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Hello,
male, 30 here and since February this year I've been battling ongoing cystic and nodular acne.
It started off at one side of my cheek as a small inflamed pimple that eventually became huge like a volcano and popped out.
I did the mistake of not going to a dermatologist and began picking on it as it was itchy all the time while relying on OTC products to cure it however it kept getting worse to the point where part of my cheek looked like I was a burn victim.
In March I decided to pay a visit and the doc prescribed me Zineryt (Erythromicin and Zinc) in combination with oral antibiotics for 10 days.
After using the Zineryt for a month another one appeared on the same side, so we switched to Acnatac (Clindamyin + Tretinoin 0.025%) in combination with taking Isotretinoin 20mg pills 2 times a week for 3 months now and my last check-up was a week ago. Since Acnatac shouldn't be used for more than 3 months and my progress was good, she prescribed me Zineryt again to finish them off.
Finally after seeing the light at the end of the tunnel and getting my hopes up again having only scars on my face, just one day after visiting the doc, this monster appeared out of the blue, this time on my other cheek. It started off as a reddish inflamed spot with a hard dot that I could feel beneath my skin and it's now this.
The circled area all feels soft and swollen and when I look down I can feel its heaviness like it's hanging.
It heavily reminds me of how this all began and I'm really scared I'm gonna have to go through this all over again.
So far I've just been using the Zineryt and have been applying ice with a cloth to the area and I think it kind of may have calmed down the swelling, however it's now trying to come outside as a giant pimple.
Is it a good idea to pay another visit this Monday and ask if the doc can prescribe me oral antibiotics again just in case? Should I ask for tretinoin again to be prescribed this time with higher strength?
My routine for the past 3 months was:
AM:
Avene Cleanance cleansing gel
Avene Cleanance Hydra moisturiser
Avene Ultra Fluid Oil Control sunscreen
PM:
Avene Cleanance cleansing gel
Acnatac
You're on low-dose isotretinoin for 3 months now so it somewhat surprises me that you're still getting these, but then again, you're on low-dose and it's just been 3 months. Probably things will continue to calm down as your cumulative dose increases. 2 questions though: Is this your first time on isotretinoin? When you take it are you taking it with an adequate amount of fat?
Other than that, I wonder if you went hardcore on diet if that could help. You're 30 and dealing with this kind of cystic stuff, and it makes me wonder if an experiment with diet might be something interesting to try if the isotretinoin doesn't deliver complete remission. Ever tried carnivore diet? I'm not saying for sure that's the magic bullet, but it is a complete elimination diet and has no carbs, and could be interesting to see if it could be a tool for you.