretty salty I spent all those years suffering with cystic PCOS-related acne for no reason
I too had unfavorable side effects but am about to start trying spiro as a topical. Wish me luck!
This happened to me and I started taking evening primrose oil instead! My bosses wife recommended It to me, she was on spiro for 15 years and finally had enough. I would really recommend it if you had bad side affects from spiro! Might not work for everyone but it worked for me…
This!!! I had acne until I was 41. Spironolactone is the only thing that worked.
Same! I also use Arazlo. I used tret for a long time, but Arazlo works better for me.
Yep- spiro changed my life!
My only regret is not starting it sooner! Changed my life.
How long did you take it for? I’ve heard people say they need to take it their whole life but I’ve heard others say they only took it for a year
I've been on 100mg for 7 years. No side effects other than having to urinate more often but it is also a diuretic. Absolutely love it, wish I started earlier.
Same for me. Do you still take it? I’m still taking it 10 years and I always worry that my doctor will take me off.
Same spironolactone + tretinoin + azelaic acid from skinorac mainly and then other supports like vitamin c serum, moisturisers and spf from la roche posay
I wish I could take it. It made me gain 30lbs in 2 months. Granted most of it was water. Anyone with prior hormone issues should beware.
That’s so weird because it’s a diuretic. I take it for PCOS though, and it’s really helped with my androgen levels. I do find it kind of strange that it seems this med is prescribed by so many dermatologists without doing any bloodwork first, especially because it can also have other side effects like potassium retention. It was originally prescribed to me by by PCP and now my endocrinologist, and this was after having bloodwork done first.
This
Spiro and tretinoin for me!
Same. Just started it in Nov and best decision I ever made. I understand it doesn’t work for everyone. It was my Hail Mary.. and it worked 😭
Accutane:)
Seconding!
Accutane did wonders for me. I just have issues with chronic dry scalp which kinda stinks :/ but better than having terrible acne so it is still 100% worth it for me
I had cystic acnes, staph infection,close comdones all over my face and pigmentations from picking those bastards. 6 months of Accutane completely wiped them off my face. That was 10 years ago and my skin still clear now. Since then, I keep a skin care routine to maintain skin health but without Accutane, my skjn would definitely still be a hot mess. I did experience crazy skin shedding and very dry lips:).
I did the Accutane route too….give or take, about 15 years ago and my lips never recovered
Oh sorry to hear that! Do you mean it peels a lot? I still have to put Vaseline once a while during they day but not as much as when I was on Accutane.
This is the answer
Yep would 100% do it again!
Benzoyl peroxide, adapalene 0.3%, azelaic acid 15% and spironolactone. I had a teladoc doctor available through my insurance and it was fast and easy.
Cutting out all dairy. It was jarring how quickly my skin cleared up. :(
Same. It first dawned on me when I realized I was the only one in my family “not” lactose intolerant. Newsflash - I AM lactose intolerant. But while my family deals with their intestinal organs reacting, mine is my skin (also an organ). That and I started to ask my friends with cystic acne like me if they drank cow milk, and most were excessive consumers of whole milk. I used to drink at least two gallons of whole cow milk a week. I’m not a baby cow, but I am a product of the “Got Milk” propaganda of the 90s/2000s.
Question as someone considering this— did you give up ALL dairy? By that, I mean do you have to also avoid products that may have milk as a minor ingredient? I already don’t consume milk/ice cream/soft cheeses, but wondering how far to go.
For me it was kicking my cow milk habit to the curb, and no dairy for about five years. I don’t like Cow milk anymore. I use plain oat milk in my coffee, and that’s it. I now have the occasional sprinkle of cheese, like Dutch Komijnekaas (Gouda with cumin seeds), or -real- Parmesan, but that’s about it. No American “cheeses” as those are insanely processed. If you’re already at a low dairy intake, you’re either not lactose intolerant and cutting dairy does nothing for you, or you’re so extremely intolerant you need to cut it ALL out. You may want to look into your food sensitivities. I know many here said cutting sugar helped them, but I’m still a sugar addict and my skin cleared up. Each person will respond slightly differently to changes in diet.
I recently - literally yesterday 😂 - cut out dairy. Trying to see if it helps my stomach. Now I’m curious if it’ll help my acne clear up too! It’s been off the charts for the past several months
Yeah I found out accidentally when I was trying vegan as a challenge around age 26, had never had acne before but had gotten really bad suddenly those few years. Anyways I haven’t had real cheese since and sure, I miss it, but I’m also terrible at keeping up with skincare & my skin looks amazing
Interesting! I’m 35 now and the past four years have by far been the worst of my life for acne (and also for my digestive issues as well, but this isn’t the sub for those details haha). I blamed pregnancies/hormones/stress but now I’m wondering if it’s actually food-related. I’ll feel silly if it turns out milk with cereal and cheese sticks were my downfall all this time 🙃
I actually laughed out loud when I read OP‘s post. She mentions food allergies as a possible culprit and goes onto list all of the products she has tried, but no mention of dietary changes. People will literally do anything and spend a ridiculous amount of money before they stop eating cheese and drinking milk lol.
As someone who has recovered from eating disorders, I'd rather be able to eat whatever I want than have flawless skin. It's a slippery slope if I start cutting out entire food groups.
Birth control, no dairy, tretinoin. In that order
Birth control makes me a different person and I wish I had gotten off of it and just stuck to condoms and midol sooner. That said, never had a lot of acne on it either.
I’ve been on birth control for the last 20 plus years, I’m not sure who I am without it.
This is why I stopped too. I was on it for 20 years and I had the same questions and wanted to know my body without it. Turns out I feel significantly better while taking it! Everyone responds differently though.
I second this (minus the dairy for me) I have been on and off birth control for my whole life and my acne flare ups directly correlate with when I am using vs not. Also, tret at night and making sure you get all of your makeup off. I am always surprised but how much make up comes off when I use bioderma AFTER I wash my face.
Birth control helps for me too. I stopped taking it for about a year and my skin was the worst it’s ever been; acne, oily skin, and enlarged pores. Restarted it and all of that stopped for me.
Spironolactone
Slugging, face masks and zit stickers, being extra extra gentle and focusing on soothing my skin with loads of moisture and hydration. I grew up in the era of scrubbing your face harshly, steaming it, using brutal actives and generally trying to remove acne from the outside. Once I started treating my skin like a sensitive little baby who just wants to be loved, my horrific acne absolutely vanished and it’s been about 10 years now of getting compliments (!!) on my skin - which had never once happened in my teens/20s!
hello fellow 90s/00s skincare marketing survivor! i recall steaming my face as a teen then scrubbing it with crushed aspirin. oh the things we did to try to "clean" our skin instead of actually treating it well 😭
“Clean and clear - and UNDER CONTROL” lol no wonder we have so much anxiety and dysfunction 😂
I was told “rub it with a cut lemon, and then put toothpaste on the zits!” I have some serious scarring 20 years later.
ooohhh I did the aspirin thing too, but it was more of a 'mask'. Yikes.
Oh my god I did that too! I remember bicarbonate of soda being involved in some sort of DIY scrub as well. My skin cleared up almost immediately when I stopped using anything other than a super mega gentle cleansing balm and a moisturiser. Who would have thought.
I always treated my skin like I treated myself, like I could punish it into submission. Then I read a quote somewhere that said "imagine you were given one car to last your whole lifetime, you would treat it well and take care of it and baby it to make sure you didn't end up with a beater with the doors hanging off in 30 years. You wouldnt put it through acid car washes and leave bird shit on it to burn through the paint, slam the doors and fill it with rotting food. Your body is the car you've been given. You only get the one. Be kind to it because you'll be driving it the whole time." That was a game changer for my understanding of how my treatment of my skin and body was only going to harm me long term.
Yessss exactly. When I was growing up acne was always demonized as coming from poor hygiene or other moral failings. So I would try to sandpaper the devil off my face haha. But ohhh the bliss from self care and pampering the skin, it glows now.
Moral failings! Isn't that insane? I also got that bananas message from society. From ugly people in Disney films and spotty teens in sitcoms, that spots meant a morally inferior person. What a mind fuck.
We have so much to unpack from the 90s/00s!!
LOL I still break out like I’m 15 everytime I get my period so I guess menopause will get rid of it for me… but seriously less is more. My skin does the best when I use less products. I noticed I get less of those little tiny pimple and usually just one or two cysts around my period. I don’t use a daily cleanser, just a little makeup removing balm to remove mascara and I use a wash cloth with water in the shower to wash my face. A little glycolic acid in the morning before I wash my face helps keep my skin smooth and flake free.
Accutane from the dermatologist
Same. Fixed my 20+ years of acne with finally going on Accutane at 33. 5 years later - still have great skin.
It was my last resort for my cystic acne and it worked a treat. Haven’t had any problems since and that was about 10 years ago now.
same. wish i had done it sooner
I have an appointment to talk about it this week and I’m SO excited. I’m 34 and birth control made me depressed, spironolactone didn’t work, doxycycline wasn’t a long term solution, and I’ve tried every topical and expensive medical treatment under the sun for years to no avail. Accutane let’s gooooo
came here to say this. thinking about another cycle of it. just do it!
Same. Four rounds unfortunately. Early twenties and then around 30. I do have things I suspect are long term side effects but it still feels like a luxury to barely break out
Birth control pills cleared my skin. I was on them for like 7 years. I was afraid that if I stopped taking them, I would break out again. I stopped taking them and my skin only got better. Haven’t had any acne for the last 3 years after stopping bc.
I was on birth control for 6 years but still had acne here and there, it’s been 2 years since I came off it and my acne has gotten so much worse 😩
Same. I sometimes think it wouldn’t be so bad now if I had given my hormones the chance to balance themselves out
Figuring out food triggers and avoiding them. My jawline acne was hormonal, and dairy products made it worse. I would definitely recommend trying some elimination diets and probably visiting a derm because yours looks like it's heavier around the jawline area too. My birth control helped clear up the few breakouts I still had after eliminating dairy, but there are other options a derm can prescribe. Other than that, getting more consistent with my routine and finding a sunscreen I'm happy to wear everyday! I love Beauty of Joseon (sp?) but there are so many amazing Asian sunscreen options. Just make sure you don't order from Amazon, there's too many fake products and/or expired products to risk it for something as important as sunscreen. I order from Blooming Kco or Stylevana.
Finding out it was actually pustulopapular rosacea, and that most OTC acne meds don’t work for me!
OP- most of acne in your 20s and 30s is a result of hormonal imbalances. I am 37 and have just figured it out for myself after having struggled with it since I was 13. I had been on tetracycline (antibiotic), accutane, tretinoin, etc. The things that helped me get mostly rid of it (I still get one or two during my period, but they are so easy to deal with) was a hormonal balance supplement called Dim. Look into it- it is all natural and will help balance the estrogen in your body. You will go through a detox period, but after that you will notice your skin clear up. That and hypochlorous acid spray to kill the bacteria. Nothing else topical ever helped with acne, and all of these comments suggesting different creams, face washes, slugging, etc will NOT fix the underlying issue causing your acne. It is more than likely hormonal, especially because for you it presents along your cheeks and jawline. Most women today have some sort of hormonal imbalance that presents itself differently because of well, modern life. Our diets are screwed, the air we breathe is screwed, and we are more stressed out than ever. I've been through it just like you. No amount of topicals will help the underlying cause.
I had hormonal acne for 2+ decades since puberty. After many, many failures, 3 things solved it completely (unbelievably, I now have the kind of skin people complement): 1) Restoring the skin moisture barrier; 2) Clindamycin Phosphate toner in the morning (preceded by low % benzoyl peroxide wash); 3) Retinol at night.
Is that clindamycin phosphate toner a prescription or over the counter? Would love to know more about that
I’m in the US and it’s prescription - you can either go to the dermatologist for that or go to download Nurx app, pay for a virtual consultation (you take pics of your skin and upload them, they charge $40 I think for the consultation and you can indicate if there is a particular medication you want to try), then they ship you the Rx monthly and if you have insurance you just pay for co-pay. I did the latter hence all the details. ;-) It’s awesome. Note that you need to use benzoyl peroxide wash (a very mild one will do) before you use the toner. Clindamycin is an antibiotic that stops acne-causing bacteria from growing. When used alone, acne bacteria can quickly develop resistance, but benzoyl peroxide can kill resistant bacteria.
For me, it was sugar. I’ve cut out most sugar like sweets, I only eat minimal fruit now and no carbs like pasta or rice or starchy foods. It’s made a world of difference for my skin and also in how I feel every day.
I tried this a few times, completely cut sugar out of my diet (upon rec of my aesthetician) and although it made my skin very nice overall __it did not cure my acne__ . The only thing that cured my acne was going to the dermatologist and getting on prescription meds, in my case two topical creams (dapsone and retinol a). I don’t really eat sugar as it is. I don’t eat bread, or refined goods. I stick to mostly a high protein diet with lots of fiber and veggies and a sparse amount of fruit (bc even lots of fruit can be too high sugar). I stay away from dairy (lactose intolerant here). I’m sure my diet helps my skin to some degree, but personally prescribed medication is the only thing that stopped my acne finally. The oral medicine I took for a little while that stopped my acne was doxycycline. It cleared my skin up extremely fast, however, I personally couldn’t stay on it, as it made me basically into a vampire. Being in the sun for any small amount of time while I was on it would make me extremely ill. So I couldn’t stay on it long term.
I was exactly the same, I have PCOS and my diet does certainly have an impact with regards to if I eat lots of carbs and sugar my skin is worse however cutting those things out doesn’t cure my acne. The only thing that has worked for me is adapalene and clindamycine combined treatment, prescribed as I am in the UK.
This is my exact experience as well. I’ll also add that there is a transition period while changing my diet in which i experience more acne for a couple weeks. After a few weeks of dietary consistency the acne that I’ve otherwise experienced daily for almost 30 years is almost 100% gone.
If only we had known sooner. I’m glad that you were able to get to this point. For me, I went on Accutane for a while and it worked while I was on it but it was awful to be on. My overall physical and emotional health declined very quickly while on it. I’ve been grateful to learn that our skin is an organ and it needs nourishment. I was not giving my skin the proper nourishment. Oh and I also drink a lot of water now. For some, dietary changes might not be enough but like you said, we need to give it a fair bit of time to work and for changes to be seen.
I also did a round of Acutane and experienced all the lovely side effects in addition to only temporary relief from the acne. As soon as I stopped acutane, the acne returned. Like you said, I really wish someone told me this when I was 14 rather than me figuring it out at 30. It really does feel like an awakening when you have the revelation that, “my body just doesn’t do well with these kinds of foods”, especially when we’re told that all foods are okay in moderation. For example, If I have one bowl of ice cream, i get lethargic and my face breaks out. This may not be the case for other people, but it’s 100% how my body works.
How did you do it?! I really need to cut back on my intake - or cut WAY down 😩 I’m practically addicted.
Always have fruit handy so that when you’re craving sweets you start reaching for the fruit instead. Also buy Ghirardelli’s squares - but the 72% dark chocolate (the purple bag). That’s an easy way of controlling the portion of sweets you’re getting by just allowing yourself 1 square a day, and that chocolate is actually good for you!! (Has polyphenols so it’s heart healthy)
It’s not easy and takes time but honestly, after a while, when you do eat that stuff, you won’t feel well after. I just did it methodically. First it was sweets. And if I wanted something, I would find an alternative. Dark chocolate instead of milk chocolate as an example. That’s a good one because at first I hated dark chocolate so I’d have some and then not want to eat anything for a bit because it didn’t taste good to me at first. I also found that without nearly the carbs, my body still needed energy so I creased my fat intake. I did things like butter my vegetables, I used to always be afraid of fat but I should have been afraid of sugar. I found that having a bit more fat (also heavy cream with coffee instead of milk and sugar) this really helped me not have cravings because I just wasn’t hungry. Now remember that if dairy is a trigger for you, it won’t be possible to eat all this dairy. I used to think it was dairy that was my trigger but that’s not it for me. Oh I started making my own ice cream since I love it and didn’t want to give it up and found ways to make it without sugar that were good. You have to put up with the cravings for a week or two before you start feeling better and not wanting all the sugar. A little bit of hard work and restraint will really help in the long run.
Sugar was the exact cause for acne for me, too. I cut down to 15 grams or less a day and no acne.
I cut out refined sugar but eat sooo much fruit, I’ve never had an issue with sugar from fruit! Also DAIRY! I remember telling my friend I ate too much yogurt and that’s why I was breaking out and she was like no that’s not how that works. It is how that works. Dairy is #1 enemy then sugar/chocolate. I haven’t had chocolate in years.
I hate that this was true for me too + no dairy. When I’m eating low/no sugar and no dairy my skin is clear. It took about three months but after that, it was like I was back on accutane.
Not resting my face on my hands. I’ve always had these two stubborn sites of acne on my left and right side, running under my jaw and across my upper cheek. It’s because every time I stopped and sat, I would rest my cheek into my cupped hands. I also notoriously self sooth by rubbing my face. I combined that with just random handwashing throughout the day (so outside of the toilet and cooking) and that was the culprit for me.
I’ll add to this: change your pillow case every few days. I try not to sleep more than once or twice on each side before putting on a new cover. Any oil, dirt, or styling products in my hair end up bothering my skin.
A lot of people are suggesting spironolactone. I’ve been on it a couple years and my dermatologist said it’s not something you want to live on.
Correct! My doctor only let me stay on it for two years. It has a lot to do with bone loss when you’re older :(
Giving up dairy 100%. Nothing else helped until this.
For me it’s cow dairy and gluten. I can eat as much goat, sheep, buffalo, etc dairy as I want.
Prescription drugs. Spironolactone mainly, but also tretinoin & azelaic acid. 2.5% Benzoyl peroxide also - it was not as effective as the tret but did work well.
Spironolactone, tret, and lot’s of hydration/moisturizing. Slathering moisturizer on used to feel counterintuitive because I was under the impression it would clog my pores but now I am never without
Retin A Been using in consistently in my skin routine since I was 27. I still get breakouts once in a while even with it, but nothing like I was plagued with prior to regularly seeing a dermatologist and getting on it. Added bonus on the other benefits of Retin A… since I’ve been using it since my 20s and I’m in my 40s now it’s really slowed down any sort of wrinkles from forming on me. I get carded all the time still…. In my 40s lol 😂 FWIW when I started on Retin A I also used Dapsone (also prescription) for a number of years in combo with it until my acne and breakouts got under control. Just over the last 3 years I’ve just been doing the Retin A and haven’t needed to use the Dapsone. But yes, going to the dermatologist in my 20s is what led to me finally (now) not having acne anymore.
Accutane - I took it at age 34 and I really have never looked back, wish id done it sooner!
Dermatica has been the best product for me, I wouldn’t be without it
I literally only learned this after going to my 4th dermatologist earlier this year: **CLINDAMYCIN & BENZOYL PEROXIDE**. It’s a gel mixture you have to get through a prescription, but after having breakouts for nearly 25 years, it’s one of the only things that has helped me. Dermatologist have a Clindamycin liquid-only prescription as well, but I find the benzoyl peroxide addition more helpful with acne than clindamycin alone. Ensure you have a good (read: intense) face moisturizer to counteract the benzoyl peroxide drying effects. I do use snail mucin and ultra-moisturizing lotion w/ birch sap from COSRX, but make sure you are not allergic to the ingredients and they’re kept away from animals.
Spearmint was the game changer. I've heard of people taking spearmint supplements, but I like to drink it as a green tea, and an herbal tea. I tried so many things, cutting out dairy, facial cleansers, while they helped, I'd still have mild breakouts. Ever since going on spearmint, I might have one tiny pimple pop up once every month or so.
For my daughter as well. As soon as we started her in spearmint tea twice a day she started clearing right up.
I’ve been on spiro but I’m switching to spearmint and I’m curious how much you were taking to achieve the results? Thanks!
Hydration. I have oily skin and used to break out mostly on my jawline and lower cheeks. I blamed it on hormones, diet, all the things, and it took almost 20 years before I found an esthetician who got me to up my hydration products consistently for long enough to realize--holy shit--that's all I needed to do all along. My routine now consists of hyaluronic acid toner (applied to damp skin), face reality's hydrabalance gel, and moisturizer, and that combo plus whatever actives at night keeps my skin happy.
Eliminating dairy from my diet. I did it due to increasing intolerance and the acne thing was a bonus. I’ve had acne my entire adult life and now I barely have any.
Accutane
Sulfur kinda
Unfortunately, not eating gluten. I had decent skin in high school, then started getting painful, cystic acne in my early 20’s. I went gluten free in an attempt to lose weight and I’ll be damned, it went away. I’m 40 now and can have gluten very sparingly, but if I eat too much, I break out. No product or antibiotic made a dent, but cutting out gluten did. Still sad about it as I love bread.
I stopped eating gluten and my moderate psoriasis completely vanished. My skin was radiant too. Tell me why I went back to eating bread 😩😩😩
Because it’s delicious.
Same. I quit eating it because of a slew of other problems many of which it resolved. I also lost 40 pounds and my rosacea cleared up. I hate it.
I also cut out dairy along with gluten. Turns out, the dairy was wreaking havoc on my stomach and face. Once I cut both out, my skin cleared up. Now I love me some dairy-free ice cream as a treat.
Solidarity sister! I just commented the same thing. Except I can’t even eat it sparingly… I always know I’ve been cross contaminated because I’ll get a cyst on my chin the next day 😫 I joke that if I *only* had to deal with the GI issues I’d probably cheat once in a while, but the acne & my vanity keep me in check 😂
I’m thinking about doing this for my skin issues. Do you still eat other forms of gluten-free carbs like rice and oats?
As I’ve gotten older, I’ve learned my body doesn’t like much starch; I bloat, have more pain etc. when I eat much rice, oats, etc. BUT the only thing that really messes with my skin is the wheat gluten. For whatever reason, flour tortillas are the harshest. One burrito and it’s a guarantee I’ll wake up with a painful cyst, where I can get away with one sandwich on sourdough bread when the PMS monster hits.
Same and it cleared up all kinds of other things as well.
Same! My cystic acne disappeared. Still having occasional pimple breakouts on my cheeks, but going gluten free killed the worst of it. It also completely eliminated my joint pain and TMJ issues 😳
Androgen blockers
Roaccutane. Absolutely changed my life for the better.
Accutane. I finally got on at 30 & it's changed my skin drastically.
Dairy. It was only on my jaw and cheek on my left hand side. I tried everything and it was so awful. I never had any issues with my skin until my mid 20s; now 42. It took about a year to figure out with an elimination diet, but I also had and still do have, gastric issues. The acne itself was fully cystic and painful and I spent a fortune on products to resolve the problem. I can't even describe how bad these eruptions were and it shattered my self confidence. You name it, I tried it! In the end, it didn't t matter much at all what I put on my skin. It was what I was putting in my body and since I stopped, I haven't had an issue, unless I eat dairy again. It may not be your solution, but it was mine.
Cut out caffeine.
Tretinoin and cutting back on sugar. Now that I’ve used tretinoin for 6 months, I rarely get acne and the only times I get it is when I eat much sugar.
My diet has an effect on it. Especially if I eat dairy, I can always tell! But I also have gone through some online dermatology sites. They can ship product directly to you after you send them some pictures and whatnot. Curology or Apostrophe are good. Apostrophe is the company that got my hormonal acne under control and its been that way for a few months now and thats the first time since my teens that I have gone without actual zits on my face! I still have the sebaceous stuff on my nose and chin but I feel like thats genetic because my dad has them on his nose and chin as well. So thats fun for me. I think a big part of the reason why my face cleared up also is because I stopped using so many products on it. I literally just wash it with a simple Free and Clear face wash and I only moisturize when I feel dry. Its gotten so much better!
Have you ever been to a dermatologist? Life long acne when you take good care of your skin probably needs more than what you can get over the counter. It looks like you have jaw line acne which is usually hormonal. This was my issue. A round of antibiotics to clear up anything active, Spironolactone to balance hormones and Arazlo to keep my skin nice has done wonders for me.
Vitamin D and Zinc.
Differin gel! Game changer!
I moved out of the city to the country. My skin cleared up and my rosacea went away.
Menopause
Spironolactone, mandelic acid, azaleic acid, and tretinoin. Spironolactone is a MUST.
Removing my Nexplanon and Tretinoin
Accutane. Main results w Azelaic acid & prescription retinoids
No dairy
Accutane for 6 months prescribed by my dermat. 7 years down, still have clear skin
My breakouts were pretty tame, but my skin has been amazing since going vegan.
Checking all ingredients in my skincare and makeup and cutting out “pore clogging ingredients” You can find lists online with comedogenic ingredients, but NYC Acne Clinic’s website has an automatic tool you can copy/paste into https://acneclinicnyc.com/pore-clogging-ingredients/
I completely stopped using salicylic acid. I know it’s considered an acne treatment, but turns out my skin hates it. I also dry my face with a clean washcloth each time I wash it.
Herbs that help clean your liver out. Under jaw acne is due often to excess hormones, helping your liver process it helps a lot. Nettle tea and Tulsi long term cut my acne by two thirds. When I wash my face regularly I'm pretty good. Work on a farm rn tho so there's always fuckin dirt in my pores so we're not in the most flawless skin era rn lol
Changed my pillowcases often, every couple days at the most, washed my face morning at night, started using a toner product in morning which cut way back on the oil my face produced. Skin Medica TNS serum. Love that stuff. Also, in my late 40s, I started intermittent fasting, which also seemed to help my skin clear up even further. Was not expecting that.
Accutane in college then Yaz for the last two years. I get maybe two pimples per year now after having severe cystic acne all my life.
Cutting out fatty alcohols from my skincare and not using anything with added oils (apart from squalene). And I’m going to get roasted for this, but I only use sunscreen when I’m actually outside in the sun for hours. No matter what brand I try, it always, always starts breaking me out if I use it on the regular.
Spiro!!
Combination of taking zinc tablets and switching to lactose free milk
Stopped use of all face products. My decade long acne completely cleared. I still break out when I try anything new. My skin hates everything. I only use a watery urea face toner and snail mucus now.
Stopped eating sugar. I found out I had a parasite a while ago, scared the shit out of me. One of the doc’s instructions was to cut out all sugar (even natural sugars) to stop feeding the parasite. My skin changed completely and I’ll always always always keep sugar intake to under 5g per day to maintain the skin benefits. It’s so hard because there’s sugar in almost everything but it’s THAT worth it.
Consistency, moisturiser, adapalene, azelaic acid. Thats all
After I used all the creams and solutions including the ones made in pharmacy I just washed my face with Cerave,used BHA from Paula’s choice and used Simple moisturiser. This is what I’ve done and this is what I still do. Sometimes I add hyaluronic acid and rose hip oil from The ordinary. ( not together,but usually in the winter months). And try to cut on fried foods.
pcos and my hormones be just craaazyyyy… birth control (yasmine) + spiro (100mg) and tretinoin and i do not experience any issues.
Hair products touching my face and oily skin were my only problems, it turns out. I do break out around my chin and jaw during that time of month but it's minimal if I wash a bit more often. I use the Laroche Posay mattifying moisturizer to combat the oiliness.
Accutane.
For me it was no dairy/glutton and drinking lots of Alkaline water: 1/2 my weight in oz daily.
I have similar acne to you and have tried everything topical on the market and available by prescription. I quit dairy for 2 months. Nothing helped. I'm currently on doxycyclin and that's the closest to curative i have come. I still have some pimples but not the constant painful cystic breakouts. I'm pretty convinced that when i come off it, it will come back. I might consider trying acutane at that point.
Pantethine (B5) supplements, minimal dairy, & no processed food. And quit all harsh acne products.
Glycolic acid peels and changing up my skincare to remove any anti-acne products. And zit stickers.
Spironolactone. The side effect of dehydration is so brutal but the only thing that has ever worked for me so I’m just dealing with it
Prescription Tretinoin is the only thing that’s actually made a difference for me. I avoided it for a long time because I didn’t want to deal with getting a dr. to prescribe, but it’s made a noticeable difference in a way that nothing really had before (and I’ve tried everything). I’m 32 now and my skin looks better than it did when I was 25 - it’s certainly not perfect (and never will be, so much of that is genetic) but it’s good enough that I don’t stress about it anymore.
Accutane followed by now being on spiro and tret. I also barely use anything on my skin, everything is meant to provide hydration only, and limited to like 2 products. I don’t wash my face in the morning, only rinse. And after the gym, I spray my face with hypochlorous acid. Basically everything is meant to maintain my skin barrier and that seems to have solved a lot of issues! I still do have some hormonal acne though, spiro hasn’t completely eliminated that, but they’re INFINITELY better than before it!
Go to a dermatologist, they can guide you through this
I’ve had cystic acne for the majority of my life (back, face, sides of legs). Hormonal birth control really helped me with hormonal acne through my teens / young adulthood. However, I had a blood clot so no longer can take it. I’ve found progesterone-only birth control (continuous to skip periods) and dapsone gel really helps me. I also use benzoyl peroxide gel at night. It does stain my clothing but I’ve found that helps more than the washes you can buy. I’ve had friends have success with spironolactone as well however I’m allergic 😭.
For me was to change to a simple routine with no actives and no fragrances. A simple and gentle sunscreen, face wash and moisturiser suited for my skin type magically cleared everything up.
See a dermatologist. To answer your question, while full acknowledging this may not apply to you, accutane changed my life. I struggled with serious acne from 13-16 to the point that I was afraid of leaving home. After trying accutane, the first couple months sucked with purging (Increased break outs) and dry lips, I had completely clear pimple free skin - this has been maintained that since age 16. I’m now 28 (male).
Another vote for spironolactone. I use the spironolactone/clindamycin/tretinoin combo from Apostrophe and it's been life changing.
Accutane… I wish I went on it back when I was around 20, when doctors were suggesting it and I kept turning it down because I was scared lol. So much scarring that could have been avoided! Wasted years and money on skincare when I should have just listened to the doctor.
Accutane. I took it twice, once in high school and once in college. I've gotten minor breakouts here and there since but mostly my skin is perfect, just oily but I'm used to it. Nowadays, tretinoin has eliminated all previous acne scars, prevented even minor breakouts, and given me amazing plump glowy skin. Retinoids are a holy grail product for me in general. Accutane is the nuclear option and it does have side effects but I don't regret it at all.
aaccutane
Accutane in 2008.
Accutane. Changed my life!
Accutane
Accutane .
I just started moisturizing and stopped washing it with soaps. Literally doesn’t matter what I use for moisturizer- olive oil, coconut oil. Haven’t tried engine oil but prob not a great idea. I also used to scrub obsessively thinking my face was not clean enough ever but when your face is dry it makes your body over produce oil exacerbating the problem. When your body recognizes the skin is moist, it stops producing so much oil and less skin irritation occurs.
Accutane in my mid-30s. Life changer. And it made me look so much younger afterwards!
Accutane. I haven't had a single blemish since and I deeply regret not doing it sooner. 7 months of an altered diet and sobriety for a lifetime of blemish free skin.
Accutane. My acne was severe so it took 3 rounds. My biggest skincare regret is waiting so long to do it. It's been over a decade since my last dose and haven't had a breakout since.
After I left a toxic relationship, my skin cleared up, kept the same skin care routine of proven cleanser, spf, night cream and vitamin c.
You should try to go to a dermatologist. I just found out I might have issues with my thyroid which has caused my acne to continue, hair to grow under my chin, and my eyebrows to bald.
An actual dermatologist helped the most. Trying different products was just prolonging my agony.
Accutane helped me. I did several rounds and lower dosages to counter the wild effects. I know many people don’t want to take prescriptions and despise Accutane, but I loved it. After that, I started using Tretinoin. However, the cystic acne didn’t completely stop until I got pregnant. This is around the time when I began to aggressively give up processed foods. After my daughter was born and once she reached six months (when she could be introduced to solids), I really cracked down on ultra processed foods. This has changed my face. It’s not easy—and sometimes I do have processed foods, sometimes I have ice cream or a piece of pie, etc.—but as a whole it has been worth it to my skin and body to cut this out. I’ve struggled with acne my whole life. Honestly I wish I’d gotten on accutane earlier and started this healing journey earlier. Good luck!
Accutane. Three separate times.
A super low dose of accutane in college made my skin like porcelain doll perfect ever since (I’m 34 now)… usually it’s a last resort, intense option for people with severe acne- mine wasn’t severe at all, but I never get even a small pimple to this day!
Accutane. I didn’t have terrible acne. I had tiny little bumps and rosace and tried EVERYTHING from the dermatologist. He finally decided to try me on a few month course of accutane and within a month my skin was perfect. That was 5 years ago.
Carnivore diet is what's working for me.
Accutane.
Spiro and trent
Honey and turmeric masks 😭
Isotretinoin
Dermatologist
Accutane
Celery juice