Welcome hun! We are in the same boat - 3 rounds of tane, every topical, The Regimen, BC, and guess what....still acne. I have also done diet changes: diary/gluten free, paleo. My next step is an elimination diet for a few months. I don't get cysts that often so i don't think SPIRO would help so i'm at a loss too. Not very helpful for you but just wanted you to know you're not alone.

hey, if its as you say it is i would suggest going on long term low does accutane. look into it and discuss as an option with your derm. an ex gf of mine did this and she swore by it.

can i ask, what type of skin do you have?

how did accutane change your skin? did it leave you with scars? indentations etc?

thanks so much if you can answer me those questions x

Hi Dee --- I too was put on tons of things...accutane worked while I was on it but acne came back when stopped...and full strength antibiotics were the only other thing that kept me mostly clear. What finally got me clear was a combination treatment that attacks acne on multiple fronts. My derm is a specialist in resistant adult acne...a genius. Before this other derms had me on one thing or another but usually just one or two things at a time but that approach did not stop acne, especially the cystic kind.

This is my current derm's treatment that I have stayed clear on now for several years (yeah!!!):

1. Monthly microderms to open pores, get rid of dead skin and pull out plugs.

2. Panoxyl 4% BP cleanser in the morning to kill acne bacteria (is gentler than topical for adult sensitive skin).

3. Topical Cleocin-T to further kill acne bacteria and provide a barrier for the day.

4. DML lotion to soothe and heal skin (developed especially for acne prone skin).

5. Cetaphil antibacterial cleanser in evening followed by DML lotion. Spot treat with Cleocin-T if needed.

6. 100 mg spiro per day (blocks androgen receptors but is not a hormone --- very safe).

In addition I eat only whole unprocessed foods and avoid all dairy, breads, processed oils, sugary foods, and alcohol. This is the same diet that cultures that don't get acne eat and it is an anti-inflammatory diet as well. I also avoid caffeine and fermented foods as these seem to inflame my sensitive skin.

I hope this helps you.

hey, if its as you say it is i would suggest going on long term low does accutane. look into it and discuss as an option with your derm. an ex gf of mine did this and she swore by it.

can i ask, what type of skin do you have?

how did accutane change your skin? did it leave you with scars? indentations etc?

thanks so much if you can answer me those questions x

I was told at the end of my second round that i wouldn't allowed to go on it again - but it's something that i could enquire about anyway and see what they say.

My skin is very oily, but sometimes i think it can be a bit dehydrated from within. I've tried being gentler with it instead of using washes and creams specifically targeted towards oily skin prone to acne (as i have heard this can make the skin want to produce more oil) but there was no difference.

My skin when i was on accutane was so good. I wouldn't really get any new spots after about 2 months and it felt great not having to worry! Completely cleared up the oil, but it wasn't overly dry! My pores were a lot smaller and tighter. Of course, i would still have some pick marks but they weren't as noticeable because my skin was tighter in general.

Hope i've answered them well enough!

Welcome hun! We are in the same boat - 3 rounds of tane, every topical, The Regimen, BC, and guess what....still acne. I have also done diet changes: diary/gluten free, paleo. My next step is an elimination diet for a few months. I don't get cysts that often so i don't think SPIRO would help so i'm at a loss too. Not very helpful for you but just wanted you to know you're not alone.

Frustrating huh! I'm literally at my wits end. Acne has caused my to have such low self-esteem and zero confidence in my self. Just wondering if it will ever end!!!

I don't have any tips to offer, but I feel your pain. I'm almost 34-- I had two rounds of Accutane, one at 28yrs and another at 31yrs. I consider myself lucky that I had no side effects from Accutane (actually, fewer side effects than antibiotics). I still get break outs and I've been off Accutane for about a year. Perhaps low dose Accutane is what people like you and I need. I've been on so many antibiotics that none seem to "work" on my acne anymore.

Adult females, apparently, are the least likely to be "cured" of acne after Accutane. Lucky us! However, since yours is bad enough to make you want to hide in your room, maybe another round of it is needed.

One thing I find difficult in treating it is that now that I'm older, I can't rely on cleansers and treatments that dry my skin out, because I inevitably end up with almost an allergic-type reaction. The thing that seems to help is Tazorac (which is ironic, because it's supposed to be more potent than differin, but it doesn't make me react the way differing does)-- however, I can't use it everyday. I have an RX for Acanya gel, which I try to use everyday, but it requires refrigeration so I can't bring it with me when I go to the gym before work in the morning.

I think my skin heals more slowly than it did when I was a teenager, too. What acne I popped in my teens quickly healed, whereas now I'll end up with a sore for a month. It's difficult to keep my hands off it, especially when it's recalcitrant to healing.

I try treat my skin depending on the climate, too. If my skin is dry, I'll clean with a more cetaphil/lotion type cleanser for dry skin-- if it's oily and the weather is humid, I'll use a gentle foaming cleanser. I've also used some ichthammol ointment w/ a band-aid on lesions at night to make them "shrink"! Weirdly, that stuff seems to help make them less inflamed, although it stinks and is not pretty.

I want to share with everyone who suffers from resistant chronic acne what has finally worked for me. Ditto on all the above for me (2 rounds accutane, major antibiotics, etc.) and my skin became so sensitive from using Proactive and other topicals that I got rosacea as well. After decades of suffering I found a specialist adult acne derm who devised the tx regime below. It immediately (yes - within a week) stopped all cysts...haven't had one since. Since then have only gotten teeny tiny zits that heal within a day or two and then with a change in diet a year ago I now am clear. I'm sooooo happy. So this is the regime...please try it. It is custom designed for very very sensitive skin.

AM --- wash gently with Panoxyl 4% cleanser. This is a BP cleanser but it is very mild, yet still effective. Apply Cleocin-T antibiotic solution. This stuff is amazing - very gentle but really zaps any zit and makes it go away quickly. Then apply DML lotion. I was worried about using lotion but this lotion was designed for acne prone sensitive skin and goes on light and dries quickly. My derm says that the lotion helps to calm and heal the skin and I agree. I then use Physician's Formula powder with SPF...it hides any imperfection and also heals. I take 100 mg Spiro to help block androgens.

PM --- wash gently with Cetaphil antibacterial bar and apply DML lotion.

That's it. In addition I avoid all dairy, sugary foods, alcohol, and processed oils. Avoiding oils (salad dressings, mayo, margarines) really helped. I eat fresh whole foods and have never felt better.

Hope this helps.

I'm sorry, I know what you're going through, I've been there. Had acne for 13 yrs now. I'm now on accutane and I'm more worried that the acne will come back when I stop than about any side effects.

Anyway, my doctor told me about the long term accutane treatments where people go on a low dose regimen (like I'm on now 20mg daily) then step down to 10, 5 and eventually to 10mg a week. It may sound awful to spend years on accutane but I imagine it would be better than locking yourself up in your room.

If I were you though I'd try spiro first with birth control and some kind of topical. There are less side effects and spiro plus birth control is effective in most women although it takes a long time. Long term spiro seems less scary than long term accutane

I'm so sorry you're going through this. Acne is so frustrating and what I wouldn't give for a cure for us all.

I went on Accutane around your age (25) and it cleared me completely for 15 years. But once I stopped birth control pills in my early 40s, it slowly came back. Cystic acne reared its ugly head about a year ago, to the point where I had 45 bad ones a year, which caused new scarring. And my middle-aged skin is no longer able to bounce back from that. So, I'm about to start my second course of Accutane.

But only because I could not tolerate Spiro. I was on a very low dose, 50mg a day, but was tired and disoriented to the point of having to stop. I gave it two months, but symptoms did not abate. And I had the WORST IB ever, which I am only now recovering from.

HOWEVER, Spiro would be my treatment of choice if I could tolerate it, so I agree with several of the other posters here to explore this option with your dermatologist as soon as you get a chance. For those women who can tolerate it, it seems to work miracles.

Good luck to you!