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Madeline A

Adult Female Acne some humble suggestions

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Hi everyone– I used to turn to these forums a lot for advice and support and I thought I would try to return the favor by telling my own experience. I by no means want to suggest that this holds true for everyone or that my struggle is over...I will continue to try to work on my own skin and in a weird way I'm worried that posting this "solution" will jinx my own skin. But in my own experience, there is a ton of misinformation out there (on the internet) and most appallingly among healthcare professionals and I wanted to try to clear up some things. 

I am 26 and struggled with acne my whole life. At 23, it became cystic and terrible. It affected my entire life and induced bouts of depression so I went on a mission to change things. I consulted something like 6 dermatologists, a gynecologist, and endocrinologist (hormone specialists), and nutritionist to figure out how to proceed. I was finally diagnosed with PCOS and over the course of a year or so, figured out a treatment regimen that works for me. So, some points:

1. Find a dermatologist you trust. The internet is great, but we are not healthcare professionals. Acne is a medical problem and it can be treated if and only if you find someone who knows what they are doing. I know insurance sometimes means that it's hard to switch dermatologists but I would encourage that you try to hunt around for one who listens to your medical history and provides personalized advice. My acne is 100% hormonal– as is most acne affecting women over the age of 18 or so. You would not believe how many dermatologists I went to who point blank denied that hormones had anything to do with acne and who prescribed benzoyl peroxide or oral antibiotics for the 10,000th time. These are doctors at some of the bests hospitals in the world in Boston. Appalling. Eventually I found a dermatologist who agreed with the PCOS diagnosis that I got from an endocrinologist (I highly recommend a visit to a hormone specialist if you are an adult with acne). If someone trivializes the problem, prescribes a regimen that has failed for you in the past, or denies important parts of your medical history (missed periods, perhaps or other relevant information) they are a hack and you should continue the quest until you find someone you trust and who specializes in adult acne– the salicylic acid is not going to cut it here. 

2. Long-term acne is caused by underlying factors such as hormones, not by an excess of bacteria on your face. BP and topical antibiotics might work for a teenager, but they do literally nothing for adult acne. I have PCOS, which most of you probably are familiar which. I have zero other indicators for PCOS (body hair, difficulty losing weight) so it was a hard problem to diagnose but at the end of the day, the problem was a hell of a lot more than skin deep. You can approach hormonal female acne in a few ways, and I've tried a couple.
The first is BCP (I am on Yasmin) and/or spironolactone. In my case, I need the combination of the two and a 200mg dose of Spiro, which is high. Again, if I didn't have such a savvy derm, she probably would never have gone for the higher dose and I would still have cystic acne. I have had multiple friends who have gone on the pill after facing adult acne who have seen great results....again this is anecdotal so please go to a doctor!!
The second is nutritional. There are great books on hormonal acne and PCOS that suggest a low-glycemic diet (limited sugars, no dairy, no complex carbohydrates and plenty of lean protein). There are also sterling examples of how this has worked for some people. I tried it for a year before going the BCP route and it 100% did not work for me. In fact, it gave me a borderline eating disorder because I was convinced there was a causal relationship between what I ate and how my skin looked the next day, which led to some pretty obsessive behavior. If you want to go this route, you can also try natural supplements, such as those suggested by Marilyn Glenville. 

3. Be gentle with your skin. After my cystic acne had subsided, I visited my derm about some pretty bad hyperpigmention on my very pale sensitive skin. After examining my skin she said, "Your scarring isn't that bad....but you are putting so many harsh products on your face you are making it look much more irritated." At that point, I was too afraid of pore-clogging products to use a good moisturizer or sunscreen and was laying on the retinoids...in the middle of summer. So stupid. She recommended Toleraine Fluid from La Roche Posay as a super minimal lotion and Skinceuticals Sheer Physical UV Defense and sure enough, my skin calmed right down. I still use retinoids in moderate amounts but I swear, using a sunscreen everyday has done much more for my skin then any corrective product. 

Hopefully my experience has been helpful for some people. Find a guru for all your skin problems and make sure they understand the internal causes of acne. Be kind to your body and to your skin and good luck! Please feel free to message with any questions.  

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Just wondering what you are using as a cleanser? 

 

The reason the sunscreen has been the thing that has helped the most is due to the Zinc oxide. It makes your skin super clear and calm ime

Edited by Early2Rise
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Funny thing... I live in Boston. Are there any derm offices that you think people should steer clear of? I'm thinking of switching soon but I don't know how to judge a good dermatologist... I've had this cystic acne for 2 or 3 years, starting in my low-20s. It's making me so desperate trying to clear up the cysts. No amount of cortisone shots or antibiotics serve as long-term solutions. :(

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IT IS THE WATER!!!!  We acne prone ppl are allergic to chemicals. STOP using them!!

Our skin and hair can't handle Free Chlorine (Cl-), Combined Chlorine ( Sodium Hypochlorite), Hydrogen Sulfide (rotten egg smell) and Iron Oxide (rust water)

Get a filtered shower head!!!! You will be amazed how your water is damaging your skin and hair. A filter will filter chemicals making your hard water softer. Trust me, I have tried everything before I started washing my body with only filtered water. Wash your face with combinations of honey, lemon, and coconut oil and sugar for exfoliation. Thayers Witch Hazel (No Alcohol) as toner. Use aloe Vera gel as moisturizer. Tea tree oil is great too. Stick to natural products as listed above.

Don't use lofas and do use wash cloths but oxiclean them when washing, do not bleach them

Birth Control is a Big No as is Man-Made antibiotics. Opt for natural antibiotics such as garlic and orgeano

If for some reason the moon turns purple and this does not work, get tested for food allergies ex dairy or gluten and Do educate yourself on GMO's

You all are Beautiful Best Of Luck!!

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