The onset of acne for me was at age 10 or 11 and was very severe on both the face and the body (diagnosed as cystic acne at 12 yeas of age). I was put on birth control at age 14 (Dianette35) and was given Retin-A as a topical cream and it calmed down dramatically. It was under control for several years (most of highschool) with the odd acne flare around the jawline during menstruation but other than that my skin was fairly good.

Then at 18 and my acne returned *full force* (if not much worse) manifesting in a new aggessive strain on the face, neck, arms, trunk, breasts, legs and back in large cystic lesions followed by hirsutism (excess hair growth) on my breasts, stomach and jaw line. It became unreponsive to topicals and other acne products as the lesions were very deep (I guess it couldn't penetrate). Accutane was constantly suggested to me by my Derm and G.P but I was too afraid to take the drug due to media reports about the degree of side effects ( Severe depression leading to suicide, liver failure, blindness)

So I went away from conventional dermatology and tried eastern medicine (naturalpathic) instead during the year of 2007. I was told to cut out dairy, gluten, casein, wheat and all animal byproducts and opt for a vegan diet with magnesium, vitamin A and other supplements. I was never big on junk food before and dairy was never a big part of my diet as I was always sort of grossed out by it (cows breast milk, yuck!) but due to the advice of my NPD I decided to get even stricter and cut out virtually every man made food and preservative - I figured I had nothing to lose and it might clear my skin and would improve my general state of health overall. I followed this diet from mid 2007-2010 and failed to improve in regards to the relief from acne. Diet just appears to be not a factor for me (or anyone else for that matter) when it comes to acne.

I went back to my original Dermatologist in 2011 (I was 22) and asked to by referred to an endocrinologist as I still was experiencing really bad body and face acne and worsening hirsutism. I was tested for PCOS (obviously) but this came back negative. My androgen levels and other hormones were all within normal range and not unbalanced in any way - which I was rreally surprised about. I was said to be what they call "androgen sensitive" and given Spironolactone.

Now at 24 my facial acne has dramatically improved except for the minor jawline acne flare getting close to my period. My skin has also become very smooth (more of a feminine texture) I have virtually no acne scars except for the odd "ice pick" type scar on the left side of my face - which I think is due to my persistant use of Retin-A as the reason I didn't scar badly.

I still suffer from acne on my shoulders and trunk all of which are cystic but the lesions few and far between (only about five or so). I also still experience hirsutism on my neck and stomach but I find this to be a lot less than before and the hair is more fine and nearly blonde (or dark blonde) as opposed to thick and black.

I think from my years of experience that Acne is predominately a genetic disease and not due to lifestyle ,diet or a disorder of the gut (like I had previously been lead to believe). I believe that all cases of "inflammatory acne" are caused by a genetic predisposition to androgen sensitivity passed down from either mom or dad (my mother had the same type of acne as me) and can only truly get better once the person becomes androgen insensitive.