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  1. Hi, I really need some advice on what alternatives to roaccutane/accutane are avaliable for moderate to servere cystic acne?? Ive had acne for about 8 years now and ive been on just about every perscription drug out there (benzoyl peroxide, lymecycline, erythromycin, clindamycin, birth control) and after a year or longer each of them have just became ineffective and my acne has came back again in some cases worse. I realise that roaccutane/accutane would be an option for long term effectiveness but as i am prone to depression i cant take this, ive also been told theres nothing more my doctor can give me antibitotics wise, im just wondering if anyone has had a similar expierence to me or if anyone knows any other options i have medication wise? Thanks
  2. Scalp Acne help!!?

    I've been battling acne since I was about 11. I'm now 26. I was on Accutane twice. It did clear me up. I was put on BC (Yaz) when I was 18 to keep it clear. Yaz gave me bad cramps so I switched to Ortho Tri Cyclen. I was on that for a long time. I switched to Orsythia, thinking my skin needed a mono pill since I still had bouts of acne. My skin has seen good and bad days. However, since Accutane (I think) I have been battling scalp acne. My scalp acne honestly bothers me more than my face anymore. I still break out on my nose since I have blackheads. My scalp is horrible. It's usually covered in acne, and yes it is acne not anything else. My derm just puts me on antibiotics and shampoo. I've also noticed recently I've been getting little pimples on my chest.... I never had chest acne!! Even on my worst days! So now I almost want to go off BC because I feel like that is the issue and maybe I have an imbalance. My skin is the clearest during my period week. But my scalp never wants to clear. It only gets slight relief during that week. I'm on antibiotics now and I feel so freakin relieved because it's the first time in a long time I don't have scalp acne. My hair isn't gross from it and i actually feel like it looks healthier too. I'm afraid to have it come back. Derm thinks it's hormonal. What do I do and who has battled this before? Honestly just tired of it and want a long term fix, not pills and shampoo. It bothers me so much and it is so painful!
  3. Sprintec birth control

    I started taking sprintec to treat my acne almost 4 months ago. During the first 2-3 months I started seeing my skin slowly improve and I got less breakouts. At the end of my 3rd month and the beginning of my fourth, I started breaking out really bad all over my face. Did anyone else experience anything similar? I was really hoping it would clear up my acne but it's only gotten worse, or the same as it was before.
  4. Does anyone have experience with the birth control implant, and whether it causes acne flares? I have had acne since puberty. Tried the usual treatments of tetracyclines, benzol peroxide, bcp, as well as any fancy treatment system I could get my hands on. Eventually went on Accutane, which was a godsend. My skin has aged a lot since accutance, and I now have big pores and some scars. But it was worth it: the accutane brought my acne down 95% and was definitely worth it. Since then, I have been on twice daily finacea, which dampens the number of small whiteheads and blackheads I still get. Since I still get flares at irregular points, my doctor has put me on Trimethoprim 200mg/day for 2 months to see if we can tip the balance. Because of frequent travelling and headaches, I decided to try the birth control implant. I read many user reviews, looked at clinical trial data, and talked to my doctor and gynecologist. My doctors agreed that there was a small chance that my acne might reoccur. I'm still in the "settling in" phase for the implant, and have been told it will take at least a few months for my body to get use to it. 2 weeks in, and no big breakouts yet. I would really like for this to work, since not having to take a pill every day is awesome. Plus, unlike IUDs, this can't be knocked out of place and doesn't feel uncomfortable. Does anyone have experience with acne recovery and the implant? Any success stories out there?
  5. Hey everyone. I have a quick question about accutane and birth control. I've been reading a lot about accutane and was considering maybe trying it. I've been told before that I'd definitely benefit from it. I'm not currently on accutane by the way, just considering it. Though my cystic breakouts are fewer and less extreme than when I was told this, I've been having a hard time battling breakouts through skincare alone, and I know I'd still qualify as severe enough to try accutane. This is probably a ridiculous question, but I know that in order to be prescribed accutane you have to agree to two forms of birth control. I know abstinence can count as one, but I don't feel at all comfortable with any other of the forms of birth control. I don't want to take the pills, but I'I probably going to end up having to if I want to try accutane. I know some dermatologists will let you simply agree to abstinence as your only form, but I doubt that'll be the case. My question is if you do agree to birth control does the dermatologist prescribe it for you or do you have to go to the gynecologist? That's my main concern at the moment. I don't exactly want to explain why but I'm not planning on agreeing to birth control pills if I have to go to the gynecologist. I'd appreciate it if only people who've been on accutane and used birth control with it would answer this, thanks.
  6. Hi im a 17 year old girl and ive had acne for the past 4 years but ive been getting spots since ive been 11. Its the usual story, ive tried everything including zinteryt, benzoyl peroxide, duac, lymecycline, tetracyline ( been on antibiotics for the past 2 years) and also differin cream and 3 types of birth control. My acne was never on my cheeks until i started using birth control and now its only gotten progressively worse. Ive tries microgynon which gave me headaches, the implant which made things much worse and im on gedarel ( same as marvellon) for 4MONTHS NOW. So i dont know if i can still consider this a inital breakout. my skin got much better in month 3 and now month 4 it seems to have started again my gp was suppose to refer me to a dermatologist because i want accutane but its been 2 months and the letter hasnt come though and things are getting much worse, idk how to hold on im getting so depressed and even missing school when my exams are coming up, please help!
  7. Hi there, I am 26 years old. All my life I had fairly clear skin. No acne but pimples every once in a while. I also was a bad picker so a pimple would turn into worse! My skin would also get bad when I got stressed - possibly because to relieve stress I would pick at my face. However, I just stopped taking birth control pills. I was taking them for 10 years and decided to switch to a copper IUD. Everything was okay at first. Although it was a very stressful time for other reasons so my skin wasn't great. Then I went on a big trip. I moved to Australia for 6 months and am currently doing 3 months in Southeast Asia. In Australia my skin started getting really bad. Little bumps everywhere. After doing some reading I believe they were whiteheads. They would never form a head. Never be that big. But I could pop them and get puss out of them. However if I did that it usually led to bigger pimples from my face being irritated. I am unsure if it is the hormonal changes but it did start about 7 months after going off of birth control. And now it has been a year and it's still bad. Maybe it's from sweating more than I'm used to in hot climates? I have switched up all my skin care products and hair care one by one to see if anything helps. It doesn't seem to be the case. My skin also really breaks out during my periods which it never used to. But when it does that they are more cyst like. At at this time it is really only the right side of my face that is really bad. Although the left still has a lot of red marks from the past (seems to take forever to heal!). I have tried to not pick and left my skin alone for weeks to no avail. Then get frustrated with the bumps and try to pop them. It's so terrible! I don't even want to be seen. I have stopped wearing makeup in hopes that it would help clear it up and I feel hideous. Any ideas would help! I will see a dermatologist when I get home but that is months away. Thanks in advance.
  8. Life after acne

    Hey guys, I really want to crete a conversation about life after acne (once you cure/temporary fix your acne). This is a topic that is not discussed a lot and i think its important. I have been acne free for 1 year and i no longer have any pigmentation either. I no longer find the need to wear makeup, and i never worry about my skin anymore. I remember when i had acne i was self-conscious and i would tell myself "when i have clear skin i will have no worries." The truth is yes you may not be conscious about your skin, but other insecurities appear.I realised that i no longer obsess with my skin, instead i would be conscious about my weight or how thin my hair is. Its important to mention that i am on birth control (what fixed my acne) and i have gained 15 pounds, have a headache everyday and my hair is thin. However, the fear of going off birth control and have my acne back is still strong. I guess what i want to get out, is that i find that once you fix one problem, another becomes obvious. thats what makes us human. I have learnt to love myself and i think thats the real cure. I have been off birth control for a week and my hair is great again, my headaches are gone and i have lost alot of water weight. My acne may come back, but at this point i've decided to deal with it. I would love to hear everyone else's experience of 'life after acne' or even if you have temporarily fixed your skin issues.
  9. Hi, I have been on birth control for about a year. Do I have to still wait the 30 day waiting period for iPLEDGE to start accutane?
  10. So here's what's happening. I started on a generic form of Yaz birth control to help with my hormonal acne that was really only effecting the sides of my face, jawline and neck. After a horrible initial breakout of about a month, the yaz really seemed to help clear my skin a lot! Never perfect, but so much better. However, I just began my 5th pack and I am starting to notice some small red dots with tiny white heads around the same areas that used to give me problems back when my acne was hormonal (jawline, sides of face), and I even feel like I have one cyst forming on the left side of my face right in the middle. I'm even noticing some small bumps / 1 or 2 real zits on my forehead which is ALWAYS at least almost perfectly clear. I was on Doxycycline for a while to help with the Yaz IB, but was careful to wean myself off very slowly. I am terrified now that my hormonal acne is coming back and/or the yaz has already stopped working after only 5 months to control my acne. Any ideas as to what might be happening? Any replies appreciated!!
  11. Today marks a new chapter in my acne journey with PCOS. I have found this forum incredibly helpful throughout my decision-making/research process and would like to contribute as well. Let's call this a little experiment shall we... To begin, a bit of backstory: I started getting acne when I was seventeen years old due to fluctuating hormones and diet (isolated to my forehead thankfully). However, upon cleaning up my diet by eliminating processed junk foods and sugar, I was fine in a year or so. With that being said, I have never had a regular "time of the month" (I'm currently 22). It got especially bad this past year, and that is when my bad hormonal cystic acne began forming (only on my cheeks...my forehead, chin and jawline are all clear). I was determined not to go on the birth control pill, as I wanted to deal with the problem naturally. I went to a holistic doctor, worked with acupuncturists and special facial treatments. Nothing seemed to help. I eliminated dairy, gluten, refined sugars and ALL processed foods. It got to the point I even eliminated any inflammatory foods (ex. tomatoes, citrus fruits...even strawberries for goodness sake!) But there was absolutely NO improvement. In fact, this past week...everything has worsened. *It's also worth noting that I have not had a visit from mother nature in over three months. Ever since this cystic acne breakout on my cheeks, my menstrual cycle has been horribly irregular* SO...I went to see my doctor and explained my troubles. She recommended seeing a dermatologist (as if I haven't already tried every topical ointment and cream in the universe and been seeing a dermatologist for years). She diagnosed me with PCOS due to my acne, irregular cycle, some excess facial hair starting, depression, and a few other symptoms (I am very thin however and have never struggled with weight- so we shall see how the birth control pill affects my weight). I asked my doctor if I could go on the birth control pill for an extended period of time. I am aware that things get worse after getting off the pill, so I intended to stay on it for fifteen to twenty years, or until I decide to have children. This is a completely personal choice of mine, as I am in an on-camera career where acne is simply not acceptable. I am quite nervous to start this pill, but I have so much hope that this will work out in three months or so. I am completely aware of the side effects, but this is so important to me for so many reasons. I have heard it gets better before it gets worse, so I will be seeing a wonderful woman who does facial treatments (specifically designed for healing the skin and not just extracting pimples) twice a week until my hormones balance out. I will also be continuing to manage PCOS symptoms as if I weren't on the pill by eating a low GI diet, getting sufficient exercise and undergoing acupuncture therapy...so hopefully if I decide to come off it sooner, I will have an easier time stabilizing my hormones. I will try to post some photos of my progress and I intend to keep weekly updates here for anyone interested. I know for me, the infamous "initial breakout" was a huge fear of mine...so I will be sure to document exactly when that affects me and how severely. Also FYI, the pill I am going on is Yasmin. I have heard great reviews about this pill for acne and PCOS, but of course only time will tell if it works well with my own body. I wish you all the best of luck with your own acne journeys. Despite all the emotional struggle (and DAYS I have spent crying over such a superficial issue), we are all beautiful and special human beings. We'll get through this together! Love you all xoxo
  12. Im suffering from severe acne right now, it came to a point that i suffered depression and even suicide attempts. I used to have a clear skin, after quitting smoking i got hormonal imbalance. At noticed 3-4 bumps at first but after a month it just exploded and covered my entire face. I really don't know what to do anymore. I went to the derma,and prescribed me doxy for 2 months. Im on my 3rd week and the cystic acnes seem to tame down. But i still got hundreds of closed comedones and acne scars due to facial pricking. I really dont know what to do anymore. Im thinking in taking dianne. Pls help.
  13. My Accutane Diary

    Hi, I'm 20 years old, dealing with mild to moderate acne for about 7 years now. Tried many topical and antibiotics, birth control pill is the only one to make a difference but it comes with too many side effects for me so finally got put onto Accutane. Started last week on 20mg a day. I will be on 20mg for 2 weeks after which I will go up to 40mg until my next appointment with the dermatology nurse on the 1st June. Week one - I've been ill and so I don't know if some of the changes I've been experiencing are due to that or the medication. I've been licking my lips a lot so they're sore and dry. Wake up every morning and my upper lip especially looks swollen. Dry skin around nose but thats probably because I've been wiping it so much due to the flu. Some dryness near chin, no break out, active pimples/white heads dried up. Went to the park to run around/exercise a few days ago and my muscles are still in pain - don't know if that's due to the accutane or just because I pushed myself too hard (worked out after a long time). Really looking forward to taking the higher dose and seeing some real improvements in my skin. I am currently still on the birth control whilst on Accutane just to minimise the initial breakout and will be stopping it after I finish this pack.
  14. I had perfect skin nearly all of my life. However; the past two years I've had one or two cysts pop up on my chin each month. They take forever to heal and always leave a scar. It's progressively gotten worse over the last few months. I currently have 3 cysts on my chin, whiteheads on my chin and nose, a few bumps on my cheek; and a cyst between my eyebrows. This might sound dramatic, but for someone with previously great skin, this is a nightmare. I'm on a new birth control to help the acne (Nortrel 1/35) and haven't noticed a difference at all in my third month. I just started taking Aczone last week. I believe my skin has gotten worse in the last week as I now have breakouts on my upper lip. This has NEVER happened to me in this area before. Why I just now getting acne at 21? I'm assuming it's hormonal. Any tips? I hope my birth control along with aczone will help.
  15. I have suffered from mild-moderate acne for about 3 years now, but it has always been focused on my forehead. Recently last year, I managed to clear my skin and I was acne free for about 2-3 months but then suddenly, at the start of this year, I broke out on my cheeks (which I have never had before!). This really damaged my self esteem and caused me to see a dermatologist. Since then, I have been prescribed yasmin birth control (been on it only fora week though)to help clear up my skin along with Stieva-A cream (which is a retinoid, used for 2 months) to help with acne along with scarring. It has been approximately two months and my acne is worst than ever. I have breakouts on my forehead and cheeks and I just feel so depressed. I don't want to go out in public. I don't want to see my boyfriend. I don't want to live anymore. I feel shit about myself constantly, I feel like people are watching me. I feel like everyone is looking at my acne and judging me. I always look at people's skin and just envy them for their beautiful clear skin. I'm so sad. I no longer have motivation to do anything because of my acne. I'm sick of this despair and struggle. Nothing seems to be working for me.
  16. Weaning Off Of Spironolactone

    I have had acne since the 5th grade, and have a very conventional story: I have treated myself and have been treated by medical doctors with the long-term use of antiobotics, two courses of accutane, topical creams, supplements...the list, and the hit to my wallet, goes on. I am now 26, and have clear skin. CLEAR SKIN. That's right - when I touch my face in the morning, there are no new bumps, no oily grease on my nose! I'll give it to you straight - I was cleared through the combination of primarily two things: 1. A dairy-free, low-carb, nutrient-rich diet 2. Spironolactone The low-carb, dairy-free diet helped to clear 50% of my acne. When I no longer saw any progressive improvement, my doctor put me on 50 mg of spironolactone. I believe my body is very dose-sensitive, because with 100 mg I became absolutely clear. Knowing well that spironolactone is not a long-term solution, I am beginning to wean myself off the spiro. The anecdotal stories I've heard of women using spiro and birth control for years and then trying to come off is terrifying. I also plan to start supplementing with DIM (diindolylmethane). I hope I can achieve the same effects, since DIM is an androgen inhibitor (see medical studies and other acne.org postings). I hope to update this posting with my progress on "coming off spironolactone" and "trying to balance my hormones" and relieve my acne without resorting to a dependency on drugs, to help those of you who have suffered like I have - especially, women who suffer from hormonal acne and are given little options from mainstream medicine!
  17. Mirena/Skyla IUD and Severe Acne

    I've been struggling with acne for a while now. I've had it since I was probably 13-14 (I'm 20 now), but it keeps getting worse and worse. When I was younger, it was relatively mild- normal teenage acne. I'm almost certain now that it is related to my birth control. I started birth control when I was 17. I started on Nuvaring, and while my acne did worsen while on it, it certainly wasn't severe. I was on Nuvaring for about a year, and decided to change birth control simply because the ring was fairly expensive. I did not use birth control for about 6 months, and I honestly can't remember how my acne was at that time. About a year and a half ago, I decided to get the Skyla IUD (same thing as Mirena, just smaller). I really enjoy the freedom that the IUD gives, but I can't say that my body has taken well to it. Insertion was VERY, VERY painful for me and the thought of having it removed makes me cringe. That is partly why I've tried my best to cope with the side effects, namely cramping and spotting for the first 3 months following insertion, severe acne, some moodiness, and a lower sex drive. I'm at my wit's end with the acne. I keep my face as clean as I possibly can- using gentle cleansers, salicyclic acid, Cetaphil moisturizer, gentle makeup with sunscreen (which I remove ASAP after getting home), etc. Despite all that, I've had borderline pizza face roughly since I started Skyla. Currently, I'm dealing with rosacea-like redness, papules, pustules, cystic acne, and a few nodules at a time just to make things even more fun. The acne is concentrated on my cheekbones, jawline, chin, and between my eyebrows. I will likely have a fair amount of scarring after it's all cleared. I've been to two nurse practioners in dermatology who only want to prescribe topical antibiotics. The first prescribed a 30-day round of oral doxycycline and topical Tretinoin, which I've been on for the past 6 months and is not very effective. The second, after me telling her that the antibiotics weren't working, simply wanted to switch me over to clindamycin (another topical antibiotic) and get me back on doxycycline. I haven't filled that script. I told the second NP that I'm convinced this is hormonal, since the Skyla is progesterone-only, high in androgenic activity, and that I tend to run high on testosterone anyways. She didn't want to hear it, told me she didn't have any solutions for me in that aspect, and told me that I'd be better off seeing a gynecologist and switching birth control. I suppose this is my fault for not seeing an MD, but in my area the wait time to see a dermatologist is upwards of 3 months. Maybe that's typical, but I'm desperate for ANYTHING to help control it. I have a few family members who are really into natural supplements (re: I'm a skeptic). They sent me some Flax Seed, Spearmint Tea, and DIM-Plus, all of which supposedly lower androgen levels. I've been taking the flax seed because, hey, worse case scenario I just get some extra fiber in my diet. The DIM-Plus scares me- there's little to no research on it (all anecdotal) and there's conflicting evidence (some say it blocks androgens, some day it blocks estrogen ie. Estroblock which I'm pretty sure is the OPPOSITE of what I need). If anyone has found a way to keep the IUD and counteract the acne, I'm open to suggestions. However, at this point I'm fairly convinced that I need to switch birth control to something with estrogen. From what I understand, birth control pills are the way to go for most people. I've heard Yaz, Yasmin, Ortho Cyclen, Diane-35 are all optimal for getting rid of acne. The reason I've never done BCPs are because I have a sensitive stomach, so nausea would likely be a pretty nasty side effect for me. I don't know if they still do the Patch in the US- is that an option? I would love to get some recommendations for dealing with this- skin care regiments, BCP advice, side effect management, etc. Thanks! TL;DR hormonal IUD probably gave me pizza face, derms won't give anything other than topical antibiotics. considering switching BC method
  18. Hi In augst it will be a year since i finished acctune course now, I am looking for birth control pills for non-acne reasons but the problem is .. my acne of course. I am still getting casual breakouts and im also after 3 laser resurfacing procedures - which would be a waste of money if my acne would come back. I am going to doctor in 2 weeks, and my question is - in this situation, should i be prescribed anti-acne birth control? in UK anti-acne birth control is is usually prescribed for severe acne... not for birth control. but non-anti-acne birth control sometimes causes breakouts ..... what is the best option in this situation?
  19. Hello, new here! I have I guess you'd say fairly mild acne but my skin has rarely ever been perfectly clear. I'm 22 years old. In my freshman year of college I was prescribed Loestrin fe for irregular periods. And that immediately caused severe cystic and regular acne on my forehead and chin/around my mouth and jaw. I went off of it after a month or 2. I've been in a relationship for about 5 months now and so I went on another pill in January (Sprintec). The GYN prescribed this after I told her my experience with acne on the other pill. My sister also takes it and has no problems. I've gone through four packs (I'm on my placebo week now), and I've been experiencing cystic and regular acne on my forehead and around my mouth and on my chin, along with clogged pores (my skin isn't even, and it used to be even except for some whiteheads and blackheads). I'm really frustrated and am not sure if I should try another pill right away, maybe an anti-androgenic one like Yaz... or whether I should get a copper IUD since it is non-hormonal. But if another BC pill would work for my skin I'd prefer to do that, since copper IUDs can cause heavy periods and bad cramps. Question though: if Sprintec, which helps a lot of people's acne, made mine worse, should I give up on hormonal BC? Side note: my periods when I'm not on BC are pretty light and short, and I don't get too bad of cramps. Also, since being on the pill, every month before the placebo week I get a few days of moodiness and depression. The past 2 months I've periodically started fights with my boyfriend and everything he does annoys me, however at the beginning of a pack I feel pretty sexual, warm and cuddly towards him. I don't know if that's normal either I do get PMS in general, though, and I am more concerned about improving my skin for the summer! I don't want to have to go to the beach wearing a full face of makeup.
  20. Hi everyone! I wanted to share with you all the knowledge I've picked up about acne and how for some women, it's actually rooted in PCOS and/or estrogen dominance. It's taken me far too long to get diagnosed with PCOS, which was actually the cause of my sudden onset 'adult acne', due to inefficient doctors. I created this in an effort to help other women who have suddenly been plagued with skin issues and other hormonal problems. In the guide, I talk about how you can use prescriptive meds, as well as food, tea and herbs, to help hormonal acne and other symptoms of endocrine imbalance. I also explain what tests to ask for as you seek a diagnosis and how to interpret your blood work. I hope this helps you on your journey to good health. Q&A About Hormonal Acne, PCOS and Estrogen Dominance How do I know if my acne is hormonal? Hormonal acne tends to manifest on the lower half of the face, especially around the chin, jawline, neck and mouth. If your acne is caused by hormonal fluctuations, it will typically get worse during the last week of your cycle. If you have PCOS, you will usually have skin issues almost every day of your cycle with some days being worse than others, since several hormones are out of balance; you'll also be more prone to androgenic back/shoulder/chest acne. Blood work (list of tests to ask for here) will confirm if estrogen dominance, PCOS, or in rarer cases, another endocrine disorder (i.e., late onset congenital hyperplasia) could be causing your acne. Saliva testing is also an option, but it isn't covered through insurance. It's best to get blood work done around cycle day 3. What is PCOS and what causes it? How do I know if I might have PCOS? PCOS is an endocrine disorder that causes acne/oily skin, excess hair on the chin/upper lip/sideburns/neck/belly/groin/chest, annovulation, ovarian cysts, weight fluctuations, obesity, high LDL/low HDL, heavy periods, blood sugar attacks, brain fog after meals, etc. Blood work typically shows elevated androgens [DHEA-S, free T, total T, DHT], a high LH:FSH ratio, elevated estrogen and low progesterone in the luteal phase. Every case of hormonal acne isn't caused by PCOS, but if you have any of these other symptoms, it's worth getting evaluated: 1 in 10 women have it, and symptoms can be subtle enough to be initially missed. PCOS also tends to strike in the early 20s, which is why many women who were acne-free as a teenager suddenly get hit by skin issues. PCOS is caused by many factors, including the environment and our genetics. If your mother, sister or grandmother has PCOS, there's a higher likelihood you'll have it, too. Some hypothesize it's rooted in inflammation; others believe the pill can cause PCOS by inhibiting ovulation after use. Even among lean PCOS'ers, insulin resistance is a common factor. (PCOS Diva gives an excellent explanation of the causes of the disorder.) Girls who go through early puberty are also more likely to develop PCOS. Example of blood work showing PCOS with estrogen dominance (my results, luteal phase): Estradiol: 400 pg/ml (extremely elevated) Progesterone: 1.6 (extremely low) Free T: 4.1 (upper limit of normal) Total T: 45 (exact upper limit of normal) DHEA-S: 498 (extremely elevated) What is estrogen dominance? There is ‘good’ estrogen all women have - estradiol (e2). Estrogen is highest from around the time menses stops until we ovulate, where it will suddenly peak and taper off as we approach menses again. So, if you have a perfect 28 day period cycle and bleed 5 days, estrogen will climb from days 5-13, then peak around days 14-15 before declining. Then there are xenoestrogens, or ‘bad’ estrogens from the environment, which are responsible for PCOS, estrogen dominance and acne. Xenoestrogens are endocrine disruptors; they mimic e2 by attaching to e2 hormone receptors in a lock-and-key mechanism. They cause a host of health issues, including impaired thyroid function, endometriosis, cysts, fibroids and PMDD. (This is why many women with PCOS also have Hashimoto’s thyroiditis.) PCOS and estrogen dominance often go hand in hand. What is a normal progesterone level and why is it important? Normal progesterone levels are essential for balanced hormonal health, stable moods, clear skin and the prevention of diseases like endometrial cancer. Like estrogen, progesterone fluctuates through the cycle. Healthy ovaries produce small amounts of progesterone until ovulation, where it peaks suddenly and steadily increases until menstruation begins. Progesterone has a soothing effect that prevents insomnia and mood swings, so low progesterone is responsible for all your annoying PMS symptoms, including chocolate cravings. (Fun fact: chocolate, esp. dark chocolate, is high in magnesium, and magnesium boosts progesterone.) If you have PMDD, a more severe form of PMS, there’s a high likelihood that you are deficient in progesterone. A natural progesterone cream, DIM and calcium d-glucarate help balance excess estrogen. (More about this below.) Does PCOS look the same in every woman? Definitely not. You can have PCOS and be lean; you can have PCOS and still get a monthly period, though your periods may be heavy or clotty; and contrary to the name, you don't have to have cysts to get diagnosed. Some women have subtle symptoms across the board with acne being their biggest complaint. For others, skin is clear but scalp hair is thinning. And hirsutism (facial hair growth) can range from having a few coarse hairs to needing to shave. PCOS is not one size fits all. However, acne tends to be one of the most common symptoms. Confusion about what constitutes PCOS and what doesn't leads many women to go without a diagnosis for years. It's a complex endocrine disorder better treated by a reproductive endocrinologist; with the right regimen, you can reverse it. What is a healthy level of estrogen? Why does too much estrogen cause acne? Estrogen fluctuates throughout the cycle, so what's considered normal at one point may be considered abnormal at another. In general, women in their 20s and 30s should have e2 levels that are roughly around 40-70 pg/ml during their follicular phase, 160-230 pg/ml during peak ovulation, and 100-80 pg/ml in the luteal phase as estrogen drops for menses. (I used this chart as a reference for e2 levels.) Why does too much estrogen cause acne? After all, estrogen is said to make skin smooth, plump and soft. This is true, but too much of a good thing ends up hurting rather than helping. In the case of estrogen dominance, it's xenoestrogens throwing the body out of whack that cause acne. (More about this below.) Estrogen eclipsing progesterone means testosterone is more readily converted into DHT via the enzyme 5 alpha reductase. DHT is a potent androgen responsible for hair loss and acne. How to Interpret Your Blood Work (And the Problem with Reference Ranges) A big problem with hormone health is using lab reference ranges for a diagnosis. Lab reference ranges are based off a wide range of healthy AND unhealthy control groups and therefore don’t provide accurate guidelines to follow. Yet western doctors often rigidly adhere to them. This is how many women with estrogen dominance and/or PCOS go undiagnosed for years. Example: When I got blood drawn in my luteal phase (a week or so before my period), my progesterone was only 1.6 ng/dl. Normal progesterone levels for a woman in her 20s in the luteal phase is at least 8 ng/dl. Yet Quest claims anything over 1.0 ng/dl is ‘normal’ for the follicular phase, so my doctor looked at that instead and brushed me off. Any competent doctor would infer that a progesterone level of 1.6 in the luteal phase (post-ovulation) means that ovulation didn’t occur. Worse still, my estradiol levels were teetering on 400 pg/ml, showing a huge disparity between estrogen:progesterone - yet Quest said up to 460 pg/ml is normal in the luteal phase, so it went ignored. Another example: Sites like emedicinehealth say a ‘normal’ level of total testosterone in young women is 15-70 ng/dl. Yet most women start exhibiting symptoms of androgen dominance, namely acne, once total T is over 40 ng/dl. As a quick summary, here's how to spot estrogen dominance and/or PCOS on your blood work: PCOS Total T over 40 ng/dl Free T over 2.5 ng/dl DHEA-S over 200 ng/dl HDL under 60 3:1 LH/FSH ratio Fasting blood glucose over 90 mmol/L (100-125 mmol/L is indicative of pre-diabetes) Estradiol over 100 pg/ml in the luteal phase (1 week before period) Progesterone less than 8 ng/dl in the luteal phase Estrogen Dominance Estradiol over 100 pg/ml in the luteal phase Progesterone less than 8 ng/dl in the luteal phase Treating PCOS with Estrogen Dominant Features (& Tips for Healing Estrogen Dominance) **Licorice+Peony: High DHEA-S occurs in over 50% of PCOS'ers. This is a potent combo clinically shown to help regulate the adrenals and lower DHEA-S, which causes male hair growth, acne and oily skin. The peony offsets the feminizing effect of Licorice by boosting progesterone. As with any adaptogenic herb, it's trial and error. Licorice+peony has helped lower my DHEA-S by almost 200 points, which is truly a miracle; it has not made symptoms of my estrogen dominance worse. Licorice has the potential to elevate blood pressure, therefore you shouldn't use it if you have hypertension. Adaptogens should be taken for two weeks followed by a short break. **DIM [soy-free] with calcium D-glucarate and fiber: For estrogen dominance. 100mg/DIM with 200mg/calcium D-glucarate and high amounts of fiber will help flush BAD estrogens out of your system, all while providing an anti-androgen effect. Note: taking DIM without these secondary supplements will let bad estrogens 'hang out' in your body, which can worsen symptoms. DIM should ideally be soy-free. Soy is a phytoestrogen, which means it will theoretically compete with xenoestrogens to bind to e2 receptors. However, soy is also loaded with GMOs. Unsurprisingly, many people break out from it [myself included]. **Natural progesterone cream: A NPC will balance out estrogen dominance and reduce mood swings, PMS/PMDD, cysts, endometriosis, and acne. This is because a, progesterone has a calming, anti-anxiety effect and b, it helps combat androgens. Ona's and Pro-gest sell natural progesterone creams with excellent reviews. Apply the cream in the a.m. and p.m. on your inner thighs, palms, neck, inner arms and breasts - these areas have a dense number of capillaries to absorb the cream better. If your e2 levels are 250 pg/ml or higher in the luteal phase, wait several cycles before using a NPC to avoid an initial flare up of acne. A natural progesterone cream will 'wake up' estrogen receptor sites when first used. The fewer xenoestrogens in your body, the easier it will be to use the cream and the faster you will see results. Read this quick helpful guide about when and how to use the cream, including if you plan on getting pregnant. John Lee explains what dosage you should take and some benefits of NPC. **Magnesium: At least 250 mg/Magnesium in the p.m. will boost progesterone levels and promote result sleep. Many people are deficient in Magnesium anyway, especially Americans (due to our iron-rich diet containing red meat). Read about all the health benefits of Magnesium. Magnesium-rich foods and supplements can induce bowel movements. This is a good thing, since going regularly means improved endocrine function and the flushing out of toxins. If you're experiencing watery BMs or diarrhea, cut back your dose. If supplementing with vitamin D and a calcium pill, it's crucial to take a Magnesium supplement to avoid mineral imbalances. Myomin: Similar to DIM, this will flush bad estrogens out and improve estrogen metabolism. L-Theanine: This soothing supplement is said to help reduce adrenal androgens [DHEA-S in particular] by regulating the HPA axis and decreasing ACTH stimulation. Selenium: Encourages healthy progesterone; proven to help acne. Low-dose selenium is excellent for PCOS’ers who also have Hashi’s, which selenium also treats. Camu-Camu powder: A potent form of Vitamin C that boosts progesterone. Camu-Camu is said to be more organic than a typical Vitamin C supplements, which usually contains GMOs. Probiotics: Many women with PCOS have leaky gut or candida overgrowth in their intestinal tract. Supplementing with a chilled probiotic and eating pickled foods are a must. Dandelion tea: An excellent bitter that helps keep the liver clean. A healthy liver means fewer excess androgens, toxins and xenoestrogens. Metformin ER: Most women with PCOS have some form of insulin resistance (even if they are thin) and Metformin works to increase insulin sensitivity. Metformin also raises progesterone and prevents the ovaries from becoming hyperstimulated. In women with high DHEA-S, the adrenals respond to improved insulin sensitivity by reducing the output of DHEA-S. Extended release is preferable to the regular version, as it has fewer digestive side effects. Women across support forums online concur that low-dose Metformin seems to work better for lean PCOS (750mg/daily). Weight loss: Excess subcutaneous fat, especially around the abdomen, boosts androgens. Xenoestrogens are also stored in fatty tissue. Reduce red meat: Many women with estrogen dominance and PCOS get heavy, clotty periods from excess iron, plus too little magnesium. Red meat also boosts testosterone. Eat more salmon: Omega 3 fatty acids have been proven to fight inflammation, a huge underlying cause of acne and PCOS. Salmon has the most; you can also try sardines, rainbow trout and tuna. Fish oil pills a more affordable option, but always break open a few capsules first to ensure the bottle is fresh! Other sources of omega 3s. Vitamin E: Take no more than 100 IU/day. Vitamin E not only helps antagonize xenoestrogens, but it also encourages faster wound healing (an added benefit for acne). Vitamin D: Most women with PCOS are clinically deficient in vitamin D, even more so than the general population. Low vitamin D contributes to not only estrogen dominance, but improper thyroid function. Taking at least 1000 iu of D3 per day will help your body metabolize hormones efficiently. Consider investing in a distiller: Did you know that a huge portion of xenoestrogens we consume comes from our water? A distiller steams out these minute impurities, including heavy metals and fluoride that also contribute to endocrine disruption. Consider going Keto: The Ketogenic diet is especially helpful for women who are overweight and/or insulin resistant. Even too many good carbs from grains, legumes and fruits can spike insulin, which hyperstimulates the ovaries to produce excess androgens. Try having fewer than 60 carbs per day for at least six weeks and see how symptoms improve. What to avoid: **Spironolactone and birth control: You may be wondering, why not Spiro, the holy grail for acne? After all, doctors prescribe it (sometimes with the pill) for PCOS left and right. But this one size fits all approach is a MAJOR mistake for treating all cases of hormonal acne. Spiro and birth control both contribute to estrogen dominance. Spiro turns off testosterone but raises estrogen in the process; the pill, the ring and the patch pump synthetic estrogen into the body - the xenoestrogens we're trying to avoid. Low-dose estrogen pills, the mini-pill and Mirena worsen acne because of their androgenic effects. (The progestin in them isn't the same as the progesterone we want to raise.) Spironolactone or birth control is the better choice for PCOS'ers with high testosterone and low estrogen. **Stress: One major trigger for both PCOS and estrogen dominance is stress. Elevated DHEA-S and low progesterone are worsened by anxiety and sleeplessness taxing the adrenal glands, which disrupts the HPA axis. Lack of sleep also worsens acne. 'Pregnenolone steal' contributes to estrogen dominance, and it may play a role in PCOS. Essentially, pregnenolone is a precursor hormone your body needs to make cortisol and sex hormones. High amounts of cortisol are released during chronic periods of stress; pregnenolone is 'stolen' to make more cortisol; and in turn, when pregnenolone is in need of a boost, it 'steals' from estrogen, testosterone and/or progesterone. Nicole Jardim agrees that pregnenolone steal is one of the leading causes of progesterone deficiency. **Commercially raised meat, poultry, eggs and dairy: Eating red meat, eggs and dairy fewer than 4 times per month will relieve symptoms. Meat and animal byproducts have been scientifically proven to increase androgens, and dairy contains estrogenic hormones. **Plant estrogens: SOY, i.e. soy milk, edamame, non-dairy vegan/vegetarian frozen meals **Sugar and bad carbs: Carbs raise blood glucose levels (bad carbs even more so), which promotes increased androgens and insulin resistance. Avoid bad carbs as often as possible, especially snack packs, candy, pastries, white bread, baked potatoes, starchy veggies like peas and corn, sweet veggies like carrots and squash, and excess fruit. Click for a list of some low glycemic choices. Other rules of thumb to follow: Limit fruit intake to once per day. Choose low-carb options like raspberries and peaches over high glycemic fruits like watermelon and bananas. Swap white bread for wheat-free whole grains. (Wheat is a common source of gut inflammation, which worsens acne.) Choose sugar-free gum and mints. Eliminate high fructose corn syrup, corn flour/oil, maize, fructose and vinegar. (Click for other surprising sources of corn.) Limit alcohol intake to once per week, especially beer (13g carbs/can). Wine is low carb but a mildly estrogenic effect on the body. Click for a guide to low carb/low sugar alcohol. Interested in going on a diet, but don't know where to begin? PCOS Diva breaks down the Paleo diet, Atkins, etc. and explains which popular diets are best for PCOS. **Plastics, plastic food wraps **Pesticides and herbicides, non-organic produce **All artificial scents: CANDLES (particularly bad offender, coated in phalates), perfume, body sprays, car and wall air fresheners, Febreeze **Coffee: Caffeine screws with your adrenals, which worsens acne. It may also have the potential to boost estrogen, too. **Zinc supplements: Zinc supplements have been shown to boost testosterone if you are even mildly deficient in the mineral. It's safest getting zinc through food sources. Canned foods, esp. cans with BPA Car exhaust and indoor toxins Styrofoam cups Salad dressings Spermicide Industrial wastes Non-organic Detergents Non-organic personal care products, including tampons and pads Paints, lacquers and solvents
  21. YAZ is destroying my skin

    Before i started taking YAZ I had mild acne, I started and my skin is HORRIBLE. I just want to know if going off of it would make my skin worse or better? I do want to stop I'm just afraid but I'm also afraid to keep taking it.
  22. yasmin!!!

    had to share!!!! anyone who is struggling with hormonal adult acne...try Yasmin!! I've been on it now for nearly 8 months & it has really made my life with acne easier! Although it hasn't cured it completely and I do still use bp at night it is way easier to deal with! I strongly urge anyone who is as down about it as I was to try it...at one point it even made me feel suicidal...it takes a good few months to work and does get abit worse in the beginning but one once it starts working is worth it. Good luck, and hugs to anyone feeling low. Xxx
  23. Hi everyone, I really need your help! I went on the Yaz generic version, Loryna, almost 8 months ago (I'm on the last week of my 7th pack) for my acne and to regulate my period. While my period is regular now, I'm still experiencing consistent itchy breakouts, many cystic and some whiteheads. It seems like every day I'm getting a new one! I'm really conflicted because when I told my gyno about this a few months ago, she said "stay on it for a year". I feel like if it's really not working, it'll just keep damaging my skin and leaving behind scars. I'm also scared that I'll break out even more if I go off of it, but honestly I've been breaking out in such weird places I haven't before (pretty much every area of my face at some point) that I'm thinking it might actually help to go off of it. So what do you guys think? Should I stay on Loryna for at least 5 more months or quit it now? Or should I try to get on another brand of birth control? Also, I've attached some pictures so you guys can see how my skin looks right now. Thanks in advance for any tips you give!
  24. I am desperately seeking out success stories from people who have dealt with acne after stopping birth control! I'm 22 and was on Yasmin for about 5 years. I went off it 7 months ago due to the risk of stroke. I immediately started breaking out although I have never in my life had issues with acne. It has gotten worse in the past 3 months & I seem to get new pimples every day. I'm starting to lose hope & going back on birth control is not an option for me. I really would like to hear stories from people who have had a similar experience! Especially those who feel their acne is clearing or cleared. thank you!
  25. 4 months with Diane-35

    Already doing 4 months into this birth control pill... It has been a roller-coaster trip. Emotionally and physically. The good news? My ACNE has get a lot better, but it hasn´t disappear completely. I have already said it, but the thing of the breasts getting bigger is 100% true!. Also, my hirsutism has improve. And I don´t have massive, long periods as before. The bad side effects? First things first, my mood: I feel sometimes SO depressed, not knowing why. And my tummy is swollen as it has NEVER been before, I feel as if i was pregnant or something. And my appetite has increased a lot! In conclusion, it´s the pill worth it? Definitely. Is it going to make your life better suddenly, will all your problems disappear? Absolutely not. I don´t know, This is what I feel about it now. I will continue posting.