Hi all - I'll try to keep this as short as possible because I could write a book on the things I've learned about acne and how to deal with it.

I'm 25 now and I've had acne for about 13 years. I've spent 10 of those years experimenting on myself for a cure. Many attempts failed, but I did find a few things that worked for me which I hope will help someone else. I've tried to be as scientific as possible in these experiments (I'm a biologist) but if something clearly wasn't working for me, I tended to discontinue it after about a week

I have tried everything. I'm not going to list everything, because the list would go on for pages. I will list those things that worked below. But first I want to describe my acne. I had standard teenage acne until I was 19 - mostly whiteheads, fairly distributed, a few cysts. Then I got severe food poisoning. My forehead broke out into an acne-like rash of under-the-skin bumps, which spread down to the rest of my face. I continue to grapple with this condition today, but it's so mild that it's hard to notice, even when I look closely. My skin is quite good at the moment.

The following things have worked for me. They will probably work on other types of acne as well, to varying degrees. Standard teenage acne is easy fix. Post food poisoning acne is much more recalcitrant.

The list:

Accutane: I took 3 courses at different doses. While this did not permanently cure my acne, it did reduce its severity by 99% while on the drug, and about 50% after withdrawing the drug. I experienced joint cracking, extremely dry lips and skin, nosebleeds, skin thinning, muscle twitches, and neurological symptoms including a 'hollowness of character' while on the drug at 40-60mg/day. None of these symptoms persisted after withdrawing the drug. After my first course, I decided to do 2 more courses at 10mg 3x weekly, which is an extremely low dose. This kept my skin completely clear, and the only side effects I saw were dry skin and lips, as well as mild skin thinning. I will note here that excessive consumption of wheat or chocolate still broke me out a little bit.

Elixa probiotics: finding these was serendipity. My acne began to come back after my third round of accutane. I took these probiotics as another experiment. To my surprise, my acne swiftly disappeared. This was a titratable effect; reducing and then eliminating the dose of these probiotics resulted in a return and increase of acne. Unfortunately, these probiotics are somewhat expensive, and the recommended daily dose is 10 pills per day ($40 for 6 days of treatment). I was able to reduce the dose to 3 pills per day, but 5 would probably be better; at 3, my skin isn't perfectly clear.

Dietary changes: through much experimentation I was able to determine that chocolate and wheat cause my skin to break out. Triggers likely vary from person to person. Even while on accutane or elixa, I found that consumption of these foods resulted in acne. Wheat is in almost everything and is very hard to avoid. In terms of diets, I would recommend a paleo type diet for acne as well as general health. Inclusion of healthy grains such as oats and rice is optional, but most of your calories should come from whole foods - specifically meats, vegetables, and fruits as well as fats such as butter, olive oil, and coconut oil.

On a related note, the SCD diet did clear my skin significantly. However, this was not sustainable for me.

Bovine colostrum: this annihilated my chest spots in 1-2 weeks and improved overall skin quality. I would recommend colostrum-LD, which is liposomally formulated for increased bioavailability.

Notable things that didn't work:

Any topical: I use CeraVe as a moisturizer 3-5x a week, and a salicylic acid cleanser once a week just to exfoliate a bit. I have used many, many topicals, including Dan's regimen. At best, they are temporary fixes that require a lot of time and money, and will dysregulate your skin. One of the reasons I went on accutane was because my skin could no longer desquamate normally due to twice daily cleansing and benzoyl peroxide. Basically, if I stopped cleansing I would get a massive buildup of dead skin on my face. This led to more acne, which required more cleansing. It's a vicious cycle, and I would highly recommend avoiding almost all topical acne treatments. Acne is not a disease of the skin. It's a disease of the body, most likely a result of intestinal dysbiosis in the majority of cases. Using topicals is a bandaid fix that does not address the root of the problem, and could cause significant damage to your skin in the process.

Antibiotics: these actually did tend to work for me, especially trimethoprim/sulfamethoxazole. I would not recommend their use, because they will probably worsen an already weak microflore. If you do use antibiotics, follow it up with an FMT; this is one of the sparingly few things I didn't try in combination, but i think it would work for acne as long as your donor has clear skin naturally and the antibiotics you're taking are broad spectrum.

FMT: I did this, and it didn't work. The reason, I believe, is that the (intestinal) bacterial species responsible for my acne was not destroyed before the FMT, and was not outcompeted by the newly introduced microbes. I might try FMT directly after antibiotics in the near future, because while elixa works well, it's quite expensive and I don't want to take pills every day for the rest of my life.

Avoiding sugar/dairy: these were never problems for me. I can eat 3 pints of ice cream and not break out. On the other hand 2 squares of chocolate will break me out, especially along my jaw and around my chin.

That's about it. I hope this helps someone. Good luck in your pursuits; I'll try to remember to revisit this thread to answer questions that might pop up.