This is going to be really long, to record what discoveries I've made in the last few months.
The TL;DR version: I'm now taking a low dose of spiro and supplementing with a dab of progesterone cream for the 2 weeks prior to my period. Also, I found a really good article that breaks down PCOS and acne and how to treat it holistically: http://ndnr.com/web-articles/dermatology/treating-pcos-acne-from-the-inside-out/
Last time I wrote I was frustrated with a breakout from supplements that left me with a strange, sebaceous hyperplasia looking lesion that lasted for almost a month. The rest of my skin was okay, but that one lesion really bothered me. Long story, short, for whatever reason, I experience abnormal wound healing whenever I get a very deep pimple which is far more distressing then any acne, because it's impossible to cover up and looks really strange, like a raised, round doughnut on the skin.
There is not a lot out there about sebaceous hyperplasia, but I did learn that scientists showed it can be induced when skin is injected with IGF. IGF is lowered when SHGB is raised - I thought about supplementing with green tea to raise my SHGB but quickly became discouraged by the evidence that green tea might raise testosterone.
Feeling depressed, I decided to try spiro since it has shown to be effective with SH, so I made the appointment with my derm.
Meanwhile, I have known that spiro can exacerbate estrogen dominance, so I thought, why not try to detox my body of the "bad" estrogen in preparation for spiro? My choices were DIM or Indole 3 Carbinol; the herbalist I go to had previously recommended I3C.
I took one pill a day for about 5 days during the week or so leading up to my period and experienced excruciating pain in my breasts, severe acid reflux and of course, a big breakout on my chin.
My theory is I flooded my body with phytoestrogen and released some of the "bad" estrogens and it was too much for me - maybe my liver needs more support - at any rate, I caused a major flare up of estrogen dominance.
I noticed something interesting, however. In the past, my main problem was noninflamed acne on my cheeks, with the occasional inflamed pimple that would resolve once the plug came out. Lately, my inflamed acne has gone way down and now my break outs are concentrated in my chin area and it always happens two weeks before my period like clock work.
The last two breakouts I had on my chin were weird - just these hard inflamed bumps that oozed clear liquid and a bit of watery puss - no real plug in them. Both have taken forever to heal. My theory is these are cysts caused by estrogen dominance.
So things have started to click for me. The two weeks leading up to my period is when I break out - before I never understood why, because everything you read says that's when your progesterone levels shoot up. But what I finally realized that is what a normal, healthy body is supposed to do, but if you have PCOS, then your ovaries get the message to create more estrogen and testosterone. I menstruate regularly, so I know I create progesterone, but I guess I'm a bit sluggish about it. Or maybe instead of just flipping one switch for progesterone, my body flips all 3 switches at once. Once my period comes and my estrogen and progesterone are at an all time low, my skin calms down and I convince myself I've beaten my acne only for it to get bad again in 2 more weeks.
I started taking 25 mg of spiro and for the last few days I'm taking 50 mg of spiro and I think this will be enough for me. I am at that 14 day mark of my period when I get my usual flare up, and sure enough two cysts popped up on my chin. They were smaller, but angry and painful.
I popped one and a tiny miniscule plug came out, but otherwise it was clear liquid, almost like a blister. Not like my usual pimples. And so strange that such a tiny plug would cause that level of pain/inflammation.
On the other one, I put a tiny amount of progesterone cream (Emerita sp?). Immediately, it became less inflamed. Today, it looks like there will be no need to extract the plug and that it will just go away.
So I am going to continue with spiro and take it along with vitex to encourage my body to produce progesterone/counteract any estrogen that is produced by the spiro. Days 14-26 I'll supplement with a small dab of progesterone cream - less than what is recommended because I want to be careful. According to articles on the internet, I may not have to take progesterone cream forever - I just need to retrain my body to make it on it's own at the correct levels. Progesterone inhibits alpha 5 reductase so maybe I won't have to take spiro forever either.
I'm going to keep taking the rest of my supplements that I know are good for me - like fish oil, chromium, etc. I'm also taking b-6, magnesium and zinc leading up to my period - this is supposed to fix the luteal phase defect, which is what I'm guessing I have (my ovaries produce more estrogen and testosterone instead of the right amount of progesterone to induce ovulation).
I'm going to keep taking milk thistle because it's good for my liver and fiber pills because it keeps me regular - all just to keep metabolizing and ridding my body of estrogen.
I'm going to keep treating my insulin resistance, for general health and well being. I've cut back on carbs and will keep eating better, for many health reasons.
I am not going to worry about blocking my body of estrogen for right now- my two experiments with that has not been good for me.
I feel like I've finally figured things out. I've known about spiro and progesterone cream for a long time, but didn't feel like I understood my body, cycle enough to take them. I am far from cured, but my gut is telling me that I finally found something that will work for me. I have read about horrible initial break outs from spiro and how progesterone can cause a flare up of estrogen dominance. But the truth is, if you're fiddling with your hormones, it's very unpredictable how your body will react. In the end, however, it's probably hormones that are causing your acne so it will take some trial and error to figure out what's going on.
So if anyone is reading this, my advice is this simple: know thyself. If you're a woman with acne, get a handle on your menstrual cycle. Experiment with one new supplement at a time to figure out how your body reacts. Consider that the two weeks leading up to your period, your skin might be more temperamental than usual and that might not be the best time to try something new.
And this article really is extremely helpful at explaining why women with PCOS deal with acne, and how to treat it, whether you're going for an all natural treatment or not: http://ndnr.com/web-articles/dermatology/treating-pcos-acne-from-the-inside-out/.
Best of luck to everyone out there!
I had a breakout, but I'm 90% certain it was caused by some new supplements I started taking. I stopped taking those supplements and the breakout did not get worse and started healing up - all during the part of my cycle when I normally do experience one huge final flare up. I'll explain more, but first, why did I start with some new supplements in the first place?
Well, I'm obsessed with having clear skin. Like everyone else here - lol! So while my skin was looking pretty great, I know I have issues with insulin resistance, as evidenced by the fact that cinnamon with meals really helps me. So I thought, I'll keep trying other supplements known to help with insulin resistance and my skin will just get better, right?
I also got a weird, cyst-pimple thing in my cleavage in the spot right under my bra underwire. It's a weird spot, and I don't get acne there very often and I figured it was due to my underwire irritating my skin. It didn't go away and I could see what I thought was pus underneath this small lump of skin.
It turns out it was sebaceous hyperplasia - an enlarged oil gland, basically. (http://on.aol.com/video/enlarged-oil-glands--sebaceous-hyperplasia-516970677).
So all of the difficult acne I've had that takes ages to go away is not actually acne - they rarely get inflamed so there is no bacteria - just a lot of sebum that's trapped in the oil gland with no where to go since it's not a blockage in the hair follicle.
So of course, this must be due too much oil which is caused by too much testosterone, right? Since I was having so much success with cinnamon, I thought I'd up the ante with alpha liopic acid - said to be very good for acne, insulin resistance, etc. Then I read that NAC (N-Acetyl Cysteine) works to increase alpha liopic acid's effects. It is also supposed to be good for detoxing the liver, which I believe is necessary to ensure old hormones are evacuated from your body. I've been taking Milk Thistle for this, but thought I'd try NAC as a double whammy.
I'm pretty sure NAC caused my breakout. It started with a weird painful welt near the corner of my lip - a place I have never broken out before. Then I got two inflamed spots on my chin that never really came to a head but were very red and oozing watery puss. Like abscesses I guess. I don't get that kind of acne very often - usually, once the inflammation goes down, it's just a small plug that comes out with a bit of sebum.
So i stopped taking NAC and Alpha Liopic Acid. In fact, all I'm taking is my herbal supplement and the cinnamon, and for the last few days it's been fine. I'll add back my supplements one at a time to see what difference, if any, they make.
The lesson? Be very careful with supplements and only start one at a time!
I'm rethinking every supplement too - for the last 3 years I've taken zinc pretty faithfully. I also started getting sebaceous hyperplasia more in the last 3 years too. I do remember wondering if zinc was causing me to get a different type of pimples, because while zinc would clear up the inflammation on some cysts that I had, I was left with lots of sebum that I would eventually squeeze out. I recently read that zinc increases testosterone (although it also acts as a DHT inhibitor too) so maybe that's contributing to the overactive oil glands?
I'm not discouraged though. Well, I was for a few days, but I have a plan:
- Continue to explore ways to reduce insulin resistance, but instead of through supplements, I will focus on exercise and diet (including just eating smaller portions, drinking water with lemon before meals too)
- De-stressing - I was starting to get sucked into the restrictive diet world, and it was stressing me out. And I have a lot of anxiety in my life right now - with having to move in a few months, moving in with my fiance, job stress, life, etc. And I realize, I don't have many healthy ways to de-stress. So I need to get off my butt and go to a yoga class and start jogging again. Or just dance around in my living room and stop obsessing over acne.
- I'm gonna keep reading up on PCOS. Apparently, there is more than one type of PCOS, and insulin resistance is just one part of it.
- Finally, I need a plan for when I do get a breakout. I can't freak out and attack my face with my fingers or harsh spot treatments anymore. I swear, I cause way more damage that way. I need a gentle spot treatment, I need a stash of antibiotics (I took just 2 and felt instant relief for this last breakout- placebo effect? maybe!) and I need professional help for those difficult breakouts - if I need to I should get a cortisone shot or something. I found a day spa that uses the skin classic for hyperplasia, so I think I'll go in and ask about it.
Other than all of that, things are going well. I have to say that I really love Finacea. I can use it with AHA or BHA with no problems - it doesn't dry out my skin and it gets rid of hyperpigmentation pretty quickly too. I still need to try pairing it with zinc and b6 - supposedly that combo inhibits DHT in skin by 90%. And maybe zinc will be that gentle spot treatment I've been on a quest for?
Oh yes, I finally got to use my Nexcare acne patches that I bought from ebay. (Google this!) They worked beautifully to drain all the pus from my breakouts - I don't get these types of pimples very often, but I will never be without a stash of these little lifesavers either.
Finally got my period a few days ago, and I am still clear.
I got minor PMS anxiety issues and a couple of zits popped up, but I'm not worried about it! My skin looks great. I'm wearing less make up everyday and I'm extremely happy.
I'm busy too. Now that my days of obsessing over acne appears to be over, I realize I have all kinds of other stuff to deal with. Oh well!
I still want to write a post recapping everything I learned but don't have the time right now. Everything I learned is already in my blog.
To anyone reading this just know that you can figure this out too. If I cleared my skin, anyone can! No crazy diets. No birth control. No antibiotics. No accutane!
So I should start today, but nothing so far.
I don't get cramps or pissy moods my more, which usually told me my period was coming soon.
I think adding the cinnamon has thrown things off a bit. I forgot to mention that I was spotting last week, which is unusual (but not unheard of) for me. I read that some women spot when they're ovulating, so I thought maybe that was the case for me too. I'm not too worried, but I am really curious to see how my skin reacts to my period starting.
Also, my skin loves finacea plus Dan's AHA - read some where that its lightening effect on PIH is comparable to hydroquine. My PIH is fading nicely. And it makes my skin feel soft - who knew an acne treatment didn't have to dry out everything!?
Not much of an update! Hope everyone is well, and making their own progress!
My period should be here in the next couple of days and my skin is looking pretty good still!
For a few days I got pretty lax with all of my supplements, except for the cinnamon with every meal 3 times daily.
I'm pretty sure that is what caused the one pimple I got on my cheek. It went away quickly, but it bummed me out because I was getting used to having clear skin!
So I'm convinced all of this works together. Maybe cinnamon cuts down on 50% of my acne, and saw palmetto and vitex cuts down on 30% and my topicals cut down on another 15%. Or whatever. Either way, I am so much closer than I have ever been in my life.
To not be dealing with a bad flare up before my period? Unheard of. To have no pms - No bloated gross feeling? No depression? No cramps? I thought it was unavoidable - part of being a woman. The world seems like a better place now that I know I don't have to go through that every month! Anyway, the day of my period is when I get a final flare up - so I'll keep my fingers crossed!
Now that acne appears to be under control, I'm obsessed with the scars I have on my face. So I bought a PMD (google it) and will start using it once my period comes and when my skin is less sensitive.
I have one scar that really depresses me, but if I'm able to make it look better I'll be so happy!
Anyone reading this - read up on insulin resistance and acne connection!
I'm due for my period in 6 days... I have not had one break out. This has never happened to me! I'm excited, but also a little freaked out. I mean, could it really be that simple?
1 cinnamon pill before every meal 3 x a day and low glycemic snacks between meals seems to do the trick. I'm still taking my regular supplements, but honestly, they never gave me the instant results cinnamon has given me.
HOWEVER, something did happen that worried me a bit. I accidentally took 2 cinnamon pills with one meal (I forgot I'd already taken one) and I saw weird flashing lights, like I was about to get a horrible migraine. I took aspirin and it eventually went away.
So I obviously need to learn more about cinnamon is doing to my insulin and glucose levels. I don't want to make the same mistake I made with saw palmetto, and take it without fully understanding it. In fact, I told my eye doctor what happened and she recommended I get a blood glucose tester to monitor my levels.
I've always suspected that I have hypoglycemia (it's probably more accurate to say reactive hypoglycemia). So I'm reading up on it, so I can understand.
Based on what I've read in the last few days, I'm convinced that reducing insulin resistance is the key to curing acne! And so many other diseases too.
I am sooooo grateful that low dose accutane didn't work for me. I am also grateful that I never went on spiro. I feel like the nightmare is over, and I can start living my life! It's exciting. When I fully understand everything I'll write my own "I cured my hormonal acne naturally" post.
Until then, all I can say is YAY! Oh and don't give up people! I thought I just had bad genes. And maybe I am genetically prone to insulin resistance - but I can still fix it. So yeah, never ever, ever give up!
Still no breakouts!
Two weeks before my period is when my skin looks like shit - this time last month, I had two big pimples on my chin that erupted over night.
My skin looks amaaaazing! It feels amazing!
I'm due to get my period at the end of the month - if my skin stays looking this good, I will declare my hormonal acne defeated!
Now, I'm off to research paleo friendly recipes. Whee!
Finacea and cinnamon!
Finacea caused a bit of purging in the first week, but it was minor for the most part and now it's working great. My hyperpigmentation is improving and my skin isn't overly dry like when I use retin a. I'm using it at night with Dan's AHA. I'm using BP and moisturizer during the day - I have a huge bottle and I feel like I might as well use it, even though my skin is clear with no active pimples.
The biggest improvement is due to cinnamon capsules that I have taken for 1 week. I noticed I get oilier after I eat, and I remember reading a suggestion to take cinnamon, so I started taking 1 capsule before my meal and omg, it's working! I'm no longer oily! This cinnamon plus the saw palmetto/vitex tincture I'm on has made my skin so dry and matte looking. It's like I had a skin transplant.
So now it all makes sense! Insulin resistance basically floods your body with testosterone. Cinnamon is supposed to help with insulin resistance, which means there is less free testosterone in my body, less testosterone converting to DHT, less oil, and hopefully, less acne!
I have always intended to follow a low glycemic diet, but never fully committed to it. But now I'm convinced! I also think, in my case, a low glycemic diet alone is not enough to correct insulin resistance and that's where supplements like cinnamon and chromium help. I'm also super excited that I can still indulge once in awhile as long as I take my cinnamon supplement!
The real test is coming up! My period will soon be here...if I get through the next two weeks without a major flare up I will be AMAZED!
I get annoyed when people stop updating these things because I wonder if they're off living their acne free life or what.
I am still not acne free. But - my skin is looking pretty good too. I'm on the same supplements and 2 weeks out of the month my skin is basically clear until 2 weeks prior to my period when I have a flare up.
Improvements I've made:
I am not touching my skin as much. It's made such a huge difference!
I ditched retin a micro as my only topical. I realized I needed an antibacterial component to my regimen. I started just doing Dan's regimen but quickly noticed that I was getting congested skin, black heads. So I've reincorporated Paula's 2% BHA. Was using them both at the same time and that was waaaay too drying. So on most days I use the BHA and moisturizer during the day and the BP and AHA at night. This cleared up my skin pretty quickly but lots of hyperpigmentation remained, so when I feel like my skin can handle it, instead of BP I'll do retin a micro and obagi clear and AHA.
I used to hate that I have to use so many products, but that was just me wishing I could be one of those low maintenance girls. Next life, maybe? To be honest, I'm happy I have so many options open to me and I think the best thing I can do for my skin is to pick something and be consistent with it.
So, I went out of town with my boyfriend (and now fiance) and it was too hard to keep up with my topicals. Waiting for them to dry before I can put on my make up takes FOREVER. So I got lax. And it was also 2 weeks before my period when I always flare up and 2 big zits showed up on my chin. Why this happens is a mystery because my chin is normally pretty clear. Little to no clogged pores - not like my cheeks. When I do break out on my chin it is 90% related to my cycle.
So now I'm trying to figure out what is happening 2 weeks before my period.
I have theories. Here is my research:
This is when your progesterone levels start to go up, so estrogen has less of an effect on my skin. Supposedly, my androgen levels are higher than normal too (there is no consensus whether your body produces more or if there is more in relation to estrogen/progesterone).
So should I take more saw p the 2 weeks prior to my period? I know it increases my estrogen too so maybe? I'll try that this cycle and next cycle and see if there is a difference.
I also wonder if I'm just really sensitive to these hormonal fluctuations and that just the increase in progesterone is causing it. Because in the past, my breakouts were a little different. I'd break out on my chin like once every 2 or 3 months. Now I'm getting like 2-3 pimples on my chin every month. So I'm wondering if the vitex is keeping my progesterone levels up more than it used to be (which is preventing the estrogen dominance, but is now causing typical hormonal acne).
At any rate, I'm not willing to keep fiddling with my hormonal levels, except for trying more saw p during the 2 weeks leading up to my period.
Other things I need to research:
luteal defect - what is it? Do I have it? supposed to be related to pre-menstrual breakouts. B6, zinc and magnesium are supposed to be good for this
Topicals specifically for hormonal acne - the beauty mag articles recommend ant-androgen topicals (Finacea, B6 and zinc) and also mentioned something to boost my estrogen receptors. This interests me too.
Essential Fatty Acids - I think I need to increase this to see if this improves kerantisation of my sebum. Both topical and oral. I started taking fish oil and also slathering my skin with hemp oil, and a hard, tiny seed that has been on my right cheek just came out. It was like a tiny piece of rice. Saw P is keeping my oil down, but maybe my sebum is prone to kerantisation and that's why I keep breaking out? It doesn't hurt to try.
Spiro - this still remains an option, however I'm worried that my depression/anxiety will return. I'm 90% certain my tincture is helping with that.
Other things I thought would be helpful to add here for posterity, I guess:
sebaceous hyperplasia - I found out that basically this is an over active oil gland. I get them following a cyst. I see a lump of yellowish sebum under the surface but no opening for it to get out. Because I have a thin face they can be pretty prominent, and if I spot treat them the skin around gets really dry and wrinkly so it looks like I have a raisin under my skin. They look horrible and I've never seen anyone else with this, so I feel kind of freakish. Anyway, I am deathly afraid of cysts on my cheek because I've gotten sebaceous cysts that needed to be removed and I still have the scars. So I got another cyst/sebaceous hyperplasia 2 months ago and was soooo upset about it. But I wasn't messing with my skin like I normally do, so it didn't look too bad. So I just ignored it - didn't spot treat it and just used my normal regimen. It finally came to a head about 6 weeks later. So while I hope to never get them again, it's good to know that it will eventually work it's way out of my skin, unlike a true sebaceous cyst which usually needs to be excised. I was also reading that anti-androgen topicals are good for these too. I was using nizoral but couldn't keep up with it while I was out of town. Also have read that finacea should help.
That's it for now. This is just for my own record keeping purposes. Also, if I ever clear my skin I can point to my log so people can read about the process. If I clear up my skin, I swear, I will dedicate my life to telling people how I did it.
Well, for now....
I've been reading, reading, reading and decided that I just cannot afford any of the horrible side effects that some people experience with accutane.
The pressure in my head worried me. Also, yesterday I had a crazy crying spell. I felt better after crying but I cried my eyes out over how unfair life is, how unfair acne is, how unfair AIDS is and how there are children growing up without mothers - I cried for the entire human race and how we're all fucked.
I have a history of depression so crying and feeling sad isn't unusual per se, but I've read that depression can be caused or exacerbated by inflammation. Maybe my brain was starting to swell up?
I don't know what the fuck accutane was doing to me. All I know is I have a young daughter - I have to be here for her mentally and physically and emotionally - how horrible would it be if I caused long term damage just because of my acne? HOw horrible if I became despondent because of my acne treatment. How horrible if I got a horrible IB and then couldn't finish the treatment because my brain explodes. My plan was to just blast out all of the sebum under my skin but what if I need a full 6 months to get to that point? And what if in those 6 months I cause irreparable damage?
There are too many what ifs with accutane. ANd of course. when you start reading about all of the bad things that can happen, you hear horrible stories. Funny how all last month I kept reading about the awesome stories of people completely cured.
So what to do now? Well the herbal tincture was working for my skin and my emotional health so I'm going to continue that and see it through. I also slacked off on the chromium so I'll stick to that for 400 mg a day.
And I'm also going to go back on Dan's Regimen. I"ve half assed used it before, and always felt it helped but it didn't do anything for the noninflamed acne that has always been my problem. Also, doing the regimen on my back seemed like such a pain in the ass.
But my back is clear now. And after experimenting for months with saw palmetto, my noninflamed acne is pretty much gone.
I've also been devoted to using retin a micro for over a year. Now I love retin a combined with obagi clear - it's fantastic for PIH. But, retin a does not do a thing to prevent my hormonal breakouts. And the breakouts get so irritated and scabby with retin a. I bought into the idea that retin a is a miracle for your skin, but when I really think about it, it's only good to use on my skin when I am not broken out.
ANyway, this is getting so long because I don't know how to keep things short, but I figure there's no reason to not try BP again. And I feel such relief.
A big motivator behind the accutane was to get clear in time for a trip in March, but it's too risky at this point. I also want to move in with my boyfriend later this year. I wanted to be perfectly clear and act as though acne has never been a problem for me. But guess what - he already knows I have acne. He loves me anyway. He may have perfect skin but he's starting to bald and he has a hairy back and I still love him. In fact, I may love him more for his "faults".
All that said, I may change my mind in a week. In fact, I'm considering doing the 20 mg a week instead just to get rid of some pockets of sebum that are deep in my skin. I don't mind being a guinea pig for that.
So yay, I feel more at ease! I can have a glass of wine with my boyfriend tomorrow and not worry that my liver is going to die!
I took the first 20 mg pill yesterday. I'm going to continue taking my saw palmetto and chasteberry tincture and hope that I can get through the next few months with no problems.
Within a couple of hours my hands felt numb and then I realized they were freezing cold. Read up on it, popped a niacin and it felt a little better.
When I tried going to bed, I felt pressure in my head and ears. It wasn't painful, but I felt off and a little panicky. I worried that I wouldn't go to sleep but I finally did.
I feel okay today, but my hands feel cold again. My skin feels nice though. Although, it was looking pretty decent before because of my herbal tincture.
Anyway, I'm thinking of easing into accutane and taking 1 20 mg every other day. It's worrisome to think what is going inside my body to cause these issues so soon especially when I read about people taking 80 mg a day and only getting chapped lips!
I was taking too much chromium - Side effects of taking too much include insomnia and loss of appetite. Definitely experienced that. There is already 400mcg in my multi vitamin - may take 1 other pill when I'm feeling anxious for no more than 600 mcg per day.
So far the sp tincture is definitely working. I don't have sore breasts or cramps I normally get before my period - I should get it any day now. I had a bit of a flare up but took more of the tincture and it calmed it down considerably. We'll see what happens when my period finally gets here. But I feel good. Not depressed. My skin is looking pretty good too, save for the spots that are still healing. My skin was starting to get oily and I upped my dosage (as Hilary suggested I could do depending on my symptoms) and it took care of it immediately. I am cautiously optimistic that I found something that works.
I'm still going to do low dose accutane to get rid of the trapped sebum plugs that are all over my face. That will start mid-december. Unless something unusual happens, I probably won't update until then.
So far so good with the women's health doctor's regimen of the Saw Palmetto/Chasteberry tincture. I started using it after I noticed my PMS flare ups starting up again, and I already feel less oily. Only side effect was for a few nights I was feeling really tired, but then I remembered that I felt really tired when I started SP the first time - both SP and Chasteberry are known to have a sedative effect.
Before I started it, I got a hormone blood test, just to see what's going on with me 2 weeks prior to my period. I decided not to do the saliva hormone test - if money was no object I would do it, but my doctor seems to have a good idea of what's going on. She's actually not a doctor - she's a midwife who specializes in women's health issues. She's also an herbalist. I lucked out in finding her - she accepts my insurance and she's given me great advice - her name is Hilary so I'll just refer to her by her name. In retrospect, the first naturopath I saw was just trying to get money out of me. Instead of recommending a treatment she was going to draw everything out. Either that, or she really doesn't have experience with herbs and was being overly cautious. The multi-vitamin pack she sold me seems good though - it's designs for health twice daily essential packets.
Anyway, this past week I've also upped my chromium intake. It's in my multi-vitamin, but I've also started taking it after most meals, so I've been taking around 800 mg per day. I have noticed a decrease in my anxiety. I'm reading up on it and I think it's another missing piece in the acne/depression puzzle.
So my plan is to continue the SP tincture - maybe take it only once a day after my period starts, and take the chromium after every meal, take my twice day multi vitamin pack, and also supplement with milk thistle or add dandelion root to my tea/coffee for my liver.
My theory is this: I am prone to acne because of a sensitivity to androgens, I am prone to insulin resistance and my liver could use help flushing out excess estrogens, etc. So acne is my body's way of telling me that there is something wrong internally. If I didn't have acne, maybe I would high cholesterol or diabetes. All of it is interconnected and I finally understand what is happening - in the past I would take supplements without a clue whether they would work for me.
So I will continue on this path. I also plan to try low dose accutane and see how far I can get on it. I have lots of trapped sebum in my skin and I believe accutane will purge a lot of it out. Chromium is good for lowering triglycerides and milk thistle/dandelion is good for my liver so I don't think I'll have a problem using those supplements while on accutane and I think they will lessen any side effects. My theory is that accutane basically seals up the sebaceous glands, forcing all of the gunk inside the bloodstream which can cause all kinds of internal problems. I will also stick with the Saw Palmetto/Chasteberry tincture because I can't find anything that says this is a dangerous combo (I'm going to keep looking though). I know if I tell my derm, she'll say to stop every supplement. Anyway, I am going to stick with a low dose - my derm says 20 mg a day, but I may just do 20 mg every other day.
My skin looks okay, despite the little flare up I experienced earlier this week. The only thing that is really bothering me is the cyst that I had on my cheek hasn't completely healed and there are still pockets of sebum trapped under the skin and it just looks like i have a circular lump that isn't inflamed or red. I think it has turned into sebaceous hyperplasia, and I remember getting this kind of thing pretty regularly when I was younger. They take forever to go away, but using retin a on it seems to be helping. I was trying to squeeze out the remaining sebum but that just made it worse. When in doubt, leaving my skin alone always helps it heal. I need to learn to leave it alone! But that's where the chromium will really help (and already is helping) - if my anxiety is reduced, I won't feel like I need to attack every imperfection on my face. Anyway, because I'm prone to sebaceous cysts and hyperplasia, I think accutane is a good idea for me and I feel like I have a pretty good plan in place.
Here's more info about the depression/acne connection:
Acne vulgaris, mental health and omega-3 fatty acids: a report of cases
When I had the crazy breakout about a month ago, I made appointments with naturopaths, women's health doctors and 2 different dermatologists.
I decided to keep all of these appointments to continue to explore my options.
My visit with the women's health doctor was awesome and I'll share her advice. Basically, she agrees that my issue with taking saw palmetto was that I didn't take anything with it to balance out my progesterone and estrogen. So she recommended a blend of SP, Chasteberry (vitex) licorice, and peony - with 2 parts chasteberry and 1 part the rest of the ingredients. She makes the tincture herself. She doesn't think hormone tests are all that helpful because I may be more sensitive to androgens then most people and that may or may not show up on my results. She also thought it'd be best to get started with this and see what happens. So now I'm trying to get my money back from the other naturopath for the salivary hormone test. Oh yeah, she also recommends milk thistle and dandelion tea for liver cleansing, chromium picolinate (500 mg) for insulin balance, and Vit B6 50 mg and magnesium citrate 100-200 mg for 1 week prior to menses.
Note - I have not tried any of this yet, just writing down what she recommended for me based on the symptoms I told her about.
The next day I saw a dermatologist who recommended either spiro or low dose accutane. I feel just doing spiro with no birth control will cause the same problems I had with SP - so she said why don't we try low dose accutane? I'm very uncertain about this, but I have a month to decide since I have to get pregnancy tests and go through ipledge. So that process has been started butI can still back out.
So I'm trying to figure out what to do? Go the all natural route or take the medication that's basically chemotherapy to obliterate my acne?
I'm gonna try the tincture thing for sure, but now I'm wondering if I could do both? Or is that just craziness? I wanted the hormonal stuff to address the emotional stuff too, so maybe doing both will yield brilliant responses for both my skin and my mind.
I realize that researching and learning about different remedies is only helpful to a certain point - after a while, you just gotta try it and see how your body reacts. Ideally, under the guidance of a doctor, which I am doing. I just know if I ask about taking the SP tincture they'll tell me not to since no one knows how they'll interract.
Hmmm. So I'll ponder this over the weekend...
I have mixed feelings - on one hand, she told me everything I already know - to improve my diet, take a multi-vitamin cocktail, to get more exercise and to take a month long hormone test because it sounds like I am deficient in progesterone. She agreed that saw palmetto could be overloading my body with estrogen. She also recommended therapy to deal with the emotional stuff - which she said can be a huge factor.
She recommended a therapist who practices Radix therapy - I'd never heard of it before, but read a bit and it's a body psychotherapy that supposedly removes blocked negative emotions. My gut is telling me I need this kind of therapy, as opposed to more talk therapy. Intellectually, I understand what is going on with me. I need something to tap into my subconscious to help me let go of all of my self destructive and sabotaging tendencies. Sooooo, I'm going to check it out. My insurance does not cover mental health, so I'll be paying for this out of pocket too.
So $500 later, I have a plan. I can't start the hormone test until my next period starts. I am to stop taking saw palmetto because it is probably interfering with my hormones. I am to start living and eating more healthily.
I know this is the right answer - I know my health is well worth the $500 bucks ($250 for the hormone test+ $175 dr visit + $65 for 1 month supply of vitamin cocktail). The truth is I was hoping for a quick fix - a magic pill to cure everything. But I also feel vaguely guilty, like I need to justify spending this much money on myself.
Talking to someone for over an hour about what is going on with me was a weird experience - I felt overwhelmed with emotions and started to cry. I don't really know why. Part of it is I am ashamed that I don't know how to take care of myself (which is me being hard on myself). Another part is admitting how vulnerable I am. And admitting how out of control my life is - I obsess over my skin way too much and it's hurting so many different facets of my life. Basically, for most of the month of October I got hardly any work done. I bailed on doing things with friends. I ignored emails. ( and over an email no one even knows that my face is broken out, yet I still ignored emails). Now I'm trying to catch up.
So I have a lot of work ahead of me. At first I was freaked out over the money I am going to have to spend, but in the larger scheme of things, it's really not that much. If anything, this financial commitment is going to force me to really try. BTW I don't want to dissuade anyone from going to a naturopath or spending money on doctors, whether it's a dermatologist or therapist or both. I've noticed that a lot of us are suffering in silence, feeling like we have to cure ourselves. There is nothing wrong with seeking professional help. There is nothing wrong with spending money for the sake of our health. Of course, all of this advice is already on the internet, so in a way I did waste my money. But it's done now. THe next step is to continue to explore this emotional stuff. I'd never heard of radix therapy so I am grateful she told me about it.
So yeah. I guess that's it for now.
I've been seriously bummed the last few days - it's a function of that time of the month and a new cyst/pimple/THING on my cheek that's been there since Sunday. I really hate that half the month is such a miserable time for me. I go to a naturopath tomorrow. I'm determined to get the mood stuff and hormonal acne bullshit figured out once and for all. I also go to a new derm next week and I will ask about spiro and low dose accutane and any other options I might have.
So the advice for PMSing ladies is to take B-complex. I've read before that biotin could cause acne, so I've avoided it. But it's in B-complex . Last week I picked a formulation with the lowest amount of biotin, and then kind of forgot about it.
I break out before my period like clockwork, but this breakout was a bit different, more stubborn, and I felt oily and gross - like I remember feeling as a teenager.
Then I realized - maybe it's the biotin. And now that I think about, I probably used to take multi-vitamins with biotin when I was a teenager and that might have contributed to my acne all those years ago.
I don't consistently take a multi-vitamin any more but I just realized that has biotin too. So I will just avoid biotin from now on. I don't think it fully caused the breakout, but it might've exacerbated things.
Not taking a daily dose of SP definitely had an impact too. I had sore boobs, cramps and a heavy period (ugh, still going through it), after not having those issues for the last few months.
Despite everything, I do feel better today. Is it a coincidence that my boyfriend is out of town? Probably not. Once again, the stress I feel when he is around is such a huge factor in my emotional well being and probably my skin. And it's totally not his fault. It's just my brain pressures me to be perfect for him. So much of this is all in my head. I know acne sufferers hate hearing that, because it makes them feel guilty, but I think it has a real impact. If I have a meeting that I'm dreading, my skin will flare up. It's like my skin is my passive aggressive way of getting out of doing shit I don't want to do. It's like a defense mechanism. Except it doesn't work because I can't just hole up in my room by myself anymore. ANyway, I'm not going to worry about moving in with him - that will not happen until my acne is under control, period. Telling myself that has already made me feel better. All of these ideas are from the Skin Deep book by Dr. Grossbart btw. i started the book but have not finished it - I must finish it!
Okay, enough babbling for now....
I feel blah today. Not depressed or anxious, just blah. Part of it is I didn't sleep well.
The other part is I am discouraged. I eased up on the saw palmetto and have a smattering of premenstrual breakouts on my face. They aren't the worst - but still, I'm so tired of this.
I'm discouraged too because I keep reading contradicting info online about how to balance your hormones. I'm discouraged that there are people who have supposedly "cured" their acne charging people for online consultations and webinars and ebooks and just making money off our misery. Meanwhile, no one really fucking knows why anyone has acne. There are so many people who act like they know, but it's too complex to ever know. I'm discouraged by the idea that a naturopath is going to tell me I have to radically change my diet. A "solution" that is not realistic is not really a solution. For me anyway.
Okay, I need to get out of this funk.
What is my body telling me today?
I started spotting so my period is coming very soon.
The hormonal acne I started getting on 10/31 was jawline and chin and saw palmetto was helping with that.
The saw palmetto also helped some of my PMS symptoms - sore breasts and cramping
I don't feel crazy anxious or depressed leading up to my period - could this be because of the B complex I recently started or because I slowed down on the Saw palmetto (been taking every 2 days)
Maybe I need to stop taking saw palmetto once I notice the spotting. Because the crazy flare ups I got were after my period started. Yet, what about the crazy anxiety I felt leading up to my period last time? I was anxious for emotional reasons too, so perhaps that was it?
I remember reading about a woman alternating her saw palmetto with a progesterone supplement. Of course, at this point, i am no longer willing to experiment with anything that will mess with my hormones without first talking to a doctor. I do think you can overload your body with too much of one thing, especially when it comes to hormones.
Spiro is still an option - just can't help but think I need something to "balance" my other hormones.
Gah, I'm just talking in circles. This is miserable. I hate obsessing over this. I am not very happy right now
I started getting my pre-menstrual breakout yesterday morning: 2 small zits on the sides of chin and what looked like it was going to be a big one right on my chin. I woke up feeling really oily too.
A month ago my skin was pretty much clear so to feel oily and get tiny zits is pretty demoralizing to me right now.
Anyway, I popped an SP and the oil went away immediately. Just one 160 mg of SP. Wow. Pretty strong stuff! If only it worked exactly the way I want it to work all of the time!!
But then I massaged manuka honey onto the zits, without having any great expectations.
OMG, the inflammation and slight pain I felt in the big zit went away. I could see and feel the tiny dot of the head of the zit. I went about my day, went trick or treating with my daughter and my boyfriend and his friends, came home. The zit felt a little inflamed so I massaged more honey on it. Again, the inflammation went down and I could see the little white head peaking its way through and I thought I wonder what would happen if I tried popping it? Well it popped out perfectly with me putting barely any pressure on it and all that's left is a little red dot. This is a zit that would have sat on my face for at least a week, that I would've irritated the shit out of with hot compresses, BHA, retin a, whatever. I have finally found the spot treatment of my dreams! One that actually really works and doesn't destroy my skin. Now I am in love with manuka honey and I will tell everyone I know what a miracle this is. I am also using it on my excision scar because it's supposed to help heal wounds and prevent scarring. So far, it's looking better with the manuka honey than just plain neosporin. Neosporin was making the edges of the scar bubble up and manuka appears to be flattening it out.
After having a horrible month, this tiny victory feels great. Just goes to show that you should never ever give up on finding something that works for your skin. The manuka honey I got is the Wedderspoon 12+ at Wholefoods. I'm using it in my green tea too. Love it!!!
Today I went to the derm to see about getting the cyst removed. I'm prone to sebaceous cysts and have had to get 3 of them removed over the years. I think I've had more than that and that some of them have gone away by themselves or with me manually draining them once they stopped being swollen. I really hate that I'm prone to these - chances are, picking at my pimples is creating them so this is yet another reason for me to never pick a pimple again.
I hate going to the dermatologist. I get flustered and feel rushed, and I don't like anyone seeing me without makeup. But whatever, I'm getting over it. The point is, I was feeling a bit apprehensive.
Then the dermatologist comes in and he is the hottest dermatologist I have ever seen. He's young and tall and just ridiculously hot, and for a split second I wanted to leave. But I didn't. I need to get over this crippling vanity...
So he ended up taking out the cyst right then and there and recommended spiro. I asked about low dose accuane and he said no, there is no such thing like that in this country. I know that is bullshit, but whatever. If I'm being truthful to myself, accutane is more than I need and I really should explore spiro first, since saw palmetto appeared to be working.
I've been reading up anti-androgens and apparently no one knows for sure how anything effects our hormones. So saw palmetto may or may not have blocked my estrogen/increased my estrogen. The female hormone supplement that I assumed to have increased my estrogen may in fact have blocked my estrogen (have read that studies indicate dong quai and black cohosh may block estrogen).
So maybe my crazy flare ups are due to too little estrogen? It's one of the two.
My plan is to get a hormonal test in a couple of weeks. What I would like to do is get a baseline test to see where I'm at when I'm not on any anti-androgen and then see what happens when I am.
So should I bite the bullet and get on spiro? Or should I stick with saw palmetto? It looks like no matter what, I need a double pronged approach - block the androgens and balance the estrogen and progesterone. This is probably why a lot of girls get on birth control while they are on spiro. I don't want to do that - last time I was on bc my acne was really bad. I know not all bc is the same, but I really don't feel like putting my body through all that trial and error.
Anyway, I feel better to have gotten the cyst out. But now I have two teeny stitches. I had an appt right after the derm and I had to go with a bandaid on my face which was mildly embarrassing. And I was supposed to do something for halloween with the BF and his friends, so I'll have to wear a bandaid or wear a mask or somehow incorporate these stitches into a costume.
I also have to go out of town for work friday, so I'm going to try to take the stitches out before then. The derm said I could get them out on Monday or if I knew someone with any medical knowledge i could get them out earlier.
The oiliness is creeping back after not being on saw palmetto for 3 days.
I did try manuka honey on a small inflamed zit on my shoulder and it worked! So there's that too.
One step back two steps forward, I guess.
So I was supposed to go to dinner with my boyfriend. A couple of hours before he came over, I hopped in the shower and used my clarisonic all over my face, including the cyst.
The skin around the cyst is irritated - the hot compress I used earlier on the cyst burned the skin and the adhesive from the bandaids irritated the surrounding skin. Putting retin a to help the PIH didn't help either.
My over-exfoliation left an oozing peeling mess. My boyfriend came over earlier than I expected and my make up was not adhering to my skin and it was awful. I had him wait downstairs until finally I called him and admitted what was going on. He picked up dinner and brought it up - I kept a blob of neosporin on my cheek all night.
My skin getting worse and to the point that I can't cover it up is my nightmare. I know that is melodramatic. I know that with all of the problems in the world, my skin problems are nothing. In fact, I know compared to other acne sufferers out there, my skin problems are not that bad (or at least, they don't start out so bad - I just make them worse).
I cried last night, told my boyfriend that I felt defective as a human being and that I don't feel like I deserve him and that I want to be pretty for him. My boyfriend was completely kind and understanding, but I could tell he struggled to find the right words - he has perfect skin so he has no idea what I was going through. It was humiliating, but I think this needed to happen. I told him I think I have body dysmorphic disorder and now that it's out there, I can't hide it anymore.
A teeny part of me thought "well, if he doesn't love you any more than you can just go back to being alone and casually dating and not worry anymore about being perfect for some man". Last night I dreamt I cheated on my boyfriend right as he slept next to me - I literally had sex with someone else on the same bed right next to him as he slept - when he woke, I had to cover up the "evidence" and I felt so ashamed.
That cynical voice in my head is the part of me that wants to keep me from getting to close to people. And my dream is about my stupid self sabotage and how a part of me fears intimacy and having a grown up relationship. And hiding what I am ashamed of.
I still think hormones are part of my problem and that I flooded my body with estrogen after taking saw palmetto for over 5 months, but now I'm going to focus more on the emotional side and stress relief.
I got this idea from the love vitamin's blog - to list 5 things I am grateful for every day:
-my loved ones - the people in my life who make me happy and who are not toxic - for the first time in my life, I have good people in my life who want to take care of me and who love me.
-my job - I bitch about it, but it really is a great job
-the internet - I have a love/hate relationship but reading about other people's struggles with skin make me feel less alone.
-good music - always makes me feel better.
Now I'm going to buy some duoderm for my cyst (which is looking much better after being slathered in neosporin) and I resolve to use duoderm for every blemish to get me out of the habit of over treating, picking, exfoliating, so I can just cover it up and allow it to heal naturally. I read about this at the skinacea site which seems to be filled with good, realistic advice.
So the nightmare wasn't so bad. I am breathing easier today - deep breaths instead of the shallow breathing I do when I'm anxious. I feel a little embarrassed but fuck it - I really can't go back now. I don't think anyone has ever died from embarrassment, and what doesn't kill you makes you stronger, right?
Last night I had to go somewhere and I felt terrible. Make up over lumps looks awful, probably worse than without. I looked around me and felt like I was the only person with bad skin around.
Came home feeling horribly tired and the cyst that is lodged in my right cheek felt a bit inflamed.
Before I left for the night I took my normal regimen of supplements which included saw palmetto.
My latest theory is the saw palmetto is increasing my estrogen, not blocking it and causing estrogen dominance/progesterone deficiency. I hate the idea of taking supplements to take care of side effects of other supplements, but last night I felt like taking 1 vitex capsule was worth a shot. I fell asleep immediately and had the best sleep I've had in a long time. I woke up feeling better and the inflammation has subsided - not sure how much of it is due to the vitex, but when in doubt it's safe to say that a good night's sleep helps so many things.
That said, I'm not going to keep taking vitex. There is a real risk of overloading my body with it - and indeed, many people say that it works well for a few months and then it stops working, they breakout, they get horribly depressed, etc.
I'm worried about stopping saw palmetto completely, but until I can meet with a naturopath to discuss controlling the estrogen, I'd better slow down at least. So I'm thinking of doing it every 2 days or so. ORiginally, I wanted to use it just during TTOM, but when I saw how it reduced my oil, I became greedy and wanted more of it.
Also, I should note that I'm pretty certain I do not have PCOS. My periods have always been normal, no facial hair, not overweight, etc.. Was reading that Saw Palmetto isn't recommended for women with no PCOS.
Everything that I am reading is recommending the same advice: Low Glycemic diet, exercise, supplements (zinc, fish oil, etc), and stress relief.
I have known this for years but have resisted. I do like to juice, but I'll juice in the morning and eat at McDonalds for lunch. There is something very upsetting for me being told I can't have the junk food I love - I always hoped that I could supplement with juicing and vitamins and eat whatever I want. Also, I need to also get off my ass and exercise - not just walk around the block but make my heart beat faster and sweat. Sitting in front of my computer may be contributing to my acne more than I even realize
My boyfriend is staying over tonight and there is some trepidation there. If I'm honest with myself, all of this is because of my fear of growing up and having a grown up relationship and opening myself to getting hurt. Hiding this problem from him is not the answer. Pushing him away is not the answer.
Writing about it and obsessing over it isn't the answer either.
I feel better today and I look around at my apartment and see bandaids and compact mirrors and neosporin and make up and bottles of supplements and it's such a chaotic mess. I don't want to live like this anymore. I'm going to clean up, go outside for a while and try not to worry about it. No one is perfect. I don't know why I feel like I need to be.
I am done with acne. It gets better, I get complacent, and then it gets worse and I'm spending my precious free time on acne.org searching for an answer. I know my acne is caused by hormonal issues and I feel as I am so close to finally figuring it out. This blog is to help me figure out what the patterns with what's going on, and to relieve some of this stress. For the most part, I cover up my acne really well so no one knows how big of a problem it is for me. My boyfriend has perfect skin and can't understand. Meanwhile, the idea of living with him fills me with dread because then he'll see me without make up and I rarely leave the house without it.
I've had acne for over 20 years. In the last 5 years I have made huge discoveries that have improved my skin greatly:
1. Make up can cause acne - I have switched to Almay and don't get as many breakouts. I think going without make up is the ideal, but I am not there yet. I've tried Jane Iredale make up but can't tell yet if it helps or hurts because I suspect it causes noninflamed acne. Now that I'm broken out again I can't use it because it's too light coverage.
2. Zinc is fantastic for quelling inflammation. Zinc has healed cystic breakouts for me in the past
3. Retin A micro is good for resurfacing the skin and combined with 4% hydroquine, is fantastic for PIH. However, I believe retin a makes my skin oily so my plan is to use it only for PIH and once that is gone/reduced switch to BHA and AHA.
4. My skin loves BHA - it's great for the noninflamed acne.
5. Moisturizer is important - gotta use it everyday, even when I'm tempted not to.
6. Saw palmetto cleared up my bacne by 99%. It helps control the oil on my face too, although that isn't always consistent.
That is what I've learned thus far. Now here is where I am at:
A couple of weeks ago my skin looked great. Just some PIH that was clearing up. Despite my skin looking great, I feel anxious and sad. Then I get my period and a few days later, I get a cyst on my right cheek. I freak out. Then I start breaking out on my left cheek. I get a zit on my back. I feel inflammation coursing through my body. I am anxious and depressed and miserable. I take the in-case-of-emergency antibiotics I have stashed. I make an appointment with my dermatologist to discuss going on accutane. I feel massive pressure to get clear in time for the romantic trip I have coming up with my boyfriend.
Then my boyfriend has to cancel the trip. Immediately, I feel relief and the inflammation starts to go down. So obviously, my stress over my relationship and being around my boyfriend for an extended period is a huge factor. And that pains me because he's a wonderful person and I do want to live with him someday.
Now I'm left with a face that is healing okay. I'm pretty sure the cyst on the right will need to be excised because I think it's an old cyst from a couple of years ago. Definitely do not want it to flare up again. Fortunately, I was able to get a dermatologist appointment for that next week.
I'm wondering if I should try low dose accutane or continue to explore hormonal balancing solutions.
Here's the thing - saw palmetto has done so much for my body acne - it's practically gone. But I am leery because there is no consensus as to whether it blocks estrogen or adds estrogen. So I believe that by messing with my estrogen levels, it's had an effect on my anxiety and depression and that partly explains my cystic flare up last month after my period started. Usually, after my period my skin is clear. So something is off balance so I'm exploring supplementing with vitex to balance the estrogen and progesterone. But I'm really worried about messing around with my hormones any further.
That said I am not willing to stop saw palmetto because of the amazing difference it had on my body acne.
My plan is to drink green tea instead of coffee, get more exercise, continue to juice as often as possible, and take fish oil. I also have a skin tea that contains chasteberry so I may drink that daily too. Also, just left a message with a woman's health doctor since I'm on a wait list for a naturopathic clinic until January.
I have to say, I feel better knowing that I am actively doing something. It feels good to have a plan. I'm proud of myself for reaching out for professional help. I'm lucky I have health insurance - I shouldn't feel bad about using it.
My period should start in 2 weeks so I'm going to keep babying my skin and hope for the best.