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Let me start off by saying acne is a b****, and I respect and understand ALL of you on this site, and have frequently come on here to learn about my acne. However this is my first post on this site, so I hope I can relay my information the best I can.

Few things about me:

22 years old

Male

5'10

160 lbs (athletic build/low body fat)

Workout 5 times a week (weightlifting)

Ill start with a brief overview of my acne.

I never had too much of an acne problem in high school. I would get an occasional breakout near my sideburns / cheek / forehead area but it was never too big of a deal. (at least I never really focused on it)

(Possibly important to note AND Extremely EMBARRASSING TO SAY: I suffered from anorexia and bulimia in my younger teens. I am a control freak and went to food when my parents split. This caused an EXTREME delay in my growth spurt. I was 5'2 95 lbs until i was about 17 when I finally kicked the eating problems I had been having since 13/14. Today I am completely gone of any of these habits thank god, and am at a very healthy weight, almost overweight due to my love of bodybuilding :) )

My first Derm appointment was when I was 18, mostly by a slightly concerned father that wanted to help me

I was prescribed doxycycline, duac gel, and BP

Unfortunately to to my overall ignorance and being generally unmotivated to treat my acne (I thought it would eventually just 'Dissappear') I never truly fulfilled any of these scripts. I would follow suit for 2- 3 weeks then act like a total negligent and never see them out.

Worse over I moved around a lot from 18-21. So I never saw a consistent derm that could consistently look at my face and see if we were making improvements. Needless to say I went to 2-3 more dermatologists in-between this 3 year period. ALWAYS being prescribed the same things : Anti-biotics with a topical and BP

However once again I wouldn't follow them rigorously. I would keep up with face washing always. 2 times a day, but didn't use the antibiotics after the first run through. I did use some topicals intermittently though.

I went through stretches of time where my face would be better than others. Last year I clearly remember just washing my face with a BP and my face looked great! (I'm looking of photos of this time last year right now, and my face was significantly better)

NOW:

My acne is ALMOST COMPLETELY ISOLATED to my chin/jawline and neck. I WILL wake up daily to a new whitehad or BUMP that i can feel is becoming acne. IF YOU MADE A TRIANGLE from the bottom of your nose to the left and right edges of your chin, 80% of my acne is located there. My forehead is COMPLETELY CLEAR, and I will get an occasional pimple on my cheeks, but nothing I am worried about (1 pimple every once in a while is nothing!)

My face I believe has finally gotten to the point where I MUST be very pro-active in treating my problem. I finally did AMPLE research about acne (THANKS TO EVERYONE ON THIS SITE!), and made an appointment with a new derm where I discussed my newly found knowledge and my strong concern that my acne MAY BE hormonal.

My derm completely SHUT DOWN this idea, as well as possibility of using accutane (She said my moderate/mild acne doesn't suggest using accutane)

She then prescribed the following:

BP wash (1-2 times daily)

Chlyndamycin wipe/pad (1-2 times daily)

Tazorac (Nightly)

Doryx (100 mg Once daily)

I have been rigorously following this plan FOR 3 WEEKS. HOWEVER i have just realized the importance of moisturizing. I have always had fairly DRY SKIN and would consistently have dry/peeling skin after following regiment. I have now incorporated moisturizing daily with CETAPHIL daily lotion.

I have been on this regimen for 3 weeks, with NO SIGN of getting any better. In fact I honestly believe MY FACE IS WORSE than the first time I went in her office. I realize these things take time, and I am more than ready to be patient, but it is demoralizing when you are so conscious of your health and see no results.

During this 3 week period I have cut out ALMOST ALL DAIRY AND GLUTEN. I have never had another symptom related to gluten intolerance but thought i should be on the safe side.

I also just went to have my hormones saliva tested. Results are as follows:

Testosterone: SIGNIFICANTLY LOW

DHEAS : LOW

Estradiol: low/normal range

Progesterone : Normal

Cortisol: ERRATIC, didn't taper off at the end of night, had a slight increase right before bed.

I went and saw an ENDO and he relayed his slight concern, but wanted me to get blood tests done to measure:

Free AND TOTAL TEST

PROLACTIN

SSH & LH levels

I will be getting these tests done on tuesday

What's worrisome is I understand the correlation between HIGH test levels and acne, but haven't seen much correlation between low levels and acne. I know vitamins like fish oil/zinc/saw palmetto are known to help regulate hormone levels but I am scared to aid the increase in any hormone as it might negatively imbalance another one and cause more acne.

Other Factors you should be aware about, however irrelevant:

I do smoke ciggarretes ( I have SIGNIFICANTLY LOWERED THE AMOUNT, used to smoke pack/day, but currently smoke 2-3 packs/ week)

I drink alcohol 1-2 nights a week (often in abundance, I am a college student)

I smoke weed (not in excess, but at night time before i go to sleep)

NO hard drugs

I eat a VERY healthy diet. Lean proteins, fruits, veggies are a staple. I AM NOT a fast food kind of guy

I do DRINK ENERGY DRINKS: I almost always drink a monster or rockstar energy drink before the gym. But I only use them before working out (4-5 a week)

I have attached images of my face FROM TODAY as well as one black and white pic from 1 year ago. IF ANYONE can help in regards to any other possible solutions, or relations I would be so grateful. Acne is psychologically demoralizing me and making me shy away from social setting during the day/under heavy light. I am willing to do anything, so anyone that can offer ANY advice thank you

sincerely,

an acne sufferer

post-415681-0-86765400-1409493817.jpgpost-415681-0-48295200-1409493821.jpgpost-415681-0-65602400-1409493822.jpgpost-415681-0-62797000-1409493824.jpg

post-415681-0-86765400-1409493817.jpg

post-415681-0-48295200-1409493821.jpg

post-415681-0-65602400-1409493822.jpg

post-415681-0-62797000-1409493824.jpg

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Hey man seems like youre on the right track as far as finding a possible cause witht the hormone test. But I would just stick with the topicals in the mean time. I am the same age and have the EXACT type of acne you do. Also lift etc. Im on my 3rd round of Accutane so that definitely isnt a cure for everyone but I think it should be a option.

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Well there are several lifestyle habits that could indeed be contributing to your acne. The smoking and drinking are definitely red flags. Energy drinks is another. Do you use Whey by any chance? Try cutting down on these and see if it helps.

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Well there are several lifestyle habits that could indeed be contributing to your acne. The smoking and drinking are definitely red flags. Energy drinks is another. Do you use Whey by any chance? Try cutting down on these and see if it helps.

I agree. I have dramatically cut down my smoking, and limit drinking as much as possible. I know these things aren't the best for you, but it's life is it not? I'm not saying drinking and smoking are the keys to my happiness/enjoyment, but it is a common thing for a student.

No whey, at the moment. But I do drink protein shakes (Muscle Milk, ones at my gyms juice bar). But I did COMPLETELY cut them out for two months while i was overseas. Didn't make the slightest bit of difference.

Im also noticing since I've been using a moisturizer (Been one week, used to be cetaphil daily lotion, now Nurtogena oil free sensitive skin) that my face is breaking out more? It may be due to other things, obviously I don't know. But would that be normal?

I never used to get these red bumps all along my chin/jawline that don't form a white head. But now I am covered with them

(P.s i shaved today and my skin looks sooooo much worse, wish i hadn't)

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First of all, your acne isn't bad at all. At what sort of distance do you talk to people? Not the same distance as from your camera taking those photos at least. Your camera is 10-20 cm away from your face, you probably talk to people with a distance of at least 5 times that. Now try to take a photo of your acne from that distance, i guarantee you that your skin will look flawless in comparison. I'm not suprised your derm wont prescribe you accutane for that.

Am i the only one thinking this?

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post-415681-0-16144100-1409524258.jpgpost-415681-0-87897100-1409524259.jpgpost-415681-0-37293200-1409524261.jpg

First of all, your acne isn't bad at all. At what sort of distance do you talk to people? Not the same distance as from your camera taking those photos at least. Your camera is 10-20 cm away from your face, you probably talk to people with a distance of at least 5 times that. Now try to take a photo of your acne from that distance, i guarantee you that your skin will look flawless in comparison. I'm not suprised your derm wont prescribe you accutane for that.

Am i the only one thinking this?

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Some people seem to have a sensitivity to their own hormones. Lots of posters on this site are baffled when their skin clears up by reducing testosterone/DHT even though their hormone tests came back low.

I personally go by symptoms. When my derm prescribed an anti-androgen they never tested for anything. The derm knew that typically excessive androgenic action causes acne. I had acne as an adult therefore I had some excessive androgenic stuff going on. Who cares what the number is--if it's causing skin problems then it's a problem for your body. Though if you had anorexia this idea of "numbers don't matter, symptoms do" may be hard for you to accept. A lot of rexies get really fixated on that number on the scale...and it can be easy to get stuck on a magic number on a hormone test telling you what your problems are. The real truth is that "normal" ranges are just averages of people who get their hormones tested. Averages aren't always helpful in solving your personal acne problem.

However, yes, it is also possible that it is not testosterone that is your problem but something else. Insulin/glucose are known as "major" hormones while testosterone and estrogen are actually considered "minor." If your blood sugar is unregulated this can wreak havoc on your skin. The fact that you are consuming energy drinks and working out constantly means that you are messing with both major and minor. Sugar and caffeine (and carbs in general) have really huge detrimental effects on your insulin cycle. Working out a lot stimulates testosterone.

I wouldn't necessarily stop working out, but you need to cut out the sugar, caffeine, and any protein shakes or other workout supps or powders you are taking. Protein powders and similar are notorious for causing acne. Cutting out dairy is a good start as dairy stimulates IGF. But cutting out dairy is often not enough. You gotta try eating more caveman style...plain meats (not breaded meats or meats saturated in sugary sauces)...vegetables...fruits sparingly...little to no grains. No soda. No fruit juice. You get the idea. Google "paleo diet" if you want more info on that.

Based on the second set of pictures you could probably find a different dermatologist who would give you Accutane. But unfortunately Accutane is not a permanent fix for a lot of people. Every day I come on here another poster says "so I went on Accutane, was clear for a little while, now it's back and bad as ever." Accutane works by shrinking your sebaceous glands. This reduces your ability to produce sebum. No sebum = no clogs = no acne. Now, hormones like testosterone encourage sebum production. But if your sebaceous glands are tiny enough, your hormones can be CRAZY and telling you to produce buckets of sebum, and your glands just can't do it because they're so small. But here's the kicker...the glands actually grow back over time. So if you don't sort out your hormones, Accutane will only be a short term fix.

Edited by Green Gables

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Some people seem to have a sensitivity to their own hormones. Lots of posters on this site are baffled when their skin clears up by reducing testosterone/DHT even though their hormone tests came back low.

I personally go by symptoms. When my derm prescribed an anti-androgen they never tested for anything. The derm knew that typically excessive androgenic action causes acne. I had acne as an adult therefore I had some excessive androgenic stuff going on. Who cares what the number is--if it's causing skin problems then it's a problem for your body. Though if you had anorexia this idea of "numbers don't matter, symptoms do" may be hard for you to accept. A lot of rexies get really fixated on that number on the scale...and it can be easy to get stuck on a magic number on a hormone test telling you what your problems are. The real truth is that "normal" ranges are just averages of people who get their hormones tested. Averages aren't always helpful in solving your personal acne problem.

However, yes, it is also possible that it is not testosterone that is your problem but something else. Insulin/glucose are known as "major" hormones while testosterone and estrogen are actually considered "minor." If your blood sugar is unregulated this can wreak havoc on your skin. The fact that you are consuming energy drinks and working out constantly means that you are messing with both major and minor. Sugar and caffeine (and carbs in general) have really huge detrimental effects on your insulin cycle. Working out a lot stimulates testosterone.

I wouldn't necessarily stop working out, but you need to cut out the sugar, caffeine, and any protein shakes or other workout supps or powders you are taking. Protein powders and similar are notorious for causing acne. Cutting out dairy is a good start as dairy stimulates IGF. But cutting out dairy is often not enough. You gotta try eating more caveman style...plain meats (not breaded meats or meats saturated in sugary sauces)...vegetables...fruits sparingly...little to no grains. No soda. No fruit juice. You get the idea. Google "paleo diet" if you want more info on that.

Based on the second set of pictures you could probably find a different dermatologist who would give you Accutane. But unfortunately Accutane is not a permanent fix for a lot of people. Every day I come on here another poster says "so I went on Accutane, was clear for a little while, now it's back and bad as ever." Accutane works by shrinking your sebaceous glands. This reduces your ability to produce sebum. No sebum = no clogs = no acne. Now, hormones like testosterone encourage sebum production. But if your sebaceous glands are tiny enough, your hormones can be CRAZY and telling you to produce buckets of sebum, and your glaI wouldn't necessarily stop working out, but you need to cut out the sugar, caffeine, and any protein shakes or other workout supps or powders you are taking. Protein powders and similar are notorious for causing acne. Cutting out dairy is a good start as dairy stimulates IGF. But cutting out dairy is often not enough. You gotta try eating more caveman style...plain meats (not breaded meats or meats saturated in sugary sauces)...vegetables...fruits sparingly...little to no grains. No soda. No fruit juice. You get the idea. Google "paleo diet" if you want more info on that.

Based on the second set of pictures you could probably find a different dermatologist who would give you Accutane. But unfortunately Accutane is not a permanent fix for a lot of people. Every day I come on here another poster says "so I went on Accutane, was clear for a little while, now it's back and bad as ever." Accutane works by shrinking your sebaceous glands. This reduces your ability to produce sebum. No sebum = no clogs = no acne. Now, hormones like testosterone encourage sebum production. But if your sebaceous glands are tiny enough, your hormones can be CRAZY and telling you to produce buckets of sebum, and your glands just can't do it because they're so small. But here's the kicker...the glands actually grow back over time. So if you don't sort out your hormones, Accutane will only be a short term fix.

I agree.

It could be the energy drinks. Ill stop them immediately and see what happens

But here's a question I never completely understood:

If I do the "something" that is producing negative effects on my face, how long until the 'breakout' should I be watching out for?

For example eating dairy items (and dairy was indeed my problem), would the breakouts come within hours? or days?

theres soo0o0o many constant "contributing factors" to acne I feel like its impossible to understand what is truly causing mine

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I have the same amount of acne as you do and I'm 19 man, it honestly sucks and I completely understand your viewpoint on the psychological standpoint, I used to have good self-confidence and now I just feel like trash with acne, it's literally ruining my life, I would say for you, find a moisturizer that is NON-comedogenic so it doesn't clog your pores causing more acne and making your existing acne worse, I would also suggest using a Zinc supplement, it'll reduce the redness and inflammation of your acne pretty well, and for the price you pay $5-10 its worth it, I would also start drinking a lot more water, and try to drink filtered water rather than tap, or bottled, the last few things I will suggest is squeezing fresh lemon into your water 1-2 times a day and also drinking 2 teaspoons of apple cider vinegar diluted in water a day, this should help, and I hope it does, all the best and good luck!

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Some people seem to have a sensitivity to their own hormones. Lots of posters on this site are baffled when their skin clears up by reducing testosterone/DHT even though their hormone tests came back low.

I personally go by symptoms. When my derm prescribed an anti-androgen they never tested for anything. The derm knew that typically excessive androgenic action causes acne. I had acne as an adult therefore I had some excessive androgenic stuff going on. Who cares what the number is--if it's causing skin problems then it's a problem for your body. Though if you had anorexia this idea of "numbers don't matter, symptoms do" may be hard for you to accept. A lot of rexies get really fixated on that number on the scale...and it can be easy to get stuck on a magic number on a hormone test telling you what your problems are. The real truth is that "normal" ranges are just averages of people who get their hormones tested. Averages aren't always helpful in solving your personal acne problem.

However, yes, it is also possible that it is not testosterone that is your problem but something else. Insulin/glucose are known as "major" hormones while testosterone and estrogen are actually considered "minor." If your blood sugar is unregulated this can wreak havoc on your skin. The fact that you are consuming energy drinks and working out constantly means that you are messing with both major and minor. Sugar and caffeine (and carbs in general) have really huge detrimental effects on your insulin cycle. Working out a lot stimulates testosterone.

I wouldn't necessarily stop working out, but you need to cut out the sugar, caffeine, and any protein shakes or other workout supps or powders you are taking. Protein powders and similar are notorious for causing acne. Cutting out dairy is a good start as dairy stimulates IGF. But cutting out dairy is often not enough. You gotta try eating more caveman style...plain meats (not breaded meats or meats saturated in sugary sauces)...vegetables...fruits sparingly...little to no grains. No soda. No fruit juice. You get the idea. Google "paleo diet" if you want more info on that.

Based on the second set of pictures you could probably find a different dermatologist who would give you Accutane. But unfortunately Accutane is not a permanent fix for a lot of people. Every day I come on here another poster says "so I went on Accutane, was clear for a little while, now it's back and bad as ever." Accutane works by shrinking your sebaceous glands. This reduces your ability to produce sebum. No sebum = no clogs = no acne. Now, hormones like testosterone encourage sebum production. But if your sebaceous glands are tiny enough, your hormones can be CRAZY and telling you to produce buckets of sebum, and your glands just can't do it because they're so small. But here's the kicker...the glands actually grow back over time. So if you don't sort out your hormones, Accutane will only be a short term fix.

Hi, i personaly have every symptom that indicates high androgen level. As far as i know androgen regulates erection for example, will anti-androgen have an impact on this? And what other side effects does it have? Is it permanent? tell me more about this please.

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dude my skin got better when i stopped using topicals and and washing my face often. honestly like not just the acne but the skin itslef looks healthier. i imagine you have no acne on your forehead because you dont put anything there besides water or something.

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As a girl I probably have no clue what I'm talking about but I was wondering if you have looked at the products you use to shave and possible try not shaving for a week or so. Because your forehead is clear it is possible that shaving or the products you are using are irritating your skin somehow. I know they also saw that jawline acne may be hormonal but I guess it's worth a thought.

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