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Hi . I am almost 47 years old . The last few years I have been noticing bigger , kind of flat lumps on my face . For CHristmas this year , my mother in law gave us a trip to Florida . I have never been on a vacation before , and I was so happy . ( I also have never been to FLorida) About 3 weeks before our vacation one of the flat lumps got severely inflamed. I used a draw out salve and moist hot packs to try to get the gunk out . It took the whole 3 weeks to get it where it wasn't embarrassing . WELL , while in FLorida , one of the other lumps starting getting inflamed . It got huge . I got many weird looks . I cried alot . I didnt want to go anywhere or do anything . It has been a week and the cyst finally started draining today . It isnt painful anymore but it is oozing . I have a dressing on it and have been applying triple antibiotic cream on it about 4 times a day . I have an appointment on May 17 th at the derm . ( It takes forever to get in to see the derm )

I have little whiteheads EVERYWHERE on my face . And many other white lumps. I have alot of facial hair too . The last derm I went to said I was approaching menopause and my body might be going through some bad hormonal changes .

I am so embarrased about my face ( especially the cysts ) , that I have been avoiding going anywhere . I make up excuses for not going to family functions . If I go to the store , I make my husband go along and he goes in the store for me . I only feel comfortable going to the store at night . This problem with my face is taking over my life . I am unemployed right now , and scared to job hunt because of the condition of my face . I try to lead a stress free life , but my acne bothers me so much , that it stresses me out .

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Although I do not have a solution, I do know how you feel.

I am 15 (male), and enjoy going to school and work, but I am constantly nervous especially in big crowds and worried about what people think of me when they look at me because of my sever acne.

I find that a good day, is when I don't physically notice the acne.

What helps me get through the hard times, is having empathy for those who have it worse off than me, (not just acne, but other situations).

I know it's hard, and I myself can not ignore it completely, but if it is not going to go away, you have to somehow accept it, and continue.

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I know acne can really take a toll on you emotionally, especially as an adult. The good thing is at 47, your hormonal changes may very well be temporary. The medical treatments should help it stay at bay until your body adjusts.

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I'm sixty and have gone through what you're going through. I can totally empathize! It's pure hell when you're dealing with inflamed cystic acne. I was so fearful about going anywhere and upcoming events were awful to even think about because I was so fearful I'd have a huge cyst (or two or three...) to deal with. It's so embarrasing to have cysts as you get older. People really don't understand. And when you're having to deal with one when you're traveling or visiting there's no privacy to take care of it. Believe me I know how it feels.

Here's what worked for me. I tried everything including two rounds of accutane and nothing worked until I followed the regime below. This regime works and I have a back-up plan if I should ever get cystic acne again.

1. Read "Healing Adult Acne" by Dr Fried. He's a dermatologist and also a clinical psychologist. I learned so much about myself and how to properly treat adult cystic acne. He gives "permission" to stop being treated like adolescents --- to demand proper care and to get respect while dealing with this disease.

2. Use an antibiotic until you stop getting big red cysts. You may have to try a few before you get one that works. I like Bactrim because it heals cysts quickly and stops all swelling. Amazing stuff. I took Bactrim for over a year, slowly weaning down, and finally stopped as the tretinoin cream started working.

3. Use generic tretinoin cream (retin-a) everyday for the rest of your life. It's the gold standard for treating adult acne and has tons of studies to prove it. The retin-a in OTC products is not sufficient - you have to get a perscription. Tretinoin cream normalizes the pores but this takes a long time to do...over a year. Lots of people give up too soon...stick with it. Cystic acne occurs very deeply in the skin so be prepared for a long time of deep plugs pushing out...not acne, just big sticky plugs. Sometimes the process of plugs pushing out causes inflammation but it passes quickly. To avoid irritation, follow directions and wait 20 minutes after washing gently before applying and don't use any other acne products. After about a year you'll have clear skin. I started with .5% and worked up to 1%. I wish with all my heart I had tried this when I was younger but I used BP instead which never really worked that well. Oh well...I can pass my experience on to others!

4. While you're going through menopause try Spironolactone to deal with extra hair and androgen surges. Androgens make cystic acne worse. Spiro is very safe to use. I've used it for 10 years. At least for me it didn't solve the cystic problem by itself but it did stop the hair issue and did help cut down on the frequency of cysts. I'm now weaning off of it because the 1% tretinoin cream is working so well. I'll get laser hair removal if hair is still an issue.

5. Be totally gentle with your skin. No salon facials, extractions, scrubs, washing with washclothes, hot water, etc. This is very important. Cystic skin is very sensitive to any pressure or manipulation. Don't pick, etc. There is some thought that skin that inflames easily is part of the process of getting cystic acne so you want to do everything you can to reduce inflammation.

6. I keep a bottle of Bactrim as a back-up and my derm is okay with this. It's totally a psychological crutch for me and helps when I'm traveling to know I have something that'll calm down a cyst in a day. In the past six months I haven't had to use it once (amazing...). I've been traveling and nothing has happened. But just knowing I have this as a back-up helps. If you've had cystic acne you'll have a bit of PTSD to contend with and it's okay to have a back-up plan!

7. Think about getting allergy testing. Get proper testing that includes skin and blood tests. I finally did last year and was shocked to discover what I was allergic to. Eating a better diet suited to my specific needs lowered inflammation and made my digestion better which I'm sure helped heal the acne. My doctor says that if you have allergies or food intolerances but ignore them that the body slowly becomes more and more inflamed and inflames acne. Lowering allergens in the body helps calm everything down.

Edited by cvd

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You might want to try Saw Palmetto (get the standardised gel caps) its a natural anti androgen and has worked for some :)

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