Hi all,

I've been lurking for quite a long time on these forums--certainly for at least the past 5 or 6 years. The site has been a source of great strength and encouragement to me during the difficult times, and I think now that I've found a regimen that has very nearly solved my problems, it's only right that I should share it here. My post will be long, but please bear with me; I think it will be best for you to have as much information as possible. (For those not interested in reading everything, you can skip to the bottom for a summary of my regimen.)

My problems began when I was in my sophomore year of high school, right before I turned 15. My acne quickly became moderate, and was at that time pretty much entirely composed of whiteheads. During my remaining years of high school and my first couple of years of college, I went, at my doctor's suggestion, with the typical antibiotic-topical combo. On the antibiotic side, I tried doxycycline, tetracycline, and sulfamethoxazole (Bactrim), among others. The antibiotics did provide some improvement, but at the cost of frequent fungal infections of the skin.

I was entirely dependent on the medical establishment for help; I just assumed the doctors would know what to do. So when, in my second year of college, I finally ditched the antibiotics, I returned to my physician for new treatment ideas. My doctor recommended that I try Retin-A. Well, after nightly application of the Retin-A for a short time, my skin started to break out horribly with nasty cysts, which I had never gotten before. I quickly returned to my doctor, and it was at this point that he suggested Accutane. Now, in hindsight, I realize this was a terrible idea, but at the time, I didn't know that Retin-A and Accutane were both vitamin A derivatives. To this day, I can't believe my doctor didn't understand that if Retin-A broke me out horribly, then Accutane probably wasn't the next logical step; it completely baffles the mind--well, my mind, at least.

Sure enough, taking Accutane resulted in an EPIC breakout. My skin broke out in ways I wouldn't have thought possible before that. It also became very, very dry, along with my lips and nostrils. My doctor assured me my reaction was completely normal, so I coped as best I could...and let me tell you, it was not easy going about my daily business in college with my face in that state. I'm actually proud that I had the psychological fortitude to make it through that period in my life without casting myself off the nearest bridge. After the first 3 months, my skin had largely cleared itself of the cysts, but it would continue to break out for the entire course of the 6 month treatment.

After I stopped Accutane, my oil levels gradually returned to earlier levels, and I should mention here that before I started the drug, I had extremely oily skin. My acne was still moderate, as it had been before, but now consisted almost entirely of papules that never came to a head. I then went back to Differin, with the same level of success as before--that is to say, virtually none.

All treatment I had received up to this point had come from my family physician, but having become supremely frustrated with the lack of improvement in my skin, I finally made an appointment with a dermatologist. It was his opinion that I should try Pandel, which is a mild steroid cream. He had me use this cream for several months, during which time I saw little to no improvement in my acne. Then one day, I noticed that I had dark hair growing high on my cheeks, right under the cheekbones. I did a little research online, and found that unwanted hair growth is a common side effect of treatment with topical hydrocortisone. Furthermore, I found that long-term treatment with steroid creams may lead to skin-thinning and pigment changes. I was shocked the dermatologist had never mentioned these potential side effects. I trashed the Pandel immediately, cancelled my next appointment, and I haven't spoken to another doctor about my skin condition since.

I started doing a lot of reading on the internet, and as a result, decided to try vitamin supplementation. I tried so many different combinations of vitamins that it would be impossible for me to recount everything in detail. I can only say that I would urge caution to anyone thinking of trying something similar. I think one can definitely throw too much at the body for it to handle. Several times, I made my acne much worse by messing with vitamins. At the same time, I also experimented with a variety of over-the-counter washes and creams, but never with much success, and again, sometimes I just made things worse.

Finally, about 3 years ago, I tried megadosing with B5 at 3g per day. I was amazed at the results. Within days, my oil problem was under control. I did experience a purge that lasted for roughly the first month of supplementation, but after that, my skin became clearer than it had been since I was 14. It did not, however, clear up completely. After the purge, I almost immediately hit a plateau. As I said, my skin was much better, but it was hard for me to be satisfied, as I was still getting small spots on a weekly basis that took a long time to fade.

I started to analyze my diet, and I quickly established that pasta was a surefire trigger food for me. This was a big deal, as I generally ate pasta several times a week. As painful as it was, I cut it from my diet, and I also cut just about every sugary food and drink just to be safe. Beer had to be cut, too. Again, I saw some definite improvement in my skin. I could in fact almost completely put a stop to my acne if I assiduously avoided all of these foods, but it seemed like I would always do something to set it off again. Furthermore, the spots were just taking too long to heal, and the hyperpigmentation that followed would persist for months. The result was that my skin still looked quite terrible in bad lighting even though I had drastically slowed the development of new acne. I kept experimenting with other supplements in addition to the B5, but never with any positive effects; I was particularly surprised that fish oil seemed to make my skin worse.

I had almost resigned myself to living with fairly bad skin, but then just a few months ago, I started doing extensive reading online again, and decided I'd give fish oil another shot, but this time, I would use a higher grade. I also came across several discussions of vitamin D and acne that seemed interesting. I started taking both at the same time: 4,000 IU of D3 daily, along with 1 g of fish oil (Lovaza, which luckily my father had a large stock of). For the first couple of weeks, I couldn't really tell whether anything was happening, but by the end of the first month, I could see a definite difference. Now, after two months, I can say without a doubt that my skin feels smoother and is noticeably less red. Even when I do get spots now, they are typically smaller and aren't even terribly noticeable in the mirror, whereas before it seemed that even the smallest spot would result in significant redness. I've also noticed improvement in the blackheads on my nose, and I don't have to exfoliate as much anymore, either. Unfortunately, trigger foods still must be avoided, but oh well, I guess one can't have it all.

I don't know whether I'd say that my skin is 100% perfect now, but I'm really pleased with what I've achieved--finally, at age 28! I think if I can maintain this for a year or so, to give the hyperpigmentation from spots I got earlier this year time to fade, my skin will be looking very nice indeed.

MY REGIMEN:

Morning: 1g vitamin B5, 4,000 IU Vitamin D3, wash face with "Grandpa's Thylox" soap

Noon: 1g vitamin B5, 1g pharmaceutical grade fish oil

Night: 1g vitamin B5

Avoid: pasta, beer, milk, fruit, soda (for me, pasta seems to be the worst trigger by far; beer is a distant second)

Notes: I don't think the Thylox soap really helps all that much; I just use it because I find it aids in exfoliation. It can be quite drying, so it might not be for everyone. My skin tends to have a lot of build-up that needs to be removed, though that build-up has been greatly reduced with the addition of vitamin D3 and fish oil to my diet.

The type of fish oil matters! I used the low grade stuff typically sold in stores, and it made my acne worse. Those pills are often only around 30% omega 3! The fish oil I use now is over 85% omega 3.

Brands: I get my vitamin B5 from Swanson, fish oil from OmegaVia (I used the prescription drug Lovaza at first), and Vitamin D3 from Nutrigold. Just telling you what I use, since I know people will ask.

Warning: One of my inspirations for writing this post was the thread started by wingedserpent. I share his belief that it is best to use vitamins and supplements cautiously. I am now in fact seriously looking for ways to reduce my intake of vitamin B5. Although I have used it for several years, I am nevertheless concerned about the potential long-term consequences. I feel ok about 4000 IU of vitamin D3 based on reading I've done, but you may want to lower it to 2,000 IU to be on the safer side. In any case, I cannot give you medical advice; only you can be responsible for deciding, either alone or in consultation with a doctor, whether you find a regimen such as mine to be worth the risk.

Thanks for reading, and good luck!