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Do I just have bad skin genetics? (long-term acne)

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I'm coming here just to see what others think about my acne situation. I'm 21 and I've been going to my dermatologist since I was about 17. In my teens I had acne on my face, neck, and shoulders. It was moderate and cystic (the deep embedded kind). First he had me try over the counter stuff...nothing ever worked. Then he tried two antibiotics...doxycycline and minocycline. They also did nothing. So then we went to the last resort: isotretinoin (formerly Accutane). Initially I was scared at all the side effect horror stories, but after doing real research, I decided to do it. We did a 6-month course and that cleared up all my acne almost entirely! After a few months it began creeping back though, and so we did another 6-month treatment.  After that one, ALL my acne was gone. I was so happy.

But it's been about a year now after that, and once again my acne is back, and it's really ugly and disappointing. It has nothing to do with not taking care of myself or my skin…I am a very clean person. I shower every day, have used cetaphil facial cleansers for years, etc. It can’t be because of “dirty pores.” I have friends who take far less care of themselves than me and they have zero acne.


Strangely, this time it has only come back on my neck, shoulders, chest, and upper arms…not on my face at all. My face has remained completely clear. But I get these red, deep, painful zits on my shoulders, chest, and upper arms…no matter how often I clean the area.


So I went back to my dermatologist 2 months ago and he said we’ll try a benzoyl peroxide shower wash along with these “pledgets” with some kind of alcohol substance in them that I wipe the area with. His idea was to avoid a 3rd course of isotretinoin. But so far through 2 months, it’s not getting better…and might be just getting worse.


I don’t get it. Thinking back, I can’t ever remember having good skin other than before puberty. Once I hit my teens and got acne, ever since then my skin has never been smooth and healthy-feeling. I don’t know what it is. Hormones? Genetics? I attached some images that show what’s going on.


I’m scheduled to go back to the dermatologist in December to see what to do next, but I just wanted to see what other people had to say about it and see if there are any theories for why this keeps happening to me and why it won’t go away for good. Thanks!





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See a naturopathic doctor. The antibiotics may have messed up your gut, enabling a yeast overgrowth. 

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