Hi all,

This is my first post here and I'm looking for some advice.

I'm a 38 y/o female. Never had acne of any consequence (just some mild breakouts here and there) as a teen/young adult. In my mid 20's to mid 30's, my skin was pretty flawless (without much intervention from me)...to the point where I could go around wearing no makeup at all if I wanted to, and people would comment on how fantastic my skin was. I was always getting asked what my skincare regimen was. Truth be told, at that time in my life, I could put anything (I mean anything) on my face and not have a problem--any soaps, makeup, etc. were totally fine. In fact, I didn't always wash my face nightly to remove makeup and it still looked great. I guess I was totally spoiled.

Fast forward to about 3 years ago. It seemed like overnight, my skin took a downward turn. I started getting bumps that would 1) never turn into anything--just remain static, 2) develop into large, deep, painful cysts that lasted for months or 3) develop into small "whiteheads" that, in response to squeezing, would heal and turn into a reddish scar. My skin also took on a more "ruddy" look.

In response, I changed my skincare regimen several times based on some internet research. I got a little improvement, but not much. I also got vigilant about washing all my makeup off every night, stopped using a washcloth to stop the spread of bacteria, and frequently changed pillowcases for the same reason. I also got some advice from an esthitician who basically said it was likely a hormonal change and I just needed to adapt to the fact that my skin wasn't going to be perfect anymore. I didn't go to a derm because I felt a little foolish--it didn't really look "that bad".

I had sort of reluctantly resigned myself to the idea that this was my lot in life going forward...then about 2 months ago, I took a course of Augmentin for a sinus infection, and within about 72 hours, my skin had a complete and total turnaround. It was really unbelieveable--I almost cried! It literally cleared up every last bump and blemish. The texture of my skin improved dramatically. And then, about 72 hours after I was done with the Augmentin, it all came back.

I talked to my primary about this, and she prescribed me a cream (5% BP and 3% erythromycin). I tried it for a month and it did NOTHING. Zero, nada, zilch. I talked with her again, and she prescribed me a 30 day regimen of amoxicillin (500mg/d) and wants to see me in a month. I just started it yesterday.

OK--that was a long intro, but here are my questions. After doing some reading here and on other websites, it seems like I can't really stay on the amoxicillin long term...so what happens after that? Do people go on and then off again and again? Should I see a derm? My primary has been a little reluctant to give me a derm referral (I think she thinks we can solve this in her office). Are there other things I can do that I'm not already doing?

Thanks so much for reading, and thanks in advance for your help!