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I Want To Get To The Bottom Of My Skin Problems

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#1 lmontgom

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Posted 01 October 2012 - 11:11 PM

So I just had an appointment with my derm last Friday and had yet another topical prescribed. I'm currently using Retin-A Micro, but since my skin is getting worse and worse (although I've been using the RAM since January and my skin was totally clear until a couple months ago), I'm thinking of quitting. I also take Lo Estrin Fe 1/20, which I'm not sure has any effect on my skin (I've been on it for a few years, and I've been clear off and on during that time). I'm tired of going to the derm and just having different meds and creams and gels shoved at me without anyone trying to get to the bottom of whay my acne keeps coming back. I've been on Accutane 4 times (my last round finished in January 2012) and while it works great each time, my skin eventually worsens (this time it only took about 7 months for me to start breaking out again). What I need are answers to what is going on internally that is causing my acne; I'm tired of treating the symptoms instead of the underlying cause.

I've made a lot of changes recently that I thought would benefit my skin from the inside out: I cut out dairy in January, I've been gluten-free for about a month, I'm eating a lot more fruits, vegetables, protein, and rice instead of junk food and carbohydrates, I've tried different supplements and vitamins (currently taking 50mg Zinc capsules and fish oil with vitamin D3), but nothing seems to be changing. In the past couple weeks, my skin has been breaking out every day, whereas I was inititally breaking out for a couple days, and then it would clear up for the rest of the week. Something is going on inside, and I need to figure out what it is as soon as possible.

It could be stress/anxiety/depression, since I noticed that the breakouts began when I moved back home after living back east for a while, and my home life is very stressful and miserable. Or, at least, I'm miserable and I have a lot of symptoms of depression (apathy, pulling away from people, hopelessness, etc.), but my anxiety is mainly tied to my skin; the worse my skin gets, the more anxious and obsessive I become, which just worsens the cycle. I've been talking to my psychiatrist about getting on anti-depressants (I was on Wellbutrin for 4 days and it broke me out in all these small red bumps, so I stopped immediately), and I'm planning on seeing a therapist as well. Lately all I do is worry about my skin, if it's ever going to get better, and I avoid leaving my room (I have no job, no friends where I live, so I spend all my time alone in a dark room. When I have to leave to go to the market or something, I feel incredibly anxious and panicky). But I'm worried that my skin issues might not be tied to my mental health, in which case I still have no clue what the cause is.

My question is what else can I do to figure out the root of my skin problems? Are there other types of doctors or specialists I can see that will run tests and figure things out instead of writing prescriptions? I know there are blood tests to determine if it's hormonal, but what about vitamin deficiencies, food allergies, or thyroid problems? Who else can I talk to about getting to the bottom of this once and for all?

#2 Murph89

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Posted 01 October 2012 - 11:27 PM

Since you have taken accutane 4 times, numerous topicals, changed your diet to gluten and dairy free, it's most likely hormonal, or a yeast infection from all the antiobiotics. But I would bank on hormonal. Pretty sure the woman here go on Spiro for that, but I'm not gonna be the one to recommend that since I'm a dude and I know nothing about that and hormones.

Your other option is to see a naturopath, but people have had mixed feelings about them. The tend to throw vitamins at you and you end up leaving with a huge bill. They can test for food allergies, but they are not always accurate, and the most common allergies are dair and gluten, and you have cut them out and you still have acne.

Edited by Murph89, 01 October 2012 - 11:29 PM.


#3 alexisc

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Posted 01 October 2012 - 11:35 PM

Good for you for wanting to figure out what is going on internally. Like you I've been on Accutane a few times and while it cleared me I wanted to treat the cause and not just the symptoms and the acne always came back. I only know what is worked for myself so that is the only advice I can give - I hope it works for you as well because I've been where you are and it's so frustrating not knowing why the acne is happening. You say you have cut out dairy and gluten which is great but I'm sorry to hear that it didn't have more of an impact for you. For myself I discovered I was allergic to corn and wheat. I also cut most sugar and all alcohol out of my diet. It was a long road figuring out what my food allergies were but once I cut them out I stopped breaking out. One thing to say is that when I took fish oil I broke out in large cysts and I wasn't even prone to cysts. I would cut that supplement out and see if it makes any difference. As well, you might just have different food allergies. For some people it's gluten, corn, dairy, citrus, eggs, nuts etc. etc. In my opinion acne is largely related to gut flora as well as nutritional deficiences and food intolerances. If you can afford it I would get a food intolerance test done and see what it says. Also if you can afford to see a naturopath and have all of your vitamins, minerals and hormones checked that might shed some light on your situation.

Where do you break out the most (like area/s of your face) and are they whiteheads, pimples or cysts?

#4 lmontgom

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Posted 02 October 2012 - 12:18 AM

Thanks for your response, alexisc, it's nice to know that people in a similar position to myself have found the root cause of their acne and corrected it, since the older I get the less convinced I am that I'll ever figure it out. When you eliminated corn and wheat, how long did it take for your skin to respond? Was there an immediate improvement in the quality of your skin, or did it take a couple months for you to notice a difference? I mainly break out on my cheeks, but sometimes I get small bumps on my forehead or chin. I've had different types of acne at different points in my life - last year I had a horrible breakout of painful nodules before I went on my last course of Accutane - but right now my breakouts are primarily pimples - not painful, but very inflamed, small and medium sized bumps, some of which become pustules after a couple of days, and some of them leave post-acne red marks behind. And I will definitely look into a food intolerance test, since that would be am excellent way to go about this process of elimination. Also, I've only been taking the fish oil since yesterday, so I don't think it has had any effect yet, positive or negative.

Murph - I've actually been on Spiro before and it didn't help. I have a feeling it's not hormonal, since my breakouts don't follow any kind of pattern and I don't tend to break out in the areas that women with hormonal acne typically experience breakouts. I've been on a few different pills over the years, and my acne has been off and on during that time, so I have my doubts that the pill every did anything for me. But I also don't want to rule it out. I had a blood test of my hormone levels done about 4 or 5 years ago and although they were balanced at the time (ruling out a hormonal cause of acne), it's totally possible that they've changed.

I'm pretty desperate to figure this out, and it seems like an elimination diet might be the easiet first step. I've heard a lot about candida diets and leaky gut syndrome, so maybe I'll stick with a strict vegetable diet for a while and see if anything changes, and then gradually re-enter foods into my diet to see if any of them break me out. I think I can eliminate coffee/caffeine, alcohol, and nuts since I don't really consume too much of them, as well as dairy since I've been off of it for almost a year with no results, but I do eat products containing corn, eggs, and processed sugar (although I've been trying to cut back on the sugar lately, and haven't had anything containing processed sugar in a while). I also think that sodium might be an issue, so I'll try and eliminate that as well. If an elimination diet doesn't do the trick, what might my next step be? The only other causes I can think of are hormones, vitamin deficiencies, and poor mental health, and while I'm working on the mental health issue, it will take along time before I see improvement (both medicinally and therepeutically). It would be awesome if my acne was in fact tied to my diet, but it might not be that simple.

#5 lmontgom

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Posted 03 October 2012 - 04:00 AM

I think it might be a good idea to see a nutritionist before I decide on any single diet-for-acne plan. There is just so much (conflicting) information on the internet that I wouldn't even know where to start, and if I could get some food intolerance/allergy tests done, that would eliminate a lot of possibilities. I also want to keep in mind that I need to take care of my mental health issues at the same time, so anything that might interfere with any meds I'll take might not be worth it. I have a hard time believing my diet has a huge impact on my skin, since from January (right after I got off Accutane) to July, I was incredibly clear and had amazing skin, and my diet seriously consisted of the worst foods and very little exercise. I literally ate Nutter Butters every day and ate so much pasta and Doritos and late-night Wawa sandwiches after a night out drinking and nothing had any effect on my skin. At the time I was also dairy-free, and I did eat healthy foods as well, but my diet was nowhere near balanced, and I was also on the pill and meds for my ADD. The only thing that changed since my acne started coming back is that I moved home and my depression got even worse (although, it seems like the depression only got worse because of the acne...) I guess it's possible that all those things from January to July (the pill, the meds, the bad eating habits, the lack of exercise) are finally catching up in my system, but I doubt that very much. Anyway, I'll talk to my GP and see what kind of specialists she can refer me to so I can take some tests and get more feedback.

#6 Green Gables

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Posted 03 October 2012 - 12:12 PM

So I just had an appointment with my derm last Friday and had yet another topical prescribed. I'm currently using Retin-A Micro, but since my skin is getting worse and worse (although I've been using the RAM since January and my skin was totally clear until a couple months ago), I'm thinking of quitting. I also take Lo Estrin Fe 1/20, which I'm not sure has any effect on my skin (I've been on it for a few years, and I've been clear off and on during that time). I'm tired of going to the derm and just having different meds and creams and gels shoved at me without anyone trying to get to the bottom of whay my acne keeps coming back. I've been on Accutane 4 times (my last round finished in January 2012) and while it works great each time, my skin eventually worsens (this time it only took about 7 months for me to start breaking out again). What I need are answers to what is going on internally that is causing my acne; I'm tired of treating the symptoms instead of the underlying cause.

I've made a lot of changes recently that I thought would benefit my skin from the inside out: I cut out dairy in January, I've been gluten-free for about a month, I'm eating a lot more fruits, vegetables, protein, and rice instead of junk food and carbohydrates, I've tried different supplements and vitamins (currently taking 50mg Zinc capsules and fish oil with vitamin D3), but nothing seems to be changing. In the past couple weeks, my skin has been breaking out every day, whereas I was inititally breaking out for a couple days, and then it would clear up for the rest of the week. Something is going on inside, and I need to figure out what it is as soon as possible.

It could be stress/anxiety/depression, since I noticed that the breakouts began when I moved back home after living back east for a while, and my home life is very stressful and miserable. Or, at least, I'm miserable and I have a lot of symptoms of depression (apathy, pulling away from people, hopelessness, etc.), but my anxiety is mainly tied to my skin; the worse my skin gets, the more anxious and obsessive I become, which just worsens the cycle. I've been talking to my psychiatrist about getting on anti-depressants (I was on Wellbutrin for 4 days and it broke me out in all these small red bumps, so I stopped immediately), and I'm planning on seeing a therapist as well. Lately all I do is worry about my skin, if it's ever going to get better, and I avoid leaving my room (I have no job, no friends where I live, so I spend all my time alone in a dark room. When I have to leave to go to the market or something, I feel incredibly anxious and panicky). But I'm worried that my skin issues might not be tied to my mental health, in which case I still have no clue what the cause is.

My question is what else can I do to figure out the root of my skin problems? Are there other types of doctors or specialists I can see that will run tests and figure things out instead of writing prescriptions? I know there are blood tests to determine if it's hormonal, but what about vitamin deficiencies, food allergies, or thyroid problems? Who else can I talk to about getting to the bottom of this once and for all?


You would be surprised how low progesterone can lead to emotional problems as well as acne. I cleared on spironolactone but have started adding in natural USP grade progesterone cream. In just a few days I sleep better, feel better, am more friendly, not as stressed, and my muscle cramps have gone away.

Diets are great for good health, but in my opinion we don't know enough about food to know how to fix something serious like low progesterone with food alone.

Please read the link in my thread to "Low Progesterone" as well as the "How do I know if I am high or low in X".

Many hormonal problems are treated based on symptoms, not based on a number from a hormonal test. Your hormone levels may be " in range", which means they fit in what doctors consider average, but not in a range that works well for your body personally.

Edited by Green Gables, 03 October 2012 - 12:36 PM.


#7 lmontgom

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Posted 03 October 2012 - 01:49 PM


So I just had an appointment with my derm last Friday and had yet another topical prescribed. I'm currently using Retin-A Micro, but since my skin is getting worse and worse (although I've been using the RAM since January and my skin was totally clear until a couple months ago), I'm thinking of quitting. I also take Lo Estrin Fe 1/20, which I'm not sure has any effect on my skin (I've been on it for a few years, and I've been clear off and on during that time). I'm tired of going to the derm and just having different meds and creams and gels shoved at me without anyone trying to get to the bottom of whay my acne keeps coming back. I've been on Accutane 4 times (my last round finished in January 2012) and while it works great each time, my skin eventually worsens (this time it only took about 7 months for me to start breaking out again). What I need are answers to what is going on internally that is causing my acne; I'm tired of treating the symptoms instead of the underlying cause.

I've made a lot of changes recently that I thought would benefit my skin from the inside out: I cut out dairy in January, I've been gluten-free for about a month, I'm eating a lot more fruits, vegetables, protein, and rice instead of junk food and carbohydrates, I've tried different supplements and vitamins (currently taking 50mg Zinc capsules and fish oil with vitamin D3), but nothing seems to be changing. In the past couple weeks, my skin has been breaking out every day, whereas I was inititally breaking out for a couple days, and then it would clear up for the rest of the week. Something is going on inside, and I need to figure out what it is as soon as possible.

It could be stress/anxiety/depression, since I noticed that the breakouts began when I moved back home after living back east for a while, and my home life is very stressful and miserable. Or, at least, I'm miserable and I have a lot of symptoms of depression (apathy, pulling away from people, hopelessness, etc.), but my anxiety is mainly tied to my skin; the worse my skin gets, the more anxious and obsessive I become, which just worsens the cycle. I've been talking to my psychiatrist about getting on anti-depressants (I was on Wellbutrin for 4 days and it broke me out in all these small red bumps, so I stopped immediately), and I'm planning on seeing a therapist as well. Lately all I do is worry about my skin, if it's ever going to get better, and I avoid leaving my room (I have no job, no friends where I live, so I spend all my time alone in a dark room. When I have to leave to go to the market or something, I feel incredibly anxious and panicky). But I'm worried that my skin issues might not be tied to my mental health, in which case I still have no clue what the cause is.

My question is what else can I do to figure out the root of my skin problems? Are there other types of doctors or specialists I can see that will run tests and figure things out instead of writing prescriptions? I know there are blood tests to determine if it's hormonal, but what about vitamin deficiencies, food allergies, or thyroid problems? Who else can I talk to about getting to the bottom of this once and for all?


You would be surprised how low progesterone can lead to emotional problems as well as acne. I cleared on spironolactone but have started adding in natural USP grade progesterone cream. In just a few days I sleep better, feel better, am more friendly, not as stressed, and my muscle cramps have gone away.

Diets are great for good health, but in my opinion we don't know enough about food to know how to fix something serious like low progesterone with food alone.

Please read the link in my thread to "Low Progesterone" as well as the "How do I know if I am high or low in X".

Many hormonal problems are treated based on symptoms, not based on a number from a hormonal test. Your hormone levels may be " in range", which means they fit in what doctors consider average, but not in a range that works well for your body personally.


I get what you're saying, but in my case, I have doubts that hormones are the issue for me. I've been on this particular brand of birth control for at least 3 or 4 years and during that time, my acne has been on and off. I've had months and months of completely clear skin, and then months of horrible breakouts with no reprieve. My breakouts have never had a pattern, like many people with hormonal breakouts do, and I don't break out in the areas where it's typical to break out hormonally. I'm not saying that hormones might not be an issue, but there are other things about my lifestyle that might have more of an impact. Besides, I've had various pills prescribed specifically for acne (Yaz, Ortho), and not only did they do nothing for my skin, they gave me horrible side effects. Lo Estrin is the only pill that gives me no side effects whatsoever. I've also tried Spiro, which I can see from your signature works well for you, but hormones aren't the answer to everyone's skin problems and I need to explore every option that's out there. When it comes to choosing a diet that will be good for my skin, I'm not thinking about changing my hormones through food, I'm thinking about overall health from the inside out. And if so many hormonal problems are diagnosed based on symptoms, than I have no hormonal problems whatsoever, since I have no other symptoms.

I started this thread because I wanted advice on what kind of specialists I can see or tests I can have done to find a solution or at least eliminate possibilities, so any info along those lines would be amazingly helpful.

#8 lmontgom

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Posted 04 October 2012 - 11:31 AM

bump. I'm seeing my doctor tomorrow and I'm wondering what kind of tests I should have done and what kinds of specialists (other than a dermo) I should get referrals for. Thanks!