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ElBarto

Tried everything! I dont know whats wrong! Please help!

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My Name is Travis. Currently 22. Never really had acne as a teen except for the odd spot. I was washing my face with soap and no skincare whatever. My face was SUPER DRY. At 19 I started getting the odd spot again, in a matter of 6 months, my acne became nodular to cystic acne mostly on my cheeks forehead nose and jawline. I have tried everything from topicals to Doxy to probiotics to vitamins D A E C K to cutting out dairy to cavemen regimen to eating a vegan diet to eating a vegetarian diet and finally the last resort ACCUTANE! Everytime time, my acne came back shortly after. Right now I am off accutane for about 6 months and my acne became nodular again on my cheeks mostly. I am currently on a cream which is a combination of isotretinoin and erythromycin which is working really well. But it dries out my face really bad and yeah btw my excessive oily skin is back. I have no clue what’s wrong. I did a hormone test and allergy test as well as a general blood test. All came out perfect. Please I am a medical student and I just want to cry everyday. My face went from dry to excessive oily in a matter of months. Before my dark marks took 1 month to heal but now they take a year. Also I don’t eat sugar, coffee or any processed food in general since the past 2 years.

Edited by ElBarto
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Hey Travis, I get you frustration. Acne can be a real pain in the ass.
It is great that you have tried out some stuff already, Vitamin A,B,C etc. All this is very good for the skin.
But even though you have tried all this and more there can still be something in the diet.
Vegetable oils (canola, sunflower, rapeseed oil), even Onions can be a cause.

Also daily routines with the skin, proper skincare etc. 

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Thank you so much for replying :):)  Unfortunately i had stopped all kinds of oils now for 2 years now and i never really buy onions except when they serve me in restaurants :( Strange thing is i think is that my acne is being caused by something which i have no idea of. Unless it's genetics then i am to be blamed for and can't do much about it i guess.

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It could definitely be genetics! Some people go through their teens without ever having acne, and then once they hit 18+, that's when the acne starts.  It sucks! I totally feel you.

My advice would be to change your pillow cases every 1-2 nights, don't touch your face, whatever you use to dry your face, make sure you change that out every couple days to avoid bacteria build up.  Unless a pimple is clearly ready to pop, don't touch (so hard, I know, haha).  For products, I'd highly recommend Unblemish by Rodan and Fields.  I've had cystic acne since I was 14 years old, and this is the ONLY product that's cleared up my acne completely.   I've tried Proactiv (which did work until I hit my early twenties),  Neutralyze, all the drugstore brands, acne.org, tried doing nothing,  etc.   Unblemish was my lifesaver.

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Thank you so much Klessard :) I am already a maniac when it comes to cleaning haha but I will definitely look into this product!

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I agree about looking into the diet thing.  It sometimes may not help your acne but it is worth giving it a shot for a few months at least.  If i had to recommend where to start, i would say cut out Dairy and if possible, gluten.  Eat lots of greens, good quality meats and fish and healthy starches such as sweet potato, quinoa, brown rice, etc.  Increase healthier fats like coconut oil and EVOO.  You may or may not see a change in your skin but it's worth a shot. 

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thank you so much :) My diet is pretty much like you. I considered myself vegan except i eat only chicken sometimes. Thank you again!

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On 8/1/2018 at 12:14 PM, ElBarto said:

thank you so much :) My diet is pretty much like you. I considered myself vegan except i eat only chicken sometimes. Thank you again!

No worries.  I hope everythign works out for you.  
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I do agree with most replies before me here but....Acne is acne. It’s all in genetics man. You can sit there and try all kinds of treatments and play around with your diet but some people have acne, it’s just the way it is. I’m 23 and still experience minor acne, though right now I am just trying to heal my skin from overuse of products and am not using anything at all on my face. Seems like you’ve tried ALOT, and while some of it will help, you have to be careful not to damage your skin from overusing products like I and many others have. So just wash your face you know, keep it clean, keep it balanced (moisturize if you need to) and use a treatment if you need to. You can try to play around with your diet but again, just have to accept genetics sometimes. Good luck man. 

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As per the dryness, look for moisturizers with urea like the one from eurcerin or products with ceramides. The reason for your dryness is a compromised skin barrier. Also, make sure that what you are using to wash your face is not harsh because harsh detergents or over washing only make matters worst. The truth about diet is that if you are not allergic or malnourished, a world whirl wind change to your diet might not do much; I am speaking from experience. Being that you are a medical student, I think stress and inadequate sleep might be a culprit. If you do not mind can you post your current skin care routine and products so that I can have an Idea of what you are using.

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Thank you so much for our replies ❤️❤️ I always had a simple skin care since I started having acne. Avenue milk gentle cleanser for sensitive skin and Avene moisturizer for sensitive skin as well. Since the acne came back after accutane, I started using the gel which is a combination of tretinoin and erythromycin. And as sunscreen I use uriage brand for sensitive skin again :) I wash my face twice a day, apply gel and moisturizer after. In the morning same but I apply a final layer of sunscreen spf 100 :)

On 8/4/2018 at 7:31 AM, Wehrlebird said:

I do agree with most replies before me here but....Acne is acne. It’s all in genetics man. You can sit there and try all kinds of treatments and play around with your diet but some people have acne, it’s just the way it is. I’m 23 and still experience minor acne, though right now I am just trying to heal my skin from overuse of products and am not using anything at all on my face. Seems like you’ve tried ALOT, and while some of it will help, you have to be careful not to damage your skin from overusing products like I and many others have. So just wash your face you know, keep it clean, keep it balanced (moisturize if you need to) and use a treatment if you need to. You can try to play around with your diet but again, just have to accept genetics sometimes. Good luck man. 

Oh man you get me, I HAVE TRIED A LOT FROM NATURAL REMEDIES TO SUPPLEMENTS TO PRODUCTS AND EVEN ACCUTANE WAS LIKE NOPE I AM OUT.
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You can ask you derm for epiduo. There are some studies stating that adapelene, the retinoid in epiduo, being more direct and effective than tretinoin for acne, and also there are numerous studies showing that BP, the other component of epiduo, being more effective than topical antibiotics. Also, try adding a sodium ascorbyl phosphate serum. Sodium ascorbyl phosphate (SAP) is a derivative of vitamin C that was clinical shown to improve acne by about 50% and by nearly 70% when used in conjuction with retinoids.
Here are clinical studies and articles on SAP:
https://www.ncbi.nlm.nih.gov/pubmed/18492184
https://www.ncbi.nlm.nih.gov/pubmed/19134126
https://www.paulaschoice.com/ingredient-dictionary/skin-soothing/sodium-ascorbyl-phosphate.html
https://simpleskincarescience.com/sodium-ascorbyl-phosphate/


One more thing; are you sure the Avene milk cleanser is thoroughly cleansing off dirt, sunscreen, and grim from you face. I can only get away with using my hydrating cleanser alone in the morning, but at night it is not effective on its own. My night time cleansing routine as follows: first, I massage a light, non comedogenic oil on my wet face to break down makeup, sunscreen, and grim, and then I go over that with Cetaphil new gentle foam cleanser; this step helps emulsify the oil making it easy to rinse without a towel or cotton pad, both of which are irritating to an already inflamed skin. After rinsing off the oil/cetaphil mess, I go in with a bit of my cerave hydrating cleanser to help restore my skin protective barrier; the Cerave cleanser has ceramides, hyaluronic acid, and fatty emollients, which are naturally part of a healthy skin's natural moisturizing factor (NMF). As per as moisturizers, I would recommend Avene tolerance extreme emulsion; there is nothing in it likely to cause breakouts. Sadly, I could not find the Uriage spf 100 you spoke of, so I was not able to check the ingredients for comedogenity.
I will be here if you need me :) Let's kick acne's ass together!
Have a pleasant day.
 

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On 8/7/2018 at 8:18 PM, besimple said:

You can ask you derm for epiduo. There are some studies stating that adapelene, the retinoid in epiduo, being more direct and effective than tretinoin for acne, and also there are numerous studies showing that BP, the other component of epiduo, being more effective than topical antibiotics. Also, try adding a sodium ascorbyl phosphate serum. Sodium ascorbyl phosphate (SAP) is a derivative of vitamin C that was clinical shown to improve acne by about 50% and by nearly 70% when used in conjuction with retinoids.
Here are clinical studies and articles on SAP:
https://www.ncbi.nlm.nih.gov/pubmed/18492184
https://www.ncbi.nlm.nih.gov/pubmed/19134126
https://www.paulaschoice.com/ingredient-dictionary/skin-soothing/sodium-ascorbyl-phosphate.html
https://simpleskincarescience.com/sodium-ascorbyl-phosphate/


One more thing; are you sure the Avene milk cleanser is thoroughly cleansing off dirt, sunscreen, and grim from you face. I can only get away with using my hydrating cleanser alone in the morning, but at night it is not effective on its own. My night time cleansing routine as follows: first, I massage a light, non comedogenic oil on my wet face to break down makeup, sunscreen, and grim, and then I go over that with Cetaphil new gentle foam cleanser; this step helps emulsify the oil making it easy to rinse without a towel or cotton pad, both of which are irritating to an already inflamed skin. After rinsing off the oil/cetaphil mess, I go in with a bit of my cerave hydrating cleanser to help restore my skin protective barrier; the Cerave cleanser has ceramides, hyaluronic acid, and fatty emollients, which are naturally part of a healthy skin's natural moisturizing factor (NMF). As per as moisturizers, I would recommend Avene tolerance extreme emulsion; there is nothing in it likely to cause breakouts. Sadly, I could not find the Uriage spf 100 you spoke of, so I was not able to check the ingredients for comedogenity.
I will be here if you need me :) Let's kick acne's ass together!
Have a pleasant day.
 

 Thank you so much ❤️ Yes I am using the same cleanser since the past few months because it removes everything while leaving my skin soft and smooth afterwards. I am heading to the derm tomorrow and shall ask! I’ve tried a combination of adapalene and benzoyl peroxide together with a sulfur spot lotion but unfortunately it did not work. This is the first time ever that a topical is working for me that is the isotretinoin erythromycin gel. Before nothing ever worked. The only things that worked were taking orally accutane and doxycycline. But topically it’s the first time that something ever worked since the past 3 years :) And for the sunscreen I use uriage eau thermal bariesun spf 50 or photoderm Max spf 100. 

On 8/7/2018 at 9:03 PM, Stephanie Betts said:

Hey Travis

So sorry to hear about your story, this is common for acne to appear in your twenties for some people, you should try making a natural facewash you can check out two recipes here at [Edited link out] or for a quicker solution you should try an acne cream called cleargenix. This is a really effective cream in fighting acne. you can also read the review on the same website.

Wish you all the best 

Thank you so much, I’ll look into it :)

Edited by Ishayat
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Unfortunately my appointment with the derm is rescheduled for tomorrow. I’ll let you guys know :)

Edited by ElBarto
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I went to the derm :) and she suggested that I stay on the gel for the next couple of months. She said it’s not worth it for me to do a second round of accutane as if your genes say that your acne will stop at a certain age, accutane won’t help much but can only stop it when you are actually on it. I will try my best on my end and actually just discovered that my cousin had a severe case too but it’s related to stress. I know that severe cases of acne due to stress are rare, and normally I am the type of guy who thinks all the time. I’ll try to de stress myself and see how it goes!

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So went to the dermatologist and she prescribed me the gel again and told me that it’s definitely not worth it to start a second course of accutane. The oil might come back along with the acne. It’s a waste of time and no money since starting a second course is just like gambling. So yeah! Going to continue the gel and see how it goes. She told me that despite my hormones levels being normal, your genes for oily skin are still here and will continue till you are 25-26 ish. Just keep a strict regimen during these years and it should be fine. To be honest being on a gel or cream during all these years sucks but well ! Thank you. I’ll try to find a holistic approach :) 

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