In my experience any many others' cystic acne that seems to randomly pop up is often due to a food sensitivity. To what food - I don't know. It's different for everyone. But you can start by taking out obvious stuff: dairy and wheat. Citrus seems to be a common antigen too.
The thing with accutane is that it's not really causing pain or discomfort in the short term (I mean dry skin, yeah ok not really a problem). The problem is that it can cause permanent damage to your body, sometimes crippling. Things you can't recover from. Accutane is a chemotherapy - a drug used for treating cancer. It works by killing off stem cells/inhibiting their growth (which is why some people experience hair loss).
I would try some diet changes mentioned above first. You could also try another topical treatment at the same time. BP could work, but cystic/nodular acne really needs an internal approach.
I agree that cystic/nodular acne really needs an internal approach which I why I feel the need to get on accutane. You think I'm going to be able to "fix my diet" being a trucker? I need to get rid of it and while actually getting rid of it try to change my diet to something better. I'm already trying to take a multi, omega 3s, omega 6's, zinc, probiotic, digestive enzymes, and eating a more balanced diet. This is hard for me as is even with my relatively loose schedule because preparing meals costs a lot of money and takes time. Its also something I have to learn more about. I guess I've been putting this off for a while now, but one day I'd love to really get into the cooking and nutrition stuff but I feel it can be like a part time job. Taking supplements and trying to eat a more balanced, healthy diet hasn't really helped much btw, but I will continue to do it just for the health benefits.
As far as the crippling effects of accutane. I've known at least several people who have used it who now have perfect skin and who have had bad acne. If anything goes wrong, I'll be having the blood tests, eating healthy, excercising, not drinking alcohol or doing illegal substances. (never have and I can't because of drug tests with trucking) The thing is, is that I'm a fucking adult now. Cystic acne will not fucking go away without real treatment and I need to do something quick because I will literally not have time to do something about it if I want to get rid of it and continue my proposed short or long term career. I think I'd have a mental breakdown if I was 3,000 miles from home breaking out absolutely terrible, knowing that I'd basically need to quit my job for a couple years so I could have clear skin and start the cycle of "trying everything, before you go on accutane because it a serious drug" thing. Then I'd need to start my career over again ffs. The problem is, is that I may never actually have clear skin if I don't go on accutane either because topicals and other orals might clear me better, but it would still linger, and I'd never had bad enough acne to go on accutane and actually nuke the problem.
Acne in teenagers is normal, and pretty harmless before it gets too bad. Cystic acne in adults is abnormal and makes you look unprofessional or like a slob. Its a serious fucking issue. Not something to be taken lightly and fucked around with.
Fuck the derm, go to your local GP like I did and refuse to leave until he sends off a letter to your derm and tells him to put you on Accutane. Beg if you have too. If you've had it your whole life, then it's not going to go away on it's own. They should know that. You said 15-20 weeks right? See, usually a Tane treatment is 6 months, so even if you did go on it, you would be practically in the middle of treatment.
But unfortunately, you do have try shitloads of crap before they put you on it. I had to failed 3 different medications before they even let me go for a blood test. You never know, one of them may work. You may just have to tough it out for this one and try a few things. You'll eventually end up on Tane (if you don't, you've probably found something that works for you) but in the mean time, all you can do is test. I hope everything works out for you. I know how awful it feels, but that's just what we have to deal with when we have acne :/
Just think, by this time next year, you'll have a clear face
Also, it's not just dry lips and chapped skin. You're going to be a truck driver, so you will have to wear sunscreen literally every moment you're out in the sun. And don't forget that it can also cause depression, despite your fitness level. Just make sure you're prepared to deal with the side effects.
Thanks for the response. I already deal with depression to an extent. If it does cause crippling depression, well then I guess I'd have to do something else but even if it did, I'm not sure I'd be able to tell. As far as I'm concerned, I think I could deal it until the cycle was over. To be honest, acne, and not having a reliable source of income are huge contributors to my depression, so I'm willing to take the gamble and say that it will be better in the long run despite both the possible and expected side effects.
I might try going to a general practitioner, but I feel that they would be the same. A problem with a lot of doctors is that they are all great at acing tests (graduating med school), but can't really break the rules. IMO, most real world cases involve gray areas.
I will definitely wear sunscreen while I'm out driving, good point. Do you have any sunscreens that are acne friendly that you know of?
Also. Do I make sense? Do I have legitimate concerns? or am I overreacting to this?
Edited by usernayme, 08 September 2013 - 11:11 AM.