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Nearly 30 Years Old, Finally Getting Serious About My Acne

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I'm interested in the community's thoughts on my situation:

I've had moderate acne since my early teenage years. I'm 29 years old now, male, white. I was born in Eastern Europe and came to the US (east coast) when I was four and now I live in southern california. The acne has been up and down (but never fully cleared), mostly on my face, neck, and back. I've always hated it but I never got much support to help fix it and I only recently became what I'd say as "fully conscious" of my ability to try to fight back against my problems, including acne.

A few months ago I went to a dermatologist for the first time since my teenage years (I forget what treatment I got back then, but it didn't work). She prescribed Adapalene Cream (0.1%) and a regiment of: gently wash face in the morning, no treatment during the day, at night wash face with CeraVe Hydrating Cleanser, then put on adapalene, then put on CeraVe moisturizing cream. I've been doing it for about 3-4 months and I've been very good about the regiment but I can't say it's gotten much better (maybe around the neck a bit), with constant breakouts on my face.

I've started to do more of my own research and found some other options including the regiment here on acne.org, and I also ordered a 20% azelaic acid foam for shaving. I have my first followup with the dermatologist in a few weeks and I plan to tell her that Adapalene isn't really working and I want to see what her next ideas are and what she thinks about acne.org's regiment.

A few years ago, I switched from a crappy diet to a more fatty diet with less carbohydrates (I lost 40 pounds) - somewhat of a paleo diet - and that seemed to improve my acne a bit. I recently found out I'm lactose intolerant (through 23andme.com genetic test) which probably explains some gastro-intestinal problems I've always had, and so I removed milk & cheese from my diet about 6 months ago, but still things haven't cleared up. My diet is: breakfast: eggs/bacon/potatoes/berries/grapes, lunch: orange/banana/shrimp/etc, dinner: rib eye or salmon with a huge plate of vegetables. I pretty much only drink water.

Any thoughts welcome!

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