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Managing Adult Cystic Acne without a Dermatologist or Prescriptions
Why I wrote this
Over the years I have google searched to help fight my acne and I have found many helpful posts on this board. I want to give back and possibly help someone in a similar situation google searching.
DISCLAIMER: I don’t claim that any of this is safe or that it will work for you. Some of this stuff may in fact harm you. Many in this community will say that some of this stuff is unsafe/doesn’t work/is counter-productive, etc. All I claim is that it seems to work for me, I do all of this stuff and I am very healthy.
TL;DR Version:
Prevention (In order of importance)
1. Avoid Sugar and Carbs
2. Get Sufficient sleep
3. Pursue General Health
Treatment
1. Reduce inflammation with Ibuprofen
2. Pop big painful zits or white heads
a. Dry them out with oil free acne face wash
b. Apply hand sanitizer to help dry out/kill
Background
29 year old male in a high stress job (military). I’ve struggled with acne since the 5th grade. I’ve seen dermatologists for years with things that worked (antibiotics) and things that didn’t work (Accutane and benzoyl peroxide).
General Theory
My general theory behind adult cystic acne is that it is hormonal based and results from systemic inflammation. I therefore looked for ways to reduce inflammation. The most important factor I've found is cutting out sugar, wheat and most carbs from my diet. I also use the anti-inflammatory medication ibuprofen in liberal amounts when I do break out. The only reason I breakout is because I stray from my strategy of avoiding sugar and binge for a few days, always resulting in bad cystic breakouts for weeks after. These breakouts resolve my will to avoid sugar and then the acne again goes away. In addition to avoiding sugar for prevention I think getting more than enough sleep each night helps manage hormones and prevents inflammation.
Avoiding Sugar and Carbs
I generally follow a low-carb paleo diet which you can find more information about by visiting www.marksdailyapple.com. My breakfast is eggs, bacon, hash browns, quiche, a banana or two and coffee. Lunch is a serving of meat and 2 servings of vegetables with a spinach salad and coffee. I fast from lunch to breakfast except for the occasional whey shake in the evening. Google search intermittent fasting if you’re interested but I don’t think it has much effect on acne.
I drink my coffee black, never drink soda and avoid all sweets. I sometimes have some sugar but almost always break out because of it. If I need a snack its fruit, veggies, almonds, cashews or jerky.
Get Sufficient Sleep
This is the other main factor in preventing acne. If you’re sleep deprived your body will produce more cortisol and probably become inflamed and then you’ll break out. I try to go to sleep at least 9 hours before I need to wake up. I rarely actually get 9 hours of sleep sometimes as little as 4 but my goal is always 9 or more. You know you got enough sleep if you wake without the use of an alarm clock and feel refreshed after you get going. If you feel like you need a nap in the middle of the day you probably aren’t getting enough sleep and/or you’re crashing from sugar intake.
Probably somewhat controversial, I take over the counter sleeping aids on a regular basis since I need to go to bed well before the sun sets to get enough sleep (accounting for being woken up in the middle of the night) and still wake up at 4:00 am. I try to sleep in total darkness and wear a beanie pulled down over my eyes (similar to a sleep mask).
Pursue General Health
I also am in good shape and exercise regularly but I don’t think this has much effect on my acne since I’ve been into sports and been in shape my whole life and struggled with acne anyway. It probably has some effect on regulating hormones though so can’t hurt. I do high intensity weight lifting similar to the programs Doug McGuff talks about in his book Body by Strength. I go to the gym 1-3 times a week hitting a mixture of legs, back, shoulders, chest, abs each time or split. I also do a sprint workout 0-1 times a week and run 2-6 miles 0-2 times a week.
Diet obviously plays a big part in general health so I recommend you follow a low carb paleo diet. I also take supplements and vitamins but again am not sure how much they effect acne. Vitamin D and Fish Oil are probably the most important followed by a multivitamin. Whey protein isolate and creatine-monohydrate are more for my weight lifting and recovery.
Treating Existing Acne
My main goal is to prevent acne in the first place but I will often regress back into unhealthy habits and then pay for it with the presence of acne. The most important thing to stop an acne breakout is to stop the inflammation. To do this I take a lot of Ibuprofen (600mg 2-4 times a day) and get a lot of sleep.
I attempt to dry out acne and kill the bacteria by popping the largest and painful cysts when they seem ready or have a white head. I pop them deep and hard attempting to “milk” them as much as possible and then put pressure on them. After I take a shower washing my face with an oil free acne cleaner and then I put hand sanitizer on the area. I think it helps dry and kill the bacteria. This will dry your skin out so do it at night. To prevent scabbing I will cover the popped zit with Neosporin and medical tape or bandaid overnight.
I hopes this helps someone, let me know what you think.
I know how painful it is 
