I thought I would start a log here...after looking around a bit I haven't found any threads that quite match my situation, maybe this will help someone else in their journey!

So, I am a 36 year old woman, and have suffered from hormonal acne since I was a teen.  When I first started getting acne as a kid, it was always around my nose...there are pictures of me at 16 in France, looking miserable because the entire tip of my nose was an enormous, painful zit.  As I got older, the acne around my nose cleared up, although the pores are quite large and there is permanent scarring in the folds on either side of my nose.  

In college and onward, the acne migrated to my chin, where it has been concentrated for many years.  For a long time I suffered from enormous and painful cystic acne...the kind that you can feel coming from a mile off, and that linger for a month.  One time I went to the dermatologist with a particularly heinous zit on my chin, and when they cut it open to extract it, they said there was actually multiple zits within the one, a phenomenon I have since "lovingly" dubbed "megazit".  

In terms of treatments, I have tried everything...birth control (different kinds, finally gave up because it makes me feel crazy), antibiotics, countless creams, extractions, you name it.  In recent years I have been using Ziana topically and Spironolactone, which has helped a lot.  I still get zits on my chin, but they are often smaller than they used to be, and they go away faster.  Still, almost every tiny zit I get on my chin scars, and while the Spiro helped, it never quite got me clear.  It's also been frustrating, since higher doses of Spiro work better for my skin, but once I get into those higher levels, my period starts coming every two weeks...basically a never ending cycle of PMS and period with no relief.  UGH.

After going to my derm for years and trying many different things, she finally suggested Accutane.  I was shocked since I thought this was something for more extreme cases, but I guess having battled hormonal acne for 22 years straight qualifies as extreme.  I just started my first dose today, and I finished my last Spironolactone pill about three days ago.  My derm seems to think that I won't have a big skin purging due to having been on Spiro for so long, but I have a feeling there is a lot of gunk that needs to be purged in my chin, so we shall see.  I have also noticed in recent months more little spots on my forehead and cheeks, but they are small enough that I haven't paid much attention to them.  As of this very moment I don't really have anything going on acne wise, but wait a week until I'm PMSing and then we'll see!  :/

For products, I have been using almost exclusively Cerave products for a few years now, so hopefully they will serve me well in the coming months.