Are you under the care of a dermatologist for your acne? If not, you really should see one ASAP to get whatever is causing your acne under control. I did not experience acne until my mid 20s. By the time I hit my 30s, my cheeks were covered in scarred pores, ice picks and boxcars. My texture was also horrible. Sadly as I aged, every pimple seemed to leave a scar. With that said, I would get your acne clear before even trying to determine the actual damage. Based on your photos (I hate to say this), I see active acne. It may not be at its worst but it is still active and can easily become worse if you try to treat your scars. In your skin's current state, it is hard to say what the actual damage is, but I do see some atrophic scars, pih and scarred pores. Lighting, angel and digital quality can also be deceiving.

Are you under the care of a dermatologist for your acne? If not, you really should see one ASAP to get whatever is causing your acne under control. I did not experience acne until my mid 20s. By the time I hit my 30s, my cheeks were covered in scarred pores, ice picks and boxcars. My texture was also horrible. Sadly as I aged, every pimple seemed to leave a scar. With that said, I would get your acne clear before even trying to determine the actual damage. Based on your photos (I hate to say this), I see active acne. It may not be at its worst but it is still active and can easily become worse if you try to treat your scars. In your skin's current state, it is hard to say what the actual damage is, but I do see some atrophic scars, pih and scarred pores. Lighting, angel and digital quality can also be deceiving.

Yes I know I do have active acne still.

I believe I have some hormonal imbalances which a dermatologist really can't help me with. And most just give accutane which I don't want to do as I have read about it causing depression and scarring. And I already struggle with my mood and clearly already have scarring.

I could go to a dermatologist to get an opinion I guess. I don't have to take what they tell me to. But I fear they won't have anything to say other than 'Here, take this very strong drug'.

I am obviously going to get the acne under control before I do anything for the scarring. I won't be doing anything until I am spot free I just wanted people's opinions on how my scarring looks, what type it is, have severe, and what treatments I should look into. I want to know all this now so that I can do research so that as soon as I am clear I can get treatments.

What treatments have you seen good results with?

For your type of scarring, which is very similar to how mine looked (see my gallery), I would go with fractional co2 laser and then dermastamping. I don't recommend wasting your time with peels as I have never received any permanent improvement from them. I don't see why you would need acutane and think you might actually benefit from antibiotics and Retin-a. If it is hormonal, they may be able to get it under control with birth control or another prescription. You really should see a dermatologist. You may be kicking yourself in a year or two if you don't because permanent scarring can get so much worse quickly. At this point, your scars aren't bad but you have only experienced acne for a year. Imagine where you could be in another year if it is not properly treated.

Thank-you.

I will certainly try to find a good dermatologist in my nearest city.

I will also look into the hormonal stuff.

Maybe I could do antibiotics and some hormonal treatment as well.

Retin-a is a vitamin a derivative, right? I have heard people say it made their skin thin and made them more prone to scarring. But I am actually not sure what its meant to do.

I already have a bit of regret. I was prescribed the BC pill last year but never took it because I read some horror stories of strokes and things. Now I wish I had have just taken it. I could be 100% clear with no scars. But I don't think about that stuff because it really brings me down. I just have to do the best I can right now.

Still don't really want to go on the BC pill but I have read lots about some other natural things that balance hormones.

Lasers scar the s**t out of me! I will do some research though and hope that others have advice also.

Thanks again.

for the retin a, if your skin can handle it, go with tazorac gel...I find the cream clogs pores, but the gel is more drying

that will help keep pores clean and slowly help with the redness...so if you do that at night, then I would do a mild acid in the day, again if your skin can handle it, like glycolic acid lotion or I love mandelic acid, I use the one from the garden of wisdom site

and of course avoid a lot of sun exposure

and I've gotten very good with coverage of my dents and depressions, I put a light foundation on the use a mineral powder concealer with a small brush and sweep over any spots or carefully inside the indents

good luck to you, your acne is mild to moderate, no cysts so thank your lucky stars there- but you should get a routine that works and I agree with the other poster, I did a series of fraxels and now I use a dermastamp and do my own scar remodeling

for the retin a, if your skin can handle it, go with tazorac gel...I find the cream clogs pores, but the gel is more drying

that will help keep pores clean and slowly help with the redness...so if you do that at night, then I would do a mild acid in the day, again if your skin can handle it, like glycolic acid lotion or I love mandelic acid, I use the one from the garden of wisdom site

and of course avoid a lot of sun exposure

and I've gotten very good with coverage of my dents and depressions, I put a light foundation on the use a mineral powder concealer with a small brush and sweep over any spots or carefully inside the indents

good luck to you, your acne is mild to moderate, no cysts so thank your lucky stars there- but you should get a routine that works and I agree with the other poster, I did a series of fraxels and now I use a dermastamp and do my own scar remodeling

Thank you so much for your reply.

My skin is quite sensitive, I can't really handle BP or salicylic acid so I don't know how I'd go with the topicals you mentioned.

In regards to your treatments, how do you find dermastamping? Do you get good results with that? I'm pretty wary of laser. I suspect I don't heal quite as well or as quick as most people, so I am thinking this is problematic when it comes to lasers and possibly needling.

Also, what type of scarring do you think I have?

About 1 month ago, not long after I noticed the scarring, it looked like rolling. So from front on, in harsh lighting, it looked like more shallow, wider, wave like scarring, but now in the same lighting etc it looks more like really crappy texture, not so wavy, more smaller a bumpy or something. This is with make-up on. I don't know why or what this means...

I forget if I already asked you this on the hormonal forum, but have you looked into Spiro? It makes me sad so many adult women struggle with this when there is such an effective solution. It really does need to be resolved hormonally.

I forget if I already asked you this on the hormonal forum, but have you looked into Spiro? It makes me sad so many adult women struggle with this when there is such an effective solution. It really does need to be resolved hormonally.

I can't remember either. I have not looked into Spiro other than what I have read here. I have looked into herbal treatments such as DIM, inositol etc though.

Spiro is an anti-androgen, yes? Is it prescribed by doctors or dermos?

I know, I have a lot of regret. I have suspected hormones was my problem for several months now but GP's wouldn't really help. Saw a naturopath but she wouldn't do anything til I had blood tests...then she moved away. Then I decided I would treat myself but didn't know where to start or what to do...

So now here I am. My acne has got a bit better, maybe its the diet changes I made months ago or my supplements, but I have scarring now.

I don't like to think about that though, what could have been, that's just depressing and not healthy. I just look forward, to what I can do now. Or I try to.

I have booked into see a GP that is really open to natural treatments ie. won't just but me on BC pills like every other doctor would. But that appointment is a month away.

Just have to cross my fingers that my skin doesn't get more scarred in that time, that I don't get any more big breakouts.

I am a bit panicked about the long wait though...

Yes Spiro is an anti-androgen that is prescribed by derms usually, although I got mine through an endocrinologist. I really suggest you skip all that nonsense with the over the counter stuff and just go get a prescription. Google it and there is lots of information and reviews.

Please don't let all the negative hype about accutane scare you out of taking it. I took it for 6 months and its an absolute cake walk in comparison to having acne. People talk about how it causes depression, its total crap. Having acne causes depression. My skin was almost identical to yours, actually worse. I stopped taking it about 6 months ago and have had maybe 4 or 5 insignificant little whiteheads since then. The best part is that because my skin isn't always in distress they no longer leave red marks. Seriously, the only side effect I had was dry skin. Hundreds, if not thousands of people on this forum have taken accutane and recorded it in the section called "accutane logs". Look through them before you decide its not for you because it was a life saver for the vast majority. Good luck in whatever you decide.

Are you under the care of a dermatologist for your acne? If not, you really should see one ASAP to get whatever is causing your acne under control. I did not experience acne until my mid 20s. By the time I hit my 30s, my cheeks were covered in scarred pores, ice picks and boxcars. My texture was also horrible. Sadly as I aged, every pimple seemed to leave a scar. With that said, I would get your acne clear before even trying to determine the actual damage. Based on your photos (I hate to say this), I see active acne. It may not be at its worst but it is still active and can easily become worse if you try to treat your scars. In your skin's current state, it is hard to say what the actual damage is, but I do see some atrophic scars, pih and scarred pores. Lighting, angel and digital quality can also be deceiving.

Yes I know I do have active acne still.

I believe I have some hormonal imbalances which a dermatologist really can't help me with. And most just give accutane which I don't want to do as I have read about it causing depression and scarring. And I already struggle with my mood and clearly already have scarring.

I could go to a dermatologist to get an opinion I guess. I don't have to take what they tell me to. But I fear they won't have anything to say other than 'Here, take this very strong drug'.

I am obviously going to get the acne under control before I do anything for the scarring. I won't be doing anything until I am spot free I just wanted people's opinions on how my scarring looks, what type it is, have severe, and what treatments I should look into. I want to know all this now so that I can do research so that as soon as I am clear I can get treatments.

What treatments have you seen good results with?

Don't be scared of Accutane. I started getting acne junior year of high school. I am now 32 years old and it was not until 2012 that I finally went on Accutane. I also was frightened by all of the horror stories, but I'll be honest with you, not much compares to having bad acne for that long. I tried every product/procedure/prescription between that time and NOTHING worked. I can rattle off just about every medication that's been out there (duac, differin, all types of antibiotics, retin-a, tazorac, aczone, lasers, every peel [glycolic, salicylic, pumpkin, TCA] blue light, birth control, facials) They would "help", but never make it go away. I've seriously done it all and spent a lot of money doing it.

Finally I decided enough is enough and found a derm to give me Accutane. They make you take a pregnancy test, sign a bunch of papers, jump through a bunch of hoops and finally put you on it. You have to get blood work every month. If anything gets sketchy, your derm will pull you off. I also did not get any depression at all. I was on it for about 5 months. I would use chapstick, but my face didn't get super dry either. Sometimes my eyes would sting at night and feel dry, but that's it. The acne immediately started going away and so did the oiliness. If acne bothers you or is affecting your self esteem..I say give it a go. My face is covered in scars from not dealing my acne swiftly and in time. Don't do the same.

I've been off it for about a year and a half now. With the use of a topical, clay mask and exfoliating - I haven't had any breakouts. Now I just have the scars to deal with, which is why I'm on this forum.

my scars are rolling, so the dermastamp is really good for those

read up on the owndoc.com forum and jump in, the improvement is slow but in 6 months you'll really notice it...don't overdo it though, start slow and see how your skin reacts and go from there

I did have fraxel treatments (4 of them) to smooth things out, and then I've been stamping the rolling scars since then, just moved up to the 1.0mm stamp, no question about the improvement, I did the 0.5mm for at least a year.

my scars are rolling, so the dermastamp is really good for those

read up on the owndoc.com forum and jump in, the improvement is slow but in 6 months you'll really notice it...don't overdo it though, start slow and see how your skin reacts and go from there

I did have fraxel treatments (4 of them) to smooth things out, and then I've been stamping the rolling scars since then, just moved up to the 1.0mm stamp, no question about the improvement, I did the 0.5mm for at least a year.

Thankyou for your reply.

Based on my pictures, do you think that dermastamping will improve my scarring?

I am not even sure what type my scarring is.

Does this method help skin texture and plump the skin up.

Really appreciate your help.

 

Are you under the care of a dermatologist for your acne? If not, you really should see one ASAP to get whatever is causing your acne under control. I did not experience acne until my mid 20s. By the time I hit my 30s, my cheeks were covered in scarred pores, ice picks and boxcars. My texture was also horrible. Sadly as I aged, every pimple seemed to leave a scar. With that said, I would get your acne clear before even trying to determine the actual damage. Based on your photos (I hate to say this), I see active acne. It may not be at its worst but it is still active and can easily become worse if you try to treat your scars. In your skin's current state, it is hard to say what the actual damage is, but I do see some atrophic scars, pih and scarred pores. Lighting, angel and digital quality can also be deceiving.

Yes I know I do have active acne still.

I believe I have some hormonal imbalances which a dermatologist really can't help me with. And most just give accutane which I don't want to do as I have read about it causing depression and scarring. And I already struggle with my mood and clearly already have scarring.

I could go to a dermatologist to get an opinion I guess. I don't have to take what they tell me to. But I fear they won't have anything to say other than 'Here, take this very strong drug'.

I am obviously going to get the acne under control before I do anything for the scarring. I won't be doing anything until I am spot free I just wanted people's opinions on how my scarring looks, what type it is, have severe, and what treatments I should look into. I want to know all this now so that I can do research so that as soon as I am clear I can get treatments.

What treatments have you seen good results with?

Don't be scared of Accutane. I started getting acne junior year of high school. I am now 32 years old and it was not until 2012 that I finally went on Accutane. I also was frightened by all of the horror stories, but I'll be honest with you, not much compares to having bad acne for that long. I tried every product/procedure/prescription between that time and NOTHING worked. I can rattle off just about every medication that's been out there (duac, differin, all types of antibiotics, retin-a, tazorac, aczone, lasers, every peel [glycolic, salicylic, pumpkin, TCA] blue light, birth control, facials) They would "help", but never make it go away. I've seriously done it all and spent a lot of money doing it.

Finally I decided enough is enough and found a derm to give me Accutane. They make you take a pregnancy test, sign a bunch of papers, jump through a bunch of hoops and finally put you on it. You have to get blood work every month. If anything gets sketchy, your derm will pull you off. I also did not get any depression at all. I was on it for about 5 months. I would use chapstick, but my face didn't get super dry either. Sometimes my eyes would sting at night and feel dry, but that's it. The acne immediately started going away and so did the oiliness. If acne bothers you or is affecting your self esteem..I say give it a go. My face is covered in scars from not dealing my acne swiftly and in time. Don't do the same.

I've been off it for about a year and a half now. With the use of a topical, clay mask and exfoliating - I haven't had any breakouts. Now I just have the scars to deal with, which is why I'm on this forum.

Thankyou for your post.

I have an appointment with a doctor that was recommended to me. I believe I have a hormonal imbalance as I have other symptoms.

I have read some people who tried accutane and it worked for a bit but their acne came back because they still had the hormonal imbalance.

So I think I'll explore that option first.

good luck and i agree you should look into spiro first and go from there. if you take it with a good antibiotic you should avoid any sort of initial breakout. the stuff works wonders!

The thing about the internet and forums like this is the freely available information, good and bad. I've been in exactly the same situation as you, feeling completely conflicted about acne treatments. I kept going back and forth on Accutane for years until my cystic acne got so bad, that I had reached the end of the line and gave in. Surprisingly, I didn't not get any of the dreaded side effects other than severely chapped lips and dry skin. And I took a very high dose for someone of my smaller build. Accutane effectively cured me of cystic acne, other than the odd pimple once every 6 months. It changed my life really.

In your case, Accutane might be a little aggressive, however if the acne is starting to scar it's worth consideration. Regardless, I would trust your doctor instead of what you read on the internet from armchair experts. Luckily I would classify the scarring as still minor, and the redness is making things look worse than it is. You are in the best position now to control the acne aggressively and prevent further scarring.

The thing about the internet and forums like this is the freely available information, good and bad. I've been in exactly the same situation as you, feeling completely conflicted about acne treatments. I kept going back and forth on Accutane for years until my cystic acne got so bad, that I had reached the end of the line and gave in. Surprisingly, I didn't not get any of the dreaded side effects other than severely chapped lips and dry skin. And I took a very high dose for someone of my smaller build. Accutane effectively cured me of cystic acne, other than the odd pimple once every 6 months. It changed my life really.

In your case, Accutane might be a little aggressive, however if the acne is starting to scar it's worth consideration. Regardless, I would trust your doctor instead of what you read on the internet from armchair experts. Luckily I would classify the scarring as still minor, and the redness is making things look worse than it is. You are in the best position now to control the acne aggressively and prevent further scarring.

Thank-you very much for this!

I think like most people, I see my scarring as being worse than it really is, so what you've said about my scarring being minor has really helped me.

I have a lot of hope for my appointment with my doctor. I may even ask her about scarring and treatments as she may know a good derm.

Thanks again.

Ok, first of all your pics are sooo close and i think they enlarge your problem. You have moderate to severe acne to me. I would suggest you to pop the white heads carefully( i see you have some). This will make the pimple fall. My suggestions are all natural, as i see they work for my situation. Have a baking soda peeling and some masks with turmeric( takes the redness away), yoghurt and honey. I pray on turmeric, its really miraculous. Licorice too in similar mask. Use sudocrem on pimples to make them come to a head. Even if you follow a derm prescription, you can do this stuff additionaly. Good luck and let us know of your progress!!!

I agree with the above statement. When I zoomed out with your pictures and looked at them from a normal distance, your scarring if very very minor. Blowing a picture up 12 x 12 in on a computer monitor will make things look hideous. That is not how people see you in real life. No one is zooming in on your skin like that.

My skin looked very similar to yours! I was so desperate with my dematologist I wanted to try anything at this point! I asked to be on accutane but she refused. She prescibed me tazorac 0.5%gel in the last 3 months and honestly I've never got so many compliments. Everyone has noticed a difference. I can tell as we'll. my face is not so angry. I have tried everything I thought I had given up. My dermatologist told me I need to stick to my ointment for more than a couple months to see if it works and it had. I thought I would share my knowledge because I've been in your shoes! Goodluck!

Thanks guys for all your comments!

I have been feeling very down about my skin the past few days.

Sometimes I honestly believe I will never be happy again. Like never truly happy.

Its been about 2 months since I noticed my scarring (it all appeared at once!) and I have been thinking about it 24/7 since. Its the last thing I think about before I go to sleep the literally the first thing I think of when I wake up. And these days I love sleep so much because its the only time I can escape this.

It scares me to think I might always be this way or that I may never be happy and carefree again. That may sound dramatic but I am sure some people would understand.

It does help to read comments I think. Especially from you, blahblah82, when you said my scarring was very very minor. Most days I think its the only thing people see when they look at me.

Its so mentally draining. But thanks everyone.

you sound exactly like me last year i never thought i would be happy again but thanks to spiro and keflex (as well as using a glycolic acid toner) i got clear and have remained clear. its been about 16 months too so please look into the spiro. you will not regret it and you can go on living your life and be happy again. the scarring sucks i can tell you that but being clear just makes it so much easier to deal with and from the pics you posted your scarring doesnt look severe yet so i would get the spiro ASAP. good luck and keep you chin up things will get better.

you sound exactly like me last year i never thought i would be happy again but thanks to spiro and keflex (as well as using a glycolic acid toner) i got clear and have remained clear. its been about 16 months too so please look into the spiro. you will not regret it and you can go on living your life and be happy again. the scarring sucks i can tell you that but being clear just makes it so much easier to deal with and from the pics you posted your scarring doesnt look severe yet so i would get the spiro ASAP. good luck and keep you chin up things will get better.

Thanks for your reply.

What makes me so angry with myself is that I never sought professional help earlier. My skin was bad but I just covered it up with make-up and sort of lived with it. My family were the only people to see me without make-up.

I did go to my doctor to get blood tests. But they were all fine. She basically said go on the pill or take anti-biotics. I didn't want to do either. Wish now that I had have because I would be clear by now with no scarring. So so much regret its basically eating me alive!

I should have realised it was a serious problem earlier.

I didn't know anything about scarring so I thought that when my acne finally cleared I would look normal again.

Its weird that my scarring is from where the inflammation/redness was, rather than the actual spot. And I never had the big cysts that most people with scarring had. But I did have a lot of redness that lasted a long time so that was probably the cause. As a result, my scarring is very shallow, like I can't feel it when I touch my skin but it has caused what looks like a bit of loss of volume in some places on my cheeks when I am under harsh lighting.

I still hope more than anything that my skin will just fix itself. When the rest of the redness clears it'll just heal...

i know that feeling of regret and being angry i was there myself and still struggle with it but just know that things will get better. if i had taken spiro when my derm suggested it a few years ago i wouldnt have say 90% of the scarring that i do now so i totally get how you feel.

my blood work was always totally fine ( i had it tested 3 times) but my acne was totally hormonal so sometimes it just doesnt show up in testing but if i were going to go on anything and i was you it would be spiro with a good antibiotic (something you havent been on before) and go from there.

once the redness subsides your skin will look a lot better i can assure you of that. my skin was so red and inflamed last year but its much better now. just try to be positive that everything will work out but dont be afraid to try new meds and stuff because if you dont get things under control now you will be even more upset if you end up with more scarring.

sending hugs your way!

i know that feeling of regret and being angry i was there myself and still struggle with it but just know that things will get better. if i had taken spiro when my derm suggested it a few years ago i wouldnt have say 90% of the scarring that i do now so i totally get how you feel.

my blood work was always totally fine ( i had it tested 3 times) but my acne was totally hormonal so sometimes it just doesnt show up in testing but if i were going to go on anything and i was you it would be spiro with a good antibiotic (something you havent been on before) and go from there.

once the redness subsides your skin will look a lot better i can assure you of that. my skin was so red and inflamed last year but its much better now. just try to be positive that everything will work out but dont be afraid to try new meds and stuff because if you dont get things under control now you will be even more upset if you end up with more scarring.

sending hugs your way!

Thankyou for this.

Another thing that sucks is that no one else in my family has or has had bad skin, like nothing beyond the normal mild teenage acne. My parents skin is totally normal for their age. Grrrr...I don't want to be the one at family gatherings with the bad skin.

Are you doing anything for your scarring? What type of scarring how you got?

Also, with Spiro, how long did it take to work? (I'm not breaking out much now, mostly just period related)

Did you get an initial breakout? And how bad was that/how long did it last?

Are you still taking it? If not, how long were you on it for?