Adult Acne Part 1: Causes and Culprits

A few months back I was reading a top women’s glossy in which the topic of adult acne was covered. The front page heralded ‘new cures‘ and suffering from breakouts myself, I flipped to the article and read with interest. Interest soon turned to anger and frustration. The latest potions, lotions and even non-surgical cosmetic procedures were listed with unproven claims and they all required significant financial outlay. I know how desperate your average woman is when faced with bad skin and the lengths we are prepared to go to to try and rectify it, so felt really short changed that there was no acknowledgement of the need for medical treatment required, save for a short line suggesting you ‘see your dermatologist‘ if you have more severe symptoms. Got one of those on speed dial?


The Everygirl

I’ve always shied away from writing about medicine on Florence Finds, (it was a big enough deal going public,) because what I write can be misconstrued. For this reason you will see my tone switch a little and may find my language more black and white. I really dislike medical chatter on the internet as NOTHING substitutes an open conversation with your GP one to one about YOUR problem. Forget what happend to your friend, what Aunty Annie recommends and the google search you did before attending. Share them by all means, in fact you probably should so your GP understands where you are coming from, but be prepeared to start afresh. And don’t underestimate your GP. Approximately 15% of all problems a GP sees are skin related (probaly 4-5 a day) and as a female GP I tend to see more women and children, so probably even more skin. If you’re not getting on with your GP try asking at reception when you make an appointment if there is a GP with an interest in skin, as we often have extra qualifications which might help you. Only the very top level of treatment for acne (Roaccutane) requires a dermatologist, so save your money.


Image: Keiko Lynn

The pep talk and the personal view.
In this and Part 2, I’m going to cover the medical options for treating acne and hopefully dispell a few myths along the way. Above all I want to encourage you to see a GP about your skin if it is bothering you. On a personal level I have only been to the GP once in my life about spots, when in reality, they have been an on and off problem for about 12 years. I have cycles of good skin and bad, often hormone related, so when it’s good I forget about it, then it comes back and I’m miserable. But the predominant thing that stops me going is myself. I tell myself my skin isnt that bad, it could be a lot worse, and there are more important things to worry about in life. For the most part that’s true and I don’t dwell on it, but sometimes it drives me mad. It’s nothing that can’t be solved with great make-up but the person I want to look my best for is Pete and I hate him seeing me with bad skin.

Don’t sell yourself short, being an intelligent well rounded woman does not mean you can’t go in search of great skin.

There might be more to life, but good skin is a great place to start.


Image: Refinery29

Getting to the bottom of things
Another thing that frustrates me about acne is that there are so many myths surrounding the cause. Dietary changes or choices, including chocolate, dairy and alcohol all get blamed, we’re told to drink more water, avoid stress and analyse our hormones.

The main culprits? Bacteria, skin and sebum (oil produced by the skin to moisturise it naturally.) Acne is still not fully understood, however it is thought that a combination of factors cause the lesions. Certain skin types are slower to shed their outer layers which can then clog up the pores with dead skin cells. Propionibacterium acnes is a normal bacteria found on the skin – a kind of bacteria which grows without oxygen (anaerobic,) so when a pore becomes blocked, the perfect environment exists for it to grow out of control. P.acnes also feeds on sebum, so oilier skins also contribute to the problem. So you can see that treatments are centred around increasing the skin cell turn over, killing the bacteria and reducing oil production.

That’s all for Part 1. Next week I’m going to tackle specific treatments, how they work and who they’re best for. I’d love to hear what you think about this and if you’ve learned anything. Although I can’t offer individual medical advice here, I’ll do my best to answer any questions you may have too, just leave a comment!

Love,
Rebecca
xo

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56 thoughts on “Adult Acne Part 1: Causes and Culprits

  1. So interesting! Being a doctor is what sets you apart from the rest in the blogging world so i’m so glad you are doing these posts…!

    I’m really lucky in that i dont really get spots, however i have always had a problem with my skin texture, it always looks blotchy and goes red so I would never go out without make up on which I think is a bit sad really!

    I’m been having regular facials in the run up to the wedding though and micro dermabrasion and have purchased a clarisonic! I’ve noticed qite a big difference. I love my clarisonic – it makes my skin so soft!

    Great post!
    Rachie xo

  2. Love this new style post, it’s good to have it straight from someone I trust. There’s so many horror stories online, especially across forums where people convince themselves everything is wrong with them because everyone else is talking about the same symptoms.

    For me this is straight-talking practical advice ~ what could be better?

  3. Hi Rebecca,

    I normally don’t comment but I for one am so pleased you’re covering this topic!

    I had horrendous skin in my teens and ended up on Roaccutane for about 8 months when I was 17. 11 years later and I’m starting to panic that my old problems are returning so I’d love to hear what your recommendations are for treatment. As much as Roaccutane sorted my skin out, I’m not convinced that I’d use it again due to the side affects. At the moment, Eve Lom is working (thanks for that recommendation!!) but I’d like to know if there’s something else I’m missing out on that can really help during bad break outs.

    As usual, loving the blog and avidly reading, if not commenting regularly.

    Mazz

    • Thanks Mazz,

      It’s a difficult choice isn’t it. I don’t know how old you are now but I often weigh treatment unpleasantries up against the amount of time you’ll get benefit from it. If you’re approaching your thirties or in them, I’d hope your skin will settle and not need another treatment.

      I say this all the time to women who don’t fancy a coil being fitted. 5 minutes of discomfort for 5 years of contraception! 😉

  4. I have struggled with a combination of very sensitive skin, eczema and general spots since I was about 12 so this is a very welcome read!

    I have had it under control to an extent through a combination of finding products that don’t irritate me and covering up what I can’t get rid of – but I am now pregnant and finding my skin is really suffering – particularly around my jaw line. I am keeping my fingers crossed that it stops when the baby is born.

    Looking forward to part 2 in case it doesn’t!

    • Spots around the chin (or muzzle area) and jaw line do tend to be hormonal, but if they’re the red angry inflamed kind which are sore and often don’t come to much, you’ll still benefit from treatment. 🙂

  5. Rebecca, Thanks for writing this. I think its (as per keeping with Florence) very honest and informative in a ‘chatting with your mate’ vein which I’m sure I’m not alone in loving.
    Its nice to have someone cut through the crap!

  6. Really interesting post thanks. Good to see something that cuts through the magazine fluff that is around on this topic.

    I am lucky not to get spots much, but I’ve had a number of dry, flaky, nasty looking patches on my face for the last 6-8 weeks. I finally cracked and, feeling a bit like this was wasting the drs time, saw my GP a week and a half ago. He took one look and prescribed me a steroid/anti-fungal/anti-bacterial cream, with strict instructions to come back if it didn’t work. Am still on the mend, but its is 90% better. Echoing what you’ve written, having good skin for my self-esteem, my husband, really matters. Keeping my fingers crossed it now all heals.

      • Totally! Have have learnt a lot from having psoriasis on my feet and not getting treatment before I scarred my feet 🙁 While not as on show as my face I avoid open shoes and so can empathise with those struggling with their skin. In the last 12 months I’ve seen two brilliant GPs (in sharp contrast to a few others I’ve seen…) and so would highly recommend trying different ones if your first dr wasn’t so helpful.

  7. Yes, thank you. Really pleased you’re doing this as it’s something that so many women hate about themselves but we tend to hide it as much as possible and then spend £100s on ‘miracle cures’ that we know won’t do anything!

    I’ve recently started using a hot flannel to wash my face morning and evening and that’s made a bit of a difference. Still get those monthly hormonal breakouts on my chin though. Grrr

  8. I have been nagging Rebecca to write this post – I reallllllly struggle with my skin and in the lead up to our wedding it wasn’t my weight that I was particularly worried about, but my face. I have spent what no doubt adds up to be thousands of pounds on any new fad treatment that comes out – great to have a proper professional take on this!! xx

  9. Rebecca, thank you for writing this. And God yes, when my skin was really bad I used to launch myself on any magazine that claimed it held the secret to new acne treatments and they would always disappoint or be massively out of my price range. And if I did take the jump and buy them, they wouldn’t work (I’m looking at you Dermalogica!).

    For me, I found that the pill helps, as does a foaming wash I use called Oxypeel (which is specialist). In the run-up to my wedding last yr, i also had microdermabrasion sessions which seemed to help (I haven’t had any since though). This is what worked for me, I know that it won’t necessarily be what works for everyone else.

    I worry for when I come off the pill, which will come eventually, so I’m really looking forward to reading your Part 2.

    xoxo

      • Bah, it’s really crappy isn’t it? Esp since being 29, I feel like I should have outgrown this by now right?!

        xoxo

        • RIGHT!!! I know it’s vain of me to care so much, but i have to think about these things with group holidays and overnight stays with people. After two years of the “Sudocrem” monster kissing him goodnight I’m pretty sre Mr G would like it sorted too!

          • Haha! The Sudocrem monstor – I love that! I tried Sudocrem for a while (it didn’t help me) but as I was only using it on my chin I was called ‘beardy’ everytime I got into bed…not very sexy at all!

          • Oh my gosh to the sudocrem cream. Awful horrible stuff that felt like it was burning my skin. Don’t even get me started on how irritating I find the Freederm adverts. I q

  10. Great post and I totally agree. My skin started to get bad when I was 28 and I saw my gp who was really sympathetic and helpful. She prescribed me a few things that didn’t really work so referred me to the dermatologist. It’s still by no means perfect but its getting better and i feel much better after getting proper professional advice.

  11. Thank you for this post, the timing is great for me and I am really looking forward to Part 2 next week.

    I have had adult acne for about 24 months now and prior to that had great skin with only the odd spot now and again. It is only on my chin but has become increasingly distressing for me over the last few months as it has really erupted and is awful to look at.

    I was prescribed antiobiotics for it last year and the first few months of this year and they did help a lot to begin with. I am uncomfortable about permanently being on antibiotics and so I have tried to come off them a couple of times now and each time it flares up worse than ever.

    I was referred to a dermatologist this week and he has recommended Roaccutane. I have heard so much about both the benefits and of course the risks and I have been really struggling to decide what to do. I have read a lot since I met with the dermatologist and to be honest a lot of what I read scares me. There is a part of me that feels that because it is only on my chin this seems like such an extreme measure. At the same time though, it is making me miserable and I love the thought of it being ‘cured’ in 6 months even if I do have to live through some tough times during that period.

    I know that everyone is different and there are no definite answers but it would be great to hear others experiences of Roaccutane and of course to see Part 2 next week.

  12. Well, after that post… let’s call this afternoon a complete write off.

    I’ve been having trouble with my skin since just after my wedding (late September 2009). Until then I never even wore foundation except when on stage or at big events – just a touch of concealer now and again.

    Now, my skin varies from *slightly bad* (i.e. manageable with extra cover up requiring me to get out of bed half an hour earlier) through to *so bad i refuse to leave the house in daylight (ior at all)/my jaw changed shape with all the lumps and bumps/I couldn’t move my mouth from the pain of the cysts on my chin*. That was when I finally saw a doctor, rather than a facialist.

    The only thing that worked was some hideously strong antibiotic that they spend about twenty minutes drilling in to me that I absolutely must not get pregnant whilst taking and must have a blood test to make sure it’s out of my system before trying for a baby… oh sign me up for some of that chemical please! Sounds tasty! But i did. I took one six month course, it kind of cleared up but wasn’t back to my pre-acne complexion. I finished the course, went back and a different doctor said that i would need another six months and then would have to wait six to nine months before planning a baby.

    In my mind if it’s that dangerous for a pregnant woman to take it, i don’t want it in my body. Also I’m not planning a baby any time soon but at 30 years old, if i want to start trying, I don’t want to have to wait around. So I declined the offer of a repeat prescription.

    I’m a big believer in treating the cause and not the symptoms, but as yet i’m entirely unable to work out what the cause is… so i’m stuck!

    In the meantime, I find that the only thing that keeps it slightly under control is Karin Herzog and Nude Skincare.

    I’m looking forward to this series of posts immensley and thanks for making me feel less like a freak and alone in my strife! 😉

    Thanks Rebecca!

    • Thanks for the comment Victoria, this is an interesting (and obviously more common that I realised from what people are saying here,) view point.

      I think you are talking about Roaccutane, as I said to K above, I’ll be writing more about it next time, but just to address your point about pregnancy…
      Roaccuatane has serious side effects in very few cases (mainly mental health related,) but is known to be teratogenic. That means it causes birth defects and deformities if it is present in the blood stream when you are supporting a developing foetus. Embryo development is so massively complex that it doesn’t take much to disrupt it (for example, I can’t remember what problem I was researching recently but a certain birth defect can be narrowed down to a hiccup in development occurring on a particular couple of hours, days after fertilisation – incredible.) Therefore, something that is to be avoided in pregnancy or when you’re trying to conceive (many medications fall into this category) isn’t necessarily bad for a fully formed adult.

      • Oh no I stayed well away from that! It was tetracycline or something like that… Unless that’s roaccutane under another guise? Two friends were also taking the same tablets at the same time as me, and I know you shouldn’t judge your symptoms by those of others but one of them had hideous migraines and had to stop and the other was rushed to hospital with weird bleeding and also told to stop. Scary times. The shit we go through for “magazine perfect” skin eh?! I would have stuck it out if they hadn’t scared me so much and also seen those symptoms.

        Your comment puts my mind at rest though, but still, putting all that in my body scares me a lot! 🙁

  13. Great post Rebecca! i’ve had trouble with my skin on and off for about 5 years and have tried all kinds of over the counter and prescribed medicines. it got really bad about 2 years ago, so bad on my cheeks that a child in a super market asked his daddy very loudly ‘whats wrong with that ladies face daddy?” – i was mortified!
    i found my gp fairly unsympathetic to my problems. i think it is sometimes perceived as a vanity thing so felt a bit like i was wasting their time. i got put on dianette pill which did miracles for my skin, unfortunately i couldn’t cope with the intolerable headaches. eventually i saw a brilliant new gp and he referred me to a dermatologist who prescribed doxycycline tablets, differin gel and dalacin. the combination worked really well and i was near enough spot free. i was told not to use products on my skin, just mild soap and water although at the moment i use l’occitane red rice products.
    i still get breakouts and have been left with some scarring so I am being referred back to the dermatologist to look at lazer treatments.
    as you say Rebecca there is no ‘one size fits all’ treatment. looking forward to the next installment. x

    • Thanks for bringing that up Michelle. You’re right, some GP’s aren’t that sympathetic to acne as a problem and I’m even guilty myself sometimes of looking at someone complaining of it and thinking, ‘well, your skin looks pretty good to me!’ But the bottom line (and medical guidance) is that if skin problems are causing distress for a person or scarring, it warrants treatment. I’m glad you found someone who could help you – often seeking out another GP is the answer – we all have our special interests and skin is a fairly popular one, so there’s usually someone who can help. 🙂

  14. The timing is great for me too! I have had acne ever since coming off the pill. I have now been taking antibiotics for a few years and don’t really like the idea of being on them so long, or the amount of time you have to wait for them to leave your system before you can try to get pregnant. I’m not sure if you can build up a resistance to them but they seem to be less and less effective. I have regular flare ups and am sitting here now with a very lumpy sore chin.

    I use a combination of three different foundations (thank goodness for Mac Studiofix), everytime I have a flare up I feel desperate and buy a new moisturiser. I have just bought a Clarisonic (I’m yet to be able to say if it helps but it does make skin texture much smoother). I would like to stop wasting money and find something that actually works.

    Really looking forward to part 2.

  15. The best thing I ever did for my skin was to stop applying lotions and potions and see my GP who put me on a different pill straight away. We then tried a few combos of skin wash/cream/antibiotics and finally found the perfect match. I used to get spots soooo bad and I now only get one, usually on my chin around period time. It has made such a difference, this is a great post Rebecca, and even more so coming from a doc.

    I also have micro-dermabrasion, love my skin the next day! Now just to tackle the oncoming wrinkles…

    • It’s so good to hear that Phoebe. The main point of me writing this post was to say, if you have a medical problem, then treat it as such and get medical help. Yes there are things you can self medicate for (and most doctors would be delighted to see that!) but if it didn’t work, you would usually go see the GP rather than endlessly trying things you can buy in Boots without any result. So why is skin different?

      xo

  16. In a strange way I feel relieved to hear that so many of you are struggling with the same issue I’ve struggled with for the past 16 years of my life. Don’t get me wrong, I wish none of us has to deal with adult acne, but somehow, when you suffer with it, everyone else seems to have the most perfect skin and you make yourself believe that you are the only one who cannot walk out of the house without any makeup. So your comments help me feel a bit ‘less alone’.
    I’m one of those people who tried Roaccutane. I was 20 and suffered with nodulocystic acne, so every spot would take weeks to clear up and if it got really angry, it would leave me the deepest of scars (on my back and face). So I decided to give Roaccutane a chance. It took two long years with regular liver checkups and appointments at the dermatologist. The results were amazing, but two years later the spots gradually started to come back. Fast forward 8 years and my skin condition is appalling again… Knowing the long term side effects of R. I would have on me, I would have never done the treatment. At the time I was a young, deeply insecure girl who would have done anything to look ‘normal’.
    Before getting married I tried N-Lite laser and microdermabrasion but I didn’t see any real changes… The thing that has been troubling me the most is spots and blocked pores on my neck. I really don’t want to use make up on my neck, but it just looks horrendous… I wish there truly was a miracle cure, but as others have said, the presence of acne is dictated by so many different factors that vary according to the individual… How can a pharmaceutical company come back with one-size-fits-all solution? I’m very very skeptical…
    Thank you so much for tackling this topic Rebecca! xx

  17. I cannot wait to read the rest of this series. I’ve always had combination skin with recular spots accross my forehead and on my nose but over the past two years my acne has been a massive problem and I am steadily becoming more anxious about walking down the aisle because of it!

    2 years ago I had the implant fitted and my skin got steadily worse and worse. I didn’t associate the two and as my periods were now irregular went to my GP. Put on the mini-pill too to sort out my bleeding, my skin got even worse and I started putting on weight. Back to the GP. Off the mini pill, onto dianette for my skin and irregularity. Bleeding sorted, skin horrendous, still putting on weight. Back to GP. Now on Adapolene gel too which made my skin literally fall off my face. I gave it 4 months, couldn’t fit into any of my old jeans and had a fairly substantial breakdown.
    I insisted the implant was taken out, and dumped the rest in the bin. My body and face are now a chemical free zone and I absolutely refuse to go back there. My chin and cheeks are now clear and am hoping my nose and forehead clear up soon. I’ve also lost 4 pounds in 4 weeks. Go figure!

    • This is a really frustrating story Laura.

      Firstly, the implant is the ONLY method of contraception PROVEN to cause weight gain. (Something in the order of 4-8kg in the first 12 months.)
      Secondly, the mini-pill AND the implant are progesterone only methods of contraception which is PROVEN to cause acne.
      Thirdly, the only way of guaranteeing regular periods is to use a combined pill as it’s the oestrogen that gives the regulation.

      I hope part 2 offers you a bit more insight and I’m really glad you’re getting sorted!

      xo

      • Gahh I wish I’d known this sooner – perhaps I would have linked the two and sorted myself out and saved my skin from the scars I now have.
        Thank you 🙂

  18. I never suffered from acne as a teenager but a few years ago in my 30s I started getting really awful deep spots. I went to the GP (female) who was very kind and extremely sensitive and understanding. She prescribed a cream which really did help a lot. However, the reason for leaving a comment is to say that looking back at that time I am totally convinced that it was stress related. After months of suffering as soon as the work related stress ended my spots disappeared and I’ve never suffered with this problem again.

  19. Great post Rebecca, I too have been sufferring from bad skin it all started when I hit my twenties some months it was worse than others and normally around my chin area but they often pop up anywhere. My skin is a mixture of being really dry or really oily. You name it I have tried every cream and potion. I have to wear make up every day to cover it up and seeing my bare face in all its glory in the mornings is the most horrendous I feel so ugly and disgusting and often think what the hell my husband must think when he see’s me.
    I have always suffered from terrible period pains so went to my doctor to go on the pill hearing this would help, he basically told me I was too fat and too old for the combined pill and that I would have to go on the mini pill, after reading all the side affecks acne being one of them I promptly didnt take it. The thought of going back to the doctors to talk about my skin feels me with a certain dread.
    I am looking forward to part 2 xx

    • Stacey, please go back to your GP and talk about your periods. There are lots more options to control your symptoms without hormones or disrupting your skin.

      Unfortunately, higher BMIs increase the risks associated with the combined pill therefore aren’t recommended.

  20. I too have suffered from adult acne for years. Like others I found my GP to be very unsympathetic and almost brushing it off and making me feel bad for wasting her time! It makes me not want to go back. Also nothing that has been prescribed has worked.

      • Thanks Rebecca, I have tried Dalacin T and ERYTHROMYCIN topical antibiotics, Benzoyl peroxide cream, an oral antibiotic and change of pill. I have contemplated using another doctor but she is generally a good doctor otherwise so I’m worried that I may be worse off if I switch.

  21. Been reading for a while but not commented. Fab blog btw.
    This is a real issue for me I have had bad acne on the lower part of my face for about 5 years now (I’m 27). I have been on all types of antibiotics and tried all sorts of topical treatments (my mum is a dermatology nurse).I’ve also had glycolic peels, microdermabrasion and the very strong TCA peels. They made the rest of my skin very nice and soft but my chin and jaw line remained spotty. I was on dianette for a few years but when I changed gps he said I needed to come off it as I’d been on too long. Since then my skin has gone from bad to worse. My GP has said we just need to rotate the types of antibiotics but I feel they are no working. He won’t hear of roaccutane as he said it’s not over my whole face (half is ok apparently?). I wonder if part of the reason is because I suffered with depression when I was 20 and I know that roaccutane can alter your mood. Sorry for the long list of complaints just wondered if you had any thoughts?

    • Prolonged antibiotic use can create resistance but frankly if you’re taking them correctly, have persisted with treatment and still aren’t seeing results, I think you need a referral to Dermatology.

      Roaccutane can only be prescribed by a hospital dermatologist, therefore I feel it’s really only them who can make the decision as to whether it’s suitable for you. (Unless of course it’s really not that bad!) either way they may have a different option. And yes, a history of low mood can affect their willingness to prescribe it.

  22. Brilliant post Rebecca covering a really morale-sapping problem. I had awful breakouts and spots on my back till my mid forties, with the exception of three pregnancies when all cleared up. So what changed? I started using muslin cloth cleansers (Liz Earle, Eve Lom, Elemis) and for the last five years have regular CACI facials which include a microdermabrasion.
    My facial skin is the best it’s ever been and I no longer need foundation or concealers.I’m actually proud of my complexion now. (Love Elemis moisturiser too, not too thick or rich) Back spots also disappeared though…on my third Mirena IUS, so that may have helped too. Good luck to all those searching for a solution!

  23. What a brilliant post!

    I have had problem skin since my early twenties (now mid thirties) and used to be on Dianette for a while which helped clear it up. The doctor made me change pills though after a few years as it has a supposed higher risk of DVT.

    Anyhow, stress seems to make my skin (chin and back) worse and my pre-wedding stress last year meant my skin really flared up. The make-up artist who was doing my wedding day make-up recommended a good product to me, but it is a temporary solution I guess. Its a cream called Quinoderm and is available over the counter. It really dried my chin skin up but be careful as it is strong and I didn’t read the box properly and it has discoloured many a hand towel and bed sheet that has come into contact with it!

  24. I cant wait for part 2! I am 25 and have suffered with bad since I was 10 years old. I had to take every cream under the sun before the doctor finally put me on dianette when I was 16, then I went onto yasmin and it’s under control. I do worry what will happen.when I have to come off the pill so for now I just enjoy the fact my face just has a few.spots and nothing more. I did change pill for a while because.I.was getting migraines during my periods.but that pill made my skin wore And I gained weight so decided /with my go) to stick with the migraines as the lesser evil – I don’t think I’m as vain as that sounds! I would be keen to know whether the implant is any good – various doctors have been trying to convince me to switch but I get the impression it’ll do nothing for my skin?

  25. Fantastic topic and obviously a winner with your readers – I had no idea so many people suffered with bad skin! I had great skin as a teenager (wish I appreciated it then!) and then started getting bad breakouts throughout my 20’s and early 30’s. I never went to a doctor about it, just used concealers and whatever the ‘hot’ new product on the market was with mixed results but there were definintely times when I didn’t want to go out or leave the house! It’s only now I’m in my late 30’s that my skin is so much clearer and I’m only getting the rare spot (normally around my period). I wish I hadn’t suffered with it for so long though now and I still have some scarring because of it which means I very rarely go without foundation. Interested to see your Part II as well.

    Thanks for sharing your knowledge, Rebecca, it’s so appreciated xxx

  26. Great blog Rebecca! I am 37 years old, and have had acne all my life and am going to see my GP to ask if I can go on Dianette, as I feel I have exhausted other treatments. I have really oily skin, and get horrid breakouts just on my chin, so I know it is hormonal. I have been checked for polysistic ovary syndome, thankfully I dont have it. I am currently taking Marvelon. I have had laser treatments which didnt really stop the breakouts but did help with the scarring, also had microdermabrasion treatments which didnt help either, but did make my overall face look fresher. I was referred to a dermatologist, he gave me differin gel, and I took antibiotics for 18months, this helped a little but not enough. I finally took the plunge and went on Roaccutane for 6 months, the results were amazing, no oily skin and spot free almost immediately. I finished my course in Sept last year, but 2 weeks ago, I have started to break out again, he told me I could have another course of roacc, but think I will try the Diannette first, as Roacc is a strong powerful drug, and even though I only suffered minor side effects, I feel uneasy taking it. I have also started using the clarisonic, really like it, but its too early to decide if it will have any positive effect on my skin. Just hope my gp with let me take Diannette! If anyone has any other tips that might help, will be gratefully Received! I use Liz Earle cleanser, and estee lauder night repair serum at night. also use Mario Badescu drying lotion on my spots at night, and sudocrem nappy rash cream on my spots sometimes!

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