Hello,
i am male, 32 years old and i suffered from acne in my teenage years which i battled with accutane. In the last few years i have been getting more pimples and cysts. Now they dont heal anymore.
To make it easier for you, here a little chronogical order with all the important details which may be important for the evaluation:
- Asthma and Allergies since childhood. Daily inhalative corticosteroid since my very bad asthma attack in the year 2010 if i remember correctly.
- Sebhorreic dermatitis (scalp, face, body) since i was born.
- acne in teenage years. Treated with accutane in 2009 (15 years ago). Acne compeltely healed. I got pimples now and then but small ones and they dried out very fast in the beginning years after accutane.
- Sebhorreic dermatitis stayed but not as worse as in my childhood anymore.
- In the last years pimples returned more and more but not really acne anymore but also not as good as right after my accutane therpay anymore.
- In summer 2018 my astham got worse. Chronic coughing developed.
- In 2020 it got even worse with the breathing. Therefore my dosis of my inhaler got increased from 250 to 1.000 micrograms per day (fluticason proproniat).
I got my first pneumonia in summer 2020 and i was treated with antibiotics for 3 weeks!
- The coughing didnt end over the next years and i was diagnosed with ABPA (allergic bronchopulmonary aspergillosis) after a lot of tests. Over the years i had to take an anti fungal medication and cortison tablets twice i think. Another antibiotic therapy in the beginning of 2021. In october 2022 i got my second pneumonia and again was treated with antibiotics, this time in the hospital to see if i had tuberculosis but it was negatif. In mai 2023 the third pneumonia and again antibiotics. I had to do an bronchoscopy in june and was diagnosed with 2 bacterias, one of them was pseudomonas aeruginosa. I had to take an antibiotic against the pseudomonas but i made an allergic shock and landed in the hospital were i was treated against the allergic shock and i was getting another antibiotic trough the veins to battle the bacteria. After 2 weeks in the hospital i got another infection 1 week after my stay there with again all the symptoms like usual: fever, pain and chills. I got a antibiotic for 3 days and cortison for 4 days. ANother bronchoscopy in september 2023 and the two bacterias were not found anymore. Unfortunately an atypic mycobacteria was found but not tread as of now.
-My coughing which started in summer 2018, ended in september 2023 which is a good thing an for one year i havent had any new pneumonia infection with symptoms.
- Since 2020 ive gotten more and more thick and painful inflammed pimples deep under the skin. It took sometimes 1-2 months for them to completely heal. Sometimes the pus came out and they heald, sometimes they healed under the skin. Sometimes a dark mark stayed, sometimes even a scar (dark brown red circle with white filling) or even an hypertrophic scar. So more and more cysts developped.
- In April 2024 i got a huge cyst on my forehead and it got so big, half of my forehead was huge and inflammed, like i had a huge tumor in my forehead. It got smaller over time but still to this day it hasnt completely gone away and i still can see a bump which is very hard when i touch it. So that was the first cyst that didnt completely heal.
- Now in august 2024 i got another cysts who are still there. I have 2 more big cysts since 1 month and they dont seem to go away, also on my forehead. And to make it worse, another big cyst on my forehead developped, it was there as little bumpb for 2 weeks until it suddenly got huge. I got another new on my cheek and another is developping on the forehead. Besides all of the other ones.
- So i have been getting these cysts since 4 years now, maybe even before but then they heald within 1 week and never got too big. Now they get huge, deep under the skin and they take 1-2 months to heald and now there are a lot of them which dont heal anymore and a hard thick bump stays on there. The pain and swelling around them vanishes but the hard thick bump stays.
I was a the dermatologist and she gave me epiduo forte fr the cysts. But for example: i treated the cysts every day for 1 month now but they dont go away completely.
I dont know why i get these huge cysts now and it is getting worse and worse. I tought about the coritcosteroid inhaler which may be the cause and the increased dosis or maybe my diet? Or all the antibiotics i had to take over the last years or my chronic lung disease?
I also can add photos if you would like to see how the cysts look. But i am getting desperate and my mental health is suffering a lot because of it. My forehead is now covered with thick hard bumps and new ones are coming. I also go a thick cys on my chest since few weeks i think.
Could you give me any advice or ideas what to try or do?
Sorry for my english (i am not a native speaker) and the long text, i wanted to keep it as short as possible.
I dont know why i get these huge cysts now and it is getting worse and worse. I tought about the coritcosteroid inhaler which may be the cause and the increased dosis or maybe my diet? Or all the antibiotics i had to take over the last years or my chronic lung disease?
Long-term use of corticosteroid inhalers can lead to weakening of the immune system and can potentially lead to acne as well. So I do wonder if that could be part of the issue.
As far as antibiotics go, that's one of those unknowns. We don't know exactly how the microbiome and acne are intertwined.
As far as diet goes, yes, I do think that impacts things. But I also wonder if the best diet in the world can combat something as strong as chronic corticosteroid use. If you want to go all in on diet, research "carnivore diet". A lot of people use carnivore diet to handle chronic illness, particularly auto-immune illness.
What's kinda interesting is that you don't have acne you say, just cysts. Am I understanding that correctly? It sounds really awful, so there's gotta be a way to get you back to not getting those.
I always think it's a really good idea to see multiple doctors as well and see if you can get a second or third opinion on what might be going on.
I dont know why i get these huge cysts now and it is getting worse and worse. I tought about the coritcosteroid inhaler which may be the cause and the increased dosis or maybe my diet? Or all the antibiotics i had to take over the last years or my chronic lung disease?
Long-term use of corticosteroid inhalers can lead to weakening of the immune system and can potentially lead to acne as well. So I do wonder if that could be part of the issue.
As far as antibiotics go, that's one of those unknowns. We don't know exactly how the microbiome and acne are intertwined.
As far as diet goes, yes, I do think that impacts things. But I also wonder if the best diet in the world can combat something as strong as chronic corticosteroid use. If you want to go all in on diet, research "carnivore diet". A lot of people use carnivore diet to handle chronic illness, particularly auto-immune illness.
What's kinda interesting is that you don't have acne you say, just cysts. Am I understanding that correctly? It sounds really awful, so there's gotta be a way to get you back to not getting those.
I always think it's a really good idea to see multiple doctors as well and see if you can get a second or third opinion on what might be going on.
Hello Dan,
thank you for your response.
Yes i know long-term use of the inhaled corticosteroid is not ideal but i cant stop with it as my asthma is chronic. I just thought about asking my pneumologist if it may be possible to reduce the dosis as i am now stable since 1 year without any new noticeable infection, coughing or any other severe symptoms like fever, pain or chills. Last time she said that my dosis will remain the same for the moment because it is now under control. I also have to make another few checks like blood testing and a new CT Scan to see how it looks like (the ABPA and the mycobacteria gordonae). But i think i will ask her next time if it is possible to reduce the corticosteroid. 2 years ago my DHEA-S blood level was under the normal level. My doctor and my pneumologist said that this is because the inhaled corticosteroid goes partially into the blood stream. But it wasnt checked anymore since then. I also am constantly tired, my sleep isnt that good anymore for years, also my digestion has changed. I always have the impression it all could be side effects from the medicine but doctors never really take notice of it and always search otherwise. Since i got the allergic shock from the fluorchinolon antibiotic, i have become more sceptical about these side effects or reactions. The antifungal medicine (voriconazole) that i had to take 3 times within the last years were also hard with severe side effects but these stopped when i finished with them.
My last antibiotic intake was 1 year ago now.
I already have heard about the carnivore diet but ive never read more details about it. I will search for it. I know that i never ate dairy products or rarely in my teenage years and it didnt effect my acne. SInce 2018 i reintroduced dairy beauce i did work out at the studio for 5-6 years. I noticed more pimples but before i also had them regularly. I am eating a lot of nuts like cashews for 10 years now but i am not sure if this is a problem. I cut out bread for years but reintroduced it few years ago.
I also have pimples with pus coming out but not as much as i had in my teenage years. I dont know when to call it acne or not. My pneumologist said it looks like acne (but she meant the cysts on my face). But yes i do also get pimples with pus, smaller or bigger, sometimes even breakouts on few places. But now i am getting more cysts as normal pimples which is really horrifying as they dont really heal anymore. I am happy about every cyst that heals on its own but right now i have the feeling they all stay. I put epiduo forte on them but i dont know if it is helping that much. For example, since my last post i got 2 new cysts on my forehead, 1 on my temple and 2 next to/on my nose. Is is really frustrating as it gets worse and worse and it does not heal on its own anymore.
I am looking to also go to another doctor as you were suggesting and will see what he is thinking about it.
Thanks.
Yeah, read about carnivore diet. I can't say that it is the cure-all, but I did it myself for a few months and absolutely loved it. Many, many people online talk about how it fixes their auto-immune diseases when nothing else ever did. I don't know if what you have is auto-immune or if carnivore would fix it, but it's worth looking into I would say. You want to do it all under the care of docs and stuff but it's cool.
From my own experience I just felt healed when I was on it. It could be placebo somewhat, but I just felt like it healed stuff. I could work out for a long time without getting sore, my joints felt better, my mood was even, I had some ringing in my ears that stopped, and I have like 10 other things that I wrote down somewhere lol.
Long story short, carnivore heals. That's what most people experience at least.