I developed cystic acne in my late 30s. I had very dry, eczemaic skin until then. Sudden onset led me to my holistic-leaning gyno who thought my cystic acne was due to a huge increase in soy protein disrupting my hormones. I wasn't so sure and went to a medical aesthetician who thought it best that I get $ monthly facials and referred me to the practice's physician who'd likely put me on a low dose antibiotic.

Developed one cystic acne spot per month, right before my period. I understand that typically acne on jaw line and chin is a result largely hormonal.

Decided against taking an antibiotic.

Suffered on and just this month, saw my gyno who told me to eliminate soy this month...I'll report back, but I am hoping that by complete avoidance of soy, I will stop these awful cystic pimples.

I found than an iud was the best birth control for controlling my acne

I took Accutane as a teen (had terrible acne) and that worked for me. As an adult I do have some flare ups and some residual scarring. My dermo offers what is called "medical facials". It consisted of a cleansing, blackhead removal, microderm and chemical peels (however, I'm sure it could include other things) and I used retin a at home. My skin was already pretty decent so the change in scarring was mostly noticeable to those close to me. However I have a friend who had skin that sounds like yours and the medical facials really did wonders for her.

I would see a dermo in conjunction with a gyno to try to get to the root of the issue.

I'm almost 40 and have tried Accutane. My skin cleared up but then I had a baby and the hormones took over again. The only combo that has worked is 1) a 6 month course of antibiotics 2) BCP- generic Yaz 3) Retin-A 2-3 nights per week (1-2 nights per week in the winter). My skin never breaks out now. The Retin A takes a few months to really start working. Your skin will look pretty crappy the first few months. Don't overdo it as it can be very drying. Stick with it and it really does work. If I used Retin A alone though, I doubt my skin would be a perfect as it is now. My acne is hormonal and the BCP keeps my hormones evened out.

Be careful with the bcp... If you get on the wrong one it can make things worse... what matters is the progesterone. Some break down into more androgens than others. I've always bebeen acne prone and recently started on bcp for an ivf cycle... 4 days later I got horrible cysts all over including my jawline. It's terrible.. am embarrassed to leave the house at times. Ugh. Good luck op.

Fresh air and yoga aren't going to fix cystic acne. These posts make me sad because they imply that if only the OP lived a more healthy lifestyle, the acne would be gone, and that's just not true. Diet changes and stress reduction are always good ideas, but they aren't going to cure her.

Try to track what you eat. I would remove all common triggers first -- dairy, gluten, sugar, eggs. Try to go without it for 30 days and see if your skin will improve. Then, reintroduce it back to your diet, one in a time to see what your skin is reacting to. I know for me it is milk, cheese ( no problems with kefir or yogurt), gluten and nuts in a larger then 10 amount. My skin is not ideal, but much better if I remove those triggers from my diet. Stress can be a big trigger to the cystic acne. Before I will jump to anything serious like Acutane, try 30 min daily walks in a fresh air, yoga classes, running.

+1 on the spironolactone. This cleared me up 100% after two failed rounds of accutane. I have also suffered from depression and anxiety and the spiro did not exacerbate that at all. Good luck OP.

Birth Control Pills! Ortho Tri Cycline is a great one for helping with acne. My husband has a vasectomy, but I've stayed on the pill simply because it helps me keep my acne under control.

Also, you may want to consider some laser therapy treatments. There is a lot of research on using blue light to kill off the bacteria that causes acne - I've had AMAZING results by using these treatments.

Anonymous wrote:I'm 44 and have had cystic acne since my mid-20's. It's hormonal, unfortunately. Since everyone's hormonal flux and triggers are different, you'll have to find your's.

Mine is usually due to my period or being overly tired. When I was on BC, the severity lessened.

You could try homeopathy or herbs to balance your hormones. Go see a naturapath.

+1

Anonymous wrote:Have you tried spironoloactone? Birth control pills?

I suffer from depression (very severe at times) and was worried about Accutane. But I did take it with no mental health problems. Just one woman's experience. Good luck.

+1. My DD had three Accutane failures. I finally took her to a gynecologist who Dx'ed her on the spot with PCOS based on amenorrhea and acne. She had none of the other PCOS symptoms.

She tested very high for testosterone and gyn put her on BC. That helped a bit, but the real boost came from adding Spironalactone. DD showed no sign of polycystic ovaries on ultrasound, but they showed up on a later MRI done for other reasons.

Definitely recommend a gynecologist familiar with PCOS.

Have you tried spironoloactone? Birth control pills?

I suffer from depression (very severe at times) and was worried about Accutane. But I did take it with no mental health problems. Just one woman's experience. Good luck.

http://acne.about.com/od/acnetreatments/a/spironolactone.htm

I read about this medication on here a few months back. I have hormonal acne, still, in my mid-30s. No experience with this medication yet, but if you're female it may be worth asking a derm about. It's on my to-do list for myself in the new year.

I'm 44 and have had cystic acne since my mid-20's. It's hormonal, unfortunately. Since everyone's hormonal flux and triggers are different, you'll have to find your's.

Mine is usually due to my period or being overly tired. When I was on BC, the severity lessened.

You could try homeopathy or herbs to balance your hormones. Go see a naturapath.

I have severe adult cystic and hormonal acne all over my face and back. I have been to 8 dermatologists in the last 5 years and have been prescribed every cream (Epiduo, Retin A, etc.) and every antibiotic (Solodyn, etc.) available. The antibiotics will make the acne less severe for a few weeks, but it always comes back and I can't continue taking them. Accutane is not a great option for me because I already suffer from depression and anxiety. I have never been on BC. I'm 23, slightly underweight for my height though I am a clean eater and work out for 30-60 minutes 5-6 times per week. I am desperate to find a solution. Does anyone out there have any recommendations for treatments that worked for you or a new dermatologist to see? I am even willing at this point to go to someone that doesn't accept insurance if it means some improvement. I have been a clean eater for 2 years and am very open to alternative treatments, too.