11 replies to this topic

[Aknimegaz]

Hi everyone, I'm new to this forum. Basically, I've been suffering with acne since about 13, though it's never usually been *massively* widespread, usually a large lumpy spot here and there & a yellowhead or four, it's always been a problem. I tend to suffer from 'lumpy spots'/cysts rather than 'normal' acne. I went on Prozac in early 2000 and strangely, for the 2 years I was on it, my acne problems were very few. I quit that back in '03 but I've had even more severe acne ever since and in late '05, I was reaching depression point yet again.

Early last year, I went to see a skin specialist and I was prescribed Duac. In the space of four weeks, all my bumps and yellowheads vanished and I thought I'd hit the jackpot - it was truly a miraculous change and I felt great. Trouble is, early on this year, after exactly a year on the Duac, it stopped working and the lumpy cysty-spot things started to grow back in full force. I've tried antibiotics combined with Azelaic acid, Differin and some other cream (EDIT - Finacea) but apart from Differin (which just didn't work) they all caused me to get cystic pustules on my cheeks and the creases at the side of my mouth - I never used to get acne on my upper cheeks but now I have scars from several large pustules that have burst. I also have started to get a very red nose, which is another p*sser-offer .

It's like my acne is at the worst it's ever been and I'm coming up to my 33rd birthday! This zit outbreak makes my spotty adolescence seem like a holiday. I'm sick of all the pain and blood and pus (and I can't believe my face can hold so much of the stuff without it rotting off...!)

I'm currently eight weeks into a Retin-A prescription but though it *sometimes* seems to work, I've been getting massive lumpy cysts (proper horrible pus-filled things the size of a large grape) on my jaw and cheek, and also on the section of skin beneath my eyes ( ) It's really getting me down, not just the physical appearance thing (I feel like a mutant) but the sheer pain I get from them, especially on a morning. It feels like something is controlling my face!

Sorry to ramble on so much, but if anyone can offer any suggestions for help with my problem, I'd be truly grateful to hear them.

[Regi_1]

Grape sized cysts sounds severe, talk to your derm about accutane.

[Aknimegaz]

Grape sized cysts sounds severe, talk to your derm about accutane.

I've got an appointment two weeks tomorrow so hopefully I'll be able to get hold of some.

Just had a bath and twenty minutes after coming out, all my yellowheads have gone massively crusty, zombified, yet sore. I don't know how to handle these things - do I keep applying Retin-A, or leave them to dry out? Trouble is, I get very oily skin around the sides of my nose yet everywhere else seems dry. I can't even shave because it will likely end up a bloodbath. It's frustrating, to say the least!!!

[NICOLAS]

Hi Ak

I am 40 and was still getting acne up to last week. However, things seem to be changing for me bigtime and I hope they do for you too!

[TheChangingman]

Accutane does sound like the best treatment if your acne is as bad as you describe. My only worry is that your history of depression might make it difficult for you to get hold of the prescription as I hear depression is a side effect of the drug. Somebody who has been on accutane would be better to advise you about that though.

About the crusty spots, it's probably best to leave them alone - certainly no picking! The retin A might help but dont over apply it - it is very very drying and can often make your face look worse. Retin A certainly doesnt sound like a strong enough medication alone to be dealing with severe cystic acne, have you been on all the conventional acne antibiotics? I'd definitley insist on an antibiotic at least when you see the derm.

[Aknimegaz]

Thanks for all your replies.

@TheChangingMan, in terms of antibiotics, I'm currently taking 500mg of Erythromycin once at morning, once at night. I did run out of them for about 10 days but I got some more a few days ago. I hope they take the edge off a bit, though they haven't been that fantastic so far.

[TheChangingman]

Unfortunatley you have to keep with antibiotics for months (2 at least) to notice definite improvement, I do hope they help, it sounds a large dosage so it probably will. In the UK you often have to try a few courses of different antibiotics before accutane is prescribed I think. If you have been on them a few months ask for a switch, Erythro didnt do much for me personally.

I wish you all the best mate, it does sound like you have had a rough time of it.

[Aknimegaz]

Again, thanks for all the helpful responses.

Today it's been the most painful it's probably ever been. I tried to call the derm to fast-track my appointment but it was on answerphone all afternoon.

The area at the left side of my nose is full of crackly bits where the Retin-A has dried stuff out and it's mega-stiff and icky, sort of like 'rhino-skin' in appearance. Then I get THREE yellowheads suddenly break out on the left side of my nose(!)

I took a pic, though it's not that great and doesn't get across quite how crackly the area is:



Can anybody tell me if I should keep applying the Retin-A over the area? It's just that it's mainly crust at the moment, with sore and seeping pus-holes beneath. Will it eventually heal if I keep on with the Retin-A or am I just making things worse for myself?

[maddy001]

Hi there. You might be suffering from the initiate breakout from the Retin-A as it purges the pores that's why you get massive cysts. The problem now is that you say that it is red, peely and sometimes painful, it could be that it might have overpeeled your face as it exfoliates and purge. What is the concentration of your retin-A? It may be too high for you. When this happens, you need to reduce the application. Don't stop using it but reduce to maybe 3 -4 times a week or you may stop for a while till the situation changes. Retin-A is actually accutane in topical form and usually takes longer to work about 2-6 months depending on the indivivual.

Also since you said the cysts were painful and sore plus you face is red, you can try icing the area with cold compresses and then apply some aloe vera gel on it to soothe the redness and pain. Check out this thread on how to deal with it: http://www.acne.org/messageboard/index.php...=166343&hl=
I also wish to know what other products you are using.

For the erythromycin, its one of the weakest antibiotics against acne and its effects will the most last you for about 3-4months that is if it works. I took it before and I had mild acne that time and that was the most it lasted me. And yes you do need time also for it to work.

Also about the accutane, I do suggest you take it especially with such severe acne. This is coming from an accutane user. From your post, you seem to suffer from depression because of acne not from other problems so it shouldn't be too much of a problem to be on accutane. But taking accutane also needs proper monitoring so do find a good derm that knows your history of acne and depression.

[Aknimegaz]

Thanks for your detailed response, Madeline

The Retin-A I'm using is 0.025% and my doctor told me to take it twice a day. On some occasions I have gone a day without it and there's been no significant problems.

At the moment, I am only using Retin-A, Erythromycin and Ibuprofen to numb the pain/inflammation. I don't use a moisturiser - I'm not sure if I should moisturise or not because on the few occasions I've tried it, I've developed even more yellowheads(!!!!) Any advice on this?

Last night I applied some Retin-A to my more 'smooth' yellowhead areas, but not to the flaky scab areas (am I supposed to apply it to these too?) I still look like a walking nightmare, but thankfully the pain has reduced a bit since yesterday.

Another problem is the redness, especially on my nose. When I eventually get my cysts/acne under control, will my nose become paler because it's one of the things that people always seem to comment upon? I've never had a red nose until the moment I started on these topical ointments! Please say it can be cured, somebody, I'm getting a feeling that I'm going to end up like W.C. Fields(!)

[NICOLAS]

Mate, I know you haven't asked this but have you tried a change of diet? Your picture looks similar to what I had (acne and redness on nose and cheeks). I thought I had a healthy diet: weetabix/cornflakes for breakfast, sandwiches for lunch and a ready made meal with pasta/corn polenta for dinner. But all those things contained wheat or corn (ie. grains), which is heavily implicated in acne, and I wasn't having any fish.

I've taken all those things out and taken fish oil supplement (omega 3 is essential). It's only been 10 days so I don't want to jinx it. But after the first few days when I didn't want to go out as I was covered in acne, my skin has cleared up completely. Probably the best it's been in 20 years and getting better with each day.

If you're interested in any of this, check out the nutrition section of the website or reply with a note of your diet.

[maddy001]

Thanks for your detailed response, Madeline

The Retin-A I'm using is 0.025% and my doctor told me to take it twice a day. On some occasions I have gone a day without it and there's been no significant problems.

At the moment, I am only using Retin-A, Erythromycin and Ibuprofen to numb the pain/inflammation. I don't use a moisturiser - I'm not sure if I should moisturise or not because on the few occasions I've tried it, I've developed even more yellowheads(!!!!) Any advice on this?

Last night I applied some Retin-A to my more 'smooth' yellowhead areas, but not to the flaky scab areas (am I supposed to apply it to these too?) I still look like a walking nightmare, but thankfully the pain has reduced a bit since yesterday.

Another problem is the redness, especially on my nose. When I eventually get my cysts/acne under control, will my nose become paler because it's one of the things that people always seem to comment upon? I've never had a red nose until the moment I started on these topical ointments! Please say it can be cured, somebody, I'm getting a feeling that I'm going to end up like W.C. Fields(!)

For the moment you are doing right. Apply the Retin-A on areas that have acne only. Don't apply it to flakey or open wounds or scab areas. It can worsen the condition. The Retin-A you are using is the lowest. I am using the 0.05%. What confuses me is why your doctor told you to apply it twice a day instead of the night only. My derm strictly told me to apply it at night only because Retin-A makes the skin more sensitive to the sun just like accutane. Could it be that you are applying it in the morning and you leave the without any sunscreen? That could be one of the reasons why you are getting red and painful because you are getting sunburnt without knowing it. Retin-A should strictly be use at night before you sleep and the next day to be washed off by the cleanser.

As you have oily skin, I don't suggest moisturizer on the entire face but the areas where you have flakey skin. Don't apply moisturizer to the scabs. Do as the thread I gave you earlier on how to deal with the scabs.

As for the redness, there are products out there that can help but for the moment, I think you need to bring down your cysts and irritation so the only thing best for the redness now is aloe vera gel. From now on do treat your skin as gentlely as possible. I hope you are using a mild cleanser not those abrasive scrubs. Try to limit as little products as possible. And when your skin is better, you can start using benzoyl peroxide for spot treating of the cysts.

Oh yeah I forgot, sunscreen is very important now that you are taking antibiotics and using Retin-A, sun senstivity is increased so do find a good sunsreen.