Could be a rebound from going off the bc. So, that would be hormonal.

Does hormonal acne ever get better on its own? Ie whilst the hormones are rebalancing I know it takes time but it's been 10 months and no improvement. I assume topical stuff won't work if it's to do with what's going on inside. My partner and I are going to be trying for a baby hopefully in the next year and I'm worried my skin will go into overdrive!!

Try to monitor your acne to see what days of your cycle it flares up...if there's a pattern it's definitely hormonal. Did you stop the pill abruptly? That may have upset your body and it takes a while to readjust. Depending on what caused your acne in the first place, I would say look into some fertility herbs or supplements that help with ovulation to prepare your body for getting pregnant. Right now, your body is trying to readjust to the lack of synthetic hormones and can't ovulate properly. Some herbs and supplements for healthy ovulation are safe to take until you conceive, and some even longer. It's not good to try for a baby right after coming off bcp, but give it a few months so that your body can hopefully build up enough progesterone to carry a baby to term. Of course, it's good to talk about your plans with a doctor who knows about these things.

Thanks for replying. I tend to flare up straight after I finish my period, which is strange as I always thought people got spots before hand. I did stop the pill abruptly yes and within a month is when the acne started however even on the pill I was never completely spot free. My doctor hasn't suggested any type of test to see if it is hormonal or if it could even be PCOS. We're not actively trying at the moment, we're just sort of in the "if it happens it happens" stage at the moment but I am worried If a few months down the line and we do want to start trying properly I haven't had any tests to see if I'm even ovulating correctly etc. Should I mention this to my doctor?

Yes, you should definitely mention it to your doctor. Your body is probably just adjusting from the change in hormones.

Hi there,

I'm 35, have been living with acne since I was 13. I've been on multiple courses of accutane, plus a continuous low dose of isotretinoin, with managed breaks, over nearly a decade (supervised by a doctor - kids, don't do this at home). My acne was exactly like yours when I was your age. A birth control pill plus spironolactone helped at the time, but the dose I needed was too high and I ended up developing blood clots as well as low blood pressure. I've also been on everything else available, including topical and oral antibiotics, B5, etc. I used to get cortisol injections for cysts as well. Nothing except for accutane made a meaningful difference.

I would strongly encourage you to find the best dermatologist in your vicinity and ask to be put on accutane. As you probably know, you will need blood work every month, and you will suffer from chapped lips and possibly other symptoms. I've had blurry night vision, hair falling out, and joint pain and noises, but they have all been temporary and reversible as soon as I stopped. If you notice any serious symptoms, especially things like depression, it is very important you stop the accutane; you can try restarting later at a lower dose, once any adverse effects clear up. As long as you're vigilant and on the lookout for any signals your body sends about its inability to tolerate the drug, none of this should detract you from trying accutane.

Like many others have said, isotretinoin has changed my life and I would do it again in a heart beat. In fact, I recently came off my last dose and am now being managed by only 25mg of spironolactone and some antibiotic/benzoyl peroxide cream. My skin is nearly perfect.

Most importantly, please don't get so stressed out about acne. It is manageable, you just need to find a good doctor and then be smart about the treatment you choose with her/him.

Finally, you acne might be persistent and hugely annoying, but it's really not that bad. If you'd like to put things in perspective, read Charles Bukowski's Ham on Rye.

Keep your chin up, and get some expert treatment!

Hi purple thanks for replying. I'm really against accutane as I've heard so many horrible stories about it. Another thing is I have tachycardia and I'd be terrified that it would affect my heart even more as I suffer with chest pains, palpatations etc. I'm already a very anxious person and I could see that my mind would force me to feel side effects. If that makes sense. I started using BP before I went to the doctors about my acne and I could see it slowly starting to work, so I think I may go back to that if my antibiotic gel hasn't worked after these next 3 weeks. I'm going to ask my doctor if I can have my hormones checked and go from there

I see. Tachycardia is actually one of the rare side effects, so i can't say you're being unreasonable.

http://www.drugs.com/sfx/accutane-side-effects.html

Hi purple thanks for replying. I'm really against accutane as I've heard so many horrible stories about it. Another thing is I have tachycardia and I'd be terrified that it would affect my heart even more as I suffer with chest pains, palpatations etc. I'm already a very anxious person and I could see that my mind would force me to feel side effects. If that makes sense. I started using BP before I went to the doctors about my acne and I could see it slowly starting to work, so I think I may go back to that if my antibiotic gel hasn't worked after these next 3 weeks. I'm going to ask my doctor if I can have my hormones checked and go from there

If you have low blood pressure, then you may also have low cortisol/aldosterone.

If cortisol is low, then you will have a tendency to convert combined thyroid (T4) to active thyroid (T3) at a higher rate than you can tolerate. Even though your thyroid levels are low, you may have the symptoms of hyperthyroidism. Your symptoms are very similar to someone suffering from hyperthyroidism.

A cortisol deficit generally also will leave you with a difficulty to control inflammation (like acne).

Are you thin?

Hi JL, I don't have low blood pressure. It's always been fine I get it checked a few times a year, I've also had a few blood tests and my thyroid has always come back fine, but does that mean I could still have hyperthyroidism? Yes I've always been thin especially when I was younger, and I can lose weight really easily with increased exercise etc. I think I am fine for my height though, I'm 5 ft 8 and for the past few years have always stayed around the 9.5-10 stone mark which I've always been told is fine.

Will a hormone test pick up hyperthyroidism if I have it?

Yes a hormone test will pick up a thyroid deficiency or excess. The best tests to order are:

TSH

Free T3

T4

Thyroid Antibodies

Virtually all acne is hormonal. If you want to test, ask for the above plus:

Female hormone panel

Free and Total Testosterone

DHEA Sulfate

8 am cortisol

SHBG

Sodium

It might be difficult to get these tests as your doc may not think they are necessary.

What is your blood pressure? They may say it's fine because it's on the low side, but is actually a mild indicator of aldosterone/cortisol deficiency. This can aggravate acne because you are losing the anti-inflammatory effect of cortisol.

Cortisol/aldosterone/DHEA all all adrenal hormones. DHEA is the primary pool for female testosterone. If you are deficient in cortisol, you will release ACTH to increase it's production and at the same time increase DHEA that converts to testosterone and aggravates acne.

It's a very sensitive balancing act...

Exposure to chemicals like phalates and xenoestrogens can and do disturb the hormonal system. Our grandparents didn't have this issue.

Hi purple thanks for replying. I'm really against accutane as I've heard so many horrible stories about it. Another thing is I have tachycardia and I'd be terrified that it would affect my heart even more as I suffer with chest pains, palpatations etc. I'm already a very anxious person and I could see that my mind would force me to feel side effects. If that makes sense. I started using BP before I went to the doctors about my acne and I could see it slowly starting to work, so I think I may go back to that if my antibiotic gel hasn't worked after these next 3 weeks. I'm going to ask my doctor if I can have my hormones checked and go from there

Look into hyperthyroidism as jlcampi suggests, a known side effect is acne plus the anxiety you are experiencing.

Hyperthyroidism really requires a doctor's help, but you can make some lifestyle changes to help:

Certain foods such as cruciferous vegetables like broccoli, cabbage, & kale among others contain goitrogens in their raw state. Goitrogens block thyroid hormone production and thus help to slow down the thyroid. Therefore anyone suffering from hyperthyroidism would benefit greatly from eating raw cruciferous veggies.

Vitamin D deficiencies are a common day epidemic. Vitamin D helps coordinate the immune response by allowing the body to recognize between foreign and self proteins. This reduces inflammation and auto-immune reactions. A healthy range for vitamin D3 (25-hydroxy cholcalciferol) is between 60-100 ng/ml which is much higher than the medically acceptable 32 ng/ml. Be sure to know your levels and get them over 60 ng/ml. Spend 20-30 minutes a day in the sun or supplement with 10,000-50,000 IU of high quality emulsified vitamin D3 for a period of time until you reach the desired levels.