Hey guys, I've been a long time visitor to the forums but this is my first time actually posting something.

I'm a 25 year old male and I have suffered from acne since the age of 16.

My condition originally started as mild but later (around 21 or so) I developed severe nodular acne with an occasional cyst or two on my neck. With the exception of a couple of pimples on my back like twice a year my acne has always been limited to my face.

There was a time my acne was so sore I couldn't even sleep at night.

I would often extract the pus without worrying about scarring too much, only to lessen the pain. It was like that before I first started taking Roaccutane (more on that later).

Also my skin and scalp are very oily. Particularly my nose, I mean I cleanse my face and in less than 45min you can literally see sebum coming out of each of my enlarged pores. I've tried countless anti-shine and sebum reducing products (while moisturizing regularly) but to no avail. I even find it difficult to apply any topicals because with all the oil it just feels like there's too much on my face. Because of the hyper production of sebum I swear my nose even appears slightly bigger than it actually is. I noticed this when I took Accutane which completely shut down the oiliness.

Needless to say that over the years I've tried all kinds of different prescription meds as well as various alternative and home remedies with little success.

Here's a short list of what topicals I've used and pills I've taken: topical antibiotics (erythromycin), benzoyl peroxide, salicylic acid, doxycycline, clindamycin, tetracycline, retinoid creams and finally the infamous Accutane.

Then I've also tried various supplements, herbal medicines (traditional Chinese medicine and Ayurvedic herbal tea) and even urotherapy and a bunch of other cosmetic stuff such as laser therapy or chemical peels.

As far as my lifestyle is concerned I've never eaten junk food or too many processed foods and I exercise regularly (at least 3 hours of cardio a week). I sleep a lot and with the exception of exams there's usually very little stress in my life. I drink plenty of water every day, usually 3-4 liters (at least 1 liter of that is organic green tea).

Around 4 years ago I went on Accutane for the first time. I think that was the first treatment that actually yielded some results.

Luckily I've never experienced too many of the side effects. So far I've been on Accutane 3 times. To my displeasure the acne always keeps coming back within the period of 6 to 12 months after I finish the course. I noticed that the character of my acne has changed a bit though. I mostly have a combination of papular and pustular acne and less often do I get nodules on my neck or under the lower lip. I also started to have fairly painful acne in my scalp which I had never experience before but hey at least you can't see those. I finished my last Accutane treatment over 18 months ago.

Up until June I had had a super greasy complexion with some mild acne which was manageable but then all hell broke loose.

All of a sudden without any change in my lifestyle I started breaking out like crazy. Even though those were just micro breakouts as I like to call them (usually 5-10 tiny pustules every morning I got up, and another 5 during the day) which heal fairly quickly but leave nasty red marks. I was in a state of continuous breakout for about 3 weeks and it just wouldn't stop.

I decided to drastically change my diet. As of now I've been gluten, soy, lactose, caffeine and sugar free. I also completely stopped eating processed foods so I make everything from scratch every day. I decided to keep a food log in order to determine whether I can trace a possible food allergy.

The strict low glycemic diet didn't stop the breakouts completely but I can say it's much better. However I'm a little afraid I'm on the verge of being anorexic since I've already lost 7 kilograms (current weight 68kg/150lb, my height is 190cm/6'3") without even trying. I'm trying not to starve but eating kinda makes me anxious because there's practically nothing I can eat when I'm on the go that doesn't contain any of the above mentioned ingredients and doesn't require some preparation. I'm desperate because I just don't want to break out any more...

Still, this morning I woke up and there's 5 new pustules around my mouth, on my cheeks and in my nasal fold¦ bummer

These are the products I've been using: Av©ne soapless cleanser, Av©ne anti-shine purifying lotion, Av©ne Clearance lotion, Bioderma non-comedogenic 30 SPF, Bioderma S©bium AKN cream, Skin79 Homme BB cream¦ I'm fairly positive neither of those break me out.

So here's my question to you guys - do you think my acne is hormonal (I think the excessive sebum production would suggest that) or could it just be dermatitis or food intolerance? Or possibly a combination of both?

After an almost decade long struggle I want to find out what causes my acne and finally solve the problem. I think there's definitely something wrong going on in my body that has to be dealt with and which doesn't require Accutane or any other meds that are just temporary.

I've been reading a lot about the Saw Palmetto extract and I'm willing to try it soon.

Anywho, here's a couple of pictures to demonstrate my current condition. I don't have any pre-Accutane pictures because the first time I got clear I deleted everything since I just couldn't look at the old photos anymore. I know it's not as severe as what some people usually post here but it still bothers me a lot.

These are 3 fairly recent shots taken with my webcam, not the best quality:

https://dl.dropbox.c...° #2.jpg

https://dl.dropbox.c...° #2.jpg

here's a more detailed snapshot, you can notice about 30 pustules: