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Seriously Frustrated And Depressed...

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Hi! Sorry this will be kind of a sad rant, but I'm just so discouraged I need to get it out somewhere. I have become so self-conscious and depressed about my skin lately that I literally don't leave the house other than to go to class or to the store if I absolutely need something. = / I am currently so frustrated with my skin it is making it difficult to concentrate on anything else.

I used to have beautiful (seriously flawless) skin. I always had mild acne, but using 2.5% benzoyl peroxide kept my face perfect for years. Then I got contact dermatitis from it when I was like 23 or 24 not sure. So I had to back off. After that my skin was never the same again and now for years I've been trying to get this under control.

My general practice Dr. tried topical antibiotics (which did nothing) and birth control and that made me an emotional wreck. So I went to the dermatologist who prescribed minocycline, topical antibiotics, azelaic acid and retin a. That worked beautifully for about 2 months. Then I started getting big deep cysts again. So she increased the mino. The increase helped a little and I thought things were getting better...but then they got worse again.

So she switched me to erythromycin and since then my skin has been absolutely back to square 1. Actually I think I'm worse than I was at square 1. Not that the treatments are actually making my skin worse, but my skin just continues to get worse for other reasons, but who knows what they are.

I've had my hormones tested and they're all normal. Retin a in the past has never helped me in the past (even after being on it for a year in the past) and so I 'm thinking of demanding that we switch up my topicals at my next dermatologist appointment. Maybe if we try something that allows us to incorporate benzoyl peroxide again since that's worked before. I'm not the type to just blame it all on the dermatologist. All they can do is go with the studies and the science and try what might work and hope it does. But it is definitely not working right now lol.

Anyways, what's worked for other people?

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Trt diet changes in addition to topicals- it has never worked for me personally but many people see changes with it.

You are not alone

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First off, I totally understand where you are coming from. It's one thing having had to dealing with acne for a long time, it's another thing having it spring out of nowhere and get progressively worse. I'm the same way - when it gets really bad I just don't want to leave the house.

Also, I think you need to be careful when using different products not to over do it. Try gradually building up a tolerance to a product, using it every second or third day at first. As for the retin-a, antibiotics and so on that your derm prescribed you, you need to give it time. I know you said it worked within the first few months and then just stopped working, but the truth is with many of these topical treatment it gets worse before it gets better.

Retin-a has a 'purging' phase or initial break out that can last a few months. You should keep using these as prescribed for at least a few more months before writing them off completely. I just started retin-a and trust me, I'm not very impressed by it so far. But I will keep using it.

You can definitely try switching up your diet, it certainly can't hurt. Try removing dairy products, sugary foods, caffeine etc. Drink tons of water and take multivitamins. I've also read that Saw Palmetto can help with acne, you may want to look that up.

Best advice it try to be patient- yes I know it's easier said than done!

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@aze and @Sasch83, Oh I already have changed my diet, although for reasons other than for my skin. I never had any intention of trying to clear my skin through diet but then I just so happened to change it in the way that everyone tells you to change it for your skin. It has done zilch for me unfortunately skin wise. In other areas it's fantastic and so don't get me wrong I love eating this way! But it doesn't help my skin.

Also I have been very patient with these topicals...I've been using them for 8 months now. I haven't had any trouble with irritation or anything so building up tolerance isn't the issue. The problem is they're just not working. =(

I've heard about Saw Palmetto too and was thinking about trying it. I figured I could just add it in and see if it helps. Might as well.

Anyways...I have a dermatologist appointment in a week and a half but it feels like an eternity away!

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Birth controls are not created equal. See my signature.

Having hormones in average range does not mean your hormone levels are right for your individually. There is some evidence to suggest that you can have normal hormone levels yet still have acne. This is linked to androgen receptors that convert testosterone to DHT through alpha-5-reductase more often than clear-skinned people. These "overly sensitive" tendencies do not show up on a hormone test.

Understandably you may not want to go through the trial and error of finding the right birth control again. Many women get clear on spironolactone, which is a prescription anti-androgen (not a birth control).

If you want to go natural, saw palmetto, stinging nettle, and vitamin B-5 act as anti-androgens.

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Yes I am aware of the differences between birth controls. Thanks though.

I decided to try saw palmetto. I'm pretty skeptical about natural stuff lol just because there's often times no logical or scientific thought behind why they work and no research done that shows they work. However, after researching it, saw palmetto seemed to have at least some valid scientific thought behind it so I figured heck I might as well try it and see.

Yes I've thought about spiro. I may ask my derm about it. We'll see. I'm somewhat reluctant because I've read reviews of it where people claimed that it gave them emotional side effects similar to what I have experienced with birth control.

Birth controls are not created equal. See my signature.

Having hormones in average range does not mean your hormone levels are right for your individually. There is some evidence to suggest that you can have normal hormone levels yet still have acne. This is linked to androgen receptors that convert testosterone to DHT through alpha-5-reductase more often than clear-skinned people. These "overly sensitive" tendencies do not show up on a hormone test.

Understandably you may not want to go through the trial and error of finding the right birth control again. Many women get clear on spironolactone, which is a prescription anti-androgen (not a birth control).

If you want to go natural, saw palmetto, stinging nettle, and vitamin B-5 act as anti-androgens.

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There was a clinical study (in Maryland? It's there, it took me forever to re-find it on google last time I tried) that showed that 320mg a day of saw palmetto reduced acne in a high percentage of users. Personally if I were doing saw palmetto I would up it to around 640mg though.

There was also a clinical study in Japan showing the effectiveness of vitamin B5 and acne.

Just based on the number of posts I respond to on these boards, the most common complaint from spiro is frequent urination and dehydration. The second most common complaint is a short-term period of hair loss (any hormonal change to the body tends to send you into telogen effluvium). There have been precious few who have complained of emotional side effects. Hormonally speaking it is mostly anti-androgen and has a pretty weak estrogenic effect. Since it doesn't mess with progesterone like birth controls do, it has less power to influence emotions.

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I know how you feel. I used to have perfect skin. I look back at pictures and sigh. I had no idea how good I had it. And I literally did nothing except maybe occasionally wash it with a bar of soap in the shower.

It sucks. I hate that hopeless feeling...never knowing when the acne will stop or end. Currently I'm trying the water only regime and it isn't going so well. But it's what I did before I had problems.

I hope you find something that works for you. What I'm learning on these boards is that every one is different. Everyone reacts differently to all of these products and regimens.

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I just made a post about "SHEA TERRA ROSE HIP BLACK FACE WASH" post is called 26 AMAZING RESULTS...READ this I have done everything you mentioned in your post.....A friend told me about it and I thought I would try, they shipped it to Canada and am thrilled!

Again I have not been on this site in a year but think this is so awesome I had to activate my account again.

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Hi Amygims --- I too had acne that just got worse no matter what I did. And I did everything...accutane, retin-a, topicals, etc. I also used topical BP for years and it worked somewhat and then like you I started reacting to it, even a little bit of it, and I had to stop. Accutane only worked when I was on it. Salicyclic acid was the worst offender - red raw skin. The cysts got deeper and more frequent and I was getting into my 40's (sigh). Here's what finally worked for me and interesting insight from the two derms who were eventually able to keep me clear.

Acne that gets worse despite using all the usual methods is termed "chronic resistant acne" and it has to be treated differently. Diet helps but not eneough in these cases. I had two derms who approached it differently. One derm put me on Spiro and gave me Bactrim. Spiro only blocks androgens. It doesn't put any hormones into your body so it is usually well tolerated. Bactrim is very effective with cystic acne. Mino never worked for me. Doxy worked somewhat but only at full strength. I was on this regime (spiro + bactrim) for about 10 years and was pretty clear.

I moved and changed derms and the new one freaked out about me being on a strong antibiotic for so long and took me off. The cysts came roaring back. By this time in life I had been following an organic gluten-free, dairy-free allergy diet religiously and I took zinc, etc. Still had cysts. I was still on spiro but by itself didn't keep me clear. Nor did tretinoin cream (retin-a) that she put me on. Talk about depressed. Almost my whole adult life with cysts...

Over a year and a half ago I switched derms. He's tops in our area. He took one look at my skin and put me on the regime listed below. He says that this kind of adult acne has to be treated with a multi-prong approach designed for sensitive aging skin that needs to be repaired and treated at the same time. Here is the regime reasoning and the treatment in parenthesis. I have been clear since on this regime. I'll get a little red bump here and there but they go away in a day. That's it...clear skin.

Block androgens because most resistant acne is due to a sensitivity to androgens (spiro).

Kill acne bacteria with BP cleanser which is better for sensitive skin than BP topical (Panoxyl 4%).

Kill more bacteria with antibiotic topical which works better when used in combo with the BP (Cleocin-t).

Reduce inflammation with low dose antibiotic that doesn't interfere with gut flora (doxy 40mg).

Dissolve blackheads, loosen plugs and strengthen skin collegen (tretinoin cream 1%).

Open pores, get rid of excess dead skin that plugs pores, build collegen (monthly microdermabrasions).

That's it. Yes, it is a pain to follow such an exacting regime but it works and it is mild on the body. It is a regime I can follow forever if needed.

Hope this helps. Feel free to message me if you want.

Oh one more thing. My derm swears by DML lotion. It is designed for acne skin and is totally non-comedogenic. It is not natural but is incredibly mild, soothing and absorbs very quickly.

The De Vita sunscreen is also designed for acne skin. It is the only one I can use without a reaction. And it has lots of soothing zinc in it.

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Your situation sounds quite similar to mine, so I'm going to tell you the regimen that I have finally whittled myself down to that has helped TREMENDOUSLY. I'm sure steps in this can be changed and different products may work, but out of the hundreds of products I've used, this particular combination seems to work the best. You don't need prescription products, I've tried just about all of them, including Accutane, and none work as well as this combination has. Some of the products are very pricey but at this point I'm willing to pay anything. I hope it can help you too! smile.png

Products:

Clarisonic brush - I use this once a day, I prefer to it at night

African black soap - I use Nubian Heritage but I think most brands are comparable. Out of all the products I use, this soap alone has made the biggest difference. I wash with it every night and most mornings unless I'm feeling especially dry. You need to use a moisturizer after this soap for sure or you'll feel itchy and terrible, but it gets you REALLY squeaky clean and clears up blemishes.

Ole Henriksen - Three Little Wonders *Moderator edit, URL removed - read the board rules* or just the Sheer Transformation lotion and Invigorating Night Gel. (The Truth Serum sometimes makes me mildly break out but it does improve the overall texture and look of my skin so I would still recommend it in small doses). Apply the sheer transformation in the morning and night, and the night gel just at night.

Benzoyl Peroxide cream (or your favorite spot treatment) - Use this on existing pimples only, it really wreaks havoc to spread it all over your face every day. Don't apply more than twice a day.

Pure aloe vera gel - I don't use this every day but it's really great if you want some extra refreshment for your skin, you can use it anytime and it feels great after being chilled in the fridge.

Fresh face mask (organic/pure ingredients have worked best for me):

Avocado

Plain Greek yogurt

Honey

Lemon

Strawberries

Blend these together and use as a face mask at least twice a week. If you can find the time, every night. It works best if you wash your face with the Clarisonic first, let the mask sit until dry (about 15-20 minutes), then wash off with your hands or a washcloth.

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Thanks everyone! I have a dermatologists appointment tomorrow. I am going to ask about spiro. I just don't want to get hung up on one thing and just start believing that it's destined to work and then end up not being able to take it due to some sort of side effects from it. If you look at reviews for spiro there are plenty of people who love it but there are also plenty who say they loved it but had to stop taking it too.

Hi Amygims --- I too had acne that just got worse no matter what I did. And I did everything...accutane, retin-a, topicals, etc. I also used topical BP for years and it worked somewhat and then like you I started reacting to it, even a little bit of it, and I had to stop. Accutane only worked when I was on it. Salicyclic acid was the worst offender - red raw skin. The cysts got deeper and more frequent and I was getting into my 40's (sigh). Here's what finally worked for me and interesting insight from the two derms who were eventually able to keep me clear.

Acne that gets worse despite using all the usual methods is termed "chronic resistant acne" and it has to be treated differently. Diet helps but not eneough in these cases. I had two derms who approached it differently. One derm put me on Spiro and gave me Bactrim. Spiro only blocks androgens. It doesn't put any hormones into your body so it is usually well tolerated. Bactrim is very effective with cystic acne. Mino never worked for me. Doxy worked somewhat but only at full strength. I was on this regime (spiro + bactrim) for about 10 years and was pretty clear.

I moved and changed derms and the new one freaked out about me being on a strong antibiotic for so long and took me off. The cysts came roaring back. By this time in life I had been following an organic gluten-free, dairy-free allergy diet religiously and I took zinc, etc. Still had cysts. I was still on spiro but by itself didn't keep me clear. Nor did tretinoin cream (retin-a) that she put me on. Talk about depressed. Almost my whole adult life with cysts...

Over a year and a half ago I switched derms. He's tops in our area. He took one look at my skin and put me on the regime listed below. He says that this kind of adult acne has to be treated with a multi-prong approach designed for sensitive aging skin that needs to be repaired and treated at the same time. Here is the regime reasoning and the treatment in parenthesis. I have been clear since on this regime. I'll get a little red bump here and there but they go away in a day. That's it...clear skin.

Block androgens because most resistant acne is due to a sensitivity to androgens (spiro).

Kill acne bacteria with BP cleanser which is better for sensitive skin than BP topical (Panoxyl 4%).

Kill more bacteria with antibiotic topical which works better when used in combo with the BP (Cleocin-t).

Reduce inflammation with low dose antibiotic that doesn't interfere with gut flora (doxy 40mg).

Dissolve blackheads, loosen plugs and strengthen skin collegen (tretinoin cream 1%).

Open pores, get rid of excess dead skin that plugs pores, build collegen (monthly microdermabrasions).

That's it. Yes, it is a pain to follow such an exacting regime but it works and it is mild on the body. It is a regime I can follow forever if needed.

Hope this helps. Feel free to message me if you want.

Oh one more thing. My derm swears by DML lotion. It is designed for acne skin and is totally non-comedogenic. It is not natural but is incredibly mild, soothing and absorbs very quickly.

The De Vita sunscreen is also designed for acne skin. It is the only one I can use without a reaction. And it has lots of soothing zinc in it.

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One thing I did that really made a difference when I went to my current derm was to bring photos of my skin at its worst. I also brought a journal of what I'd used, how my skin reacted, and how my skin has been over the years. This helped my derm understand what I've been through. I think that derms hear many sob stories and assume patients are exaggerating. But photos don't lie!

Back when my skin was getting cysts I too could have a week here and there where my skin would look almost clear. And then later in the same day I could start to get swelling and by next morning would have cysts! It was wierd to go from almost clear skin to lumpy bumpy inflamed red and infected cysts all in 24 hours! That's why I always thought it must have to do with diet. But I followed a strict diet and no change. I too had times where when I went to the derm my skin magically would look better when only the week before it had been looking like a teenager's nightmare.

Never have been able to figure out why cystic acne works that way but my current derm says that deep cystic acne is actually forming weeks before it swells up. And the reason it suddenly seems to appear is because the pus (sorry) ruptures the pore wall which then results in an immediate reaction of swelling redness, etc. Then when the cyst ruptures on the surface either due to manipulation or normal release, then it goes down quickly since the infection has now been removed from the body.

This explanation helped me understand better why the regime my derm has me on works. It is specifically designed to stop acne before it starts...by strengthening the pore walls (tretinoin cream), removing plugs (tretinoin cream, monthly microdermabrasions, BP) and killing acne bacteria.

Re: monthly professional microdermabrasions. My derm says they are a cornerstone of this regime. So they are worth the money even if having to sacrifice elsewhere. I'd have to agree because my skin has been totally changed by them...and I mean totally. I look decades younger...I'm not kidding! Went out to lunch yesterday and my friend said I just keep looking younger and younger...no wrinkles.

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One thing I did that really made a difference when I went to my current derm was to bring photos of my skin at its worst. I also brought a journal of what I'd used, how my skin reacted, and how my skin has been over the years. This helped my derm understand what I've been through. I think that derms hear many sob stories and assume patients are exaggerating. But photos don't lie!

Back when my skin was getting cysts I too could have a week here and there where my skin would look almost clear. And then later in the same day I could start to get swelling and by next morning would have cysts! It was wierd to go from almost clear skin to lumpy bumpy inflamed red and infected cysts all in 24 hours! That's why I always thought it must have to do with diet. But I followed a strict diet and no change. I too had times where when I went to the derm my skin magically would look better when only the week before it had been looking like a teenager's nightmare.

Never have been able to figure out why cystic acne works that way but my current derm says that deep cystic acne is actually forming weeks before it swells up. And the reason it suddenly seems to appear is because the pus (sorry) ruptures the pore wall which then results in an immediate reaction of swelling redness, etc. Then when the cyst ruptures on the surface either due to manipulation or normal release, then it goes down quickly since the infection has now been removed from the body.

This explanation helped me understand better why the regime my derm has me on works. It is specifically designed to stop acne before it starts...by strengthening the pore walls (tretinoin cream), removing plugs (tretinoin cream, monthly microdermabrasions, BP) and killing acne bacteria.

Re: monthly professional microdermabrasions. My derm says they are a cornerstone of this regime. So they are worth the money even if having to sacrifice elsewhere. I'd have to agree because my skin has been totally changed by them...and I mean totally. I look decades younger...I'm not kidding! Went out to lunch yesterday and my friend said I just keep looking younger and younger...no wrinkles.

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Actually my current derm is the one I had when I was in my early 30's (before I moved away) and he was the one who put me on two rounds of accutane. Believe me...accutane is a miracle drug. I loved it. While on it I was totally clear (after about a month of old cysts working their way out). He and I both hoped it would cure my acne. Sadly it didn't but it did change my skin to be much less oily and to allow other meds to work much better. Before accutane nothing worked...my skin always had cysts no matter what I did. After accutane I stayed somewhat clear if I was on full strength antibiotics or BP regimes but I still got several cysts each month. If I didn't do anything I got cysts weekly...a mess.

The biggest mistake I made was not following through with a good acne regime AFTER accutane. I just assumed I was cured so only washed my face. Plus while on accutane you have to use lotion and I assumed I could keep on using lotion eventhough my skin was getting a little oily again. In truth I didn't need it and I'm sure it was plugging up my pores. Not everyone needs lotion! Within two years I was breaking out again...much less but still getting cysts. I should have done what Dr Naverson recommended which was to always do some form of BP to keep down bacteria and pores open. I moved away and when I moved back went to his office (much bigger now) and saw another derm. She was okay but really didn't understand the tenacity of my acne. Then I saw Dr Naverson. He remembered me and got right to work clearing up my skin again. When I think of all the years I could have had clear skin if only I had followed through with him and his advice! Oh well.

What I'm trying to say is by all means do the accutane! It will really help even if it doesn't cure your acne. Then afterwards be sure to do everything recommended. You'll love accutane, especially if you have been dealing with cysts. Another thing is that cystic acne can become quite scarring so you'll want to avoid that. Accutane changes the severity of cysts, even if you continue to get them later.

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Actually my current derm is the one I had when I was in my early 30's (before I moved away) and he was the one who put me on two rounds of accutane. Believe me...accutane is a miracle drug. I loved it. While on it I was totally clear (after about a month of old cysts working their way out). He and I both hoped it would cure my acne. Sadly it didn't but it did change my skin to be much less oily and to allow other meds to work much better. Before accutane nothing worked...my skin always had cysts no matter what I did. After accutane I stayed somewhat clear if I was on full strength antibiotics or BP regimes but I still got several cysts each month. If I didn't do anything I got cysts weekly...a mess.

The biggest mistake I made was not following through with a good acne regime AFTER accutane. I just assumed I was cured so only washed my face. Plus while on accutane you have to use lotion and I assumed I could keep on using lotion eventhough my skin was getting a little oily again. In truth I didn't need it and I'm sure it was plugging up my pores. Not everyone needs lotion! Within two years I was breaking out again...much less but still getting cysts. I should have done what Dr Naverson recommended which was to always do some form of BP to keep down bacteria and pores open. I moved away and when I moved back went to his office (much bigger now) and saw another derm. She was okay but really didn't understand the tenacity of my acne. Then I saw Dr Naverson. He remembered me and got right to work clearing up my skin again. When I think of all the years I could have had clear skin if only I had followed through with him and his advice! Oh well.

What I'm trying to say is by all means do the accutane! It will really help even if it doesn't cure your acne. Then afterwards be sure to do everything recommended. You'll love accutane, especially if you have been dealing with cysts. Another thing is that cystic acne can become quite scarring so you'll want to avoid that. Accutane changes the severity of cysts, even if you continue to get them later.

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I am in my 40's and have dealt with adult acne for more than 20 years. As a teen, surprisingly my face was pretty clear. My first discovery that helped keep me clear for about 10 years was BP. However about 5 years ago, BP just stopped working for me. Actually, it was making things worse. I started to only put BP on certain areas, and those were the areas that I would get cysts. I tried all kinds of different formulations of BP, but eventually just had to give it up. Then I found the Paula's choice products. I used a lot of the products from the anti-aging line (not the acne products). My skin never looked better in my life. Like seriously beautiful. This lasted for about 2 years. Then it all went bust. I think I started using too many of her products and just started putting something like 6 different things from her line on my skin. Then one day, I develop a serious, horrible rash. Had to go on oral predinose. Itchy and a mess. Took months for it to go away. Because I was so thrilled by how her products had made my skin, I kept trying to re-introduce them to my skin. But I only kept having the same reaction to everything I tried. I had to give up on the paula's choice line. Personally, I kind of feel that if I hadn't put so much on my face, maybe I could have kept using it. But now my body just reacts to it. So then, I did nothing. And yes, my face looked awful, cysts returned, blackheads, you name it. When I was younger, I used antibiotics, Accutane, etc. Now that I am older, now matter how bad my skin gets, I just won't used them because they really mess with my body and health. Antibiotics give me chronic yeast infections and Accutane gave me a liver problem. Anyway, my most recent thing I've tried is retin a. Tried it for about 6 months. Went through an awful purging, then thought it was getting better, then just seemed to get worse again. I had to stop retin a. Now just started on Differin. Supposed to be less irritating. We will see. All I know is that it just sucks to be in your 40's and to still be dealing with it!

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I hear you, it seems like very few adults have acne , especially males.

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I am in my 40's and have dealt with adult acne for more than 20 years. As a teen, surprisingly my face was pretty clear. My first discovery that helped keep me clear for about 10 years was BP. However about 5 years ago, BP just stopped working for me. Actually, it was making things worse. I started to only put BP on certain areas, and those were the areas that I would get cysts. I tried all kinds of different formulations of BP, but eventually just had to give it up. Then I found the Paula's choice products. I used a lot of the products from the anti-aging line (not the acne products). My skin never looked better in my life. Like seriously beautiful. This lasted for about 2 years. Then it all went bust. I think I started using too many of her products and just started putting something like 6 different things from her line on my skin. Then one day, I develop a serious, horrible rash. Had to go on oral predinose. Itchy and a mess. Took months for it to go away. Because I was so thrilled by how her products had made my skin, I kept trying to re-introduce them to my skin. But I only kept having the same reaction to everything I tried. I had to give up on the paula's choice line. Personally, I kind of feel that if I hadn't put so much on my face, maybe I could have kept using it. But now my body just reacts to it. So then, I did nothing. And yes, my face looked awful, cysts returned, blackheads, you name it. When I was younger, I used antibiotics, Accutane, etc. Now that I am older, now matter how bad my skin gets, I just won't used them because they really mess with my body and health. Antibiotics give me chronic yeast infections and Accutane gave me a liver problem. Anyway, my most recent thing I've tried is retin a. Tried it for about 6 months. Went through an awful purging, then thought it was getting better, then just seemed to get worse again. I had to stop retin a. Now just started on Differin. Supposed to be less irritating. We will see. All I know is that it just sucks to be in your 40's and to still be dealing with it!

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Aww, hi I am new here. One thing I noticed right away: everyone is suffering a lot, everyone seems to respond differently to a degree but there are definitely similarities and obvious no-nos and positive experiences. I feel for you, the past two weeks I have barely been able to make myself leave the house, but I also have had to go and teach classes of beautiful fresh-faced young college kids while my own face was peeling, pussing, generally gross. It has been painful. Scary....

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Aww, hi I am new here. One thing I noticed right away: everyone is suffering a lot, everyone seems to respond differently to a degree but there are definitely similarities and obvious no-nos and positive experiences. I feel for you, the past two weeks I have barely been able to make myself leave the house, but I also have had to go and teach classes of beautiful fresh-faced young college kids while my own face was peeling, pussing, generally gross. It has been painful. Scary....

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40yrs old female here. On week 9 of Accutane. So far it's the only thing that has worked. I am clear since week 6. Hoping it will be a permanent solution. No side effects except really bad back ache.

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40yrs old female here. On week 9 of Accutane. So far it's the only thing that has worked. I am clear since week 6. Hoping it will be a permanent solution. No side effects except really bad back ache.

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If your derm doesn't understand how ipledge works, I would find a new derm. She obviously doesn't prescribe accutane and you should have someone with knowledge about it.

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If your derm doesn't understand how ipledge works, I would find a new derm. She obviously doesn't prescribe accutane and you should have someone with knowledge about it.

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