Hi Tom, I'm so sorry to hear about that. It's horrible to have to go through something and to feel like the 'miracle cure' of Accutane didn't work. What exactly did your dermatologist say after the accutane failed? Did he give no other option or hope?

The fact that accutane literally had absolutely no effect is slightly unusual...have you ever had an allergy test? It may literally be something as having a severe reaction to a soap, detergant, certain fabric in clothes which would explain why Accutane didn't rid it entirely -- and also why a paleo diet wouldn't effect it. I mean, if it's something that's physically touching your skin constantly, nothing will help it unless you diminish the culprit. If not, I'm not the most knowledgeable in this field however, are there any laser treatments you could perhaps have or invest towards?

I really really hope we can figure this out for you! But I'm sure there are so many people here who will be able to give better suggestions than myself.

Dude I know how you feel, although mine is not as sever are yours , its been close. Ive fought this for 15yrs or better, sometimes its worse, other times is dies down.but never completely goes away. Recently I got a jock itch from hell and went to see my GP. We tried the topical stuff first but it wouldnt kick it. Then he gave me an Oral Anti-fungal (Fluconazole ) that finally did the trick. The reason I mention this is because my Back almost completely cleared up. I asked if I could stay on the Anti-Fungal for a few more weeks until everything was cleared up but he refused. Instead sent me to a Dermatologist. The Derm Dr wanted to put me on Accutane and I tried to explain what had happened. I said no to the Accutane, so instead they put me on a Anti-biotic. Now Im about 2 months into the antibiotics and Im almost back to where I started. IDIOTS. Originally this was all on my back, but this time its spread to my buttocks. Im so pissed off and frustrated I cant even begin to tell you, but Im sure you understand. I told this moron what had happened with the Antifungal and he completely ignored me like I didnt even know what was going on with my own body.

Once I realized this was more fungal than bacterial I started using the Nizoral shampoo with moderate results. Maybe Im not letting it sit long enough, I dont know. Ive read a few things here over the last week and Im gonna try the Selson Blue and Tea Tree Oil. Ive been doing some reading about fungal issues and a lot of people refer to Candida Yeast. Now from what I understand, Candida is a bitch to get rid of since it normally resides in us naturally. Problem is it runs amuck when there is an imbalance and this can be caused from antibiotics. Now Ive tried approaching the acne from the Candida angle before with no luck. Tried Candida cleanse and other related stuff, again with zero results. AlsoIve tried every over the counter Acne Body Wash out there..no luck.BP no luck (helps it dry up after the fact)..prescription Topical Acne Meds.no luck..actually, everything over the counter Ive tried with no results.

So thats all I can share nowwill keep you posted if the Selson Blue and Tea Tree Oil produce anything positive.

I really really feel for you, its so hard when even the medical proffessionals dont seem to know what they are doing!!! I had cystic acne for ten years or more, accutane did work, but as soon ad i stopped taking it, it came back and i was left with all the really lovely side effects of the drug! Did you know that it is banned in other countries??! Its a debilitating drug, im actually pleased you didnt stay on it! Xx i have completely changed my diet and suppliment with a whole food suppliment, my skin has totally cleared up! Im still at the mercy of my hormones once a month and get one or two cystic spots ! Also, ive slipped on my diet, the cyst spots come back, so its tried and tested! Feel free to add me on fb if you need any help xxx rebecca botham

It absolutely sounds like your acne is fungal and not bacterial. Trunk/back cystic acne that doesn't spread to the face almost always is. Derms always assume it's bacterial, for some reason.

Test out your theory with some some Lotrimin Ultra cream. It's more likely that the infection is Malassezia fungi than it is Candida. Candida acne tends to look rather more rash-like than cystic. Lotrimin Ultra is the only OTC cream sold in the US that effectively treats malassezia-induced skin conditions. Start using a climbazole-based OTC shampoo as a body wash and look for Climbazole powders. A cleanser that people with fungal skin disorders have seen great results with is Head & Shoulders shampoo. You wash your whole body and hair with it in the shower and let it sit on the skin for 3-5 minutes before washing it off. Take tea tree oil baths and add some epsom salts in as well. Other great natural anti-fungals: grapefruit seed extract, oregano oil, garlic, olive leaf oil, and cloves. Natural Xylitol powder is also great for stopping the spreading of yeast. It can be dissolved 50/50 in water and added to any shampoo, body wash, or cleanser--even toothpaste, as it's edible.

Add some very high potency probiotics (60-90 billion cultures) to your regimen and/or Threelac--because you need healthy flora inside and out to fight off any kind of fungal infection in the long-term. And try to cut out as much yeast and sugar from your diet as possible until you get the fungal infection under control.

Lose the BP and other topical antibiotics. Healthy skin has natural good flora on its surface that kills the bad stuff. Loading up our skin for long periods of time with topical antibiotics does to our skin what oral antibiotics do to our gut. Replenish the natural flora on your skin's surface with topical probiotics. You can make a cream/mask at home very simply. Just break open a capsule or two of high-potency probiotics and add it to some greek yogurt or kefir and spread it all over your back, legs, and other affected areas after a shower.

If you do go on an oral anti-fungal like Fluconazole or Nizoral, your doctor needs to be monitoring your liver enzymes--this is very important.

It very well may be fungal. I would get a second or even a third opinion from a different derm. It's not always good to self medicate but I also know that there are a ton of incompetent derms out there. I'm really sorry that you're going through this. You can try washing with Nizoral shampoo to see how that goes. It has anti-fungal ingredients in it. But since it's merely a wash, I do not think it will be the answer to your skin troubles. You probably will need a medication that will absorb into the skin and treat the infection.

Keep your chin up and keep us posted!

hey,sorry for your plight.the only treatment I know will work for you is taking broad spectrum antibiotics that cover skin like cephalosporins- duricef keflex vantin ceclor cedax ceftin spectracef velosef.most importantly take each dose of antibiotic DIRECTLY with 600 mg of ibuprofen generally they come in 200 mg make sure and check dosage for a total of 1200mg a day with 2 doses of antibiotic.this will really knock out your acne good until you develop resistance to the anntibiotic youre using then immediately switch.you can also rotate these antibiotics on a 2 week basis to help avoid that if your dr is on the ball and understanding.when everything clears u can try 800 mg a day of ibuprofen but 1200 is safe as long as you arent on blood thinning meds. check with primary dr of concerns if taking other prescriptions.good luck trust me this will help immensely. btw bactrim the antimicrobial can also be used instead of cephalosporins but plenty of side effects usually