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Where Do I Go From Here?

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#1 mike*

mike*

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Posted 12 September 2012 - 09:28 PM

Hello. I am a long-time lurker, and I finally decided to come out of the shadows. I have various skin problems that I've not yet been able to get control of, and I was hoping that someone could give me some advice as to where to go from here.

Here is my all my relevant history (you're in for a long read).

GENETICS/HEALTH:
My dad had really bad acne that cleared by the time he went off to college. He also has skin problems as an adult, some kind of SD, I believe, but has that under control now. My mom never really had any major skin issues, but gets the odd pimple. I had severe anaphylaxsis (allergy to peanuts and all nuts), as well as asthma, when I was younger, and now I'm only allergic to peanuts, pistachios, and pecans, and no longer have asthma. All my life I've been underweight regardless of diet (I'm 6'0" and currently weigh 128 lbs.). I get hungry often, often get anxious, and nauseous.

SKIN HISTORY:
Ever since I was younger, I had what my GP diagnosed as eczema on my elbows and knees, although I suspect it could be psoriasis. I used 1% hydrocortisone on the patches on and off my entire life. I've also had very dry facial skin since then.

I started breaking out when I was about 13. My breakouts got progessively worse until about age 15. I never had cysts, but I had many whiteheads at all times. At that time, I didn't wash my face much, and was prescribed Clindamycin which never helped, nor did BP.

It was around that time that I took Minocycline and was on it for the vast majority of 4 years. It kept my breakouts more manageable, but its effectiveness was inconsistent and I was never completely clear. It was around 19 that I tried to limit processed foods and caffeine, but I never really noticed a strong correlation between certain foods and breakouts. However at the time I was still drinking and doing some illegal drugs occasionally. I made some product switches but nothing worked 100%.

Then I finally demanded to see a dermatologist, who put me on Accutane from February-August 2011. At the beginning, it made my acne very worse and my face was really red, to the point where people thought I was sunburnt and warned me against the risks of sun exposure when I never went outside. My skin was also very dry. At this point, I was using the 1% hydrocortisone for my eczema on my face and this seemed to control flares (I didn't know about the dangers of steroids at the time). I was completely clear and I began eating junk again. I'd go get a slurpee and eat a large pizza to myself, then later go get a latte and dessert. I was more social, began partying often, and enjoyed life. Yet not a single pimple after the first couple of months.

Then within a month of stopping Accutane, I seemed to get weird patches around my mouth, that were diagnosed as dermatitis (probably to my use of steroids on my face). Then I started wearing makeup to cover them up, which further irritated the patches, causing a vicious cycle that lasted until Christmas break. I got the odd pimple but nothing severe, even though I continued to eat junk. Then after Christmas, I decided to go dairy, gluten, and soy free. I had some rice and a few drops of cream in my(caffeinated) coffee every day and I wasn't really breaking out much.

The acne gradually came creeping back, so in mid-January 2012, I went back on Minocycline. This time, my acne steadily increased, and for the first time, I was scarring. Then in late February, I had two surgeries under two weeks, had Prednisone and antibiotics and my acne suddenly got even worse after a week or two. I got large cysts, one on each of my cheekbones, and one above each eyebrow. I couldn't leave the house anymore. All my acne was scarring, and the scars still remain to this day. I went off the antibiotics and started seeing a naturopath. My acne gradually got better. I was mostly good with diet, but would cheat every few days. My breakouts were much less severe and were very spaced out. I was breaking out once every two weeks. Also I noticed that when I would break out, I'd feel an itch in an area on my face, then go look in the mirror, and find that there was a couple bumps there and a rash there!

Finally, I got back into the dermatologist in mid-April and went back on Accutane. Like last time all my "bad pimples" resurfaced, including the cysts. Soon after, I got the results of my food intolerance test and I was intolerant to virtually everything. So I went on an anti-candida regimen, oil of oregano, coconut oil, and probiotics (which I continued with up until recently) I noticed I was breaking out even more. I also cut out coffee, any dairy at all, any gluten, no rice. For three months, literally all I ate was vegetables and chicken (not even fruit) and raw chocolate. My breakouts subsided eventually, but I'd get the odd zit. Now it seems like as my facial hair grows back, I keep getting red patches that are incredibly itchy, as well as razor bumps. Also, I find that if I cheat at all (and even if I don't), I get small zits. The two times I've consumed a dairy product, I've gotten a very small pimple between my eyebrows, and when I had half a piece of garlic bread, I got a little zit on my cheek (I usually get acne on my cheeks, not on my forehead). Whereas before I noticed no strong correlation between what I ate and my skin, it seems like there is now -- is avoiding these foods making me more sensitive to them? I wake up with these rashes, despite moisturizing, and doing yogurt masks which help. I now keep getting a zit every other day and I'm on my last month. My face is also always itchy, especially a day after shaving, and I mean intensely itchy to the point where I wanna scratch my face off (but never do). Elidel helps, but I still have problems. Also worth noting, I have a hive-ish white bump on my chest that has been there for months and I never get body acne, ever. My skin is never consistently clear for a long period of time, even on Accutane, whereas last time around it was perfect. Now I mostly eat chicken, sometimes beef, apples, chocolate, broccoli, asparagus, olive oil, garlic, and sometimes other fruits such as plums or grapes, but barely ever. I drink water, tea sometimes, and vegan protein powder. The only sugar I consume is from fruit, but keep in mind when I didn't even consume fruit, I still broke out sometimes.

Supplements I've tried: A, C, Fish oil, Folic acid, B5, oil of oregano, milk thistle, probiotics, Genuine Health Vegan Protein Chocolate, D, cinnamon, PGX.

Now, my main questions:
1. Could there be any link to the eczema/psoriasis on my elbows and knee and what is going on my face?
2. Could my skin problems be due to shaving?
3. Why is my face so itchy all the time and what is this indicative of?
4. Could my acne be due to hormones? Would it be worth seeing an endo?
5. Does my low weight/health indicate any sort of link to my skin?
6. How should I go about diet? Should I try working dairy and gluten back into my diet every few days so I become less sensitive, or will this just break me out worse?
7. My skin is VERY dry and produces virtually no sebum (pre-Accutane too!). What supplements or products would help with this? Is this the cause of my skin issues?

I know this was very long-winded, but I appreciate any advice. I'm open to anything. I just don't wanna be a victim of my skin issues anymore. It's ruined my life and I need some answers.

Thanks in advance! Posted Image
- Mike

Edited by mike*, 12 September 2012 - 09:37 PM.

21-year-old Canadian nerd with a penchant for neuroscience & nutrition!

REGIMEN:
Conditions: mild-to-moderate recalcitrant facial acne, lots of post-shave irritation, eczema/psoriasis/dermatitis (not sure which), chronic pruritus, chronic xerosis
Cleanser: Spectro Jel for Blemish-Prone Skin
Moisturizer: Cerave
Treatments: Accutane 50 mg/day (round 2); yogurt/aspirin masks
Shaving: the bane of my existence
Diet: meat, fruit, vegetables, and raw chocolate, only!
Results: mostly clear, but skin is not stable and now have seemingly developed hypersensitivity to my restricted foods


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