I have ready a study of relapses after accutane where women who had Pcos were more likely to relapse

hmm interesting, but I don't have pcos. When I lived in Texas, a derm gave me spiro and that did help. It didn't help as much as accutane, but I did see a difference and improvement in my skin, but my doctors I have had in cali always say spiro is only for patients who have PCOS. Every derm through out the years tells me something different, but I really wonder why some people have long lasting success with accutane and some don't.

Hey ninergirl,

Let me start by saying I am in no position to give you advice on Accutane, as although I have been recommend it multiple times by separate dermatologists, and even told it is the "only option" for me, I have always refused it. In my darkest moments I have defiantly considered it but for me personally, the cons outweighed the pros.

I am also in no position to preach, as I know that acne is a very personal battle and that every sufferer will make their own decisions. So please feel free to disregard my thoughts and I wish you the very best of luck in your acne treatment!

My first thought when I read your post was that no acne treatment should be given a fourth chance to work, especially not a drug as serious as Accutane. I am also truly alarmed that your doctor/derm would advise you to go back on Accutane after such a short period of time and after 3 previous failed attempts. I know that sometimes acne can feel like a bottomless pit that you can never climb out of, and so if a doctor tells you "this will work" you have no choice but to trust them and do as they say, but my personal experience of doctors and derms is that they rarely have any answers apart from Accutane, retinols and benzoyl peroxide. Now, if these treatments worked for everyone, acne wouldn't be a problem.

I want to suggest that before you decide to attempt your 4th round of Accutane, consider the possibility that there is something out of balance in your body and that your acne is your body's way for screaming for help, and that going on Accutane may not be the care it needs.

I am by no means suggesting that you should not go back on Accutane if you feel that it is what you want to do. But consider that you may be in this exact same position next year or the year after and it may be worth attempting something else first.

You say you eat healthily and you exercise. Which is fantastic! But if you would be interested, and feel comfortable discussing it I would love to know what your typical days food looks like and what kind of skincare regimen you follow so I can attempt to give you a little bit of advice before you take the leap!

Best wishes,

J

I agree with Jlopez 100%. I am a three time user of accutane and had started a fourth course last September to end up in the emergency room with high liver enzymes a month in. That did it for me. Accutane most likely will not help to cure your acne. I agree that you should post your diet to see if tweeks can be made. I have done the gamet of paleo, gluten and dairy free and my acne still sucks so I'm not saying it's going to be your solution but it's definitely worth a try.

I am a teacher too and I'm 31 so I know how much anxiety being in the professional world and having acne can cause. If topical so are not working, it may be helpful to visit a naturopath that can guide you. Also, get a skin care regimen that will support what you're doing on the inside. It is sometimes not easy for many of us to fix our insides as many would have us believe as acne can be caused by many factors and only addressing one of these factors may not bring the results we seek.

If you ever need to chat from one teacher to another/one accutane user to another, feel free to PM me.

Good Luck!

Hi JLopez. I appreciate your response. Its always good to hear different perspectives especially from people who have had their own personal struggles with acne as well. Well I don't have a specific diet I follow. I eat a lot of protein and healthy carbs like sweet potatoes. I don't really ever drink milk. The only dairy I intake is probiotic organic yogurt. The proteins I eat are egg whites, grilled chicken, and farm salmon. I will eat rice , Quinoa. I love sushi as in real sushi just the raw fish, but I don't eat it daily. I eat it maybe once every couple of months. I do drink coffee in the morning but usually just one cup and sometimes have an occasional diet soda. I gave up soda and caffeine for a long time as in years and I saw no difference in my skin. My favorite veggies are carrots, and broccoli. I also love fruit. I eat a ton of fruit based on whatever is in season. I do truly believe acne and what products they use affects everyone different and we all have different regimes that may or may not work. I believe what will work for one person may not work for someone else because their skin is different. Guess not all acne is treated the same or equally. I guess for me the hard part for myself is believing it is diet that is causing my acne and horribly oily skin. Not that I don't think it doesn't mean thats true for others, or maybe I just haven't found what food is causing it, but obesity runs in my dads family and I have some severely obese family members who have the most amazing skin like porcelain. They never had to deal with acne, yet they eat like crap. I was pretty much vegan in college and I would say that is when my skin was at its worst. I also use face reality skin care and do go to them and they have helped me greatly you can google to find more about the company. They have helped me I guess get my skin under control as the founder is a dermatologist and is not a believer in popping pills for acne. So I use their sensitive skin face wash, and gentle toner, and I use mandelic acid every morning and night and I have to say that is the one gem I found in all these years and still can't believe more acne sufferers don't know about it and why don't derms know more about it. I believe it is very similar to salcyci acid which has never done much for me and made me break out more and red, but I don't have sensitive skin, any ways I was told it is much more stronger than salycic acid, but not so strong that its harsh on your skin but helps your skin shed faster to keep skin clear of debris and oily and purge of the current ones much faster. That being said I feel like in some ways the way my skin is now they see it as being "clear" but to me having to blot my face after 30 minutes of washing my face and then continue to do so through the day at 36 years old and having deep closed comedones all over my chin and jaw and cheeks that never come to head, but can see the holes of where they are if that makes sense......to me means I don't have clear skin...lol And again they too tell me like every one else that I am lucky I won't age with oily skin, but its not "normal" to have an oil slick face at age 36. Ill take wrinkles any day over an oil slick face. Again I know I will never have perfect skin I just want improved skin and less oil. I feel like I will be 80 and super oily still...lol I just want some oil reduction gosh that would be amazing. I am totally open to suggestions and really appreciate the advice. And I get so much mixed information about accutane its all so confusing to know whats true and whats not. I mean i have even had different derms tell me different things just so frustrating and the other part of me feels like there will never be a "cure" for acne do you know how fast the dermatology department stands to lose and insurance companies if there was a cure for acne??? And all the over the counter brands how much money they would lose if there was no need to get customers to keep buying the latest and newest so called help acne cleanser, medication, etc. Any ways I digress. Any tips or advice I am very open.

Hi Leelowe1: Thank you too for the advice and support!! I really appreciate it! I have to say I am very envious of people who I know have the most amazing confidence and have acne. I look at them and want to be like that because I know logically its just skin and life could be a lot worse, but it definitely prevents me from doing things in social situations because I am worried about how my skin looks instead of enjoying time with others. Its also great to meet another teacher! I feel like I am always the only teacher with acne that I am that teacher with the bad skin at whatever school I work at

Hi Ninergirl,

Okay prepare for a big post!

Frankly your diet sounds great, and although I am a firm believer in experimenting with elimination diets, I also know from personal experience that eliminating food groups can be damaging to people who are a little obsessive, as it can lead to eating disorders. Therefore I am cautious to recommend eliminating food but the unfortunate truth is that people often have food sensitivities they are unaware of and these sensitivities can lead to acne.

It is very possible that dairy or caffeine do not cause your acne, as I don't believe that any acne triggers, even the commonly known ones, are universal. A couple of things that come to mind in terms of diet are:

1. If you have the funds you could consider a food allergy test. I believe they are fairly inexpensive and will give you a comprehensive list of things you have a sensitivity to. Even things like broccoli or rice, for example, could be causing a sensitive reaction, as everyones body is different. This also avoids the necessity for you to undergo any strict elimination diet which may cause further problems. A side note: I believe although eliminating food sesitivities is key, it is important to remember that when battling acne you must be ADDING nutrition, not taking it away.

2. I do not believe you have mentioned gluten in your diet plan. Do you actively a avoid all gluten? If not I would highly recommend experimenting for at least 2 weeks with complete gluten elimination. The single factor which has improved my skin condition the most was the elimination of all gluten. It has taken a long time (upward of 5 months) for my gut to begin truely healing, but my skin has improved slowly and consistently from day one. I must add here that having a "little bit of gluten" every now and then is not going to allow this elimination to work. As if you have a sensitivity, each time you ingest gluten, you run the risk of being back to square one, as even a small amount of gluten can cause serious inflammation in the gut.

Check out this article which lead me to my gluten-free diet: http://www.huffingtonpost.com/maura-henninger-nd/gluten-and-acne_b_2601648.html

3. It may also be worth trying a candida cleanse, as candida in the gut can be a huge cause of acne. It is essentially caused by excess sugar and starches which feed the candida in the gut. Even seemingly healthy foods such as salmon and sweet potatoes can cause candida. This diet could be done in conjunction with or as a kickstart to a gluten elimination diet. As you only need to candida cleanse for 7 days.

Here is a website with some helpful information on candida and candida cleanse recipes: http://www.thecandidadiet.com/cleansing.htm

4. You say you have family with porcelain skin who can eat whatever they want. I can strongly empathise with you here, as all my siblings have beautifully clear skin and neither of my parents ever had a problem with acne. They eat what they want, cakes, coffee, pizza, you name it, sleep in their makeup(!) All the things I used to dream of doing. But the truth is that, although it can feel like a punishment that we cannot do the same, acne may be a blessing in disguise for some, as it is our bodies way of telling us that we have an imbalance and we are suffering from chronic inflammation. The choice we have, as I see it, is to feel bitter and cheated that we cannot eat what we want, or somehow thankful that acne has given us a reason to try with all our might to be healthy. I have never been as healthy as I am now, and it's all thanks to my acne. Let me give an example: I was clearly suffering from a gluten intolerance, and this made itself present on my face for me to look at every day and get frustrated and cry about, so after all the drugs and the prescriptions failed me, I fought with everything I had to get to the bottom of it holistically, and no my skin is not perfect, but I exercise and I meditate and I eat good, nutritious foods. If my gluten intolerance had not given me the acne on my face as a window to my health, I may have continued to suffer inflammation inside my body that eventually lead to something much worse, such as an autoimmune disease.

5. As far as skincare goes, I know how easy it is to get attached to a skincare routine and believe that it is working for you but there is always a chance that it is causing problems. I checked out your skincare regimen online and some things to note are:

Your cleanser contains Ammonium Lauryl Sulfate which is essentially soap, which specifically aggravates acne by increasing oil production. These foaming agents which leave the skin feeling refreshingly clean immediately after, lead to your struggling skin massively overproducing oil after washing to compensate for the natural oils you have stripped away. It also contains a number of irritating chemicals, alcohol, some water, and Butylene Glycol which is a pore clogging ingredient.

Your toner is mostly ok in terms of being none irritating and appears to be alcohol free, except it contains some more unnecessary irritants, including Phenocyethanol which is a sister of the paraben family, and there have been a number of studies showing its toxicity. It also contains Tetrasodium EDTA which has been shown to be a skin irritant in animal test studies.

I don't know enough about Mandelic Acid as an acne fighting ingredient as I don't know what kind of formula you are using, and I can't tell you to stop using something you love so much! But just to offer a different perspective, I know in my case excessive chemical exfoliation, which is what you are getting a lot of with the Mandelic Acid, caused my skin texture to be poor. It works for some people but not for others. I personally have very sensitive and stripped skin, and found that over exfoliating my skin with chemical exfoliants was causing massive irritation and oil production.

Also, on moisturising, you haven't mentioned any form of moisturiser here. Skin which has no moisture on its surface, because it has been stripped away by soaps and chemicals, overproduced oil to protect itself. I won't go any further on skincare as I know you may want to disregard this information and continue with the skincare you have been using, as you seem to think it is working for you, which is great! However, if you would be interested in a different approach please let me know and I can make some suggestions as to products that might help you out and some further reading!

Hopefully some of that has been helpful in some way, and please let me know if you would be interested in any more help and I would love to give you some more suggestions. Best of luck!

Hi Jlopez! Thank you! very informative! I have always thought of going gluten free, but it concerns me how fattening all the gluten free foods are. I feel like not all but many gluten free foods substitute gluten for fat...lol But I try to stay away from breads as i am true believer I am a carb addict...lol Its not good for the waist line and I just can eat and eat so i did switch to gluten free bread when i want a sandwhich or toast. I feel like I don't get those crazy carb cravings where I want to keep eating it even though Im full. I use physicians formula bb cream. I use the smallest amount. Its the one moisturizer that doesn't make me super oily and seems to still moisturize my skin and actually does what it says and even my skin out, but not sure whats in the ingredients. If you have any suggestions let me know. Thank you very much your feed back was super helpful and insightful and may take the plunge and go gluten free!

Hi Jlopez! Thank you! very informative! I have always thought of going gluten free, but it concerns me how fattening all the gluten free foods are. I feel like not all but many gluten free foods substitute gluten for fat...lol But I try to stay away from breads as i am true believer I am a carb addict...lol Its not good for the waist line and I just can eat and eat so i did switch to gluten free bread when i want a sandwhich or toast. I feel like I don't get those crazy carb cravings where I want to keep eating it even though Im full. I use physicians formula bb cream. I use the smallest amount. Its the one moisturizer that doesn't make me super oily and seems to still moisturize my skin and actually does what it says and even my skin out, but not sure whats in the ingredients. If you have any suggestions let me know. Thank you very much your feed back was super helpful and insightful and may take the plunge and go gluten free!

You can just try elimination diet. That's what cleared my acne. The thing is, any food can cause acne. Aside from dairy, soy, and the obvious junk foods; apples, cabbage, and grapes cause me acne. I stick with foods I don't react to and I'm clear as a baby's bottom!

Hi Jlopez! Thank you! very informative! I have always thought of going gluten free, but it concerns me how fattening all the gluten free foods are. I feel like not all but many gluten free foods substitute gluten for fat...lol But I try to stay away from breads as i am true believer I am a carb addict...lol Its not good for the waist line and I just can eat and eat so i did switch to gluten free bread when i want a sandwhich or toast. I feel like I don't get those crazy carb cravings where I want to keep eating it even though Im full. I use physicians formula bb cream. I use the smallest amount. Its the one moisturizer that doesn't make me super oily and seems to still moisturize my skin and actually does what it says and even my skin out, but not sure whats in the ingredients. If you have any suggestions let me know. Thank you very much your feed back was super helpful and insightful and may take the plunge and go gluten free!

Hey Ninergirl,

I'm so glad you found the feedback helpful!

One of the first things I discovered when going gluten free is that the worst thing you can do on a gluten free diet is go towards "gluten free" substitute foods. You are simply replacing grains with different kinds of grains, which will not be much kinder on your gut in the long run. The most important aspect of going gluten free, especially for the skin, is replacing all the bread and pasta and pizza with healthy nutritious proteins and vegetables which will provide your body with the nutrition it needs to thrive and therefore support your gut and skin in healing. I can also attest to the fact that I lost 30 pounds when I went gluten free, with almost no effort on my part.

So in terms of a skincare routine, having looked at the products you are using I have some recommendations. Now, I know when I had a very chemical skincare routine I believed it was working for me firmly, and nobody was going to convince me otherwise! So again, please feel free to disregard this information:

I personally keep to the caveman regimen, which could be seen as an "extreme" form of skincare but it has worked better for me than any skincare routine. Essentially, I do not wash my face, aside from occasionally letting cool water run over it in the shower (about once a week.) This, along with my diet, has taken my acne from severe to moderate in a matter of months. When I went back to using skincare a few weeks ago (old habits die hard!) My acne came back full force. So I am now into day 10 of the caveman regimen round 2!

However, I know this concept does not appeal to everyone, so therefore I would recommend a gentle, natural, ph balanced skincare routine, to support your skins healing, not strip it and abuse it when it needs you the most! This basic routine would consist of a cleanser to gently and non-abrasively clean the skin, a toner to return the pH balance and a moisturizer to keep your skin nourished. (Also please check out reviews for these methods on acne.org. They often much better and more consistently positive than the reviews for commercial cleansers!

Cleanser recommendations: Two things I would recommend are raw honey cleansing which you can read more about here: http://empoweredsustenance.com/wash-face-with-honey/

And oatmeal cleansing, here is a helpful video on the subject: http://www.bubzbeauty.com/bubbi-likes/126-oatmeal-cleanser.html

Toner recommendations: An Apple Cider Vinegar toner, which I have used before to great success as it perfectly balances the skins pH, preventing bacteria and promoting healing. You can read more here: http://tasty-yummies.com/2013/05/22/how-to-make-your-own-apple-cider-vinegar-facial-toner/

Moisturiser recommendations: Now, this is a difficult one because I know those with oily skin dread the thought of an oil on their face. However, bare with me for a second, the reason your skin overproduces oil is because it is over compensating for the oil you have stripped away with washing. So if there is oil present on your skin it no longer needs to overproduce, so oil balance and sebum production normalises, leaving you with happier healthier skin. The one problem is not every oil works for everyone. Some oils to consider are jojoba, which behaves like sebum on the skin, so can be very beneficial for acne, and hemp seed oil which has a comodogenic rating of 0, so it will not clog your pores. Please consider researching these oils and consider trying one for yourself.

If what you're doing isn't working, it might be time to try a new approach!

Good luck!