Look into Accutane - discuss with your doctor. Accutane is not just an easy prescription to write. You need to be aware of its side effects and what it could do to your body. I was on it for 6 months and it helped stop cysts from forming.

The redness will go away in due time - I know it's tough to deal with. You can try a combination of niacinamide, vitamin c (ascorbic acid or magnesium ascorbyl phosphate) serum, azelaic acid, alpha arbutin.

Before going to Accutane (isoretinoin), make sure you get a test for microscopic demodex skin mites and a test for hormone levels. A complete workup to test for all 4 possible causes (bacterial, fungal, demodex, hormones) should be done. The treatment for each type of acne is completely different. When selecting a dermatologist, ask if they will do this type of workup when you call to make an appointment. If they won't, keep looking until you find a competent dermatologist who will do the tests. Some still do visual exams and try to guess what's wrong. Make sure they know you have had this for 10 years.

There are 2 types of demodex skin mites on humans. Demodex Follicularum live in pores around the hair follicles. Demodex Brevislives down deeper in the oil glands and may cause cysts if they get overpopulated. The mites eat skin oil. They live and die on a 2 to 3 week cycle. The cyclical behavior frequently makes dermatologist write off the cause as hormonal without testing your hormone levels. This happened to me for decades.

If its demodex there is a highly effective, 2 week, 2 drug combined treatment using inexpensive generic Oral Ivermectin + Oral Metronidazole. These drugs have an excellentsafety record, and are consideredfar safer than Accutane. The treatment is much faster with few if any side effects. Here's the treatment from a medical study in the May 2013 International Journal of Infectious Diseases.

https://www.sciencedirect.com/science/article/pii/S120197121201315X

Accutane greatly reduces the amount of oil the glands produce. With demodex the oil reductioncan result in starving off a large portion of the population of mites. But Accutanedoesn't directly kill the mites. The surviving mites population may rebound and the skin condition relapses. Here's a case of that happening to a patient in Canada. His family doctor tried antibiotics which didn't work followed by Accutane which initially appeared to clear his skin. After he stopped Accutane the skin relapsed. A thorough workup by a competent dermatologist identified the real cause as demodex.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489393/

I had demodex for decades. It was misdiagnosed for decades as bacterial acne by 4 different board certified dermatologists. They never tested for anything, just did the quick visual exam. The last one said "Gee, maybe its hormonal". Didn't test for that either. The Oral Ivermectin + Oral Metronidazole treatment cleared my skin. Cost with insurance was just $13.03. That was after years of being prescribed the most expensive new antibiotics, retinoids, benzoyl peroxide drugs at astronomical cost. None of those drugs ever worked. That is why it is really important to get a good diagnosis based on actual tests rather than a quick, guess based visual exam.

Although you have eliminated dairy and sugar from your diet, there may be other food allergies causing the problem. I would suggest moving to a plant based, low carbohydrate diet.

I also had those deep cysts under the skin, and they completely went away after I changed my diet.

Check out my post for more information:

acne.org/forums/topic/388757-1000-scars-cystic-acne-cured-with-low-carbohydrate-plant-based-diet/

On 1/25/2022 at 9:54 PM, AcneCured said:

Although you have eliminated dairy and sugar from your diet, there may be other food allergies causing the problem. I would suggest moving to a plant based, low carbohydrate diet.

I also had those deep cysts under the skin, and they completely went away after I changed my diet.

Check out my post for more information:

acne.org/forums/topic/388757-1000-scars-cystic-acne-cured-with-low-carbohydrate-plant-based-diet/

I have since my post i have eliminated coffee and it dramatically improvedy skin. I have also noticed that if i eat even one chocolate bar i receive hormonal acne the next day.

So yes, there was a food allergy causing my acne.

Its not perfect but compared to what i had when i created this post im happy.

If your seeing a reaction to sugar, then try to avoid high sugar fruits, berries, and fruit juices.

The other common sensitivities are alcohol and gluten.

Keep up the good work.