Hi 
After stalking this site I have decided to sign up so I can finally ask for help about what to do with my acne. Here's a brief history of my skin:
At age 10 I started to get blackheads around my nose and on my chin which have never gone away.
Age 11- started getting the occasional whitehead, had constant white spots on the apples of my cheeks
age 12- got lots of red spots on my forehead, chin, in the summer I developed chest and back acne which still remains.
age 13- went on tetracycline, twice, became resistant and it stopped working.
14- went on doxycycline, cleared up a bit of my forehead and chin spots, blackheads still remained. Cleared my chest a bit, did nothing for my back.
age 15- repeat prescription of doxycycline, still had some spots, bacne and blackheads on my chest with some whiteheads. Acne spread to the tops of my arms, had some spots above my bellybutton,
15- doxycycline course finished, still had bacne, blackheads on chest, chin, nose, some spots on forehead.
I had skin that looked fine with make-up, got complemented once on my clear face! but my back was still spotty. About 5 months after stopping doxy, I developed the worst acne I've ever had on my face. I had whiteheads, blackheads, pustules, nodules, disgusting yellow and white things that have left some mini icepicks, i have some small rolling scars on my face. I developed most of this new acne on my cheeks, which is where I've never had acne before. I feel so insecure, now after getting this acne I've realised how much confidence I had before, I no longer participate in lessons, I avoid getting to close (physically) to people and can't look them in the eye because I always see them looking at my skin, I am so self-concious. Throughout the oral pills, I've tried salicylic acid, whatever they put in clearasil, tea tree oil, tcp, sudocrem (which i never expected to work really but) benzoyl peroxide (which has helped a bit but only with antibiotics), witch hazel, olive oil, castor oil, facewash with aha and jojoba oil, and now zineryt(topical erythromycin and zinc) and benzoyl peroxide, i've stopped eating so much sugar and dairy, I have a vegetarian diet, am taking vitamin c and evening primrose oil for scars. BUT my main question is: what can i take after trying doxycycline? I am taking a 3rd course of doxy but really want to swap to something else, every time i stop it comes back worse, so do you have any ideas of what i can ask my gp for? I now have some hard, dark purple bumps under my skin, scars, pimples, blackhead and whiteheads. I am female- what about bcp? The only thing I am concerned about is acne coming back worse after stopping bcp. Also anything that can help with redness? I am sensitive to vit e so I can't use that. Anyway thank you for reading if you have any ideas please let me know p.s sorry no pics- i don't have a camera and don't let people take pictures of me. I am now 16- is my acne mainly hormone related?
After I went on Doxy (did absolutely nothing for me) I switched to Minocycline. Mino did seem to help somewhat with the cysts, but other than that my acne remained. I have acne just on my face now, but I used to have a tiny bit on my back and chest. After the Mino my derm put me on Accutane (Claravis 40mg & hope to be upped in dose on Monday). I'm at the end of my first month now.
It seems to me that you skin is very very resistant and it may require accutane at the end of the day. I know some people may have other options, but you really have done a lot for your skin and I think the longer you post-pone your accutane course, the more scarring you may have. Maybe inquire with your derm..?
Also, I'm not sure about the hormonal thing..
Thank you for replying! I think that my gp may put me on mino after doxy, which I don't really want because I always become resistant to antibiotics and the acne eventually gets worse, however I think that my doctor wants to exhaust every antibiotic before considering something more serious. I've considered accutane a lot, at first I was really worried about the side effects but as my skin gets worse I am warming up to the idea, however I have family history of depression/ bipolar so would I be at more risk of getting these side effects? If my gp mentions roaccutane I will try it, but i sort of want to see if acne clears up naturally after puberty, which, according to family history is meant to finish when i'm 17, I just don't want to get more serious scarring!
How have your side effects been?
Well, as for the depression and mood disorders that run in your family, they run in mine too and I have experienced no emotional set-backs at the hands of accutane. Actually, the mino and/or birth control made me MUCH more emotional the accutane. I'd be driving my car and start crying for no reason; it was really strange. I used to also suffer from severe depression for many years and after I employed some cognitive behavioral techniques (I'm a psychology student) I was able to over-come these things and I have not experienced a depressive episode since.
I am currently creating an empirical literature review on isotretinoin, and one of the studys I read stated:
"Isotretinoin but not antibiotic treatment was associated with decreased brain metabolism in the orbitofrontal cortex (-21% change versus 2% change for antibiotic), a brain area known to mediate symptoms of depression. There were no differences in the severity of depressive symptoms between the isotretinoin and antibiotic treatment groups before or after treatment."
I can conclude from this that it is *possible* to experience depressive symptoms while on accutane, but not entirely likely. In this study, they also said that those whose PET & MRI scans showed the greatest change in their orbitofrontal cortex also experienced symptoms of headache while taking accutane. That is something to watch for.
As for my symptoms, they have been unbelievably managable, actually. I have experienced dry lips, but by using aquafor on a regular basis and lightly exfoliating my lips I have been able to keep then in check. My face is a bit dry of course as well. The worst thing so far is the dry hair. I was born with scalp eczema that has persisted my entire life, and usually I am able to keep the symptoms of that down by washing regularly. But with accutane my hair & scalp are so dry that I can't keep the scalp flaking under control (TMI sorry lol). As for any other symptoms, I can't think of any..
ETA: I'm a bit psyched out about the idea of hair loss (not that I've experienced it) so I may ask my derm how to best moisturize my scalp so that my likelihood of hairless is lessened. I can't even imagine losing my hair temporarily (let alone permenantly!) at 21 yrs old.
Thank you for replying! I think that my gp may put me on mino after doxy, which I don't really want because I always become resistant to antibiotics and the acne eventually gets worse, however I think that my doctor wants to exhaust every antibiotic before considering something more serious. I've considered accutane a lot, at first I was really worried about the side effects but as my skin gets worse I am warming up to the idea, however I have family history of depression/ bipolar so would I be at more risk of getting these side effects? If my gp mentions roaccutane I will try it, but i sort of want to see if acne clears up naturally after puberty, which, according to family history is meant to finish when i'm 17, I just don't want to get more serious scarring!
How have your side effects been?
First off no, you do not need to take accutane and you should definitely try a BCP before accutane. But you have to understand how antibiotics work, there's two different types, bacteriostatic and bactericidal. Doxycycline is a bacteriostatic, meaning it will prevent the bacteria from reproducing, after that happens your immune system should then kill off the bad bacteria, but that's easier said than done. The other type of antibiotic, bactericidal literally kills the bacteria, it'll wipe out a good portion of the bacteria in your gut, good and bad, but it will definitely get rid of the acne. My theory is that people who do use tetracycline type antibiotics a lot, the bacteria in their body has built up a resistance to it and your immune system isn't strong enough to fight them off. Minocycline is also a bacteriostatic, but a stronger one with a wider spectrum so it may work better.
First off no, you do not need to take accutane and you should definitely try a BCP before accutane. But you have to understand how antibiotics work, there's two different types, bacteriostatic and bactericidal. Doxycycline is a bacteriostatic, meaning it will prevent the bacteria from reproducing, after that happens your immune system should then kill off the bad bacteria, but that's easier said than done. The other type of antibiotic, bactericidal literally kills the bacteria, it'll wipe out a good portion of the bacteria in your gut, good and bad, but it will definitely get rid of the acne. My theory is that people who do use tetracycline type antibiotics a lot, the bacteria in their body has built up a resistance to it and your immune system isn't strong enough to fight them off. Minocycline is also a bacteriostatic, but a stronger one with a wider spectrum so it may work better.
thanks for your response 
My problems with antibiotics is that afterwards the acne just comes back, would this not happen with a bactericidal then? I'll ask about these types of antibiotics at my next appointment, as well as a bcp I really don't want to take another tetracycline.
Don't do accutane. It's a chemotherapy, and thus kills stem cells and other quickly dividing cells. Side effects could pop up around 60 when your telomeres start to run out. Absolute last resort.
It sounds like your acne is caused by the antibiotics. It sounds like what's happening is the antibiotic is killing the P. acnes bacteria on your face and giving you results. You have to remember that this is a systemic medication, so it's also killing your gut flora. Since it comes back worse each time, I would say that the antibiotic is providing an environment that supports pathogenic bacteria in your gut, and that this is the cause of your acne. You clear up because the bacteria on your face are necessary for the formation of lesions, but the underlying problem is still there.
You could get a stool test done to see the status of your flora. My guess is that you have one or more pathogenic strains overgrowing. Removal of these via targeted antibiotic or herbal supplement, and then subsequent supplementation with probiotic-rich foods (especially fermented vegetables like kimchi and sauerkraut, if you can't stomach those, then unwashed organic green salads, unwashed being the key) might lead to improvement or cure.
Of course you got acne from something in the first place. I'll point the finger at milk, but you could also consider a wheat intolerance. You eat a vegetarian diet, and this usually includes lots of wheat and other grains. You could try going without wheat for 2-4 weeks at minimum, and seeing if your skin improves. This would be hard, being vegetarian, but there are many grains to choose from I guess. Just don't eat buckwheat either. Stick to rice and quinoa. Oh and remember that wheat equals bread, pasta, pancakes, breadings, cereal, and tons of other stuff.
Another poster mentioned that bacterial resistance could lead to your immune system not being able to fight them off. The immune system destroys bacteria differently than antibiotics do (sometimes by eating them whole) so this is unlikely, but I certainly agree that the antibiotics are a likely secondary culprit in all this.
Hi just wanted to say theyre are things u can do if your derm is understanding.i had been on antibiotics over 18 years.tell derm u would like to running prescriptions switchin back and forth week to week to delay and help stave off resistance alot longer. Ask for duricef 2 500mg a day the other can be minocycline if he wants. Also great for acne ,omnicef spectracef, ceftin, vantin, cephalexin, ceclor, cedax, the last 2 are once a day pills. Most importantly with whatever antibiotic being used ALWAYS take 400 mg of ibuprofen directly with antibiotic results 10x better u will be amazed.helps with absorption of meds quells inflamation too.if interested have alot more info to help. Good luck