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I am going to try and keep this short as possible.

I am 25 and have always suffered from acne. I was diagnosed with PCOS November of 2010 and was put on 200mg of spironolactone a day for high testosterone. I am also on birth control but still can't get totally clear. I still break out a lot around my period even with these two medicines. I take fish oil, a prenatal, vitamin d and c, cinnamon with chromium, and a calcium supplement. I read somewhere that most of those are good for PCOS. I was getting pretty clear for awhile but now breaking out again. I am not sure if it's hormones or what. I was taking a zinc supplement but read somewhere that it raised testosterone so I stopped. I have organic apple cider vinegar for pimples, Dan's AHA, Witch Hazel, Jojoba oil...I've tried everything. I break out mainly around my mouth and nose. I have a cystic pimple right by my nose right now and it's red and huge. I'm not sure what else to try. I also do a plain yogurt mask and that seemed to help for awhile but now it seems like everything that was working has stopped. I don't have insurance right now so when I get some, I will go back to the doctor but for right now I don't have any. Anybody have any advice? I would sure appreciate it. I am a long time lurker but finally decided to try and get some personal advice.

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Some people have problems with fish oil or flax. Have you considered eliminating that for a while as it may be causing the breakout?

Aspirin masks have helped some people a lot (there are numerous recipes floating around the internet, most of which comprise of aspirin disolved with water into a paste, with or without honey whichever is your preference) It is supposed to reduce inflammation and calm any existing spots.

There are mixed results with Evening Primrose Oil in regulating hormones but as you're on BCP, I'm not sure if this would interfere...or possibly make the problem worse...

What kind of regime are you on at the moment? Are you consistent with it? What kind of spot treatment, cleanser and moisturiser do you use?

How is your diet? I'm not sure what kind of nutritional investigation you have done in regards to acne but a lot of people on here (myself included) have found benefits to reducing inflammatory or potentially acne-causing foods/ingredients.

The most common foods to avoid are: sugar, soy, dairy, gluten and processed foods. (I have eliminated gluten and it hasn't cleared me completely but helped significantly with breakouts) You may want to try avoiding those foods for a trial period (not too short or it won't take effect) and see whether it reduces the inflammtion or severity of acne (Nutrition and Holistic Health section would really help with ideas about this side of treating acne)

:)

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Have you tried a BP cleanser? These are much milder than topical BP. My derm is having me use one and I've got very sensitive skin. However, you may need some kind of daily topical in addition to your oral meds. This is actually the way derms usually attack the problem. Witch Hazel is touted as a natural acne tx but it only helps soothe very mild surface acne. Except for Dan's AHA the things you mention don't usually do that much for deeper hormonal acne. Lots of women, me included, love Spironolactone. It is mild but very effective.

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I ran out of fish oil and didn't get any for months but I guess didn't seem to see a connection. I can try to stop it again and see how my face is around next month's period. I read on here that multivitamins can cause flareups...is that the same for prenatals? And what zinc is best? I was taking 50mg of zinc gluconate but stoppd when I read it can raise testosterone. Is there one that doesn't? Should I cut it in half and take only 25mg? What do you recommend?

I'm using this glycolic acid and vitamin a face wash from the health store. I just started it and it's pretty good. I don't flare up a lot except around my period and then it's a LOT. For some reason the BCP and spiro haven't stopped that. I use the Witch Hazel and ACV and all that for PIH and it seems to be helping. But I get 5 or 6 pimples all in a week before my period and they take the next 3 weeks to heal and then I get them all over again. I don't know what to do. I need to find some anti-androgen remedies because after a year on 200mg (isn't that a high dosage for it not controlling hormonal breakouts?) my testosterone is still high. It's lower then it was, but still higher than normal.

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Sorry --- I didn't read your initial post carefully eneough and so suggested spiro. Have you seen an endocronologist? They do testing and make recommendations for imbalances. I have that kind of cycling thing too...get a cyst, takes days to heal and a week or two later get another one. I think diet, etc. helps with the degree of inflammation but if you are truly dealing with high testosterone then that'll trump diet everytime. Plus if you are sensitive to androgens then that compounds the problem.

Your pores are overwhelmed by the effect of the androgens that get past the BCP and Spiro. In this instance then it really makes sense to use BP in addition to your BCP and Spiro. It just might tip the scale in your favor. Why? Because it effectively kills acne bacteria and helps clear out clogged pores so you will theoretically break out less even if the hormone thing is not completely taken care of. There is nothing in your regime that is doing that right now. You are on top of the hormone part but not the acne bacteria part.

I was in the same boat. For years I was treating my cystic acne by using Tretinoin Cream (good for restructuring pore lining), Spiro (good for androgen sensitivity), and Bactrim (antibiotic) for flare-ups. This worked really great for me until my old derm decided to take me off all oral meds to see if I could maintain on just tretinoin cream. Big mistake. At that time (Oct 2011) I also started following an allergy diet, suppliments, and anti-acne diet. Helped but I still broke out with cysts. The past two months I've had one cyst after another. My new derm explained to me yesterday that I have to use something to kill the acne bacteria. So he put me on what used to be a perscription BP cleanser called "PanOxl-4". Can get it now OTC. It's good for people with sensitive skin because the BP is partially washed off...just a bit remains. He also put me back on Spiro and added Oracea. He is also adding Cleocin-T topical to further kill the bacteria. This is a rather intense tx regime but he thinks it is needed...eventhough I only get 1-2 cysts at a time they are big and painful and I'm sick to death of them! So we will see. I am also doing monthly microdermabrasion. But this can get expensive depending on where you get it done. My new derm firmly believes in it and says that this will get me closer to maybe one day only having to use a topical.

Hope this helps. I can truly empathize with your frustration!

Edited by cvd

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Sorry --- I didn't read your initial post carefully eneough and so suggested spiro. Have you seen an endocronologist? They do testing and make recommendations for imbalances. I have that kind of cycling thing too...get a cyst, takes days to heal and a week or two later get another one. I think diet, etc. helps with the degree of inflammation but if you are truly dealing with high testosterone then that'll trump diet everytime. Plus if you are sensitive to androgens then that compounds the problem.

Your pores are overwhelmed by the effect of the androgens that get past the BCP and Spiro. In this instance then it really makes sense to use BP in addition to your BCP and Spiro. It just might tip the scale in your favor. Why? Because it effectively kills acne bacteria and helps clear out clogged pores so you will theoretically break out less even if the hormone thing is not completely taken care of. There is nothing in your regime that is doing that right now. You are on top of the hormone part but not the acne bacteria part.

I was in the same boat. For years I was treating my cystic acne by using Tretinoin Cream (good for restructuring pore lining), Spiro (good for androgen sensitivity), and Bactrim (antibiotic) for flare-ups. This worked really great for me until my old derm decided to take me off all oral meds to see if I could maintain on just tretinoin cream. Big mistake. At that time (Oct 2011) I also started following an allergy diet, suppliments, and anti-acne diet. Helped but I still broke out with cysts. The past two months I've had one cyst after another. My new derm explained to me yesterday that I have to use something to kill the acne bacteria. So he put me on what used to be a perscription BP cleanser called "PanOxl-4". Can get it now OTC. It's good for people with sensitive skin because the BP is partially washed off...just a bit remains. He also put me back on Spiro and added Oracea. He is also adding Cleocin-T topical to further kill the bacteria. This is a rather intense tx regime but he thinks it is needed...eventhough I only get 1-2 cysts at a time they are big and painful and I'm sick to death of them! So we will see. I am also doing monthly microdermabrasion. But this can get expensive depending on where you get it done. My new derm firmly believes in it and says that this will get me closer to maybe one day only having to use a topical.

Hope this helps. I can truly empathize with your frustration!

Thank you for your reply. So do you suggest getting a topical BP? When I had insurance I seen a derm and he gave me BP but that was a couple of years ago before I was diagnosed with PCOS. If I can get insurance again in the next month or so, I will go see the derm again but for now I am stuck buying OTC. Is there anything you suggest? I'd sure appreciate your opinion.

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Yes --- I think that adding BP in some form may be what your skin needs in addition to the hormone treatments. According to my derm a good way to start BP is in a cleanser. Try that first and see if it makes a difference. You can buy one OTC. The one I am using is very gentle and is OTC. I just happened to purchase it at my derm's office because it is the one they like to recommend. If your skin responds well then you may want to use Dan's 2.5 or another 2.5 BP topical. But the cleanser might be eneough. If you go to the topical then follow Dan's directions but I would not use as much as he does...especially if you have sensitive skin. My derm also recommends DML lotion when using acne products...it protects the skin but allows meds to work. It is proven to be non-comedogenic and hyperallergenic. I buy it at my derm's office but you can buy it online. It is cheap and you only use a tiny dime-size amount. Lasts forever.

I know you are trying to go the natural route. There are so many testimonials from people here who have had success by following a diet or adding suppliments or not washing, etc. But when I look deeper into their posts and background, they are usually very young and have only been "clear" for a couple of weeks. And their acne is usually more superficial. Many people say they have cysts but they are just pimples. In other words their success may be more due to naturally outgrowing acne or having very superficial acne that responds to a simple treatment. Unfortunately if you have chronic deep hormonal acne it takes doing more. I have tried and tried doing the natural route and it never ever worked. That said I still think there is merit in following a low glycemic diet, avoiding dairy, and adding good suppliments. You will be healthier overall. Also I have tried all natural acne products and have not been impressed thus far. Again, my acne is too deep and my skin is too sensitive for many of these products...because they usually contain oils that seem to aggravate cystic acne. The more mainstream products...the good ones...are not totally natural but they are reliable and you can trust that they are made in a consistant way.

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