Hi @Brendaa151!
Sending so much love to you. I know acne can bevery emotionally draining.

Mine actually looked somewhat similar to yours. And I believe it to be hormonal (which is also related to the gut).What does your diet look like? Are you experiencing gut issues? Menstrual cycle plays a huge role as well.Herearefew things that helped me:

Diet: eating a balanced diet (sounds easier than it looks).And also looking closely at blood sugar. Make sure each meal incorporates healthy fats, proteins and carbs. I used to be plant-based and had to make a point to balance my diet. Balancing omega 3s and 6s decrease inflammation and this is known to help acne - this can be done by taking a fishoil/ algae oil supplement.

Understanding your menstrual cycle: I HIGHLY recommend reading The Period Manual by Dr. Lara Briden. This book has changed my life and she has excellent information about acne and post-pill healing. Dr. Jolene Brighten also does a lot of work with post-pull acne.

Supporting gut health: if you struggle with gut issues, theres a lot of ways to support your gut/digestion. Eating more whole foods, not drinking with meals, resting your body, etc. I took a supplement called Berberine to fix my digestion - its a super powerful supplementand I recommend taking it with the instructions from the The Period Manual. It is known to clear up acne because it really clears up the gut.Magnesium is also super helpful.

Decrease testosterone: 2 cups of spearmint tea a day help mewith this. Also make sure youre incorporating some healthy fats into your diet and getting the proper rest! Taking a zinc supplement is helpful for this.

Nourishing your skin: Does your skin ever seem dehydrated? Dehydrated vs. dry is quite different. A lot of cleansers tend to dehydrate your skin. Youre on the right track with jojoba oil! My skin drank this up, along with other cold pressed oils that were good for acne - grape seed oil, and rose hip oil (great for scars). I also cleanse my face with cold-pressed oil and wear some in the shower to avoid the steam dehydrating my skin.

Breathing: it might sound crazy, but I feel that breath work lowers my cortisol levels, which helps with stress and inflammation. I triedto think that each deep breath I tookwas easing redness, and calming the inflammation. I really think it did.

Lastly, I want to let you know that you are so much more than your acne. I understand how tolling it could be and it feels likeit takes up your whole life. I recommend journaling about it and writing out anything good that mightvecome from the situation.Just remember that youare not alone in this and youre on the road to healing. I hope this helps! Let me know if you have any questions about the resources I provided or if you wanted to chat!

Best,

Alexa

Have you been tested for microscopic demodex skin mites? Everyone has at least a few ofthese mites. They are not a problem unless they get overpopulated due at some point to a lowered immune system caused by illness or stress.

The mites eat skin oil and live on a 2 to 3 week cycle. When they die they cause pustules and papules of dead mites. The cyclic behavior can cause this condition to be confused with hormonal acne. Because they eat skin oil any drug like birth control pills, accutane (isoretinoin), etc. can reduce the skin oil and starve off some of the mites. That can make the skin appear better while on one of those drugs. When the drug is stopped the mites rebound. The skin condition caused by mites may be called demodicosis or Rosacea Sub Type 2 with papules and pustules.

A knowledgeable dermatologist can test for demodex to determine if you have more than "normal". A doctor should also be able to test your various hormone levels to determine if that is the actual cause of the skin issues. Ihad demodex for decadesand it was misdiagnosed by 4 board certified dermatologists as bacterial acne. Their diagnosis was based on brief visual exams. They never tested me for anything. The last one finally said "Gee maybe its hormonal", but never tested for that either. When one prescription drug or antibiotic didn't work, they just prescribed something else.

If it is demodex there is a 2 week, 2 drug combined highly effectivetreatment with cheap and safe generic drugs that really works. It was what finally cured me after literally decades after being treated with antibiotics (including minocycline), retinoids, benzoyl peroxide , etc. - none of which ever worked. The treatment consists of Oral Ivermectin and Oral Metronidazole. The treatmentwas published in a proper medical study in the May 2013 International Journal of Infectious Diseases. If necessary, print the paper out and show your doctor. The link to the paper is here: https://www.sciencedirect.com/science/article/pii/S120197121201315X

Treatment:

1. Oral Ivermectin Doses: 2 once a week doses of Oral Ivermectin based on body weight: 200 micrograms Ivermectin per kilogram of body weight. That worked out to 12 mg per dose for me. My family doctor prescribed this treatment for me. He rounded up the Ivermectin dose a little so that it was a multiple of 3 mg to avoid having to break the 3 mg tablets. Take the first dose on day 1. Take the second weekly dose on Day 8 of treatment. Take eachOral Ivermectindose on an empty stomach with a big glass of water.

2. Oral Metronidazole Doses: 250 mg of Oral Metronidazle, 3 Times daily. Take with food.

Topical treatments that can help over time and will support the oral treatment while in progress:

1. Wash with: Tea Tree oil face wash (The Body Shop makes several, Desert Essence Original Face Wash, and others are available)

2. Wipe clean face with: Cliradex Wipes and allow to dry - Use one wipe after washing face morning and night.

3. Hypochlorous Acid (HOCL) Face Spray - (0.01%-0.02% concentration). The HOCL spray can be massaged around face with clean fingers to ensure an even coating. HOCL is soothing, non-irritating and non-allergenic to skin - contains the identical HOCL chemical produce by the human bodies white cells. Kills 99.9% of bad bacteria, kills fungus and viruses, kills juvenile demodex skin mites reducing the population over time. Doesn't kill the "good" bacteria needed for healthy skin. Tattoo artists and piercers swear by HOCL to help their clients heal up without infection. Hospitals use HOCL to disinfect ICU and Operating Rooms. Medical and Dental offices use HOCL to disinfect their treatment rooms. HOCL has been in use for over 100 years in the medical industry - it works. BrioTech Labs sells spray bottles on Amazon for $6.95 per 2 ounces or $11.95 for 4 ounces). Other brands available on Amazon include Occusoft Hypochlor, Heyedrate Lid and lash cleaner, etc.

4. Use a clean towel for the face daily as demodex skin mites can live on a wet towel or washcloth for up to 54 hours.

5. Ordinary washing of towels and other linens in a standard washer/dryer at 59 degrees Centigrade will kill demodex. So you don't need to do anything special with laundry other than frequent laundering especially of the towels.

If you can't get to a doctor, there is one other topical non-prescription option that can help. Soolantra Cream (Topical Ivermectin 1%)is an expensive prescription drug frequently prescribed for treating demodex skin mites. The over the counter option is to get the Ivermectin Horse Paste (Durmectin, etc) from Amazon at about $5-$7 per small tube. Its 1.87% Ivermectin in a paste form. Use it on a clean face at night before bed. The mites come out at night, so that is the best time to treat them. Doctors prescribe the topical Soolantra treatment at night for 16 weeks. Its slower than the oral treatment but can be very effective.

Just be aware that while being treated for demodex, the topical Ivermectin or Oral Ivermectin- Oral Metronidazoletreatment kills them. The treatmentmay temporarily cause what appears to be a bad breakout. That is an excellent sign that the treatment is working. Stick with it until they are all dead.