Can anyone help with acne problems??

Hi Everyone

Does anyone else suffer from acne? I'm sorry this is quite long but wanted to give a bit of background in case anyone else shares this problem. Very keen to get any advice.

I was on Dianne 35 (contraceptive pill) for 9 years and stopped taking it when I got married 3 years ago. While on the pill, my skin was great. Since going off the pill, acne started. It actually started while in USA so I thought it might be diet related as I was on holiday and eating typical "holiday" food. When I got home, it continued to get worse so I went to the doctor who put me on antibiotics which cleared it up but he didnt let me stay on it in case I became immune to antibiotics. When I went off the antibiotics, it slowly came back.

I dont think it is related to diet as I am a dietician and eat very well. I also drink 2 litres of water a day in winter and 3 litres of water a day in summer. I dont think it is related to poor skin care as my non-acne-affected areas of my face is in quite good condition. I also use an oil free foaming face wash morning and night as well as oil free moisturisers and makeup.

My acne seems to only be located around my jawline which someone once told me is related to hormones. I started charting my acne/breakouts on FF but there seemed to be no obvious cycle to them so not sure if it is related to hormones. The doctor said if it is related to hormones, it will eventually settle down but how long will this take? I am 28 years old and quite embarrassed by my breakouts. I sometimes think my skin is improving and bang! three pimples appear overnight out of nowhere.

I have tried almost every "anti-acne" product on the market and nothing seems to help. Am I missing something or am I just really susceptible to hormone changes? If so, will they ever disappear? I am quite embarrassed by this and am sick of the waiting game.

Has anyone else gone through this, and if so, what worked?

Thanks

I have just turned 33 & am still prone to having skin like a teenager at times! It drives me insane & when I mentioned it to my mum (who is 52) she told me it is only in the last few years that her skin has settled down.

Hope you find some answers

Iv never really had bad acne. But iv had my fair share of zits.
I used to use a tea tree oil soap which worked really well. Now i use this stuff called ~ Bee Natural - Honey Facial Scrub. It makes my face feel really really clean & i haven't had 1 pimple since i started using it. Only prob is that i buy it from the Byron Bay markets, so i doubt they sell it in any of the supermarkets. If u ever get there u should def check it out tho.

MD Formulations, which I have recommended in another thread is fantastic- sheds dead skin cells, helps with scarring, clears up blackheads and open pores! If you wany any info or product recs, Pm me :)

I don't know Dayl ... I have a very good friend who had terrible acne at school. She was prescribed Dianne 35 for the acne and consequently has absolutely beautiful skin now, but who knows what will happen when it comes time for her to TTC and she has to stop the pill.

It sounds like perhaps the fact that you were taking the Dianne 35 while you were a teenager may have stopped the acne starting earlier than it would have (rather than it being a result of the holiday food).

Have you considered getting your GP to refer you to a dermatologist to see if there is a TTC-safe alternative to the Dianne 35, or a non-pharmaceutical alternative?

I had a horrible rash years ago which was poorly treated by my GP of the time but I got wonderful results when I finally went off to the dermatologist. Ask for a referral, or if not, ask your doctor to find another GP in your area who specialises in skin conditions. It may not be acne at all (mine - which looked like acne - turned out to be some thing quite different in the end).

BTW - hint for pimples, Blackmores has this fabulous pimple gel, it works like a dream on any pimples, boils, cold sores, or any other pustulous outbreaks, it comes in a tiny little glass vial, contains tea tree and other herbal oils and works better than anything I know. Smelly, but good. The pimple sort of calms down and then dries out over 1-3 days (depending on the severity). It might bring you some short term relief?
HTH

Hi there!

I feel like this post could have been written by me!

I was on Diane and then Yasmin for 10 years and it really helped my acne. I have gone off the pill in June and my face is horrible!!!! it is so oily and nothing I seem to do helps. I get a lot of pimples around my jaw line, mouth and inbetween my eyebrows. It is horrible and seems to just be getting worse. I am 26 and I am embarrassed too.

When I was a teenager I went on something called Roaccutane which helped but I will never ever recommend to anyone as it is linked with depression and suicide...

I have tried clinique, benzac, clearasil, tea tree, all sorts of things... I wonder if there is a way we can have some hormonal treatment (other than the pill)?

Hi Dayl, I had terrible acne as a teenager and was on Diane also, I was also on some medication and had a very strict facial cleansing routine. It did ease up but I still suffered from the occasional break out. Since getting pregnant I have had the most horrible skin, reminds me of being a teenager again! Anyway, I use a soap called 'soapaderm' or there's another one starting with G that is sold at the supermarket in the soap section. I wash with this morning and night. I also use garnier pore tightener, and oil of olay moisuriser - the one designed for acne prone skin, has salacylic acid in it. I always wash my make up off with garnier wipes. This morning and night routine is the only thing that keeps my skin under control. It is definitely hormone related and I'm hoping that once baby is born and my hormones return to normal that my skin will return to normal too. Good luck, I can really sympathise as I understand how embrarrasing it can be.

I might browse the internet and see if there is some kind of hormonal treatment a GP can give us, or something! it is a bit hard as whatever it is I know I don't want it to affect any attempts at TTC thus why I went off the pill in the first place!

from this I am going to make an appointment with the GP to talk about hormone testing/referral to a gynae that specialises in hormones.

A Final Note

Acne is Extremely Common
Almost everyone has at least a little of it at one point or another in their life. Though acne is supposed to go away after the teens, it can persist for many years. A few whiteheads or blackheads or an occasional small red pimple can usually be tolerated. However persistent or severe acne is much more troubling.

If someone has acne which is enough to bother her, it is best not to just wait to “grow out of it.” One her first visit, one of my patients said to me recently, “I’m 63 and I’ve been waiting for my acne to go away since I was 18. Though acne, fortunately, rarely lasts this long, it is still common in the thirties and forties. If you are bothered by acne, it is reasonable to seek medical help for it.

Acne is one of those conditions about which insensitive jokes are still made. Yet research has shown that acne lowers self-esteem and is extremely stressful. One study has shown that unemployment rates are higher in both women and men with acne, showing that people with acne are discriminated against. Though our society has been learning not to discriminate against people who are physically challenged, no one speaks up for the miseries of acne.

Acne and Polycystic Ovary Syndrome (PCOS)
PCOS is a very common female hormonal disorder, one in which great advances in treatment have been made. [PCOSupport: The Polycystic Ovarian Syndrome Association Web Site] One of the four main features of PCOS is testosterone-induced skin and hair changes. These are acne, increased facial and body hair and scalp hair thinning. Other features are irregular periods, difficulty controlling weight and metabolic changes. Female acne can be a sign of PCOS. If you have some of the other features, getting worked up for PCOS is a good idea. On the other hand, many women with hormonal acne have just acne, nothing else.

Acne, the Teenage Years and Beyond
Studies show that the earlier acne appears the more likely it is to be severe, so the popular idea that acne is only a teenage problem is erroneous. Teenagers are often more bothered by acne than they let on. I work a lot with adolescents and find that though they may not admit to their parents that their acne is distressing, it is a great relief to them when treatment clears their skin.

When acne is more severe it should be regarded as a pressing medical problem, because permanent scarring may result. A few acne scars may not show, but an accumulation of scars over time can cause considerable damage to the complexion. If acne is enough to cause distress, it is best to get it treated promptly to minimize scarring.

Hormonal Testing for Acne
For more than very mild acne, hormonal testing is useful. This is the same as carried out for extra hair growth or alopecia, and consists in measuring androgens to see if elevated levels are involved in causing the acne. However, even if androgen levels are normal, they are still involved in starting the acne process. Some, but not most, women with acne, have a hormonal disorder. Evaluation by a physician experienced with these conditions is a good idea for severe acne that is not controlled by dermatological medications, or when there are also irregular periods, increased hair, or a weight problem.


Treating the Hormonal Cause of Acne
If have acne and are reading this article, it is likely that the standard measures have not cleared your skin. Fortunately, treatments directed at the hormonal cause usually work when standard ones have not.

Here’s why:
Hormonal treatments block the stimulating effect of androgens on the oil glands. Because this form of treatment stops acne before it begins, it often gives the best result. Only a few specialists are familiar with hormonal treatment and it requires blood tests, and oral medication. However, these may be well worth it if your acne cannot be controlled by standard measures. Even quite severe cystic acne which has resisted treatment for years often clears completely with properly planned hormonal treatment.

I’ll return to hormonal acne treatment shortly but want to review the standard measures first.

Skin Care for Acne
Good skin care is particularly important for women with acne. However, good hygiene, though it will help to control acne, is unlikely to take it away. For that, medication is needed as will be discussed later.
Despite what your mother and your friends may tell you, diet is not an important factor in acne. Chocolate and high fat foods do not cause acne, and eating less of these foods — though it may be good for health overall — will not solve an acne problem. Nor is acne due to poor hygiene. Basically, if you have acne it is not anything you are doing.

Anyone with a tendency to acne should only apply non-comedogenic preparations to their skin. “Comedone” is the medical term for whiteheads and blackheads so “non-comedogenic” simply means not causing breakouts. Non-comedogenic products will not feel greasy if rubbed between the fingers.

A soap-free skin cleanser, such as Purpose®, or a soap that is only slightly drying such as Clinique® for dry skin, is best. Soaps with perfume or high moisturizer content may cause problems. Astringents contain alcohol which dries the skin. Although use of an astringent may make the skin feel less oily immediately after use, it will not stop the increased oil production involved in acne and may irritate the skin. Abrasive preparations also are best avoided.

Some women with acne notice that it gets better after sun exposure. This is not a good way to control acne for two reasons. Firstly, long term sun exposure greatly increases the risk of skin cancer (including melanoma). Secondly, though the skin dries up initially after sun exposure there may be a rebound later, when oiliness actually increases. Sunbathing may therefore exacerbate acne in the long run. Use of a non-comedogenic sun screen lotion that has a Sun Protection Factor (SPF) of at least 15 is recommended. If you are in the water, it will need to be reapplied frequently, whatever it says on the package.

Another important aspect of skin care for people with acne is the use of moisturizers. Dry skin is particularly common in people who live in a northern climate. While women with acne usually have oily skin, when acne is treated, the skin often gets dryer. Some women have oiliness in some facial areas and dryness in others. Many will benefit from the use of a moisturizer, but of course it should be non-comedogenic. There are hundreds of moisturizers on the market, many of which are not really effective. Two good ones are Vaseline Intensive Care Extra Strength (not made from Vaseline which should not be put on the skin), and Mi Fine Skin. The latter was developed by a Cleveland dermatologist, Beno Michel, MD and is the best in my experience. It can be ordered by telephone (1-800-SKIN-066 or on-line www.mifineskin.com). I have no commercial interest in this product but my wife and I use it and have ceased to have dry skin problems.

While acne is not caused by poor hygiene, a good routine can help it. For mild acne, regular use of a skin cleanser at least twice a day, and a daily application of over the counter preparation with benzoyl peroxide, will produce some improvement. But if a regular skin care routine does not help enough, a visit to a physician experienced with acne is the next step.


Non-Prescription Acne Treatments
If acne is mild, there are simple, home treatments for acne that don’t require a prescription.
The best over-the-counter (OTC) acne medicine is benzoyl peroxide (BP). It is sold under several brand names, of which the best known are Oxy 5 and Oxy 10. These have 5% and 10% benzoyl peroxide respectively. BP is an antibacterial, and seems to dry the oiliness of the skin also Like other topicals, BP does need to be applied daily. If redness or irritation of the skin develops, BP often still works if it is put on for 30 to 45 minutes and then washed off. This works better than skipping days.

There are many other OTC acne remedies, not all of which are effective. Some contain ingredients that can irritate the skin or even make things worse. I suggest using a product which contains benzoyl peroxide without a lot of additional ingredients.

Standard Prescription Acne Treatments
Here are the most common medical treatments which most with acne have probably tried already:
Topicals such as tretinoin (Retin-A) and adapalene (Differin) which make the surface protein of the skin less sticky. Topical antibiotics such as erythromycin and clindamycin sold under a variety of brand names.
Oral antibiotics such as tetracycline, minocycline, and erythromycin. Of the oral antibiotics, I think erythromycin is most suitable for women as it does not cause the photosensitivity or yeast infections sometimes induced by tetracycline or minocycline.

Two oral contraceptives (OCs ) have been approved at this time (11/01) for treatment of acne in women who want to be on the pill. These are OrthoTriCyclen® and Estrostep®. (I was involved in the research for both and have lectured and consulted for both companies.) The number of pimples are reduced by about 50%, on average. This is a significant improvement.

However, the pill does not give adequate clearing for all women with acne. For a woman whose skin is still broken out despite use of one of these OCs, or who does not want to take an OC, there are other ways to prevent hormones from triggering it. OCs can be combined with the other acne treatments described above or with other hormonal treatments as described below.

Hormonal Treatment of Acne
Many women with marked acne do not get enough clearing with these standard acne treatments. In this situation, treatment directed at the hormonal cause may produce much clearer skin. These approaches are not often used by dermatologists, who treat most acne. If you have persistent acne and want to consider this form of treatment, you may need to see a physician with special expertise in female hormone problems who might be a endocrinologist or a gynecologist. Be sure to check first because not all doctors who deal with female hormones work with acne.
At the Hormone Center of New York, when I see a woman who has had acne which won’t go away, the first step is to measure hormone levels in order to determine the specific hormonal factors which are causing her acne. Treatment varies depending on the individual but usually involves lowering free testosterone and protecting the oil glands from this hormone. Counteracting the hormonal cause of acne often clears up the skin when the conventional measures have failed.

Oral contraceptives can be part of the treatment because they lower free testosterone. The addition of medications which block testosterone can dramatically clear the skin. Spironolactone (Aldactone®) is usually quite effective. Though often used with an OC, spironolactone can also be used by itself. Spironolactone was originally developed as a blood pressure medication. It blocks aldosterone, a blood pressure-raising hormone. Because testosterone is chemically similar to this hormone, it is also blocked by spironolactone.

Finasteride, sometimes useful for other testosterone problems in women, probably will not help acne and there is serious worry about its safety in pregnancy. This is discussed in detail in the section on treatment of unwanted hair. [Hormones and Unwanted Hair] Although birth defects have not been reported with use of spironolactone to my knowledge, they are theoretically possible since it blocks testosterone, so it is important not to get pregnant while taking this medication also.

A new OC, Yasmin® contains drospirenone, a close cousin of spironolactone, as its form of progesterone. It is not labeled for acne in the United States at this time and is equivalent to a rather low dose of spironolactone. Dose is definitely important with spironolactone; low doses are less effective.
Any acne treatment takes at least a few weeks to work. Once a breakout has occurred, healing is gradual. The best thing is to prevent the breakouts from happening in the first place. This is why acne treatments should be used all the time, not just when lesions appear.

Accutane
The last resort is isotretinoin (Accutane®), a potent form of vitamin A. This drug has made a great difference for some people with bad acne but it can have serious side effects and so must be used very carefully with close monitoring. Absolute avoidance of pregnancy is essentially since fetal isotretinoin exposure can produce serious birth defects. Fortunately, once it is out of the body, isotretinoin will not affect pregnancy outcome. While isotretinoin has a place, in my experience, hormonal treatment is much easier to tolerate and often gives a better result. This is because androgen blockers not only cut down on breakouts but often give a brighter, feminine appearance to complexions which have been damaged by acne.

Acne and Extra Hair
Increases in hair growth and female acne do, unfortunately, go together because the hormonal cause of the two conditions is the same. In both cases, androgens (testosterone and related hormones) act to trigger the condition.
The initial event in acne is increased oil production. The oil is produced in the sebaceous glands which are part of the same skin structure as the hair follicles. The two are part of the same skin structure, called the pilosebaceous unit. While the sebaceous gland responds to testosterone by making more oil, the hair root responds by growing hair that is longer, thicker and darker.

The sebaceous glands respond immediately to testosterone and so acne usually appears fairly soon after levels go up. The hair follicle however may take months or years to respond so increases in hair growth generally appear at a somewhat later age than acne. Not everyone follows this pattern however.


What Causes Acne?
Acne is an androgenic disorder, like hirsutism [Hormones and Unwanted Hair], which means that it is set off by the effects of the family of hormones called androgens. These include testosterone, DHEA-S and others. Testosterone is the most important of these. While androgens are often thought of as male hormones, this is misleading because adult women have active levels in their blood. Women’s levels are only about a tenth of those found in men

The first event leading to acne is stimulation of the sebaceous (oil making) glands by testosterone. Next, the pores plug up and trap the oil inside. Bacteria grow in the trapped oil, causing the production of irritating chemicals. Finally the body’s immune system comes into play. There is both good and bad news about this immune response. While it fights the bacteria, it also causes the redness, swelling, pus-like fluid and later scarring which make acne so unsightly.

Many women notice that their acne is worse in the week before their period. The exact reason for this common pattern is not known, but obviously it is related to hormonal changes during the cycle, perhaps a rise in testosterone at midcycle.

Other Oily Face Conditions
In addition to pimples, increased oil can cause flat areas of inflammation on the skin. In the midline this is called seborrheic dermatitis; in the butterfly area of the nose and the skin next to it, the inflammation is called acne rosacea. The latter can be very embarrassing because it sometimes makes the nose red, which can be confused with the signs of excessive alcohol use.

A Final Note
For me as an endocrinologist, acne is one of the most satisfying conditions to treat. It often gets much better with the hormonal treatments described above, everyone can see for themselves how great the change has been and the person’s life can be greatly changed for the better.

Thank you to everyone who has responded with your advice.

Wow Purpley - you sure have done your research. I was told by the doctor that anything that goes into or onto your body while TTC could affect your body and thus your baby if you fall pregnant. She recommended that I dont use anything if we are planning a baby as she believes it will improve on its own once my hormones settle down. If it doesnt, then we can investigate further at a later date.

Oh well, fingers crossed for everyone who suffers from this embarrassing condition. I hope this thread may have helped others too.

Thank you all again for your responses.

Dayl,

I was on Diane for 8 years and went off it in May. Since Aug/ Sept my pimples have come back. At first i was quite happy to see them, strange I know, but i saw it as a sign that the pill was finally out of my system. However, since AF arriving last week my pimples are out of control! I spoke with my SIL about it who has a similar problem, but she is PG. She is using some sort of cream that is PG friendly!Or so the stuff says! She is going to give me some to try out. I'll get the name and let you know how it goes!

I hope things settle down for you soon!

Thanks a lot Bron. That would be great. Sounds like you and I share the same story. It took a few months for my pimples to start too and I still have them almost 2 years later.

Thanks for your reply. look forward to getting the name of the magic potion.

Dayl,
I had a similar problem to you. I was on a different pill, but when I came off of it I broke out the following month. My skin was pretty horrible for about seven months. I kept waiting for it to settle down, but it never happened. That is until I got pregnant. Within 4 weeks of being pregnant my skin was back to its clear and normal self. Hopefully the same thing will happen to you. Good luck TTC.

I was on roaccutane when younger and it cleared up my acne but there are now known sideeffects of depression which i didnt know but i was one of the lucky ones.
My friends have used miessence,myself included and their skin is like porclein now,so smooth and clear.Mines quite good too but im never going to get rid of the faint scarring from my acne.

caddie i had problems with roaccutane and depression... scary isn't it.

It is! I remember for a few years after being very sensative to sunscreen,moisteriser and the sun.I use to get very dry lips.

I was on dianne for many years to help combat migranes (Dr thought they could be pill related). When I went off it my skin broke out so bad on my chest, shoulders and jaw
It was nasty :(
I bought new clothes to hide it because nothing worked to clear it up for about 6 months. It went away almost overnight. Very strange it was.

WOW!!! I am 37 and had absolutely ZERO acne as a teenager and young adult. It wasn't until I was about 25 that I got the worst acne, I still have quite pitted scars on my temple area today. I have only just made the connection after reading this thread that it was the same time as I went off Diane35!!! That drug has a lot to answer for!!

I had two bouts of roaccutane - after the first I had the best skin for abour 18 months, probably because I had to go back on the pill to take the roaccutane to start with and the second round of drugs gave me chronic fatigue syndrome and reactive arthritis so be really really careful with that drug.

Since then I have just lived with it...benzyl peroxide works for a bit but just makes you skin oilier and I never had oily skin to start with in fact the opposite, my skin was quite dry. Moisturisers were useless , they just seemed to clog the pores more.

What has had the most benefit to me is planning my wedding. My mum out of the blue said she would pay for me to get my face looked at with the view to getting a facial peel to reduce the scarring and look "pretty" on my weddng day (I am still not sure whether I am grateful or insulted that she noticed...hehe). Anyways I have been seeing a cosmetologist ( not a beautician!) and for the first time ever have had a proper medically based skin care regimen worked out for me. She uses a brand of skincare called cosmedix which is a medically based product as opposed to other stuff she also sells like clarins and md formulations which she calls fluffy skincare. I have had two sessions of a glycolic peel, microdermabrasion and CPL light therapy and on tuesday had a full strength vitamin A fruit peel. I have one pimple on my face which is probably due to ovulation and the redness and scarring from all the other acne has almost gone already. I am a convert to proper skincare, not the fluffy stuff but the real good quality and not necesarily anymore expensive stuff.
Okay a full regime has set me back just under $500 but that is a god 6-8 months worth of product and it is a simple two step morning and night (diff stuff in morning to night) routine...easy peasy.

By the way she advised very strongly against anything with benzyl peroxide in it because it may get rid of the pimple in the short term but in the long term it is further weakening the cell structure of the skin and cause rbeound breakout when you stop using the product. Vitamin A used topically actually works on the DNA of the cell strengthening it and improving skin health and it is quite safe to use topically during pregnancy.

And thanks purpley for posting that article......I have a problem with a few old lady chin hairs popping up now I am an old fart as DH puts it so lovingly. It is interesting that there is that hormonal connection between the two...something to thin about and look into.....hopefully after we have a bub!!

Wow Mel this connection to breakouts and Dianne is just creepy!

I'm sure you will look fabulous on your wedding day :D

Both Diane and Roaccutane are drugs to be carefully considered.

Roaccutane after my experiences on it I recommend to no one!

That is interested about the benzyl, I am using that all the time... would you be able to tell me more about cosmetologists?

Hi,
My daughter uses COSMEDIX skincare and it's helped dramatically.
The skincare is made of all natural ingredients and it's chirally correct. I found out about it on an Acne Special I was watching on the Oprah Show.
My daughter had terrible acne at 13 years old and after getting her braces on her teeth last March her face broke out even worse. She's been using COSMEDIX Benefit Clean to wash her face before school and at night. She uses Phytoharmony moisturizer after cleansing every day, and the Clarifying serum in Summer when her face gets very oily.
She's finally starting to get her self confidence back now that her skin is looking much better, and she's happy again.
COSMEDIX products are expensive but they last a long time because they are concentrated so you only need to use a little each time. I buy them from a good Beautician on EBAY Australia called HOLLYWOODBEAUTY4U
I buy 4 at a time from her and save a lot of money. I couldn't afford it if I had to pay full retail price. I can highly recommend this lady if you want to buy any.

Hope this info helps anyone else out there that suffers from Acne.