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Hello!

Long Post ALERTTTT

So I have been taking Junel FE as my prescription birth control for over a year. The reason I initially started with this one was because it had good reviews as an acne treatment. I've struggled with acne since at least 6th grade so I figured that would be my best option. I haven't had any issues with BC at all. Actually I was pretty surprised at how clear my skin had gotten until maybe 2 months ago. Suddenly I started getting cystic acne which I've never had before, at least not like this! It started with a missed period but I took multiple tests and wasn't pregnant. I stopped taking the BC for maybe 2 weeks thinking it was that but I didn't see any changes so I continued using it. Since then I've had a large flare up on my chin, jaw and cheeks. They are very deep and painful and really don't come to a head. I started seeing my esthetician again, she helped me clear up my (non cystic) acne a few years ago. I have started using Face Reality Mandelic wash, Mandelic serum 10%( i think), benzoyl peroxide acne med 2.5% (i think) and icing my face 2x a day. I have been doing this for over a month with little to no improvement. In fact I'm afraid things may be getting worse. I also have been taking an Acnetame supplement (pantothenic acid) which I've had good results with before but I still haven't seen improvement. At this point i am so distraught and I don't know what to do! I'm even to the point that I'm considering Accutane which I swore I'd never do. My esthetician recommended I try DIM to help regulate my hormones and I just started them last night but at this point I don't know what to do. Has anyone experienced this before? It seems so strange to me that after using this BC for over a year I'm suddenly having issues and can't understand why. I’d love to hear from ppl with cystic acne and what you’ve done to heal it. Thank you for your help!

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Could be hormonal or some type of bacterial infection.  But there are at least 2 other possibilities.  Could be fungal acne or microscopic demodex skin mites.  If anti-bacterial treatment isn't working, the cause might not be a bacterial infection.  Or it could be bacterial but require a different type of treatment.

Fungal acne is more common in humid environments.  Good anti-fungal topical treatments are available.  The oral drug Diflucan has also shown excellent results in treating fungal acne.  There are different kinds of fungus, so that effects which drug to use to be the most effective.

The last possibility is microscopic demodex skin mites.  Everybody has demodex.  A healthy immune system keeps them under control.  If demodex get overpopulated, it can cause acne like symptoms - medical names:  demodicosis or Rosacea Subtype 2 with papules and pustules. demodex folliculorum, ocular rosacea/blepharitis demodex, itchy skin and scalp, body acne, scalp acne among others. 

A demodex infestation is cyclical.  Your skin will look better for a week or so and then boom, the mites start dying and papules and pustules may start appearing.  2 anti-parasitic treatments are available.  One for mild cases is topical Soolantra cream (1% Ivermectin).  The 2nd is a highly effective oral treatment using 2 old, inexpensive, generic drugs (Oral Ivermectin and Oral Metronidazole).  I took the 2 drug oral treatment, it worked after decades of misdiagnosed skin and eye problems.

Do you have a dermatologist who can run test to try and determine the underlying problem?   A test for hormones (androgens?), fungal infection and demodex over population as well as a possible bacterial infection?

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The other possibility is a thyroid hormone problem.  Have you had your thyroid hormone levels checked?   This is a simple blood test.

If your thyroid is too low or too high it can cause missed periods and acne.  It is a simple blood test to check your thyroid level.

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18 minutes ago, ElaineA said:

Could be hormonal or some type of bacterial infection.  But there are at least 2 other possibilities.  Could be fungal acne or microscopic demodex skin mites.  If anti-bacterial treatment isn't working, the cause might not be a bacterial infection.  Or it could be bacterial but require a different type of treatment.

Fungal acne is more common in humid environments.  Good anti-fungal topical treatments are available.  The oral drug Diflucan has also shown excellent results in treating fungal acne.  There are different kinds of fungus, so that effects which drug to use to be the most effective.

The last possibility is microscopic demodex skin mites.  Everybody has demodex.  A healthy immune system keeps them under control.  If demodex get overpopulated, it can cause acne like symptoms - medical names:  demodicosis or Rosacea Subtype 2 with papules and pustules. demodex folliculorum, ocular rosacea/blepharitis demodex, itchy skin and scalp, body acne, scalp acne among others. 

A demodex infestation is cyclical.  Your skin will look better for a week or so and then boom, the mites start dying and papules and pustules may start appearing.  2 anti-parasitic treatments are available.  One for mild cases is topical Soolantra cream (1% Ivermectin).  The 2nd is a highly effective oral treatment using 2 old, inexpensive, generic drugs (Oral Ivermectin and Oral Metronidazole).  I took the 2 drug oral treatment, it worked after decades of misdiagnosed skin and eye problems.

Do you have a dermatologist who can run test to try and determine the underlying problem?   A test for hormones (androgens?), fungal infection and demodex over population as well as a possible bacterial infection?

Thank you so much for such a detailed response! I don't have a dermatologist at the moment. I wasn't planning on getting one honestly but maybe I should to at least be sure I know what I'm dealing with. I called my PCP to get an appointment scheduled for blood work, I am hoping he'll be able to check my hormones somehow. I was moreso thinking that it is hormonal since its primarily on my chin and jawline but I'm not sure really.

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20 hours ago, ElaineA said:

The other possibility is a thyroid hormone problem.  Have you had your thyroid hormone levels checked?   This is a simple blood test.

If your thyroid is too low or too high it can cause missed periods and acne.  It is a simple blood test to check your thyroid level.

I haven't had my thyroid checked since over a year ago. I made an appointment with my pcp for mid July and I'll ask him to check that too. 

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