I've been viewing these forums on Acne.org for a while now and decided to post. This will be long but I feel as though my history with this disease is pertinent to how I became clear(ish). I hope my story will give others hope. I've been through a lot with this, so ask any questions!

I started breaking out around the age of 13 (thank you puberty!). I tried Dan's regimen for a year with only minimal success. ProActiv was popular with every other teenager my age, so I gave that a shot as well. ProActiv was not the miracle cure it promised to be. I saw my first derm at the age of 15 since my mom urged me to go; my acne was not going to go away with a simple stop at RiteAid or CVS. I was hopeful and excited to get to the bottom of my breakouts as I entered high school.

My freshman year of high school it was like my derm was using me as a science experiment. I tried a whole list of medications to include a lot of topicals such as a sulfur cream,clindamycin gel, differin, ziana, and finally retin-a. I was on each for about three months at a time. Every topical had an antibiotic to go along with it like doxycycline,minocycline, bactrim, etc. My acne would clear somewhat and then come back with a vengeance after my body grew resistant to the antibiotics. Topicals only helped to clear active break-outs and not to prevent them.

It was nearly my 17th birthday when I started to get deep painful cysts that would take weeks to go away. I trotted back to the derm, only to have her put me on birth control. Unlike most sexually active teenagers, I was on birth control for acne. I was put on ortho-tricycline low, which happens to be the worst for stabilizing hormones due to it being a three phase BC. My breakouts did not improve; they become more frequent and painful and I remember crying during television shows due to the roller coaster of emotions. The estrogen increase hit me hard. After six months I told my doctor to take me off it. One look at my face and I was immediately prescribed Accutane.

My first round of accutane was glorious. I was clear after 2 months with minimal side effects. My senior year of high school was one of the best skin wise. People started complementing me. I wore my hair down instead of up. I wasnt afraid of mirrors or to wake up in the morning and have to look at myself.I entered my freshman year of college and began to break out again. My acne slowly returned, and within six months of being off Accutane my skin was worse than when I began treatment. I went back to the derm, and she put me on a second round, saying it was common in women to need a second course. I went back on a second course with the same results as the first but with more side effects. As you can guess, a year after my second course my skin went back to the same grossly state, except I was getting body acne, not just facial.

I went on a third round (yes three!) of Accutane my junior year of college at the age of 22. My derm told me that if my acne came back that she would refer me to an endocrinologist. There were more and more studies coming out that Accutane Failures or women who have their acne come back after several courses or treatment most likely have an underlying hormone issue. She ordered a hormone panel along with my routine being on Accutane bloodwork. My acne came back my senior year of college, and I immediately made an appointment with an endocrinologist upon getting my hormone level results.

My testosterone levels were high enough to warrant an anti-andrrogen drug. The doctors office called me and did more bloodwork to ensure I didnt have something wrong with my adrenal gland, which thankfully I did not. Around the time I went off birth control (which I was prescribed for acne) in high school, my periods started getting funky. I would go two or three months without getting my period, and when I did, they were painful and lasted more than a week. I did not think much of it because I was a three sport athlete and extremely thin. I figured that my low body fat was more the culprit behind irregular periods.

My senior year of college, about a month before seeing the endocrinologist, I had an ovarian cyst that caused me some pain but went way on its own. When I went in for my appointment it took the doctor three minutes to diagnose me with PCOS, as the only symptom I didnt have was weight gain. I was put on Yasmin and Spironolactone, and left thinking I was on my way to being clear. Yasmin had the label of being awesome in treating acne and also has anti-androgen affects.

Yasmin was a nightmare for me, much like Ortho-TriCycline. I was crying at everything, gained 25 pounds, and started getting acne along my jaw line which I had never gotten before. 8 months later I went back to the doctor who was completely shocked I was still breaking out and that I had gained weight. As he put it; I was the first case he had ever seen like this. He prescribed me metformin (insulin levels correlate with testosterone levels) and flutamide instead of spironolactone, and put me on a low estrogen BC pill. Flutamide isnt a drug to be messed around with. My doctor said I was one of three people he prescribed it to.

I lost the weight and began clearing up immediately, and everything was peachy for a year with a few minor breakouts around my period. Flutamide left me with zero appetite and bright green urine, as well as low energy. I couldnt drink even a beer and didnt have the energy to go out with friends. Due to my bloodwork coming back funky I went off the drug and figured my overall health was more important than acne. Birth control alone was not helping with my skin and while the low estrogen was better, I was still a basket case and incredibly moody. I stopped taking the birth control as well. At this point I was 24 years old wondering if I should just give up and live with it. My acne creeped back within a month after stopping flutamide.

I met my partner at the age of 23 (while I was on Flutamide and clear) and acne stopped being my overall focus in life, which is another reason I gave up on the meds that made me feel like crap. When youre single and want to look your best its an annoyance and self-esteem crusher. While it was still unfortunate to have graduated into the adult-acne column, my skin had stopped being the center of my world. I took the time to try the holistic method which is in no way a quick fix. I eliminated dairy and gluten for six months. My skin improved, but not enough to cut out cheese. (I love Mexican food, as a side note.) Birth control messed with my hormones and it took two years for my periods to become normal after stopping it. My diet change no doubt helped with normalizing my cycle. At 26 I had normal periods for the first time in my life without the assistance of a pill.

What caused me to want to become clear and find a solution to my acne instead of just living with it is the fact that I have a wedding coming up. My periods becoming regular naturally helped with the severe break outs, but I still had mild to moderate acne, just no more cysts. Blackheads and white heads were still very much a presence on my face. I went to see a popular derm in Boston who recommended I try a higher dose of spironolactone (I was only on 50mg with Yaz prior). My derm stated that doctors are quick to prescribe birth control when hormones are involved, but if your periods are regular there is no reason to prescribe birth control. Usually anti-androgens alone are needed for women who have normal cycles. Spironolactone is not affective in small doses according to her, so she started me off at 100 MG.

Insulin resistance plays a huge role in acne and hormones. Diabetes runs heavily in my family. Beacyse of this, I take Berberine. I saw an immediate decrease in breakouts from the berberine alone within a month and am completely clear on month 5. I havent had a breakout since month 2, just red marks to deal with.

Throughout this whole ordeal there are a few things Ive learned:

Adult acne is way worse than having teenage acne. As an adult, most of your peers have grown out of it.

Acne is a symptom of something else happening in your body whether it be hormones or another disease.

Dermatologists wont tell you acne is related to diet. It is.

Acne is never something that will entirely go away and always needs to be managed.

The people who love you wont see your skinas critically as you do.

Cheers!

Sarah