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Hi everyone, I am making this post to ask for some advice or opinions. I am a 20 year old male who has really persistent cystic acne that has been annoying me for the last 3 years, and it never goes away no matter what I do. I exclusively get cysts on my cheeks only and I have tried literally everything, gone to dermatologists, tried azelaic acid, tretinoin, benzoyl peroxide, niacinamide, antibiotics (doxycycline and tetracycline), with the exception being that I have never tried Isotretinoin because my profession unfortunately does not allow me to use it (aviation).
I am 90% sure its hormonal acne and dermatologists have also agreed, mostly because my mother had really bad hormonal acne in the past so I suspect I got it genetically from her. And I get my acne exclusively on my cheek which further supports the hormonal claim.
This, combined with me trying countless of dietary and different treatment changes which have not worked, is leading me to think that increased DHT levels are most likely the culprit of my acne, something that none of the aforementioned treatments have actually targeted.
(Regarding potential DHT levels; I have a lot of body hair, not much facial hair and have no hair loss or thinning as of writing this.)
So I am curious what options there are for me at this point. Most hormonal acne treatments which are successful are for women and consist of spironolactone which males cant take because of feminisation and similar side effects. I have seen a product called Winlevi but I am in europe and I dont think its sold here. Could any hair loss medications maybe be useful? Just thinking out loud at this point
Curious to hear your opinions and advice.
You're in an interesting predicament. Normally when people have cystic acne that doesn't respond to anything, isotretinoin is an option (albeit with all the side effects). But you're right that if you take it, aviation isn't a career option because of the eye stuff.
I have never heard of DHT blockers helping with acne. They don't block testosterone, and that's what kicks up oil production, so I doubt they'd do much.
One option that is out there for severe acne, albeit off-label, would be auto-immune drugs. I got curious about it so I researched it a while back and wrote an article on it. If I could go back to when I had really severe acne, I might ask my doc about them instead of going on isotretinoin. They are serious medications too, but with my lifelong side effects from isotretinoin, I wonder if they would have been a better option to try. Anyway, it's just a thought that you could discuss with your doc as a potential option.
Hello Dan, thanks a lot for responding.
I had a read through the article you attached related to auto-immune drugs and its certainly interesting, I never considered something like that. However, I wouldnt classify my acne as severe but rather as moderate (I shouldve specified this in my original post, my bad), so It isnt insanely bad but it definitely bothers me and my self esteem enough that I would like to get rid of it once and for all
So I dont think these types of drugs are something I would consider at the moment especially as they are rather serious as you mentioned, but its certainly something that could maybe work.
I am curious to hear your opinion on this: as a kid I suffered from pretty bad dust mite infections but around the age of 15 it seemed to have gone away for the most part with me getting some allergic reactions every now and then but really rare. Im wondering if could be worth to look into this childhood allergy as a potential acne cause? I read quite a lot of stuff online that anti-histamines have cured some peoples acne, so Im curious if this could be worth considering? Again, just thinking out loud
Cheers
Antihistamines have cured acne? Any hard science on that you can point me to?
Also, since your acne isn't severe, I should also ask have you tried The Regimen? It is BP based but it's using BP the right way, which makes all the difference.