Were you messing with those areas before you took the picture (i.e. rubbing, popping or applying a topical)? The reason I ask is because the area looks extremely inflamed and swollen. This, in addition to the lack of large white-heads tells me the infection is deep within the skin, and unfortunately, topicals will be very unlikely to make a dent. I suggest going to a (good) dermatologist as soon as possible.

Make sure to mention the time-line of your cystic breakouts (i.e., it is very important to mention that the breakout dramatically increased in severity over the course of 24 hours). Also mention the uncharacteristic break-out of your chest area. In the mean time, a hot-compress and ibuprofen will help with the pain and itchyness.

Yup --- looks just like the acne I used to get. Awful and painful too! I'm so sorry. I do have some ideas that might help you. First, diet is important and I agree with above that it can take time for a bad diet to make a mess. So you must change your diet right away. Avoid all dairy (because of the inherent hormones that affect your hormones), sugary foods, caffeine, and possibly the usual rosacea triggers (look up on web for list). In addition you must avoid all processed oils (butters, margarines, salad dressings, etc.) because these things inflame the skin and also make skin oilier if you are prone to inflammatory acne. Eat whole fresh foods and drink lots of water.

I think you have a mix of rosacea + acne so you have to treat from both perspectives. The BP cleanser may be helpful. Wash extremely gently...just gently swooshing over skin with fingertips to the count of 60 (this lets BP get into skin). Dry by patting gently...no rubbing. Do your topical. It will help. I use Cleocin-T and love it. It totally knocked out the cystic acne, along with using the BP cleanser (Panoxyl 4%). You may want to consider using Spironolactone. It blocks androgen receptors which in turn makes for less inflammatory acne. It is not a hormone...just blocks androgens. Another thing that made a HUGE difference in my deep cystic acne was starting monthly microdermabrasions in derm's office with a diamond tip. Totally opened up my very blocked pores and let the meds in.

You have deep acne and it is going to take a multi-prong approach to get it under control. Trust me...I know this from years of dealing with the same thing. My derm is a specialist in adult acne and he put me on the regime below. Ask your derm about this combined approach.

Send me a message if you want. Would love to hear how it goes!

I'm sorry it has taken so long to reply.

In reply to you all, I had not picked at my face before taking those pics... That's just how my acne is. Big and inflamed. When I get a pimple, the surrounding area becomes inflamed.

So this is my update:

I started eating healthy again.

I eat lots of fruits and veggies. I avoid most processed foods. A little dairy here and there. The dairy doesn't seem to affect me. I'm totally gluten free. It doesn't effect me when I eat it though. Just want to stay healthy. Maybe balance my hormones. Idk

I saw a derm a couple days after my post. It only got worse. More cysts. My inflammation. It was awful. Usually I only get one cystic at a time. This outbreak was not normal for me. The derm put me on an anti biotic. A couple of the pimples cleared up within a few days. And the rash on my chest is completely gone. But that is about all the antibiotic has done for me. Since I've been on it, I have continued to break out. Not like crazy crazy. But my normal pesty inflamed pimples. Also, a couple weird abscess type pimples. They start as cystic pimples, but just as they stop hurting, they fill with water like pus. Like a hard cyst covered in a pocket of watery substance... That does not hurt. I had one on my chin that the derm tested, twice, because it came back after she drained it once, and both times

It came back negative for bacteria.... Now I have another one doing the same thing in between my eyebrows. It's like a cyst that turns into a painless absess. So strange. If it's not bacteria, what is causing it, and why on earth is my derm having me stay on antibiotics if the abscesses aren't caused by bacteria?

I think this must be hormone related? What else causes oily skin? My skin becomes oily throughout the day. Always worse by the end of the day. What is causing the oil?

I used to have beautiful skin. Now I can't even make eye contact with people. I hate it. I want to be able to go to play dates with my daughter and enjoy watching her learn and explore without feeling awkward talking to the other parents. I want to be able to go to business meetings without wanting to run in the other direction. I want my life back....

Everything started after I got that dang mirana removed two years ago.

Yup --- looks just like the acne I used to get. Awful and painful too! I'm so sorry. I do have some ideas that might help you. First, diet is important and I agree with above that it can take time for a bad diet to make a mess. So you must change your diet right away. Avoid all dairy (because of the inherent hormones that affect your hormones), sugary foods, caffeine, and possibly the usual rosacea triggers (look up on web for list). In addition you must avoid all processed oils (butters, margarines, salad dressings, etc.) because these things inflame the skin and also make skin oilier if you are prone to inflammatory acne. Eat whole fresh foods and drink lots of water.

I think you have a mix of rosacea + acne so you have to treat from both perspectives. The BP cleanser may be helpful. Wash extremely gently...just gently swooshing over skin with fingertips to the count of 60 (this lets BP get into skin). Dry by patting gently...no rubbing. Do your topical. It will help. I use Cleocin-T and love it. It totally knocked out the cystic acne, along with using the BP cleanser (Panoxyl 4%). You may want to consider using Spironolactone. It blocks androgen receptors which in turn makes for less inflammatory acne. It is not a hormone...just blocks androgens. Another thing that made a HUGE difference in my deep cystic acne was starting monthly microdermabrasions in derm's office with a diamond tip. Totally opened up my very blocked pores and let the meds in.

You have deep acne and it is going to take a multi-prong approach to get it under control. Trust me...I know this from years of dealing with the same thing. My derm is a specialist in adult acne and he put me on the regime below. Ask your derm about this combined approach.

Send me a message if you want. Would love to hear how it goes!

Were you messing with those areas before you took the picture (i.e. rubbing, popping or applying a topical)? The reason I ask is because the area looks extremely inflamed and swollen. This, in addition to the lack of large white-heads tells me the infection is deep within the skin, and unfortunately, topicals will be very unlikely to make a dent. I suggest going to a (good) dermatologist as soon as possible.

Make sure to mention the time-line of your cystic breakouts (i.e., it is very important to mention that the breakout dramatically increased in severity over the course of 24 hours). Also mention the uncharacteristic break-out of your chest area. In the mean time, a hot-compress and ibuprofen will help with the pain and itchyness.

I hadn't picked at my face, before those pics.. That's just how my skin reacted to the pimples. Usually, my skin is so sensitive, the skin surrounding a pimple gets inflamed. That outbreak only got worse. It was crazy. Could you read my long reply that I just posted? It goes into detail with an update of my situation. I'd love to hear your feedback!

I was wondering... This all started to get really bad when I went to stay with my grandparents to take care of them while my grandpa recovered from knee surgery. Their house is swarming with bacteria, I swear. Stop reading if you have a weak stomach... Their house was kept at 75 degrees and there was feces and urine in the air daily because they both were diapers and they leak constantly. I was the one there to clean it up.

I mean the air was so horrible in that house that fruit left out in a fruit bowl would go bad in a few days. Like the fruit would rot from the outside. It was so weird.

Could my acne problem have gotten worse from this? The timing is right, but I don't know.

Two weekends ago, I was able to go home. I haven't gotten a new pimple since then. Just the persistent ones that were there before I left. Including one weird abscess thing...

Maybe I'm over thinking it. Idk.

Yes --- a bacteria laden environment along with broken sensitive skin (active lesions) could have aggravated your acne. Plus I'm sure it was emotionally stressful. I broke out more when caring for my mom who was in diapers and it was hard to keep things clean. Hopefully being home and in a cleaner environment will help...along with less stress!

FYI: spiro is one of the most benign ways to assist hormone issues, especially sensitivity to androgens...mainly because it is not a hormone itself --- it only blocks androgens but putting itself into the androgen receptors. I wouldn't be afraid of it. I have read tons of info on it, most written by doctors saying spiro is okay to take long term for acne. In fact it was originally developed as a really mild diuretic for heart issues that could be taken forever.

The only other way to help your body regarding hormones is to avoid dairy, red meats, and chronic stress. That said, you may be able to avoid spiro or the hormone issue by making sure your pores work as well as possible...which means being on a treatment regime that opens pores, helps dead cells slough off and kills acne bacteria effectively. BP does this, as does topical antibiotics.

I have been on spiro since 2001 with no problems. By itself it did not keep me clear but as part of the regime below (see signature) I think it helps. That said, I intend to try weaning off of it next year because my ultimate goal is to only use topicals and diet if possible.

Yes --- a bacteria laden environment along with broken sensitive skin (active lesions) could have aggravated your acne. Plus I'm sure it was emotionally stressful. I broke out more when caring for my mom who was in diapers and it was hard to keep things clean. Hopefully being home and in a cleaner environment will help...along with less stress!

FYI: spiro is one of the most benign ways to assist hormone issues, especially sensitivity to androgens...mainly because it is not a hormone itself --- it only blocks androgens but putting itself into the androgen receptors. I wouldn't be afraid of it. I have read tons of info on it, most written by doctors saying spiro is okay to take long term for acne. In fact it was originally developed as a really mild diuretic for heart issues that could be taken forever.

The only other way to help your body regarding hormones is to avoid dairy, red meats, and chronic stress. That said, you may be able to avoid spiro or the hormone issue by making sure your pores work as well as possible...which means being on a treatment regime that opens pores, helps dead cells slough off and kills acne bacteria effectively. BP does this, as does topical antibiotics.

I have been on spiro since 2001 with no problems. By itself it did not keep me clear but as part of the regime below (see signature) I think it helps. That said, I intend to try weaning off of it next year because my ultimate goal is to only use topicals and diet if possible.

Thank you for your response!! (:

I have an appointment with the dermatologist in a couple weeks. I'm going to ask to be put back on spiro again, I think. I was on it for over a year. At first it worked amazing. I was on it and doxy and my skin was flawless for 6 months. Not one outbreak. But after 6 months I started getting oily and red skin. I got off my antibiotic then, and only broke out a little bit. I stayed on spiro for another 6 months and the red and oily skin persisted. When I got off it my skin went nuts. I've been off for about 6 months now i think, and it's just continuously gotten worse. Do you think I just needed a higher dose? I was on the lowest dose. Why would the spiro stop working after it worked so perfect for 6 months? That's the reason I haven't gone back on it. I'm just confused about this whole mess. Lol. Dang it.

Also, I don't know if this means anything, but my face symptoms get better and then worse. For the last 6 months. They will start to get better for about a week. My oil starts going Away. The redness fades, and I get no new outbreaks. I start to feel positive like maybe things are going to finally go back to normal. Then BAM! I get hit again, with an even worse outbreak then the time before. This is constant. Better then worse, then better then worse. Over and over. Now I try not to get excited when things start looking positive. I've tried to see if it's food related, But I can't pinpoint anything. So maybe my hormones are just crazy. Could this all be from coming of spiro? It's been 6 months!!

The cycle of better and worse is not unusual with acne because it is directly affected by the increase and decrease of hormones, especially androgens, in our body. Hormones surge naturally and when there is ongoing stress and when you eat hormone laden foods (dairy, red meats, etc).

The reason for a multi-prong treatment approach is to make sure that even if a surge happens the skin has what it needs to effectively shed dead cells that clog pores and to kill acne bacteria if that fails. People with acne are usually sensitive to hormones and have skin that sheds poorly. It is often too hard to totally figure out why hormones are surging...it just happens.

People with normal skin also have surges but genetically they may have much dryer skin and have pores that shed well and don't clog up as much. Also they may have less of an inflammatory response and this also helps pores stay clear. And thus less acne.

A first cue that hormones are surging is an increase in oily skin...and then pores clog and acne happens. A preventative approach is one that helps the skin to function well even if there are problems.

First avoid all oils in the diet except for oil that is naturally in foods (avocado, salmon, etc.). Some people with really chronic acne also avoid nuts as they are too oily even in their natural state. If you do this you will notice a dramatic decrease in oily skin within 2 weeks. This is not talked about much but it works and is based on cultures that don't get acne...they don't eat processed oils (oil, margarine, butter, mayo, etc.) at all.

You have to use a cleanser or topical that helps the pores stay open and clear. I use a BP cleanser (Panoxyl 4%) that is very effective but gentle. There's lots of other options depending on what your skin likes. Some people swear by salicylic acid...personally it makes my skin red and raw.

Then you need to use an antibiotic topical. Some people like tea tree oil products, others like BP. I like Cleocin-T...mild but effective.

And of course...Spiro will help decrease the amount of androgens affecting your skin. It takes about 4-5 months for Spiro to kick in. But at least for me, spiro is only effective when used with the whole regime below.

Hope this helps.

How long have you been on spiro? What are your side effects?

How long have you been 99.9 clear?

What does zinc do for your acne? And Vitamin D? I have both of those in my medicine cabinet.

What is Cleocin-T?

And DML Lotion?

Panoxyl? LOL