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[cvd]

I give up! Nothing has worked except for accutane and full strength antibiotics...and these drugs can not be taken for very long. My really sensitive skin can not tolerate BP or other OTC products. I get my hopes up everytime I'm put on a new regime that maybe this one will keep me clear. And sometimes it does for several months but then the swollen bumps, redness and cysts come back in flare-ups where I have to go on a short course of antibiotics again. I'm 60 years old and way to old for this. So depressing.

I saw a "new" dermatologist this past week who is the head dermatologist at the best clinic in our area. He is very well known and impossible to see but my regular derm was out of town and he had a cancellation. First off his exam was totally different than any I have had before. He listened at length to my history which is a long one since my acne started at age 15. Actually he prescribed Accutane to me in my 30's and remembered me...this was ages ago when he first started his practice in the area. I had such success with accutane, at least initially, that I thought I was "cured". I moved away and just moved back to this area several years ago. I tried to get into him but never could. During this exam he also looked at my skin with special magnifying headgear for quite some time. He ran his fingers over my skin, looked in my ears and on the front of my chest near my neck. He concluded I have some seb derm, mostly hormonal acne, and possible some rosacea. He was totally understanding...I think because he had (or maybe still does and it is under control) severe acne. The deep scars tell the story.

This is the treatment regime he has me on for the next 7 months for my very resistant, chronic acne. I've never followed such a complicated treatment regime - one that includes oral meds, topical med, microdermabrasion, and diet all at the same time. Again I am hopeful...and will log my progress for the next 7 months until my next appointment with him.

AM
Cetaphil Antibacterial Soap - gently wash 3 seconds with lukewarm water
Noncomedogenic hypoallergenic lotion - I use Neutrogena for Combination Skin
Oracea
Spironolactone 50 mg

PM
Wash same as above and wait 20 minutes
Tretinoin Cream .1%

Once a month
Microdermabrasion - "wimp" setting to start

Diet
Continue to follow prescribed allergy diet and avoid dairy

This week I'm getting over a very bad outbreak...possibly the worst flare-up I've had in a year. It's calming down now but I'm still emotionally upset by it and my skin is bumpy, red, and there are the lovely red flat marks showing where the cysts were. I'm about 5 days into the oral meds (oracea + spiro), 1 year into the topical (tretinoin cream) and 2 months into the diet.

[cvd]

New swollen bump today...not sure what it is. Hoping it doesn't develop into anything too awful. Also hoping the inflammatory quality of Oracea has kicked it...that'll help!