Okay so this is quite long but I appreciate anyone and everyone taking time to actually read this because I just feel like no one is taking the time to actually understand my situation.

I feel like this is really my last resort to finding some kind of resolution, I've been through so much in general over the last few years paired with my skin issues and I really need some answers, I am genuinely fearing for my own life because my anxiety and depression has gotten that bad. I am having counselling over the phone once a week now just to be clear but I need to sort of the issues bothering me to get to the root of this.

I've been fighting a battle for the past few years but was 95% clear until the summer of 2019when I abandoned my routine (washing my face twice a day and applying azelaic acid and benzoyl peroxide) for about 4 or 5 days. After that I began breaking out in small white itchy spots (which would often turn in to big spots)which were resistant to the stuff I was regularly applying to my face... until I added hydrocortisone in to the mix.

Adding the hydrocortisone stopped the itching and combined with my routine seemed to stop most (not all) of these little whiteheads from appearing, I know hydrocortisone isn't supposed to be applied to the face - I'm well aware in fact but nothing else worked and I was desperate.

I began applying a lot of hydrocortisone because it seemed to be helping but eventually it seemed to cause red marks / hyperpigmentation in areas and my routine spiralled out of control and would take 4 hours every night.

When I finally saw the derm it wasn't what I expected at all, I had pinned all my hopes on finally getting answers from this appointment but it was awful, the derm was 2 hours late for starters and I overheard the staff saying they had no idea where he was(despite me being the very first appointment of the day and I was there super early and the only person in the waiting room).

I was then seen by a trainee to keep me from waiting any longer, he briefly looked at my skin and I tried to explain my whole situation. He didn't offer any advice. He then left the room with me in it and maybe 20 mins later returned with the derm I was supposed to have seen. This guy then talks to me for 5 mins and prescribes me something, I thought it was a topical cream because of the discussion I had had with the trainee explaining that I am reluctant to take any pills because when I was a teenager I took pills for acne then and I believe they may have been the cause of my tinnitus.

I went away and it was only when I got home I decided to google what had been prescribed to find that it was the a pill and the same medication I had been given as a teenager.

I complained to my doctor by email and got no response and after a few weeks chased it up and eventually she said she would refer me to another derm at a different hospital for a second opinion.

However during the wait for another appointment I've just moved house and have a new doctors, I emailed about my situation 4 times over the course of 2 weeks and received no response and then I phoned and spoke to a doctor who I explained my situation to (as he seemed to have absolutely no idea and I feel like I'm starting from scratch again) and he said to me:

"Well what do you expect a dermatologist to do? They'll want to treat you with oral antibiotics and a topical and since you don't want to take antibiotics then there's nothing they can prescribe to you topically that we can't".

Having that said to me has really hurt my confidence again and makes me feel like there's no way out of this. I literally don't know what to do, even before this Covid situation I stopped leaving the house and now I'm even worse. I want to be out there enjoying my life but I feel like a freak honestly. I'm getting upset just typing this.

After a bit of research online I asked the doc if I could try Differin and simplify my routine. It still takes a long time at night though.

My routine since November 2020 has been:

Cetaphil gentle skin cleanser

Simple's light moisturiser

Cetaphil gentle skin cleanser

Simple's light moisturiser MIXED with Differin

let dry for 30 mins

Acnecide (benzoyl peroxide 5%) on top of that

Exfoliating once a week with Clearasil ultra rapid action scrub.

This routine has some good stuff to it in that when those itchy little whiteheads come up (which they often do) then they seem to go in a couple of days rather than turning in to big spots which is what would happen most of the time before. My skin texture also seems better and some old spots/scars have mostly faded.

HOWEVER my face has been bright red since November doing this routine, I haven't left the house and my anxiety is awful. I'm having counselling for this over the phone once a week.

I tried using just the Differin but found that it doesn't seem as effective, I was still breaking out pretty regularly, although the redness was less.

I feel like the Differin and anything else with the same consistency never seems to work for me because it doesn't like stick to my skin like acnecide does, this stuff just looks greasy on my face and leaves it vulnerable once it wipes off on my pillow at night, rather than creating a barrier like acnecide. Oh and just to be clear acnecide by itself isn't effective enough. I've also tried the 2.5% acnecide and I don't know what's wrong with it but the consistency is completely different, much more watery but the worst part is that for some reason it makes my face burn and turn red immediately after touching it.

I realise this is a lot of info. Any questions just ask.

Thank you.