Hi, I'm 24 and have experienced what my GP described as moderate to severe acne for a few years now. The most problematic parts of it have been those small leaky cysts (almost always on my cheeks and/or chin), with the whole thing exasperated by the fact I'm a life long compulsive picker. 

I've been on Lymecycline and adapalene gel since around March 2015, with a dermatologist doubling my Lymecycline dose from 408mg to 816mg per day earlier this year. These help, but not completely. My dermatologist won't put me on roaccutane because of my mental health (depression & C-PTSD) which is fair enough, but still disheartening. I'm 24 so I'm at an age where most of my friends are getting over their acne, but mine's still grumbling along.

I'm working on picking/dietary/lifestyle causes; trying to cut down on dairy, carbs, sugar and smoking. I now only wear make up if I'm going out to dinner or the club or something (maybe once a week). My picking habits and skin have improved massively since getting acrylic nails put on, but it's still nowhere near clear and there are still a lot of scars/hyperpigmentation (?) that I'd like to clear.

I've attached a photo of the section of my face doing the worst atm. The big red spot high up on my cheek was a cyst that I picked (naughty, but I'm trying!) and I feel like there were multiple heads/pockets of pus within it that went quite deep down into my skin. I'll usually have around two of these at any one time; a lot of the marks left on my face are from old cysts. I've seen you give some really good advice to other people on here, so any help or advice you have for me would be hugely appreciated. Thank you 

9 hours ago, HollyH said:

Hi, I'm 24 and have experienced what my GP described as moderate to severe acne for a few years now. The most problematic parts of it have been those small leaky cysts (almost always on my cheeks and/or chin), with the whole thing exasperated by the fact I'm a life long compulsive picker. 

I've been on Lymecycline and adapalene gel since around March 2015, with a dermatologist doubling my Lymecycline dose from 408mg to 816mg per day earlier this year. These help, but not completely. My dermatologist won't put me on roaccutane because of my mental health (depression & C-PTSD) which is fair enough, but still disheartening. I'm 24 so I'm at an age where most of my friends are getting over their acne, but mine's still grumbling along.

I'm working on picking/dietary/lifestyle causes; trying to cut down on dairy, carbs, sugar and smoking. I now only wear make up if I'm going out to dinner or the club or something (maybe once a week). My picking habits and skin have improved massively since getting acrylic nails put on, but it's still nowhere near clear and there are still a lot of scars/hyperpigmentation (?) that I'd like to clear.

I've attached a photo of the section of my face doing the worst atm. The big red spot high up on my cheek was a cyst that I picked (naughty, but I'm trying!) and I feel like there were multiple heads/pockets of pus within it that went quite deep down into my skin. I'll usually have around two of these at any one time; a lot of the marks left on my face are from old cysts. I've seen you give some really good advice to other people on here, so any help or advice you have for me would be hugely appreciated. Thank you 
 

Thanks for replying and sharing. 

Do you have acne anywhere else? What is the extent of your lifestyle modifications (how strict were you on cutting down carbs; what is your smoking history)? Any history of PCOS or in the females in your family? What is acne like in your family? Did you start your period early, normal, or late compared to your friends? What is the timing of your acne (constant, comes and goes [how often?])? When you get a pimple does it look like the one to the bottom-left of the cyst you picked or whtat do they look like?

11 hours ago, 99f said:

Thanks for replying and sharing.

Do you have acne anywhere else? What is the extent of your lifestyle modifications (how strict were you on cutting down carbs; what is your smoking history)? Any history of PCOS or in the females in your family? What is acne like in your family? Did you start your period early, normal, or late compared to your friends? What is the timing of your acne (constant, comes and goes [how often?])? When you get a pimple does it look like the one to the bottom-left of the cyst you picked or whtat do they look like?

Thanks for your response!
I very occasionally get acne on my scalp, but these usually aren't noticeable and I don't look for them or mind them at the moment because my nails make it impossible to pick.
I've been completely vegan before for six months and it didn't make a difference to my acne. Have tried low and no carb diets for weight loss and they're really not for me, I'd be looking into cutting out gluten specifically to see if there was any sort of intolerance, but I wouldn't be able to let carbs go completely hahahah. I've smoked cigarettes on and off for the past nine years or so, I currently don't smoke cigarettes.
I've been very lucky as there is no history of PCOS in my family, or any other chronic long term physical health conditions. However I'm also the only one in my family with acne, so it could all start going downhill here (I'm also the only person who suffers from hayfever, weirdly). My mum and her sister have oily skin and get the occasional spot, but other than that have very good skin and are ageing really beautifully.
I'm not sure when my friends started their periods but I know I started mine a year younger than my mum and the other women in our family started theirs. I get fairly consistent acne, except for one point in the first few days of my period where I'll have no active pimples whatsoever. It's a bit strange because I think in some ways I'm very sensitive to hormones (it means I can't use hormonal contraception for acne or birth control because it's too detrimental to my mental health), but I don't get a BIG PMS flare up of acne like some women do.
The pimples I get do look like the ones to the bottom left of the picked cyst; they're like that or smaller/less bothersome. They're all fairly normal, come to a head, can be popped when they're ready, and heal up just fine.

Thanks again so much for your time, it's really appreciated!

Dont pick please,simply do not pick ever again.you will scar your face and end up wishing you never picked so dont pick ever,let your skin deal with the cyst.

get on the right oral anti biotics and topicals and moisturiser.

your crying now for spots,you be crying for scars and scars dont heal themselves and are harder to treat.

so stop! Dont pick or pop!

Scalp acne points me towards demodex - please read up on them. They can be treated with topicals and/or oral Rx