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Rafiki3

I'm Truly At Wits End. I Can't Live Life Anymore. Is This Hormonal? My Cheeks And Jaw Are Destroyed. Please Help Me, Warning Pictures

Background: 19 year old male, acne since 15. Been on antibiotics in the past, other things too, always dealt with whitehads and redmarks. Now as a university student, I am dealing with an unbelievably horrible breakout. Things just don't get better for me, my life has amounted to this. I need help.

I do not function like a normal person anymore. I can't live my life at all. I've had acne for 4 years, and this is now the worst breakout to date. I don't understand, I truly don't. I try to do everything right, I don't drink or smoke. I am trying to eat healthy. I read so much about how to prevent acne and I get nowhere. Is this hormonal and is there any hope for me? My face is DESTROYED by red marks and stuff already, but all these red bumps and whiteheads make me want to die in public. All I can think about is my face, which makes me even more depressed and stressed. I'm seriously trapped. I can't even shave like a normal person anymore, not that I want to. Shaving always would give me irritation and whiteheads, but I can't even shave my face because of all my redmarks and active acne going on. It's unbelievably frustrating.

Is accutane going to help with this? Will it leave redmarks and scars anyways? I want this GONE, my life is miserable. Is accutane likely my solution or should I look into something else? I am so reluctant of derms, they prescribe me Epiduo and I am just so scared to use it. It makes me redness WORSE and as you can see that's my biggest problem (both in terms of active acne bumps/whiteheads and also I have red marks and scars)...

My skin is so different from everyone elses, I can't even explain it. Also my facial hair is disgusting. The pictures are pretty disgusting just as a heads up. Obviously I put the flash on to illustrate my problems, but even in normal lighting it looks THIS BAD. Please god help me. I don't know what caused this recent breakout of what you see now. A lot of it itches. I am trying to be so healthy right now but I am waking up with NEW WHITEHEADS OR BUMPS DAILY. For the love of god why.

I am not on any products right now. I take a zinc supplement and fish oil. I exercise often. I am so self-conscious. I'm begging for help. I cleanse with cerave gentle cleanser, and moisturize with cerave moisturizing lotion. It's hard for me to even cleanse my face, feeling all my bumps and disgusting acne kills me. I can't look at mirrors, I have become an outcast and I feel like I'm on a horrible path. I cannot just pretend this is not there, I understand people say that and I respect them. But I can't live a normal life when I do not at least look somewhat like everyone else. My skin is absolutely horrible. What should I do? I tried retinoids and BP in the past, never helped much. I'm extremely reluctant to go back on any products - I feel they will only make things worse, make my red marks last longer and scars get more discolored. I know BP is harsh. What do I need to do? Is there any solution for me?

I'm begging for advice. Honestly even the pictures don't do this justice. In even normal lighting, it just looks absolutely disgusting. And I know it's not just me feeling this way. I see people looking at my face. I can't even hold a normal conversation face to face nowadays without wanting to curl up and die. It's pathetic and I don't want to live like this. Please help.

WARNINGS PICTURES:

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Edited by Rafiki3

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Did you notice your acne getting worse after adding the fish oil and/or zinc? To me, it looks like it might be an allergic reaction or some type of folliculitis. I actually had a similar breakout with those type of bumps on my jawline a few months ago and it wasn't responding to any acne topicals. I treated it by getting extractions from an esthetician (who confirmed it was folliculitis when she found trapped hairs in the infected follicles) and using tea tree oil. Some people use nizoral shampoo (check the folliculitis threads for more info), but I suggest you start with diluted tea tree oil to confirm whether it's folliculitis or not.

To minimize the redness, remove all products with sulfates from your routine, and try not to use harsh water on your face. Some cerave products contain alcohol, which in your case might be irritating to your skin.

You can try a honey or yogurt mask to calm down the redness, but do a spot treatment at first to see how your skin reacts.

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stop with whatever you are taking. Oral and topical wise. Go to a derm and ask about accutane- my cousin has the same issue in the same spot- and went on accutane- now 3 years later doesnt even break out!

Talk to a derm about it.

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good thing is its not really that bad! really and u have no scars so thats good , looks like hormonal acne easy fix

so what would you use to treat hormonal acne?

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Did you notice your acne getting worse after adding the fish oil and/or zinc? To me, it looks like it might be an allergic reaction or some type of folliculitis. I actually had a similar breakout with those type of bumps on my jawline a few months ago and it wasn't responding to any acne topicals. I treated it by getting extractions from an esthetician (who confirmed it was folliculitis when she found trapped hairs in the infected follicles) and using tea tree oil. Some people use nizoral shampoo (check the folliculitis threads for more info), but I suggest you start with diluted tea tree oil to confirm whether it's folliculitis or not.

To minimize the redness, remove all products with sulfates from your routine, and try not to use harsh water on your face. Some cerave products contain alcohol, which in your case might be irritating to your skin.

You can try a honey or yogurt mask to calm down the redness, but do a spot treatment at first to see how your skin reacts.

Thank you. I do not know if the zinc and/or fish oil has made it worse. I don't think so but I suppose I will stop taking them as I guess they haven't really helped. What could I be allergic to in either of those do you think? I actually started the zinc sup because I read it helps. And I just added fish oil since I am not able to eat fish as much as I used to at all.

I am not sure if this would be folliculitis. I really can't see any trapped/ingrown hairs, and a lot of these horrible red bumps or whiteheads just seem to be in and of themselves - no hair problem with them. However I guess I can't be 100% sure. What do I do with the tea tree oil? Are you saying apply as a topical to my spots? Will that help? Or at least, it won't make anything worse?

I realize my shampoo has sulfate. Do you know any shampoo I can use instead?

And yes, I just realize my moisturizer has alcohol, I guess I need to switch that too. Do you know any good moisturizers that won't give me problems?

Thank you very much for your help. I just would like to know more about how I can start spot treating to figure this out. I am thinking it has to be hormonal, and I just want to end it for good. I don't need perfect skin, but I need to get rid of all this active stuff and all my redness.

stop with whatever you are taking. Oral and topical wise. Go to a derm and ask about accutane- my cousin has the same issue in the same spot- and went on accutane- now 3 years later doesnt even break out!

Talk to a derm about it.

Thank you. I'm going to stop both of my supplements. I am scared of accutane from hearing stories of some side effects, but I also want to live without a red face and living in anxiety. Hopefully I can schedule a derm appt soon. I want a clear face but I'm just reluctant that I could be one of those people saying "I wish I never took accutane". I've heard great stories and bad ones...I guess it's just a risk I have to take. Do you think accutane is applicable to my situation though, I have the right problems that will treat it?

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good thing is its not really that bad! really and u have no scars so thats good , looks like hormonal acne easy fix

so what would you use to treat hormonal acne?

i take DIM and I3c supplement togethor , it will stop acting from forming around jawlines , chin , mouth area and also u want to eliminate all dairy , sugar , greasy food for couple months stick with drinking only water Also try taking some liver supplements like milk thistle whenever you eat

Edited by LeadingForce

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Have you tried the acne.org BP? I've used Epiduo and it was pretty good, but Dan's acne.org BP is far better. I would say try the regimen, my acne was about as bad as yours and now I'm all clear, it has helped tons of other people as well. The reason why you probably don't see a whole ton of people talking about the regimen is because the people with success have already moved on and left this site!

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Did you notice your acne getting worse after adding the fish oil and/or zinc? To me, it looks like it might be an allergic reaction or some type of folliculitis. I actually had a similar breakout with those type of bumps on my jawline a few months ago and it wasn't responding to any acne topicals. I treated it by getting extractions from an esthetician (who confirmed it was folliculitis when she found trapped hairs in the infected follicles) and using tea tree oil. Some people use nizoral shampoo (check the folliculitis threads for more info), but I suggest you start with diluted tea tree oil to confirm whether it's folliculitis or not.

To minimize the redness, remove all products with sulfates from your routine, and try not to use harsh water on your face. Some cerave products contain alcohol, which in your case might be irritating to your skin.

You can try a honey or yogurt mask to calm down the redness, but do a spot treatment at first to see how your skin reacts.

Thank you. I do not know if the zinc and/or fish oil has made it worse. I don't think so but I suppose I will stop taking them as I guess they haven't really helped. What could I be allergic to in either of those do you think? I actually started the zinc sup because I read it helps. And I just added fish oil since I am not able to eat fish as much as I used to at all.

I am not sure if this would be folliculitis. I really can't see any trapped/ingrown hairs, and a lot of these horrible red bumps or whiteheads just seem to be in and of themselves - no hair problem with them. However I guess I can't be 100% sure. What do I do with the tea tree oil? Are you saying apply as a topical to my spots? Will that help? Or at least, it won't make anything worse?

I realize my shampoo has sulfate. Do you know any shampoo I can use instead?

And yes, I just realize my moisturizer has alcohol, I guess I need to switch that too. Do you know any good moisturizers that won't give me problems?

Thank you very much for your help. I just would like to know more about how I can start spot treating to figure this out. I am thinking it has to be hormonal, and I just want to end it for good. I don't need perfect skin, but I need to get rid of all this active stuff and all my redness.

>stop with whatever you are taking. Oral and topical wise. Go to a derm and ask about accutane- my cousin has the same issue in the same spot- and went on accutane- now 3 years later doesnt even break out!

Talk to a derm about it.

Thank you. I'm going to stop both of my supplements. I am scared of accutane from hearing stories of some side effects, but I also want to live without a red face and living in anxiety. Hopefully I can schedule a derm appt soon. I want a clear face but I'm just reluctant that I could be one of those people saying "I wish I never took accutane". I've heard great stories and bad ones...I guess it's just a risk I have to take. Do you think accutane is applicable to my situation though, I have the right problems that will treat it?

Yeah i here you! I got off accutane about 4 weeks ago! But im happy i did it.

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I would agree with trying the regimen and if that's not effective, I would look into Accutane. I had acne from age 20-30, I refused Accutane twice before I finally broke down and started my course at the beginning of the year, I finished over the summer. It's not an easy drug to take and some people do get an initial breakout but most people have remarkable results. Since you're worried about the side effects, maybe you could talk to your dermatologist about starting a lower dose and gradually increasing based on how you tolerate it? If you decide to take it, my only advice would be to read some of the logs on this site to give you an idea of what to expect and be aware of the serious side effects so you can report them immediately to your doctor if needed. Good luck to you!

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Have you ever tried an elimination diet before? I took accutane and my acne came back. Now it is very much in control from completely changing my diet.

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You mention shaving as a difficult process - what are you using to take your facial hair off? I got a stubble trimmer by Axe/Phillips, and it saved my face! My acne was similar to yours, although more compacted near the jaw. It does get pretty close, no smooth feeling though :( but better than shaving rash by a million times :) I still need to deal with my forehead acne though.

The regimen would be a great start I believe. Start slow, even just once a night for the first few weeks.

Perhaps a short term antibiotic such as doxy or cephalexin can help you get rid of what you have now - I would ask about it at either your dr or urgent care/mini clinic.

Good luck!

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Thanks for all the replies.

So every cleanser and moisturizer I look at has some type of alcohol in it. Even the Cetaphil Gentle cleanser...should I still get that one? I don't know if the alcohol is that big of a deal, but maybe it's time for me to switch my cleanser/moisturizer anyways and try something new. Any recommendations? My face gets pretty tight in the winter after using the cerave hydrating cleanser.

Some of the acne on and under my jaw is itchy and it's so aggravating to try and function while I feel my face...

I also have some forehead acne going on, kind of the same whiteheads/red bumps. I am thinking this has to be hormones and stress. Are there any tests I should have done by my doctor? I also think a food test would be a good idea, is that somthing I can ask my general doc to do?

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For a gentle cleanser, you will have to do some research on ingredients etc. I usually double check everything using the cosdna.com website, although it's not always 100% accurate.

For cleansers, I recommend:

1. Image cosmetics ormedic cleanser

2. boscia cleanser with botanical blast

3. image cosmetics The Max cleanser

But I'm sure if you search around you might find less pricey ones. Boscia has a travel kit for acne-prone skin and it's pretty good & non irritating. I initially bought the travel kit to see if I liked the products, and I also got free samples at sephora. I never buy without trying first because I don't know how my skin will react.

For spot treatment, I recommend:

1. Skinbiotics Derma E oregano oil & tea tree

2. get 100% pure tea tree oil from a pharmacy and dilute it with water. Then dip in a q-tip and spot treat only. Don't apply all over because it will dry out your skin.

Also, if your acne isn't responding to typical acne topicals like bp and salicylic, then besides tea tree also try calamine lotion (the Walgreens type with the fewest ingredients, no mineral oil). Do a spot treatment for a couple of nights to see if your skin is responding, then apply only on your spots, not all over because it's drying. Let it dry overnight once you're comfortable using it.

Edited by WishClean

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You don't need to have a "food test." Those can be super expensive. You can follow an elimination diet. I had horrible hormonal acne and all the inflammatory stuff is pretty much gone now thanks to changing my diet.

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"Epiduo" should be helpful, but it is only available from a doctor. Try a hot wash cloth over with medium pressure over some of those deep acne bumps. Start increasing your daily vitamin C intake as well, although supplements may be better than eating citrus fruits directly as they could aggravate the bumps around your mouth.

You could get a hormone test but I find they don't show any difference unless your hormones are quite severe. I know for a fact i have hormonal imbalances yet tests never show anything.

I think it may also be worth it to start using distilled water to cleanse your face along with your products. Do you have 'hard water'? NO shower water. I heat a mug of distilled water in the microwave, pour it into a drink bottle and use in the shower for washing and rinsing my facial skin. It has helped ALOT.

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Please make an appointment with a dermatologist and tell him/her all of this. You may have to try a few topicals or oral antibiotics first, but if you're really set on trying accutane, you could ask for it and see if s/he is willing to skip the light artillery approaches... Just make sure you read everything you can get your hands on about accutane, and monitor your lipids as well as keep an eye out for adverse effects (low(er) mood, joint pains, hair falling out, blurry night vision, etc.) They tend to be reversible, but you should stop accutane until they clear up, and then you can try restarting on a lower dose.

Please also don't stress yourself out so much - you CAN get this under control and you can have nice skin once again. Between now and the dermatologist, you might look at getting some 5% benzoyl peroxide available over-the-counter. It's partially effective, although it's not enough for those of us with moderate to severe acne. I've been dealing with acne for over 20 years (first got it at 13, and am now 35). I've been on everything: topicals, oral antibiotics, spironolactone, accutane, zinc, B5... It's no joyride, but it is definitely possible to manage the condition so you can regain your confidence and your ability to shave!

Keep your chin up and get thee to a dermatologist, pronto. By the way, your skin under the acne looks awesome. You're going to clear up beautifully once you find the right meds (likely accutane).

PS I always tell people to read Bukowski's novel/autobiography Ham on Rye for perspective. (Beware that the main theme is hedonism to the point of tragedy; he was a drunk, and a womanizing misfit, a combination that lends itself well to captivating writing, but what struck me the most about his biography was his experience with disfiguring acne. His accounts of frequent surgical interventions to remove boils on his back made my skin problems pale in comparison...

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Background: 19 year old male, acne since 15. Been on antibiotics in the past, other things too, always dealt with whitehads and redmarks. Now as a university student, I am dealing with an unbelievably horrible breakout. Things just don't get better for me, my life has amounted to this. I need help.

I do not function like a normal person anymore. I can't live my life at all. I've had acne for 4 years, and this is now the worst breakout to date. I don't understand, I truly don't. I try to do everything right, I don't drink or smoke. I am trying to eat healthy. I read so much about how to prevent acne and I get nowhere. Is this hormonal and is there any hope for me? My face is DESTROYED by red marks and stuff already, but all these red bumps and whiteheads make me want to die in public. All I can think about is my face, which makes me even more depressed and stressed. I'm seriously trapped. I can't even shave like a normal person anymore, not that I want to. Shaving always would give me irritation and whiteheads, but I can't even shave my face because of all my redmarks and active acne going on. It's unbelievably frustrating.

Is accutane going to help with this? Will it leave redmarks and scars anyways? I want this GONE, my life is miserable. Is accutane likely my solution or should I look into something else? I am so reluctant of derms, they prescribe me Epiduo and I am just so scared to use it. It makes me redness WORSE and as you can see that's my biggest problem (both in terms of active acne bumps/whiteheads and also I have red marks and scars)...

My skin is so different from everyone elses, I can't even explain it. Also my facial hair is disgusting. The pictures are pretty disgusting just as a heads up. Obviously I put the flash on to illustrate my problems, but even in normal lighting it looks THIS BAD. Please god help me. I don't know what caused this recent breakout of what you see now. A lot of it itches. I am trying to be so healthy right now but I am waking up with NEW WHITEHEADS OR BUMPS DAILY. For the love of god why.

I am not on any products right now. I take a zinc supplement and fish oil. I exercise often. I am so self-conscious. I'm begging for help. I cleanse with cerave gentle cleanser, and moisturize with cerave moisturizing lotion. It's hard for me to even cleanse my face, feeling all my bumps and disgusting acne kills me. I can't look at mirrors, I have become an outcast and I feel like I'm on a horrible path. I cannot just pretend this is not there, I understand people say that and I respect them. But I can't live a normal life when I do not at least look somewhat like everyone else. My skin is absolutely horrible. What should I do? I tried retinoids and BP in the past, never helped much. I'm extremely reluctant to go back on any products - I feel they will only make things worse, make my red marks last longer and scars get more discolored. I know BP is harsh. What do I need to do? Is there any solution for me?

I'm begging for advice. Honestly even the pictures don't do this justice. In even normal lighting, it just looks absolutely disgusting. And I know it's not just me feeling this way. I see people looking at my face. I can't even hold a normal conversation face to face nowadays without wanting to curl up and die. It's pathetic and I don't want to live like this. Please help.

WARNINGS PICTURES:

Most of us understand what you are going through. You are depressed. The most important thing to track when down is that the storm will clear, the clouds will fade and the sun will shine again. Chat with your family doc about the way you feel as soon as you can. They can help relieve the stress, anxiety and depression while you are working on clearing your skin.

All acne is hormonal.

1st free testosterone stimulates sebum production;

2nd insulin exacerbates and increases sebum production.

You can decrease insulin immediately by only eating meat, vegetables and fruit.

Dealing with the unopposed free testosterone requires your docs help.

Ask them to order the following blood work:

Male Hormone panel

Estradiol

SHBG

8 am cortisol

DHEA sulfate

Good luck. This is a problem that can be solved with the correct advice.

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It doesn't look bad really, it looks like you have minimal-no scarring. Which is something you should be extremely thankful for! As a topical I would try apple cider vinegar, the smell is awful.. but the results are amazing! It'll clear the area of bacteria and in about 3 days I GUARENTEE results. go to a derm about pills or somehing to treat internally. I really would only resort to accutane as a last option though. Good luck bud!

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It doesn't look bad really, it looks like you have minimal-no scarring. Which is something you should be extremely thankful for! As a topical I would try apple cider vinegar, the smell is awful.. but the results are amazing! It'll clear the area of bacteria and in about 3 days I GUARENTEE results. go to a derm about pills or somehing to treat internally. I really would only resort to accutane as a last option though. Good luck bud!

dont bs me its bad. its worse in real life than the pictures. i cant believe i only posted that one week ago. everything is full of painful whiteheads on my jawline now. i dont even know how to freakin moisturize or cleanse without aggravating them. i am actually glad that i am being let go from my part time job because i cant even bare to go out in public. this is pathetic, acne has overpowered my life, and yes i know im weak for letting it happen.

the derm recommended doryx along with benzaclimin and retin a. im reluctant to start. i know antibiotics dont really help in the long run, and im just scared the topicals will increase redness and the probability that marks will stay in the form of hyperpigmentation. am i right in thinking that?

i guess i might as well just get these prescriptions filled though. im already not living my life, im already planning to stay inside alone as much as i can now until this improves. do you guys think the oral + topicals are the way to go right now? would accutane honestly be a better option overall for me or should i do this standard regimen that my derm prescribed? thoughts please

ive been eating super healthy, i pray to god it pays off a month from now. im drinking a green smoothie once a day. i am just praying for some help...should i start the prescriptions? i understand it could make it worse before it gets better, but i just need an honest real answer if its going to cause more permanent damage in any possible way? i think i have mild cystic acne. and im disgusted by my jaw how there's so many ITCHY TENDER whiteheads clumped together with these red INFLAMED bumps. WTF is going on. is an oral + topical the best thing for my type of acne right now? yes its similar to the picture in my first post, but i feel like its gotten worse now. they just keep coming even when i try not to do anything all day. i dont even know how to touch them when i need to moisturize without freaking BREAKING the whiteheads or aggravating them. WHAT DO I DO

also ive tried ACV as a topical before. it really didnt make a difference. and i dont even think i can apply it right now its so tender and inflamed without breaking the whiteheads...idk what to do. im not sure how i'll apply topicals either in the area, i guess i should just go over the whiteheads with my fingers regardless of if i ibreak them or not? this is SO FRUSTRATING.

ive also drank ACV before, 2tsp mixed in 8oz water a day. i did that for a while and honestly saw no improvement. thanks for the ACV suggestion but im not going to do that at the moment.

please help with any advice or thoughts regarding my post above this one

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I know it's frustrating - and there is a lot of good advice here- see a derm, get the BP/clindamycin combo and use that morning and night...or just use the regimine if you can't afford the doctor...it's worth a try

on food, ditch dairy, start there first, and I mean DITCH it, completely - use almond or coconut or hemp milk as a substitute, try this for 30 days...this is the big one that helps most people

change your pillowcases every other night, and make sure you aren't using fabric softener, just a mild free of dyes and perfumes detergents...

and a mild wash, like cerave face wash and for shampoo stick to head and shoulders classic clean and skip the conditioner

do the regimine morning and night

give it 30 days and come back to us and let us know, get outside get some fresh air and sunshine, try to relax as best you can with people who love you for you....good luck to you

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Thanks. Everything you just said I have been doing. I switched to almond milk a year ago. I change my pillow literally every 1-2 days. I don't use a conditioner. I use cerave hydrating cleanser any cerave moisturizing lotion. I don't think they're bad but I've never found anything "better". I would be willing to try a different moisturizer but idk what.

I can afford prescription luckily. So will the bp morning / retinoids at night combo be safe for me? Is it going to increase permanent redness/increase scars? That's all I'm worried about. Would it simply be better to kill this for good with accutane or should I do the recommended products? And thoughts on the doryx? I took doryx 1.5 years ago if that matters so it's been awhile. It probably helped back then at the time I don't remember.

What exactly is the purpose of benzaclimin morning and then retin a at night? I just want to understand what each product is doing for me. Are they both equally important? Should I just use one of them? I read that bp causes more redness? And retinoids thin the skin and make it weaker? I'm not bashing the topical I'm just nervous. I want to understand how they are going to help my face without making it worse long term/permanently based on what I have read they kinda do. What are the positives of them being used on this type of regimen please. Is it really the best option for me? If it is ill start on Monday, I just want to be ABSOLUTELY SURE AND COMPLETELY UNDERSTAND WHY AND HOW THEY WILL HELP ME SPECIFICALLY

I don't even know how the hell to cleanse and moisturize with my jaw like this, and not to mention the cold weather. I've barely left the house so I only cleanse and moisturize every other day right now (I have been working out every other day for the time being).

Sigh...thank god I'm on winter break

Edited by Rafiki3

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Thanks. Everything you just said I have been doing. I switched to almond milk a year ago. I change my pillow literally every 1-2 days. I don't use a conditioner. I use cerave hydrating cleanser any cerave moisturizing lotion. I don't think they're bad but I've never found anything "better". I would be willing to try a different moisturizer but idk what.

I can afford prescription luckily. So will the bp morning / retinoids at night combo be safe for me? Is it going to increase permanent redness/increase scars? That's all I'm worried about. Would it simply be better to kill this for good with accutane or should I do the recommended products? And thoughts on the doryx? I took doryx 1.5 years ago if that matters so it's been awhile. It probably helped back then at the time I don't remember.

What exactly is the purpose of benzaclimin morning and then retin a at night? I just want to understand what each product is doing for me. Are they both equally important? Should I just use one of them? I read that bp causes more redness? And retinoids thin the skin and make it weaker? I'm not bashing the topical I'm just nervous. I want to understand how they are going to help my face without making it worse long term/permanently based on what I have read they kinda do. What are the positives of them being used on this type of regimen please. Is it really the best option for me? If it is ill start on Monday, I just want to be ABSOLUTELY SURE AND COMPLETELY UNDERSTAND WHY AND HOW THEY WILL HELP ME SPECIFICALLY

I don't even know how the hell to cleanse and moisturize with my jaw like this, and not to mention the cold weather. I've barely left the house so I only cleanse and moisturize every other day right now (I have been working out every other day for the time being).

Sigh...thank god I'm on winter break

Several people have suggested diet modifications. Have you tried any of them?

What are you eating on a typical day?

The best approach to dealing with this kind of problem of is not to rely on a single approach. Pharmaceuticals are fine when prescribed properly, however you may need a multi-faceted approach to get a handle on what's going.

When using topical preparations, I always liked benzamycin gel. You must put it on liberally.

Now I manage primarily through diet modification.

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Thanks. Everything you just said I have been doing. I switched to almond milk a year ago. I change my pillow literally every 1-2 days. I don't use a conditioner. I use cerave hydrating cleanser any cerave moisturizing lotion. I don't think they're bad but I've never found anything "better". I would be willing to try a different moisturizer but idk what.

I can afford prescription luckily. So will the bp morning / retinoids at night combo be safe for me? Is it going to increase permanent redness/increase scars? That's all I'm worried about. Would it simply be better to kill this for good with accutane or should I do the recommended products? And thoughts on the doryx? I took doryx 1.5 years ago if that matters so it's been awhile. It probably helped back then at the time I don't remember.

What exactly is the purpose of benzaclimin morning and then retin a at night? I just want to understand what each product is doing for me. Are they both equally important? Should I just use one of them? I read that bp causes more redness? And retinoids thin the skin and make it weaker? I'm not bashing the topical I'm just nervous. I want to understand how they are going to help my face without making it worse long term/permanently based on what I have read they kinda do. What are the positives of them being used on this type of regimen please. Is it really the best option for me? If it is ill start on Monday, I just want to be ABSOLUTELY SURE AND COMPLETELY UNDERSTAND WHY AND HOW THEY WILL HELP ME SPECIFICALLY

I don't even know how the hell to cleanse and moisturize with my jaw like this, and not to mention the cold weather. I've barely left the house so I only cleanse and moisturize every other day right now (I have been working out every other day for the time being).

Sigh...thank god I'm on winter break

Sorry for the long rant, but I wanted to make sure I answered all of your questions because I empathize with how you feel -

First of all, I want to say that you've come to the right place. I think most people here have felt the extent of desperation you are feeling, if they aren't feeling it now. I want to answer your question about why and how the medications you are asking about will help you. Based on research I've done, The BP helps to kill bacteria through a process called oxidation, which basically means it introduces oxygen molecules into the areas that P. acnes (the bacteria that causes acne) live. Because this bacteria is anaerobic (it can only survive in an oxygen-free environment), it kills the bacteria relatively effectively. It also helps to prevent bacterial resistance (because no bacteria can survive oxidation), and so it's often combined with topical antibiotics (which is what the benzaclimin is, I believe). It also helps by preventing pores from clogging in the first place by increasing cell turnover (which is why it dries out your skin). People complain about it because the oxidation process also releases free radicals that can hurt healthy skin as well (this is what causes the dryness, redness and peeling people talk about). This can make your existing red marks (called Post Inflammatory Hyperpigmentation, or PIH) appear worse, but I found no evidence that this is permanent. Keep in mind though, that *acne lesions, or the inflammation caused by acne, destroy healthy skin*, much more so then BP does, so you have to weigh the pros and cons. Personally, I dont use BP because I didn't find it to be extremely helpful for my kind of acne, but it has worked for ALOT of people.

Retinoids like retin-a help the skin by making the top layer of skin thinner, and the bottom layer thicker. It will actually improve your skin in the long run (although it does dry it out and can make it flakey, which is where moisturizer comes in). However, it is VERY important to keep in mind that retinoids like retin-a can cause an initial break-out. The BP and the doryx will help to minimize this issue, and will help keep the IB at bay while your work.

Also important to remember, both BP and Retina can make you VERY sensitive to sunburn, which is very BAD for your skin. It is extremely important that you wear sunblock, even in the winter when you will be inside, because even sunlight through a window can burn you. Make sure the sunscreen you use is a non-comodgenic one made for your face. Honestly, I use Vichy sun-cream made for sensitive skin, but it's a bit pricy. I've used Aveeno moisturizer with SPF-30, and it worked fine. I switched to Vichy only because I liked the texture better, but aveeno never broke me out and it actually helped my redness somewhat.

One final note - I'm starting accutane in a couple weeks because, like you, I am at my wits end. One thing I have noticed that makes me feel better about the side-effects with accutane, is that it is the only medication I have researched where there are significantly more positive reviews than negative ones. If you think about it, most people tend to comment about negative stuff in product reviews, and the fact that people actually took the time to talk about how well accutane worked for them more than they talked about how it didn't makes me believe that it is worth the side effects.

Also, your frustration is totally valid, don't let anyone make you think it isn't. This is your face, your life, and your body. Do your due diligence, but in the end - you have to decide on what scares you more - Living with acne that has a high likelihood of negatively impacting your skin if you leave it to it's own devices, or living with temporary side effects of medications that will likely help, and at the least, has no likelihood of hurting your skin more than the acne does?

Also remember, acne is NOT your fault. Yes, it is your responsibility to be healthy and to treat your body well, and only you can make your acne better, but just remember that you did not choose to have acne.

I

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