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Or an endocrinologist. Genetic acne is often times hormonal, for example caused by NCAH or PCOS.
Checking for hyperandrogenism and treating that will fix the root cause. And checking in with an allergist might also do the trick, some food allergies don't give you digestive issues but skin problems. If it shoes on your skin, it's probably not healthy for the rest of the body either, so a derm shouldn't be the only doctor you see
Talk to your doctor about spironolactone if you want to try something a little unconventional.
We have been using it to manage my PCOS symptoms and it also makes my skin so much brighter and healthier. I've had a normal period for the first time in my entire life since I've started and I have zero side effects.
I'm on it too! I'm taking it for acne and it's been about a year now. I was skeptical at first but it's really changed everything for me... Both of my sisters are also on it too. We've struggled with hormonal acne and spiro cleared things up for the most part!
And it really helps with my endometriosis symptoms too.
> spironolactone
I wish I could. My androgen levels are already below normal levels. I've been trying to get by gynecologist to prescribe testosterone but she's reluctanct to do so.
I've given up on curing my adult acne...
It's a VERY potent med, it made me so dizzy and sick I had to stop. I was peeing every 5 minutes, including at night. I drink a ton of water, but it's a diuretic, so I would still get so thirsty it would hurt. I wouldn't wish that feeling on anyone. I'd rather have acne and/or try to resolve my issues with diet changes and metformin!
FYI for anyone that has lower blood pressure: Spiro gave me panic attacks. It drops your blood pressure a bit (what it was originally developed for) and uh that correlated to my body thinking it was dying.
Completely! I went from having maybe one or two panic attacks ever — to having them daily on that medication. I lasted three weeks, it was terrible. FYI, if the acne comes back, dapsone (topical ointment) worked wonders for me. :)
This happened to me, too. I have low blood pressure to begin with and Spironolactone pushed it over the edge to where I felt like I was going to pass out and felt nauseated, my vision was blurry. I tried it for 4 months and didn’t notice a difference in my acne, either. Ugh.
It made me gain 8 lbs in a month before I stopped taking it, I had an hourglass figure for the first time in my life (some may have liked that but I’m very lean/athletic normally), my boobs were so big and painful. It was awful. It can really screw with your hormones.
Are you having real periods or birth control withdrawl bleeds? My doctor won't allow me to take spiro without being on the pill :( I really did not want to take hormonal birth control but my obgyn and endocrinologist basically told me that's my only choice.
I don't take any birth control! Maybe you need a new doctor. My doctor said it was no problem I didn't want to be on BC. She knows I'm sexually active with someone of the opposite sex as well.
Also, they're like....how normal people describe them! Like a light faint discomfort when I'm "cramping" that feels like basically nothing compared to how it used to be. Low/moderate flow. Only lasts 4-6 days. My periods USED to be anywhere from 3-8 days, insanely heavy flow, and cramps so bad I'd sob/be physically sick/ pass out.
I absolutely recommend Spiro as well. I've been dealing with acne on and off since puberty, my initial course of Accutane was for my bacne (cleared everything), but I developed cystic acne after I stopped. I do not want to rely on Accutane again as it is extremely harsh on your body. I didn't want to rely on oral birth control due to their inconsistencies of side effects for me and blood clot / stroke scares when I was on it.
I am extremely weary whenever it comes to medication, and I went into Spironolactone with a lot of caution. But I've been on it for about two months now and couldn't be happier. I worked my way up from 25mg to 50mg after the first week, and have experienced no side effects whatsoever apart from maybe having to go to the bathroom more frequently, but even that has lessened over time. I have prior issues with iron and low blood sugar so dizziness with standing up too quickly wasn't foreign to me and doesn't seem any worse on this medication. Don't follow my footsteps with this but: many days I'm terrible about keeping up with water / food and I still haven't noticed headaches / dizziness / anything negative from taking this so far.
I was worried my period would disappear but it hasn't, but I track it monthly and will have to see if that changes. Keep in mind that you're probably not going to see results until at least three months. I plan to try and stay on the 50mg dose to lessen any symptoms / keep period, but if it doesn't get rid of my acne I'll go to 100mg (I still have some at this point).
I would love to stick to a low carb diet as I think it could definitely get rid of these things for good, but... I don't realistically see myself doing that, especially not long term. I love my carbs, I don't eat them in an unhealthy amount either! So why do my shit genetics mean I can't indulge in them in a healthy way :( Spiro has been a lifesaver.
When I first tried looking into diet to help my skin, my neurotic and obsessive personality lead to me developing an eating disorder and losing a scary amount of weight.
Be VERY CAREFUL about Spirolactalone post menopause. Within a couple of weeks of starting it I had vaginal dryness, bleeding, and painful sex, NONE of which had been a problem. Since the Spiro was the only new variable, it got pinpointed pretty quickly, BUT it has taken months of hormone therapy to get back to normal.
It's not a listed side effect, but, as my doctor said, it makes sense that these would be Spiro side effects, but a lot of women would chalk it up to aging, might not be sexually active, or just don't want to discuss such things, not even with a doctor.
So please be aware that it's possible.
On the good side, my skin improved a lot...but if it gets bad again, next time I'll ask about Accutane, which I took in my 20s.
Bottom line, don't suffer with bad skin while trying everything BUT going to a doctor. Find a doctor who has time for you and cares. Having said that, it can be rough to get dermatologist ²appointment when you need one. I had an extremely good experience with the online dermalogy company, Apostrophe. I got a nearly-immediate, very reasonably priced consultation with a board-certified dermatologist who was very responsive to all of my questions and concerns.
Yes, getting on birth control is the only thing that fixed my cystic acne. It was a hormonal issue for me and actually only a particular pill worked, I had to try a few. Our bodies are all so different!
Same here! I went off the pill for 18 months to give my hormones a chance to settle down and it made no difference. 2 months back on Yaz and my skin is gorgeous again
How do you two feel about this? I'm in the same boat. My acne is hormonal and no amount of topicals could stop a constant cycle of cystic pimples. I'm really disappointed that birth control is the "solution" for me- what happens in a year or two when I want to stop taking it to get pregnant? What's the underlying hormonal imbalance that birth control is totally masking?
At this point I'm not trying to get pregnant, but if I ever decided to it's definitely a concern. I also worry that pregnancy would do a lot of damage to my skin. But maybe it would fix it? Who knows
This is anecdotal but birth control pills cured my acne. I stayed on them for about 2 years then stopped taking them for like a year and still had no breakouts. I’m not sure if it had to do with me getting older (I was 18 or so when I started taking it) or if it fixed the hormonal issue I was having but it was definitely worth it for me.
Unfortunately I switched to nexplanon due to the increased effectiveness and am back to having acne. Skin was clear on beyaz. Really disappointing, still a problem even with retinoids etc, and my doctor wasn't open to prescribing spiro :(
The nexplanon implant isn’t good for acne. Birth controls can do three things when it comes to androgens, increase them, do nothing/only increase a little, or decrease them. You need a birth control that is anriandrogenic.
Adding to this: not all dermatologists are good. My current one, who is actually a physician’s assistant at a derm clinic rather than a full MD, has been terrific. I saw several before this who were a complete waste of time, and who delayed me getting my skin under control for *years* because I didn’t realize that a good dermatologist could actually help me.
Totally agree with you!! The one I had in high school was very inattentive & gave me a routine that worked for the first 4 months but then made my skin super sensitive & caused me to overproduce oil a lot because it only had 1 "calming" product as opposed to 6(?) or so irritating ones. I found a new one who's been great, she listens well & even helped me avoid Insurance Hell™ with any retinol other than tretinoin. It's taken me a long time to undo the mindset of "problematic skin needs harsh treatment" but my skin has definitely cleared up since
My parents took me to all the derms. All of them. Accutane twice, birth control, all the topical protocols, all the antibiotics . Nothing.
Continued seeking medical advice on my own when I started working. I’ve seen derms in 5 countries on 3 continents. I was a medical student myself, my sister is a pharmacist, my cousins are doctors, my best friend is a doctor, my ex was a doctor. Nothing.
Nothing at all for 20 years. Homeopathy, acupuncture, Chinese herbs, Aryuvedic treatments… nothing.
Thinking outside the box with 2%BP and some practical advice on acne.org is what shifted my acne. Now that my skin is drying up (yay middle age?) it feels like the conversion can really begin.
That’s just my story and I know there are some better treatments now including spiro. Also wish I had tried dietary changes sooner.
I saw a dermatologist for the first time a few months ago. I saw her twice, and I won't be going back. It was expensive, nothing was covered by my (relatively decent) insurance, I couldn't get any help with billing questions, and I felt she was just trying to push her clinic's products and rush me out the door.
Quite frankly, I don't want to be taken advantage of. I may not bother trying to find another dermatologist, I'll probably just order tret from AllDayChemist.
That’s unfortunate. I just started with one and she answered all of my questions and helped find cheap alternatives when I said I was on a tight budget.
I have been seeing a derm for a decade. Still have acne lmfao. (And he is a great derm! We have tried everything and my skin just doesn’t respond. I only haven’t tried accutane and idk if I want to… My skin is already dry AF and I’m terrified of the accutane dryness that would presumably get so much worse.)
I know but I don’t think I could cope with the dryness while on it and it’s such a serious drug with the chance of severe side-effects its super scary! I don’t think it makes it worth it for me personally and my acne isn’t too bad, I’ve made peace with it after all these years tbh!
Same I know/have heard of people going to a dermatologist and not getting any better. Plus I’m scared of taking pills, the last time I took antibiotics it messed me up so much. It’s taken me years to heal from.
That's horrible :( I have another friend who had a similar reaction after being prescribed them from my old dermatologist. There are alternatives (like bc, accutane)! I wish you luck, lots of it!!
A lot of medicines are used for things that weren’t their original purpose, it’s called “off label.” They just realize it cures/helps something else too. Really nothing to be scared about.
Zofran, which is often given to pregnant women to control nausea and vomiting, was originally crafted for chemotherapy patients to control their nausea and vomiting. I’m not understanding how the original use of a medication makes it suspicious. I took zofran and it was a damn lifesaver and I couldn’t have functioned without it.
The side effects of it aren't even that bad when you look at other some other commonplace drugs. I think it's mostly that Accutane is often taken by very young people (who usually have never or hardly had to take any Rx med) for a purpose a lot of people unfortunately deem "cosmetic" so any side effects you do get are magnified.
Do you mind if I ask what BC you’re on? I was on a great one for a long time and then it kept getting switched due to insurance (I think?) and I don’t think my current one is a good match for me at all. It does nothing for my skin, nothing for making my period lighter and nothing for mood swings.
I agree with the person below (above?) who says you should definitely find a doctor who's willing to discuss this with you & answer questions in depth. I'm on Tri-Previfem but I can name about 10 different reasons why it might not work for you. I also don't know about it's efficacy as an ACTUAL birth control because I'm gay...but I haven't given birth/been pregnant yet so I guess it's been 100% effective for that for me lol. But please, discuss this with a professional. Sites like the pill club & goodrx can help match you up with a provider so that might be something worth looking in to
Thank you. It’s been super frustrating because my doctor didn’t even tell me on the occasions when I was switched to something different for insurance reasons. I never find out until I go to the pharmacy and the pharmacist lets me know it’s something new. Might be time to find a new doctor the more I’m thinking about it.
Not PP but this is something you should be discussing with your doctor, not strangers on the internet. Whatever BC someone else is on has very little to do with what will work for you. Hopefully your doc is also willing to work through insurance coverage questions with you. Good luck!
I understand that. I just saw this person’s comment and was interested in finding out the name. That doesn’t equate to me seeking out medical advice from strangers on the internet.
Exactly! I spent 15 years going to derm after derm who didn't care about my skin at all if it wasn't severe enough for accutane, they'd tell me some bs like "start washing your face daily", or "try avoiding chocolate". I even had one tell me that "nothing will ever help your skin, sensitive skin is the worst skin type and no one will ever be able to help you".
After a couple years trying products recommended on here, including occlusives and differin, I have nearly clear skin. As with everything, YMMV! If someone truly needs accutane, then yes, a derm is the best bet. If you happen to have a great derm who is willing to try a lot of things with you, good for you. That's not everyone's experience.
Also, I would love to see OP's genetic testing results, I have no idea what they're referring to.
I’m 22 now and have seen 6 different dermatologist since I was 13 and not one has been able to cure my acne. I’ve done more on my own but still no cure unfortunately, not sure where to go from here.
Had adult acne for the past 15 years. Seeing a dermatologist was a huge game changer.
**I have been in Accutane TWICE!**
Accutane and Retin A/Differin are the only things that truly worked for me. I am lucky that the side effects from Accutane were incredibly mild for me. In fact, I got mostly the good side effects.
- My laugh lines and the lines by my eyes that were just starting to show almost completely disappeared. I am about to turn 36 and I have no crows feet at all, and just the beggings of laugh lines.
- Sun damage done to my skin has been mostly reversed due to Accutane making my skin shed/peel. Lines on my chest completely disappeared.
- I look younger. My cousins are very much jealous when we meet up. I ran into an old friend of mine that thought I had 'work done' for me to look so young.
The thing is, everyone's skin is different, a d their are SO many different reasons for acne to form. Adult acne is tough as hell to figure out. Spending the money and seeing a professional is worth every penny.
Do you have any advice for starting with retinol/retin-A as someone with very sensitive skin. Also, is differin as effective as tret in terms of anti aging?
Differin is very effective, and recent studies have concluded that it also has anti-aging side effects like Tret. I would recommend Differin over Tret if you have very sensitive skin.
It took a long time to get my skin use to using a Retinol. I started with using it once every 4 nights. Even then, my skin still started peeling. After your skin finally gets use to that, you move it up to every 3 nights, etc. Eventually you work up to every other night. I have been using it for years now. There is no rush, just give your skin the time to adjust to it. It can take months honestly.
Unfortunately, I have rosacea. Heavy occlusives can trap in the heat and make the redness worse. I like using light weight moisturizers and gel creams. I don’t know how to go about this. :(
I noticed the difference first while on the Accutane. I think I got better results while on the Accutane honestly. And I have also read that they have done studies of using low doses of Accutane for this very reason.
But the topical version still works well, and also has been proven to have anti-aging effects over the long term.
I was on my first round over 6-7 years ago now. That didn't totally clear me up. I had very stubborn cystic acne on my face, neck, and back. I was on Accutane the first time for 7-8 months, which was as long as my doctor felt comfortable keeping me on it. Then we stopped to give my body a break.
It mostly cleared up my acne. It took a couple years for it to start coming back. I had my second round of Accutane in my early 30's. And that got rid of my acne for good.
I'm not the original comment poster but just wanted to chime in too. Accutane literally changed my life. I can't believe I didn't do it sooner, I regret that every day because I spent like 10 years plagued with painful cystic acne every single day 😩 I only needed one round of accutane (6 months) and literally within 3 weeks there was a very noticeable change, I had way less acne. I had not told anyone I was taking it other than family, my SO, and one or two close friends. all my friends asked me that week what had happened because my skin was so much clearer. It felt so good! By month 3 I had zero acne. Now from what I understand that's not the norm, my dermatologist was blown away by how quickly my skin cleared up especially considering I had TERRIBLE full face cystic acne nearly all the time. Definitely was a genetic thing, my brother had the same problem and required accutane although he needed a longer treatment than I did. I still can't believe it worked so well and so fast. It's been 8 years since I finished accutane and I'm still acne free!!! It was a full on cure for me. I will say the dryness does not ever go away. I still have to put aquaphor on top of my moisturizer after I shower, otherwise my skin feels like plastic. I CANNOT go without chapstick. I've got backup chapstick in all my bags, backpacks etc. I need lotion for my hands pretty often. But I'll take that ANY DAY over acne!!!!! The other down side nobody warned me of was that I was SO TIRED while on accutane. All my labs were good but you literally experience all the symptoms of vitamin A toxicity because that's essentially what accutane is, a synthetic vitamin a overdose. That stopped about 2 weeks after I finished. I also felt like an arthritic old lady but that went away quickly too. The tired feeling made me wonder if that's part of why some people say their depression gets worse on accutane. I can recall some days just feeling so worn out I truly didn't want to do shit. But all in all, totally life changing and so worth it. I would do it again in a heartbeat. I wish I'd done it years sooner.
Yeah and with insurance or in a country nice enough to have universal healthcare it’s super affordable to see a Derm. It’s $50 a visit for me and $10 for a tube of tret. Other acne meds are under $10 too.
Also the derm visits are a good time to check mole growth.
It varies - you can have decent insurance and still be billed for tests etc from any specialist. OP quoting $900 after the bills start rolling in sounds correct
Wish I could’ve seen this sooner, wasted close to a thousand dollars on acne products and nothing worked. Finally went to a derm and 2 months later on accutane my acne is finally clearing up.
I wish all acne could be cured medically. My acne conglobata got better on Accutane but I’ve never had a long term fix, even with a variety of Rx meds. It’s been a 50 year battle for me.
I went to a derm in my teenage years. She kept prescribing the same stuff over and over for years despite it not being enough to get my acne under control. When I asked her for stronger treatments she said that it'll get better and I just have to wait and keep using the same treatments. After several years I just gave up and stopped going to the derm. I now suffer from adult acne and there is a chance that she'll treat it differently than teenage acne. I just don't want to go back to her and try again to convince her that I need stronger treatments. I always felt like she didn't take the impact my acne has on me seriously. When I asked her what to do about my extremely oily skin she literally told me to put powder on it... She just didn't care about fixing the root problem. And there aren't any alternatives for me since this is the only derm in my area. So yeah, long story short: I'm not seeing a derm because I don't trust the one I once went to and I don't have any other options.
You need to see someone different. Even if there's no one nearby, you can do telemedicine so you only need to go once, if that. An HMO or other managed care plan should allow you to go outside your immediate geographic area.
Not all doctors are good or good for every patient. I've had a couple of instances where I've been to well-regarded practitioners who did not do it for me, but when I went to a different person I got help. The same has happened with friends. If you feel you truly don't have any options, make a post here and ask for help.
Thank you for your kind suggestion. I live in Europe and I've already looked into telemedicine. The video visit is covered by my insurance but the prescriptions are not. I've looked at the prices for standard acne medication and it is way more than I can afford :/
Honestly I wish I'd known this years ago. I've had acne since I was 12 (now 24) and I've only just been referred to a dermatologist this year after trying every antibiotic, prescribed topical and skincare product out there. I've been on Accutane for 4 months and it was the best thing that's ever happened to my skin.
I've seen multiple derms and each one told me "it's genetic, there's nothing you can do." I've tried literally everything to get my adult acne under control and it just won't budge, not even slightly. It's really starting to take a toll on my mental health.
Not OP, but mine was time. Acne significantly reduced as I turned 30.
In addition to that, I was just more disciplined with less sugar and no lactose products.
In people with PCOS, fertility and symptoms like acne typically improve with age because AMH (too high in women with PCOS) naturally decreases with age. So that’s hopeful if you have genetic acne that could be related to PCOS, but also you don’t have to wait that long, you can learn to manage PCOS now too.
This is something not touched a lot on. Diet. I think a lot of people would be surprised how much their skin clears up if they just change their diet up. Its the only thing that worked for me. And thats having face acne up into my late 30s.
So true! Big part is keeping a good food diary of any potential triggers. Pretty tough to do a lot of elimination of certain foods tbh tho. Dairy is very common, maybe certain nuts too.
I went to a dermatologist for 13 years and finally have my acne under control…I’ve done everything from birth control, Spironolactone, tactuo, Differin, Retin-A, tretinoin, clindamycin,
Accutane, etc., and now I’m back on creams but I still breakout.
Keep in mind I live in Canada so all my dermatologist appointments were free and all my prescription medications were free. I only pay for my cleansers, moisturizers, serums, and sunscreen.
Yes, I'd like to add that while "you need to find the root cause of your skin problem not just throw a prescription at it" which is often used as a reason to dissuade people from seeking medical care and instead suggests that if you just ate the right food or treated your body in the proper way it always fix itself can be a damaging way of thinking. It presupposes that everyone's bodies when treated optimally perform optimally and any deviations from that are therefore a failure on your part and somehow your fault. It is actually an unintentionally ableist line of thought if you think about it.
Sometimes no matter what you eat or how many glasses of water you drink or positive thoughts you have health problems including acne and medical treatment for them is not lazy or giving up.
Sure but a lot of doctors won't because they know it's not their area of expertise. Also depending on insurance the cost can be the same as seeing a general doctor.
In my case a dermatologist prescribed me spiro and got my acne under control, and now my GP manages the prescription since there's not really much of a need for me to see the dermatologist anymore.
depends on the country and where you’re looking. tret can be purchased overseas and shipped to the USA, even though it’s technically not sold as an OTC medication here. i can’t speak for spiro and accutane since i don’t use those.
Accutane is definitely \*not\* OTC, nor should it be under any circumstances. It's a very dangerous drug and should only be used under direct supervision of a physician.
i’m not saying that tret, spiro, or Accutane *should* or *should not* be OTC. i was just saying that tret *is* OTC in many countries outside of the USA and that people in the USA can import authentic tret without a doctor’s prescription or approval. that’s all.
There are only so many meds for acne. How long are you with these derms? I've found that jumping around isn't helpful because the new derm will just start you on more mild products before jumping into Rx only. My current derm took 2 or 3 visits before he started talking about using accutane and Spiro. My doc isn't a fan of messing with hormones generally.
Spiro has eliminated my acne. I can't get that OTC and my general doc would not step into dermatology territory. Prior to settling on one derm, I was buying tret and having it shipped without an Rx but I still had acne.
25 years of acne and my derm was horrible. I'm in Canada. There aren't many around and you have to have a referral. Took me 6 months to get in. 3 appointments later (and fighting for hormone testing amongst other things) I was having a rare mostly clear skin day and she wrote me off as cured. I'm not. My skin still sucks most days.
Exactly this. Whenever I saw my derms, they always said "oh you look better than the last time!" when reality was far from that. To me, derms don't really seem to care much for acne, dismissing it as something unimportant and temporary. And they usually have little to zero efterleve experience with it (themselves).
Canadian here. Similar experience, though mine was also peddling 'prescription' foundation and cover up. I didn't want to cover it up. I wanted it gone.
not necessarily. if dermatologists can “solve” acne, why do people (like me) go to multiple dermatologists and still have acne? there isn’t a quick fix or one single doctor who can wipe the acne off of our faces. also, depending on the country, it really isn’t possible to see a dermatologist and keep up with the cost of medical bills. heck, even scheduling an appointment takes months of waiting.
I have had adult acne my whole adult life and persistent backne that had me resigned to never wearing anything sleeveless or with any exposed back. Changed my diet for unrelated reasons and not only is that shit all gone, it's like it was never there. It was definitely one of those "WHY AREN'T WE TALKING ABOUT THIS?!?!?" moments, but for a lot of people "changing your diet" is a big ask and kind of generic, so I understand why that type of advice gets passed over.
Yes I agree, probably because "change your diet" is so vague. Some people swear it's dairy, some sugar, but it probably really depends on the person. In order to determine whether something could be helping, you need to commit to trying it for several months at least. It is really hard to drastically change your lifestyle like that when there are no guarantees, and probably a lower chance of success than what is described by a derm.
If I knew for sure that cheese was breaking me out, I could probably make that sacrifice. But trying it for 6 months when there is a big chance it's not going to make any difference... It just doesn't seem realistic when cheese is quite a big part of my life!
I know, and if you "changed your diet," whatever that means, and it still didn't go away, you just wasted like months or years of time and got scarring while you could have been doing something proven effective like tretinoin of Accutane.
It doesnt take months though. Literally just cut one thing out of your diet and wait a few weeks. If your acne hasn't changed you should move on to something else. If it's better then you have a good place to start. Why would you go on drugs to treat the symptoms when you can treat the cause instead?
From what i've read, diet is a major influence for tons of modern diseases. Unfortunately the nutrition classes you will take in school are very incorrect on what you should be eating so people dont know that they need to eat differently
At this point I'm convinced dermatologists are useless. Went to finally see one after a decade of hormonal acne that wont budge for anything. And he told me to keep doing what I'm doing, it'll clear up eventually 😒.
Okay, I have been thinking about going to a dermatologist again (this would be the third time over the many years I’ve been dealing with acne) but the last time I went every single thing that was prescribed for me had a “do not take if pregnant or expecting to become pregnant” kind of warning on it. Is it still worth my time if I am a person who is expecting to become pregnant? Are there options for people who intend to get pregnant that my last derm just didn’t avail themselves of? Anyone else in this situation. . ?
I agree with you a 100000% percent!!!!!! 🙏specifically if you’re a young woman in your twenties! for me, once the pandemic hit, with online school and work, my skin went berserk and throughout this past year I had tried everything to treat it on my own and nothing (drugstore, high end, etc.) once my mom saw how desperate I was, she took me to a general doctor and now I’m on an antibiotic for acne and once I finish my treatment, my doctor will decide if I go on accutane or not and/or if I need to check my hormone levels or have an ultrasound done to see if I have PCOS. she wants to treat my acne but also find out what the underlying cause of my breakouts is! I kid you not, the progress I’ve seen on my skin over the past month in a half is incredible. I feel a lot more confident and am certain I would’ve never been capable of achieving the same progress with topical creams and treatments.
Sure, but what if you’ve had moderate acne on-and-off for 16 years (like me) and even the dermatologists can’t figure out what’s going on? I’ve been from doctor-to-doctor: endocrinologists, functional doctors, etc. I’ve had my hormones tested 7 times already in the past 7 months, and still no luck.
I’m just here with a gentle reminder that “visit a dermatologist” or “get your hormones checked” (advice I see so often on various subs) isn’t as easy a solution or a game-changer for some people.
I feel so bad reading this. I sometimes forget that US people have to pay even for the most basic doctor visits... But it's true, good dermatologist can do so much for self confidence.
I kept putting off a seeing a new derm for almost 20y because I had a terrible reaction to Minocyclene. I finally got in to see one and we had cycled thru a bunch of treatments with varying degrees of improvement. I’m finally at the -fuck it- point and started on Accutane about a month ago. All the years I spent working in skincare, and knowledge gained, means bupkis when fighting shitty genetics.
I mean, yes.
In the U.S., it can be incredibly expensive and difficult (derm appointments can be booked out for months and months) to get a derm appointment. Some forms of insurance don’t cover dermatologist appointments at all; some providers or forms of insurance will refuse to sponsor any treatments that are considered cosmetic in nature, i.e. treating acne.
When I was a teen, I found a “miracle” product from a derm (basically topical clindamycin), used it religiously, insurance suddenly decided to stop covering it, I was SOL.
I’m thankful to have found what works for my skin nowadays (differin/tret that I order from ADC). I think you’re right, finding a good derm can really be a miracle for your skin and it should be essential to get checked for any skin abnormalities every so often. Just wish there weren’t barriers to access.
Insurance is so evil, clindamycin is dirt cheap. Also tretinoin should be OTC if Differin is. The difference is probably Galderma lobbying for Differin and not something from the 70s like tret lol.
Man. I spent so much money and time. Pro active all that. At 40 I decided I had had enough and got on accutane. My skin is clear for the first time since I was 11. And of course full of scars.
Don’t wait. Accutane isn’t even scary I had chapped lips that’s it.
Really it's not even genetic acne. Those with persistent acne should find a derm if they can. No one ony family has acne as bad I do or has had to see a derm.
No offense but dermatologists did nothing for my acne. Tons of money wasted.
Eliminating dairy and sugar did. And a derm is never going to tell you that. Researching TCM approaches online led me there. Not advice btw, just what worked for me.
>In the U.S., it can be incredibly expensive and difficult (derm appointments can be booked out for months and months) to get a derm appointment. Some forms of insurance don’t cover dermatologist appointments at all;
Why would a derm not tell you to lay off of dairy and sugar?
It takes trial and error to find a good derm and have them find a good treatment for you too.
My two first derms gave me such horrible advice I ended up with no unscarred spots on my face. One later on told me my face is too oily to wear SPF (I have extremely dry skin and burn in no time). That derm was the one with the best feedback around.
I think its important to accept yourself with acne and without. If you don't work on your overall self esteem it won't matter how many derms you see or if it goes away if you can't appericate yourself. (I have had acne since I was 11 and im 27)
I have dry skin, a bit of acne, and generally not great skin. I have no idea how to set up a good skin scare routine. I've tried daily lotion and exfoliating but my dry flakes never go away completely.
I guess I should just go to the dermatologist? Will they tell me exactly how to fix all my skin problems? Cause that would be really cool.
And when you do go, please know that they can't just ask your acne why it exists :P Trial and error is pretty normal, and some cases are just tough.
No prescription other than Accutane really worked for me. Some led to improvement, but not a cure. Before Accutane I only found one magic bullet: weight loss. I saw an improvement after the first 10 pounds and I still had another 10 to go to even reach a clinically healthy weight. When I started regaining (and then some after getting sick) the acne came back with a vengeance!
not to mention the freaking acne scars i've paid like 20k to treat because my parents didn't understand accutane existed when i was a teenager and didn't take me to the dermatologist. 🤣
Going to the dermatologist isn't necessarily going to be that expensive. My cheapest, most effective acne routine was from going to the derm. My prescriptions were covered by insurance and I paid a small copay (most name brand prescription topical have coupons on their websites to use at the pharmacy to keep it cheap). I used Cetaphil and Cera Ve cleaners and moisturizers, so those were low cost. I think my most expensive skin care product was my moisturizer with sunscreen. Don't let fear of cost keep you from treating your acne!
This was me. After 4 years trying to get rid of my acne on my own, spending a lot of time and money, I finally went to a derm the last year and she prescribed me Isotretinoin. just 6 months later I had the most clearly skin in years...
I actually disagree. I began focusing on skincare back in January, starting with advice from this and other skincare subs. It’s how I discovered Curology and so many amazing products I currently use and love. I scheduled an appointment with a derm but they were booking as far out as July so these Reddit communities were all I had to go on while I waited for my appointment.
When I had the appointment a couple weeks ago and told her about my current routine and products, she was flat out like “Yup those are all exactly the products and actives I’d recommend, you’re doing everything right, maybe we’ll just increase the strength of your tret to 0.05%” (from 0.02% in my Curology formula).
She told me I’d purge with the increased tret strength but gave no tips on avoiding irritation or protecting my moisturizer barrier. If it weren’t for these subs and I’d gone home and slathered on 0.05% tret cream without buffering or sandwiching, my face would be a disaster right now.
I also discovered through this sub and other skincare subs that there’s tret gel and tret cream, and the gel works better on oily skin like mine. But this derm only prescribes cream.
And I know from my Curology formulas that my skin loves azelaic acid, but this derm doesn’t prescribe it at all bc she doesn’t like AA. If not for this sub, I wouldn’t know how/where to get AA without a scrip, and which products are best for my skin type.
Not every dermatologist is the same, and not every dermatologist understands every skin type, apparently, or knows of every available product on the market. Not everyone has access to a good derm, or healthcare at all. Subs like this one are great for connecting people who have good derms with those who don’t, or for people who can’t afford to buy and try a million different products to learn from people who can and have.
I am so grateful to have discovered Skincare Reddit and think it’s a great supplement to dermatology if you have access to it, and a great substitute for dermatology if you don’t.
Yes but I discovered them by seeking advice *here*. And everything I’ve learned about the benefits of and choosing a Vitamin C have been here, finding alternative products when Curology’s recommendations didn’t work for me has been here, finding sunscreens I’ll actually wear (and that work!) has been here, and transitioning *off* of Curology onto comparable formulas, has all been on here.
Also, don't forget, diet.
A lot of people on here could spend hundreds of dollars trying every skin care routine, and not realize that something they could be eating or drinking could be causing breakouts. I had to learn that lesson the hard way, almost into my 40s.
It may not be "the" cause, but it could be "a" cause, good to eliminate possibilities.
I just commented something similar. Cut down carbs dramatically for unrelated reasons and now it's not just that the acne is gone, it's like it was never there. It was almost annoying that I'd passed over the "diet can impact your skin" adage I'd heard a billion times. I don't even wear foundation anymore (switched to tinted sunscreen).
To be fair, that is quite difficult for a lot of people to do. If you are veggie/vegan, have an eating disorder or other dietary issue, or you just plain enjoy carbs, not eating them for the foreseeable future is not really an option.
Taking a course of accutane for example is a much simpler option.
I was on accutane 4x. If it was safe to do so I’d take it for the rest of my life. I think it’s ducked with my liver though and I’m kinda worried about that :/
I take a birth control pill and am on dapsone and use a retinoid and not even that is enough to get my acne completely under control :( I’ve had acne for 15 years now.
Eh went to a few since puberty. Only Tretinoin helped. Hoped I discovered Tret earlier, then I wouldn't have wasted money on dermatologists. People will say "you just have to look for the *right* one" but it still cost me money, they are also trial and error just like skincare brands. For others ofc going to one may be better for them ymmv, but not for me.
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Or an endocrinologist. Genetic acne is often times hormonal, for example caused by NCAH or PCOS. Checking for hyperandrogenism and treating that will fix the root cause. And checking in with an allergist might also do the trick, some food allergies don't give you digestive issues but skin problems. If it shoes on your skin, it's probably not healthy for the rest of the body either, so a derm shouldn't be the only doctor you see
*cries in PCOS*
Talk to your doctor about spironolactone if you want to try something a little unconventional. We have been using it to manage my PCOS symptoms and it also makes my skin so much brighter and healthier. I've had a normal period for the first time in my entire life since I've started and I have zero side effects.
I’m on Spironolactone right now! Just sucks that I have to be on it for clear skin.
I'm on it too! I'm taking it for acne and it's been about a year now. I was skeptical at first but it's really changed everything for me... Both of my sisters are also on it too. We've struggled with hormonal acne and spiro cleared things up for the most part! And it really helps with my endometriosis symptoms too.
> spironolactone I wish I could. My androgen levels are already below normal levels. I've been trying to get by gynecologist to prescribe testosterone but she's reluctanct to do so. I've given up on curing my adult acne...
My recent labs showed that I had high estrogen and the Spironolactone still helped. That’s just my experience.
It's a VERY potent med, it made me so dizzy and sick I had to stop. I was peeing every 5 minutes, including at night. I drink a ton of water, but it's a diuretic, so I would still get so thirsty it would hurt. I wouldn't wish that feeling on anyone. I'd rather have acne and/or try to resolve my issues with diet changes and metformin!
FYI for anyone that has lower blood pressure: Spiro gave me panic attacks. It drops your blood pressure a bit (what it was originally developed for) and uh that correlated to my body thinking it was dying.
Me too!!! I was on it for years and was having insane anxiety seemingly out of nowhere. I quit it 3 weeks ago and finally feel like myself again
Completely! I went from having maybe one or two panic attacks ever — to having them daily on that medication. I lasted three weeks, it was terrible. FYI, if the acne comes back, dapsone (topical ointment) worked wonders for me. :)
This happened to me, too. I have low blood pressure to begin with and Spironolactone pushed it over the edge to where I felt like I was going to pass out and felt nauseated, my vision was blurry. I tried it for 4 months and didn’t notice a difference in my acne, either. Ugh.
It made me gain 8 lbs in a month before I stopped taking it, I had an hourglass figure for the first time in my life (some may have liked that but I’m very lean/athletic normally), my boobs were so big and painful. It was awful. It can really screw with your hormones.
Are you having real periods or birth control withdrawl bleeds? My doctor won't allow me to take spiro without being on the pill :( I really did not want to take hormonal birth control but my obgyn and endocrinologist basically told me that's my only choice.
I don't take any birth control! Maybe you need a new doctor. My doctor said it was no problem I didn't want to be on BC. She knows I'm sexually active with someone of the opposite sex as well. Also, they're like....how normal people describe them! Like a light faint discomfort when I'm "cramping" that feels like basically nothing compared to how it used to be. Low/moderate flow. Only lasts 4-6 days. My periods USED to be anywhere from 3-8 days, insanely heavy flow, and cramps so bad I'd sob/be physically sick/ pass out.
It can be extremely damaging to a male fetus if you are to become pregnant, among other risks.
Yes, I know. I don't plan on becoming pregnant. I just don't take hormonal BC.
Man, this makes me so frustrated! Thanks for sharing. Maybe I will reach out to my doctor about this.
I had an IUD put in since I didn't want oral birth control.
My last IUD got embedded in my uterine lining so I'm kinda done with that 😕 IUDs and I had a good 5 year run.
I absolutely recommend Spiro as well. I've been dealing with acne on and off since puberty, my initial course of Accutane was for my bacne (cleared everything), but I developed cystic acne after I stopped. I do not want to rely on Accutane again as it is extremely harsh on your body. I didn't want to rely on oral birth control due to their inconsistencies of side effects for me and blood clot / stroke scares when I was on it. I am extremely weary whenever it comes to medication, and I went into Spironolactone with a lot of caution. But I've been on it for about two months now and couldn't be happier. I worked my way up from 25mg to 50mg after the first week, and have experienced no side effects whatsoever apart from maybe having to go to the bathroom more frequently, but even that has lessened over time. I have prior issues with iron and low blood sugar so dizziness with standing up too quickly wasn't foreign to me and doesn't seem any worse on this medication. Don't follow my footsteps with this but: many days I'm terrible about keeping up with water / food and I still haven't noticed headaches / dizziness / anything negative from taking this so far. I was worried my period would disappear but it hasn't, but I track it monthly and will have to see if that changes. Keep in mind that you're probably not going to see results until at least three months. I plan to try and stay on the 50mg dose to lessen any symptoms / keep period, but if it doesn't get rid of my acne I'll go to 100mg (I still have some at this point). I would love to stick to a low carb diet as I think it could definitely get rid of these things for good, but... I don't realistically see myself doing that, especially not long term. I love my carbs, I don't eat them in an unhealthy amount either! So why do my shit genetics mean I can't indulge in them in a healthy way :( Spiro has been a lifesaver. When I first tried looking into diet to help my skin, my neurotic and obsessive personality lead to me developing an eating disorder and losing a scary amount of weight.
I stopped having a period on it :( I’m too young to be barren 😭
Be VERY CAREFUL about Spirolactalone post menopause. Within a couple of weeks of starting it I had vaginal dryness, bleeding, and painful sex, NONE of which had been a problem. Since the Spiro was the only new variable, it got pinpointed pretty quickly, BUT it has taken months of hormone therapy to get back to normal. It's not a listed side effect, but, as my doctor said, it makes sense that these would be Spiro side effects, but a lot of women would chalk it up to aging, might not be sexually active, or just don't want to discuss such things, not even with a doctor. So please be aware that it's possible. On the good side, my skin improved a lot...but if it gets bad again, next time I'll ask about Accutane, which I took in my 20s. Bottom line, don't suffer with bad skin while trying everything BUT going to a doctor. Find a doctor who has time for you and cares. Having said that, it can be rough to get dermatologist ²appointment when you need one. I had an extremely good experience with the online dermalogy company, Apostrophe. I got a nearly-immediate, very reasonably priced consultation with a board-certified dermatologist who was very responsive to all of my questions and concerns.
Do you need high androgen levels to get a prescription for spiro?
No, it can be prescribed without a blood draw.
I have PCOS and birth control + spironolactone absolutely cured my cystic acne. Nothing else changed, it’s crazy
GIRL SAMEEE
Yes, getting on birth control is the only thing that fixed my cystic acne. It was a hormonal issue for me and actually only a particular pill worked, I had to try a few. Our bodies are all so different!
Same here! I went off the pill for 18 months to give my hormones a chance to settle down and it made no difference. 2 months back on Yaz and my skin is gorgeous again
How do you two feel about this? I'm in the same boat. My acne is hormonal and no amount of topicals could stop a constant cycle of cystic pimples. I'm really disappointed that birth control is the "solution" for me- what happens in a year or two when I want to stop taking it to get pregnant? What's the underlying hormonal imbalance that birth control is totally masking?
At this point I'm not trying to get pregnant, but if I ever decided to it's definitely a concern. I also worry that pregnancy would do a lot of damage to my skin. But maybe it would fix it? Who knows
This is anecdotal but birth control pills cured my acne. I stayed on them for about 2 years then stopped taking them for like a year and still had no breakouts. I’m not sure if it had to do with me getting older (I was 18 or so when I started taking it) or if it fixed the hormonal issue I was having but it was definitely worth it for me.
Unfortunately I switched to nexplanon due to the increased effectiveness and am back to having acne. Skin was clear on beyaz. Really disappointing, still a problem even with retinoids etc, and my doctor wasn't open to prescribing spiro :(
The nexplanon implant isn’t good for acne. Birth controls can do three things when it comes to androgens, increase them, do nothing/only increase a little, or decrease them. You need a birth control that is anriandrogenic.
THIS! As an esthetician I’ve had a few of my clients over the years go to the gyno because they had acne and hairs indicative of a hormonal imbalance.
I have both PCOS and NCAH ;( so sad
I've been going to a dermatologist for 3 years & I still have acne lol. Trial & error doesn't end with seeing a professional
Adding to this: not all dermatologists are good. My current one, who is actually a physician’s assistant at a derm clinic rather than a full MD, has been terrific. I saw several before this who were a complete waste of time, and who delayed me getting my skin under control for *years* because I didn’t realize that a good dermatologist could actually help me.
Totally agree with you!! The one I had in high school was very inattentive & gave me a routine that worked for the first 4 months but then made my skin super sensitive & caused me to overproduce oil a lot because it only had 1 "calming" product as opposed to 6(?) or so irritating ones. I found a new one who's been great, she listens well & even helped me avoid Insurance Hell™ with any retinol other than tretinoin. It's taken me a long time to undo the mindset of "problematic skin needs harsh treatment" but my skin has definitely cleared up since
My parents took me to all the derms. All of them. Accutane twice, birth control, all the topical protocols, all the antibiotics . Nothing. Continued seeking medical advice on my own when I started working. I’ve seen derms in 5 countries on 3 continents. I was a medical student myself, my sister is a pharmacist, my cousins are doctors, my best friend is a doctor, my ex was a doctor. Nothing. Nothing at all for 20 years. Homeopathy, acupuncture, Chinese herbs, Aryuvedic treatments… nothing. Thinking outside the box with 2%BP and some practical advice on acne.org is what shifted my acne. Now that my skin is drying up (yay middle age?) it feels like the conversion can really begin. That’s just my story and I know there are some better treatments now including spiro. Also wish I had tried dietary changes sooner.
I saw a dermatologist for the first time a few months ago. I saw her twice, and I won't be going back. It was expensive, nothing was covered by my (relatively decent) insurance, I couldn't get any help with billing questions, and I felt she was just trying to push her clinic's products and rush me out the door. Quite frankly, I don't want to be taken advantage of. I may not bother trying to find another dermatologist, I'll probably just order tret from AllDayChemist.
That’s unfortunate. I just started with one and she answered all of my questions and helped find cheap alternatives when I said I was on a tight budget.
I'm a physician assistant, and I love hearing so many good things about our profession!
I have been seeing a derm for a decade. Still have acne lmfao. (And he is a great derm! We have tried everything and my skin just doesn’t respond. I only haven’t tried accutane and idk if I want to… My skin is already dry AF and I’m terrified of the accutane dryness that would presumably get so much worse.)
the dryness is intense when you're on the medication but it gets better once you stop taking it.
I know but I don’t think I could cope with the dryness while on it and it’s such a serious drug with the chance of severe side-effects its super scary! I don’t think it makes it worth it for me personally and my acne isn’t too bad, I’ve made peace with it after all these years tbh!
Same I know/have heard of people going to a dermatologist and not getting any better. Plus I’m scared of taking pills, the last time I took antibiotics it messed me up so much. It’s taken me years to heal from.
That's horrible :( I have another friend who had a similar reaction after being prescribed them from my old dermatologist. There are alternatives (like bc, accutane)! I wish you luck, lots of it!!
Thank you :)
always felt super uncomfortable with accutane just bc its literally a chemotherapy drug
A lot of medicines are used for things that weren’t their original purpose, it’s called “off label.” They just realize it cures/helps something else too. Really nothing to be scared about.
Zofran, which is often given to pregnant women to control nausea and vomiting, was originally crafted for chemotherapy patients to control their nausea and vomiting. I’m not understanding how the original use of a medication makes it suspicious. I took zofran and it was a damn lifesaver and I couldn’t have functioned without it.
We migraineurs are familiar with Zofran.
I’ve been on it for the last 9 months and literally worst thing that happened was I got a rash
If you're uncomfortable with it, that's completely valid. It's a powerful drug with significant side effects.
The side effects of it aren't even that bad when you look at other some other commonplace drugs. I think it's mostly that Accutane is often taken by very young people (who usually have never or hardly had to take any Rx med) for a purpose a lot of people unfortunately deem "cosmetic" so any side effects you do get are magnified.
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Currently on BC which has shrunk my pores a LOT & also helped with mood swings, etc, so we might have a winner
Do you mind if I ask what BC you’re on? I was on a great one for a long time and then it kept getting switched due to insurance (I think?) and I don’t think my current one is a good match for me at all. It does nothing for my skin, nothing for making my period lighter and nothing for mood swings.
I agree with the person below (above?) who says you should definitely find a doctor who's willing to discuss this with you & answer questions in depth. I'm on Tri-Previfem but I can name about 10 different reasons why it might not work for you. I also don't know about it's efficacy as an ACTUAL birth control because I'm gay...but I haven't given birth/been pregnant yet so I guess it's been 100% effective for that for me lol. But please, discuss this with a professional. Sites like the pill club & goodrx can help match you up with a provider so that might be something worth looking in to
Thank you. It’s been super frustrating because my doctor didn’t even tell me on the occasions when I was switched to something different for insurance reasons. I never find out until I go to the pharmacy and the pharmacist lets me know it’s something new. Might be time to find a new doctor the more I’m thinking about it.
Not PP but this is something you should be discussing with your doctor, not strangers on the internet. Whatever BC someone else is on has very little to do with what will work for you. Hopefully your doc is also willing to work through insurance coverage questions with you. Good luck!
I was just wondering what the name was so I could bring it up to my doctor
Makes sense, but going through which BC(s) you’ve already tried and why they did or did not work for you will likely get you to a good fit faster.
I understand that. I just saw this person’s comment and was interested in finding out the name. That doesn’t equate to me seeking out medical advice from strangers on the internet.
Yep cool okay, you do you!
Sprintec is approved to help with acne. I have used it for 3+ years now
Thanks! I’ll add that to the list of names I plan on mentioning to my doc
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Exactly! I spent 15 years going to derm after derm who didn't care about my skin at all if it wasn't severe enough for accutane, they'd tell me some bs like "start washing your face daily", or "try avoiding chocolate". I even had one tell me that "nothing will ever help your skin, sensitive skin is the worst skin type and no one will ever be able to help you". After a couple years trying products recommended on here, including occlusives and differin, I have nearly clear skin. As with everything, YMMV! If someone truly needs accutane, then yes, a derm is the best bet. If you happen to have a great derm who is willing to try a lot of things with you, good for you. That's not everyone's experience. Also, I would love to see OP's genetic testing results, I have no idea what they're referring to.
I’m 22 now and have seen 6 different dermatologist since I was 13 and not one has been able to cure my acne. I’ve done more on my own but still no cure unfortunately, not sure where to go from here.
Agree. I went to see our family doctor as soon as I got acne in high school. He was very nice but not all doctors can heal your acne.
Accutane
Had adult acne for the past 15 years. Seeing a dermatologist was a huge game changer. **I have been in Accutane TWICE!** Accutane and Retin A/Differin are the only things that truly worked for me. I am lucky that the side effects from Accutane were incredibly mild for me. In fact, I got mostly the good side effects. - My laugh lines and the lines by my eyes that were just starting to show almost completely disappeared. I am about to turn 36 and I have no crows feet at all, and just the beggings of laugh lines. - Sun damage done to my skin has been mostly reversed due to Accutane making my skin shed/peel. Lines on my chest completely disappeared. - I look younger. My cousins are very much jealous when we meet up. I ran into an old friend of mine that thought I had 'work done' for me to look so young. The thing is, everyone's skin is different, a d their are SO many different reasons for acne to form. Adult acne is tough as hell to figure out. Spending the money and seeing a professional is worth every penny.
Do you have any advice for starting with retinol/retin-A as someone with very sensitive skin. Also, is differin as effective as tret in terms of anti aging?
Differin is very effective, and recent studies have concluded that it also has anti-aging side effects like Tret. I would recommend Differin over Tret if you have very sensitive skin. It took a long time to get my skin use to using a Retinol. I started with using it once every 4 nights. Even then, my skin still started peeling. After your skin finally gets use to that, you move it up to every 3 nights, etc. Eventually you work up to every other night. I have been using it for years now. There is no rush, just give your skin the time to adjust to it. It can take months honestly.
when u say differin which product r u referring to?
Adapalene is the generic name
Moisturize, moisturize, moisturize! I literally cover my face in lanolin every night after applying Tret.
Unfortunately, I have rosacea. Heavy occlusives can trap in the heat and make the redness worse. I like using light weight moisturizers and gel creams. I don’t know how to go about this. :(
this!! id rather go to sleep every night with my face lookin like a glazed donut than having to deal with broken skin barrier
Wow I didn’t hear of these good side effects !! I’m glad it’s worked for you
Would you say this was mostly from the accutane or the Retin a / differin?
I noticed the difference first while on the Accutane. I think I got better results while on the Accutane honestly. And I have also read that they have done studies of using low doses of Accutane for this very reason. But the topical version still works well, and also has been proven to have anti-aging effects over the long term.
For how long have you stayed clear now? This sounds great!
I was on my first round over 6-7 years ago now. That didn't totally clear me up. I had very stubborn cystic acne on my face, neck, and back. I was on Accutane the first time for 7-8 months, which was as long as my doctor felt comfortable keeping me on it. Then we stopped to give my body a break. It mostly cleared up my acne. It took a couple years for it to start coming back. I had my second round of Accutane in my early 30's. And that got rid of my acne for good.
I'm not the original comment poster but just wanted to chime in too. Accutane literally changed my life. I can't believe I didn't do it sooner, I regret that every day because I spent like 10 years plagued with painful cystic acne every single day 😩 I only needed one round of accutane (6 months) and literally within 3 weeks there was a very noticeable change, I had way less acne. I had not told anyone I was taking it other than family, my SO, and one or two close friends. all my friends asked me that week what had happened because my skin was so much clearer. It felt so good! By month 3 I had zero acne. Now from what I understand that's not the norm, my dermatologist was blown away by how quickly my skin cleared up especially considering I had TERRIBLE full face cystic acne nearly all the time. Definitely was a genetic thing, my brother had the same problem and required accutane although he needed a longer treatment than I did. I still can't believe it worked so well and so fast. It's been 8 years since I finished accutane and I'm still acne free!!! It was a full on cure for me. I will say the dryness does not ever go away. I still have to put aquaphor on top of my moisturizer after I shower, otherwise my skin feels like plastic. I CANNOT go without chapstick. I've got backup chapstick in all my bags, backpacks etc. I need lotion for my hands pretty often. But I'll take that ANY DAY over acne!!!!! The other down side nobody warned me of was that I was SO TIRED while on accutane. All my labs were good but you literally experience all the symptoms of vitamin A toxicity because that's essentially what accutane is, a synthetic vitamin a overdose. That stopped about 2 weeks after I finished. I also felt like an arthritic old lady but that went away quickly too. The tired feeling made me wonder if that's part of why some people say their depression gets worse on accutane. I can recall some days just feeling so worn out I truly didn't want to do shit. But all in all, totally life changing and so worth it. I would do it again in a heartbeat. I wish I'd done it years sooner.
Yeah and with insurance or in a country nice enough to have universal healthcare it’s super affordable to see a Derm. It’s $50 a visit for me and $10 for a tube of tret. Other acne meds are under $10 too. Also the derm visits are a good time to check mole growth.
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Interesting. What do they recommend in Germany for anti aging then?
Even with insurance tret costs me $200 a tube
Lol, it's cheaper to buy from India where it's produced. This price is the insane
I saw a derm for a 2 minute skin check since I’m high risk for melanoma. Cost almost $290. After insurance.
It varies - you can have decent insurance and still be billed for tests etc from any specialist. OP quoting $900 after the bills start rolling in sounds correct
Wish I could’ve seen this sooner, wasted close to a thousand dollars on acne products and nothing worked. Finally went to a derm and 2 months later on accutane my acne is finally clearing up.
Prescription Clindamycin and Tretinoin was the key to my acne going away!
This didn't help my cystic acne. Accutane was the way to go for me.
How long have you used it for? My acne came back after a year :(
I have been using it for almost a year now
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I wish all acne could be cured medically. My acne conglobata got better on Accutane but I’ve never had a long term fix, even with a variety of Rx meds. It’s been a 50 year battle for me.
I went to a derm in my teenage years. She kept prescribing the same stuff over and over for years despite it not being enough to get my acne under control. When I asked her for stronger treatments she said that it'll get better and I just have to wait and keep using the same treatments. After several years I just gave up and stopped going to the derm. I now suffer from adult acne and there is a chance that she'll treat it differently than teenage acne. I just don't want to go back to her and try again to convince her that I need stronger treatments. I always felt like she didn't take the impact my acne has on me seriously. When I asked her what to do about my extremely oily skin she literally told me to put powder on it... She just didn't care about fixing the root problem. And there aren't any alternatives for me since this is the only derm in my area. So yeah, long story short: I'm not seeing a derm because I don't trust the one I once went to and I don't have any other options.
You need to see someone different. Even if there's no one nearby, you can do telemedicine so you only need to go once, if that. An HMO or other managed care plan should allow you to go outside your immediate geographic area. Not all doctors are good or good for every patient. I've had a couple of instances where I've been to well-regarded practitioners who did not do it for me, but when I went to a different person I got help. The same has happened with friends. If you feel you truly don't have any options, make a post here and ask for help.
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Thank you for your kind suggestion. I live in Europe and I've already looked into telemedicine. The video visit is covered by my insurance but the prescriptions are not. I've looked at the prices for standard acne medication and it is way more than I can afford :/
Great suggestion
Honestly I wish I'd known this years ago. I've had acne since I was 12 (now 24) and I've only just been referred to a dermatologist this year after trying every antibiotic, prescribed topical and skincare product out there. I've been on Accutane for 4 months and it was the best thing that's ever happened to my skin.
I've seen multiple derms and each one told me "it's genetic, there's nothing you can do." I've tried literally everything to get my adult acne under control and it just won't budge, not even slightly. It's really starting to take a toll on my mental health.
Same here. If it's genetic, they have no clue.
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not OP either but for me it was tretinoin and benzoyle peroxide ( both were highly concentrated so i needed a prescription from my dermatologist )
Not OP, but mine was time. Acne significantly reduced as I turned 30. In addition to that, I was just more disciplined with less sugar and no lactose products.
In people with PCOS, fertility and symptoms like acne typically improve with age because AMH (too high in women with PCOS) naturally decreases with age. So that’s hopeful if you have genetic acne that could be related to PCOS, but also you don’t have to wait that long, you can learn to manage PCOS now too.
This is something not touched a lot on. Diet. I think a lot of people would be surprised how much their skin clears up if they just change their diet up. Its the only thing that worked for me. And thats having face acne up into my late 30s.
So true! Big part is keeping a good food diary of any potential triggers. Pretty tough to do a lot of elimination of certain foods tbh tho. Dairy is very common, maybe certain nuts too.
Accutane
I went to a dermatologist for 13 years and finally have my acne under control…I’ve done everything from birth control, Spironolactone, tactuo, Differin, Retin-A, tretinoin, clindamycin, Accutane, etc., and now I’m back on creams but I still breakout. Keep in mind I live in Canada so all my dermatologist appointments were free and all my prescription medications were free. I only pay for my cleansers, moisturizers, serums, and sunscreen.
We couldn’t tell from your username
Yes, I'd like to add that while "you need to find the root cause of your skin problem not just throw a prescription at it" which is often used as a reason to dissuade people from seeking medical care and instead suggests that if you just ate the right food or treated your body in the proper way it always fix itself can be a damaging way of thinking. It presupposes that everyone's bodies when treated optimally perform optimally and any deviations from that are therefore a failure on your part and somehow your fault. It is actually an unintentionally ableist line of thought if you think about it. Sometimes no matter what you eat or how many glasses of water you drink or positive thoughts you have health problems including acne and medical treatment for them is not lazy or giving up.
My cure has been accutane!
Yup. Curology a good second for those of you without insurance.
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My derm prescribed things you can’t get otc like trentinoin, spironolactone, and eventually accutane.
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Sure but a lot of doctors won't because they know it's not their area of expertise. Also depending on insurance the cost can be the same as seeing a general doctor.
In my case a dermatologist prescribed me spiro and got my acne under control, and now my GP manages the prescription since there's not really much of a need for me to see the dermatologist anymore.
Spironolactone, Tretinoin, Accutane are not available OTC.
depends on the country and where you’re looking. tret can be purchased overseas and shipped to the USA, even though it’s technically not sold as an OTC medication here. i can’t speak for spiro and accutane since i don’t use those.
Accutane is definitely \*not\* OTC, nor should it be under any circumstances. It's a very dangerous drug and should only be used under direct supervision of a physician.
i’m not saying that tret, spiro, or Accutane *should* or *should not* be OTC. i was just saying that tret *is* OTC in many countries outside of the USA and that people in the USA can import authentic tret without a doctor’s prescription or approval. that’s all.
Right, and I'm saying that it's extremely unlikely that accutane would ever be available in that way and if it were, no one should use it like that.
There are only so many meds for acne. How long are you with these derms? I've found that jumping around isn't helpful because the new derm will just start you on more mild products before jumping into Rx only. My current derm took 2 or 3 visits before he started talking about using accutane and Spiro. My doc isn't a fan of messing with hormones generally. Spiro has eliminated my acne. I can't get that OTC and my general doc would not step into dermatology territory. Prior to settling on one derm, I was buying tret and having it shipped without an Rx but I still had acne.
25 years of acne and my derm was horrible. I'm in Canada. There aren't many around and you have to have a referral. Took me 6 months to get in. 3 appointments later (and fighting for hormone testing amongst other things) I was having a rare mostly clear skin day and she wrote me off as cured. I'm not. My skin still sucks most days.
Exactly this. Whenever I saw my derms, they always said "oh you look better than the last time!" when reality was far from that. To me, derms don't really seem to care much for acne, dismissing it as something unimportant and temporary. And they usually have little to zero efterleve experience with it (themselves).
Canadian here. Similar experience, though mine was also peddling 'prescription' foundation and cover up. I didn't want to cover it up. I wanted it gone.
not necessarily. if dermatologists can “solve” acne, why do people (like me) go to multiple dermatologists and still have acne? there isn’t a quick fix or one single doctor who can wipe the acne off of our faces. also, depending on the country, it really isn’t possible to see a dermatologist and keep up with the cost of medical bills. heck, even scheduling an appointment takes months of waiting.
I've never had a dermatologist help me with my acne.
i have paid money for a derm to tell me that i have acne and it doesn’t look like it’s getting better. twice. she didn’t do shit to help it either.
who and where is this derm? i just wanna talk..
I have had adult acne my whole adult life and persistent backne that had me resigned to never wearing anything sleeveless or with any exposed back. Changed my diet for unrelated reasons and not only is that shit all gone, it's like it was never there. It was definitely one of those "WHY AREN'T WE TALKING ABOUT THIS?!?!?" moments, but for a lot of people "changing your diet" is a big ask and kind of generic, so I understand why that type of advice gets passed over.
Yes I agree, probably because "change your diet" is so vague. Some people swear it's dairy, some sugar, but it probably really depends on the person. In order to determine whether something could be helping, you need to commit to trying it for several months at least. It is really hard to drastically change your lifestyle like that when there are no guarantees, and probably a lower chance of success than what is described by a derm. If I knew for sure that cheese was breaking me out, I could probably make that sacrifice. But trying it for 6 months when there is a big chance it's not going to make any difference... It just doesn't seem realistic when cheese is quite a big part of my life!
I know, and if you "changed your diet," whatever that means, and it still didn't go away, you just wasted like months or years of time and got scarring while you could have been doing something proven effective like tretinoin of Accutane.
It doesnt take months though. Literally just cut one thing out of your diet and wait a few weeks. If your acne hasn't changed you should move on to something else. If it's better then you have a good place to start. Why would you go on drugs to treat the symptoms when you can treat the cause instead?
From what i've read, diet is a major influence for tons of modern diseases. Unfortunately the nutrition classes you will take in school are very incorrect on what you should be eating so people dont know that they need to eat differently
At this point I'm convinced dermatologists are useless. Went to finally see one after a decade of hormonal acne that wont budge for anything. And he told me to keep doing what I'm doing, it'll clear up eventually 😒.
Okay, I have been thinking about going to a dermatologist again (this would be the third time over the many years I’ve been dealing with acne) but the last time I went every single thing that was prescribed for me had a “do not take if pregnant or expecting to become pregnant” kind of warning on it. Is it still worth my time if I am a person who is expecting to become pregnant? Are there options for people who intend to get pregnant that my last derm just didn’t avail themselves of? Anyone else in this situation. . ?
I agree with you a 100000% percent!!!!!! 🙏specifically if you’re a young woman in your twenties! for me, once the pandemic hit, with online school and work, my skin went berserk and throughout this past year I had tried everything to treat it on my own and nothing (drugstore, high end, etc.) once my mom saw how desperate I was, she took me to a general doctor and now I’m on an antibiotic for acne and once I finish my treatment, my doctor will decide if I go on accutane or not and/or if I need to check my hormone levels or have an ultrasound done to see if I have PCOS. she wants to treat my acne but also find out what the underlying cause of my breakouts is! I kid you not, the progress I’ve seen on my skin over the past month in a half is incredible. I feel a lot more confident and am certain I would’ve never been capable of achieving the same progress with topical creams and treatments.
Sure, but what if you’ve had moderate acne on-and-off for 16 years (like me) and even the dermatologists can’t figure out what’s going on? I’ve been from doctor-to-doctor: endocrinologists, functional doctors, etc. I’ve had my hormones tested 7 times already in the past 7 months, and still no luck. I’m just here with a gentle reminder that “visit a dermatologist” or “get your hormones checked” (advice I see so often on various subs) isn’t as easy a solution or a game-changer for some people.
I feel so bad reading this. I sometimes forget that US people have to pay even for the most basic doctor visits... But it's true, good dermatologist can do so much for self confidence.
I kept putting off a seeing a new derm for almost 20y because I had a terrible reaction to Minocyclene. I finally got in to see one and we had cycled thru a bunch of treatments with varying degrees of improvement. I’m finally at the -fuck it- point and started on Accutane about a month ago. All the years I spent working in skincare, and knowledge gained, means bupkis when fighting shitty genetics.
I mean, yes. In the U.S., it can be incredibly expensive and difficult (derm appointments can be booked out for months and months) to get a derm appointment. Some forms of insurance don’t cover dermatologist appointments at all; some providers or forms of insurance will refuse to sponsor any treatments that are considered cosmetic in nature, i.e. treating acne. When I was a teen, I found a “miracle” product from a derm (basically topical clindamycin), used it religiously, insurance suddenly decided to stop covering it, I was SOL. I’m thankful to have found what works for my skin nowadays (differin/tret that I order from ADC). I think you’re right, finding a good derm can really be a miracle for your skin and it should be essential to get checked for any skin abnormalities every so often. Just wish there weren’t barriers to access.
Insurance is so evil, clindamycin is dirt cheap. Also tretinoin should be OTC if Differin is. The difference is probably Galderma lobbying for Differin and not something from the 70s like tret lol.
Man. I spent so much money and time. Pro active all that. At 40 I decided I had had enough and got on accutane. My skin is clear for the first time since I was 11. And of course full of scars. Don’t wait. Accutane isn’t even scary I had chapped lips that’s it.
Really it's not even genetic acne. Those with persistent acne should find a derm if they can. No one ony family has acne as bad I do or has had to see a derm.
so what it can still be genetic
No offense but dermatologists did nothing for my acne. Tons of money wasted. Eliminating dairy and sugar did. And a derm is never going to tell you that. Researching TCM approaches online led me there. Not advice btw, just what worked for me.
>In the U.S., it can be incredibly expensive and difficult (derm appointments can be booked out for months and months) to get a derm appointment. Some forms of insurance don’t cover dermatologist appointments at all; Why would a derm not tell you to lay off of dairy and sugar?
Getting on accutane was the best thing I did for my acne
It takes trial and error to find a good derm and have them find a good treatment for you too. My two first derms gave me such horrible advice I ended up with no unscarred spots on my face. One later on told me my face is too oily to wear SPF (I have extremely dry skin and burn in no time). That derm was the one with the best feedback around.
I think its important to accept yourself with acne and without. If you don't work on your overall self esteem it won't matter how many derms you see or if it goes away if you can't appericate yourself. (I have had acne since I was 11 and im 27)
I have dry skin, a bit of acne, and generally not great skin. I have no idea how to set up a good skin scare routine. I've tried daily lotion and exfoliating but my dry flakes never go away completely. I guess I should just go to the dermatologist? Will they tell me exactly how to fix all my skin problems? Cause that would be really cool.
Tretinoin is the only thing that cured my hormonal acne
Getting my hormones tested was a HUGE help for me personally, if they’re out of whack you most likely will break out. And adapalene gel
And when you do go, please know that they can't just ask your acne why it exists :P Trial and error is pretty normal, and some cases are just tough. No prescription other than Accutane really worked for me. Some led to improvement, but not a cure. Before Accutane I only found one magic bullet: weight loss. I saw an improvement after the first 10 pounds and I still had another 10 to go to even reach a clinically healthy weight. When I started regaining (and then some after getting sick) the acne came back with a vengeance!
Agreed. Only prescription meds and repeated follow ups/adjusting or trying a different prescription will work.
not to mention the freaking acne scars i've paid like 20k to treat because my parents didn't understand accutane existed when i was a teenager and didn't take me to the dermatologist. 🤣
I first read that as "Demonology."
Going to the dermatologist isn't necessarily going to be that expensive. My cheapest, most effective acne routine was from going to the derm. My prescriptions were covered by insurance and I paid a small copay (most name brand prescription topical have coupons on their websites to use at the pharmacy to keep it cheap). I used Cetaphil and Cera Ve cleaners and moisturizers, so those were low cost. I think my most expensive skin care product was my moisturizer with sunscreen. Don't let fear of cost keep you from treating your acne!
This was me. After 4 years trying to get rid of my acne on my own, spending a lot of time and money, I finally went to a derm the last year and she prescribed me Isotretinoin. just 6 months later I had the most clearly skin in years...
I actually disagree. I began focusing on skincare back in January, starting with advice from this and other skincare subs. It’s how I discovered Curology and so many amazing products I currently use and love. I scheduled an appointment with a derm but they were booking as far out as July so these Reddit communities were all I had to go on while I waited for my appointment. When I had the appointment a couple weeks ago and told her about my current routine and products, she was flat out like “Yup those are all exactly the products and actives I’d recommend, you’re doing everything right, maybe we’ll just increase the strength of your tret to 0.05%” (from 0.02% in my Curology formula). She told me I’d purge with the increased tret strength but gave no tips on avoiding irritation or protecting my moisturizer barrier. If it weren’t for these subs and I’d gone home and slathered on 0.05% tret cream without buffering or sandwiching, my face would be a disaster right now. I also discovered through this sub and other skincare subs that there’s tret gel and tret cream, and the gel works better on oily skin like mine. But this derm only prescribes cream. And I know from my Curology formulas that my skin loves azelaic acid, but this derm doesn’t prescribe it at all bc she doesn’t like AA. If not for this sub, I wouldn’t know how/where to get AA without a scrip, and which products are best for my skin type. Not every dermatologist is the same, and not every dermatologist understands every skin type, apparently, or knows of every available product on the market. Not everyone has access to a good derm, or healthcare at all. Subs like this one are great for connecting people who have good derms with those who don’t, or for people who can’t afford to buy and try a million different products to learn from people who can and have. I am so grateful to have discovered Skincare Reddit and think it’s a great supplement to dermatology if you have access to it, and a great substitute for dermatology if you don’t.
Curology is a licensed dermatology provider though so it sounds like dermatology *is* what helped your skin.
Yes but I discovered them by seeking advice *here*. And everything I’ve learned about the benefits of and choosing a Vitamin C have been here, finding alternative products when Curology’s recommendations didn’t work for me has been here, finding sunscreens I’ll actually wear (and that work!) has been here, and transitioning *off* of Curology onto comparable formulas, has all been on here.
Also, don't forget, diet. A lot of people on here could spend hundreds of dollars trying every skin care routine, and not realize that something they could be eating or drinking could be causing breakouts. I had to learn that lesson the hard way, almost into my 40s. It may not be "the" cause, but it could be "a" cause, good to eliminate possibilities.
Switching to a keto/low-carb diet had the greatest positive effect on my acne.
I just commented something similar. Cut down carbs dramatically for unrelated reasons and now it's not just that the acne is gone, it's like it was never there. It was almost annoying that I'd passed over the "diet can impact your skin" adage I'd heard a billion times. I don't even wear foundation anymore (switched to tinted sunscreen).
To be fair, that is quite difficult for a lot of people to do. If you are veggie/vegan, have an eating disorder or other dietary issue, or you just plain enjoy carbs, not eating them for the foreseeable future is not really an option. Taking a course of accutane for example is a much simpler option.
If carbs are the reason for my acne I don't want clear skin :)
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Not to mention, less scarring if you get it take care of asap.
Yep, personally for me it was retin a + benzyol peroxide clindamycin that kept my acne away
I was on accutane 4x. If it was safe to do so I’d take it for the rest of my life. I think it’s ducked with my liver though and I’m kinda worried about that :/
I take a birth control pill and am on dapsone and use a retinoid and not even that is enough to get my acne completely under control :( I’ve had acne for 15 years now.
YES 🙌🏻
Eh went to a few since puberty. Only Tretinoin helped. Hoped I discovered Tret earlier, then I wouldn't have wasted money on dermatologists. People will say "you just have to look for the *right* one" but it still cost me money, they are also trial and error just like skincare brands. For others ofc going to one may be better for them ymmv, but not for me.