Skin In A Spot Of Bother – A Journey of Adult Acne

A slight change in theme to my usual posts but something that, unfortunately, is close to my heart that I wanted to share. I’ve struggled with adult acne for 6 years after having flawless skin in my teens. Aged 19 I didn’t know what a black head was, fast forward, and I’m now fluent in acne-speak knowing terms from non comedogenic to salicylic acid to cysts. Twice during this period I’ve achieved clearer skin and wanted to summarise my skin’s history in case others may find it helpful. I’d really encourage others in a similar position to do their research for treatment options.

Skin Care and Make Up:

My first port of call of those years ago was to target my acne with skin care. Generic anti blemish treatments from drug stores left my skin eczema prone whilst gentle formulas did nothing for my spots. I tried the The Body Shop’s Tea Tree range before Clinique’s Anti Blemish 3 step system. Both ranges were too harsh and I settled on La Roche Posay’s Effaclar range and used this religiously for over 4 years, most products are still my go-tos. It didn’t fix my skin but equally didn’t leave it dry, was gentle for sensitive skin and whilst I still got blemishes it was the best skin care regime I’d tried. It was cheaper than Clinique and products like the large cleanser last up to a year. I swapped make up to anti-blemish and no comedogenic formulas. However; I still had spots.

Diet:

For 3 months I quit dairy, caffeine and massively reduced the amount of processed sugars and junk food I was eating after online research informing me this could help. There was no notable difference.

Prescriptions:

Desperation led me back to the internet and I came across the NHS page for acne which stated that if your skin was affecting your happiness to see a GP. I’d previously not thought to do this as I didn’t expect to be taken seriously. I was afraid my struggles would be invalidated and that I’d be labelled as vain. Prior to being given acne treatment I’d trialled 3 contraceptive pills including the progesterone only mini pill none of which made any difference.

Below is a list of medication trialled in 2016 when I first achieved clear skin and their pro’s and con’s;

Zineryt – topical lotion applied to acne prone areas – it wasn’t hugely effective for me and the active ingredients in the product only last 8 weeks meaning every 2 months you have to pay for a further prescription
Lymecycline – a course of antibiotics – after 4 weeks of taking tablets multiple times a day I began to see some difference but it was minimal. I luckily didn’t experience any negative side effects but these do render contraceptive pills useless.
Oxytetracycline – a course of antibiotics – I began to see real success with these fairly quickly and didn’t experience any negative side effects; however, as with lymecycline they also stopped birth control pills working properly. I had to have regular blood tests to check they weren’t causing my liver any damage and was taking multiple tablets a day which effected when I could eat. After 8-9 months I stopped taking these as my GP recommended around 6 months was the maximum course.
Duac Gel – topical benzoyl peroxide gel – used once at night once antibiotic course was over to keep acne at bay. This caused my skin to become red as if sun burnt, swollen and puffy so not something I was able to use. It can bleach hair and fabrics.

This route probably cleared my skin up for around 9-12 months.

2020 I began the journey again, this time reluctant to take 8 antibiotics a day that would effect my eating habits and contraceptive cover. Here’s what I tried second time around:

Lucette – a combined contraceptive pill with identical hormones to Yasmin which was thought to help acne but considered slightly lower risk for blood clots. This did not agree with me at all, week 2 I felt dizzy and nauseous. During the break I experienced extreme period pain, my vision half blacking out and unable to eat.
Zineryt – topical lotion applied to acne prone areas – this time I experienced horrible reactions leaving large, dry, sore, blister like areas that wept. I was using it as advised along with…
Adapelene – topical retinoid applied at night – Zineryt was used in the morning and Adapelene at night. Prior to the reaction my skin was clearing up in record time and I was excited. The side effects I experienced weren’t listed in the leaflets and after trawling the internet I learnt that Adapelene could react badly with salicylic acid in beauty products. I swapped by pharmacists’ advice to a rich moisturiser for sensitive skin that was non comedegenic by Cetaphil. Once the reaction cleared up I began using Adapelene in smaller quantities less frequently with great results. The medication doesn’t effect any other aspects of my life and whilst I still get blemishes the difference is noteable. All other topical medication I’ve tried in the past have either caused my skin to swell, be really sore or peel but this works wonders for me now I’ve found the right balance.

A note on some medications I refused and the importance of doing your research to work out what’s right for you:

Dianette – a contraceptive pill with male hormones known to be high risk. Fortunately, prior to doing any research I declined this pill from my GP purely because I didn’t like the idea of popping male hormones. I was offered it again after Lucette was unsuitable. This pill has been banned in several countries for being high risk for blood clots and known for causing depression leading to suicidal thoughts. It shouldn’t be prescribed to anyone with a family history of mental health issues. One GP said I could only take it for 6 months and another for 12. I didn’t want to take this pill and I shouldn’t have been offered it as I fall into the category of those to whom it shouldn’t be prescribed. I honestly feel really lucky that I researched this to dodge it.
Roaccutane – isotretinoin tablets – according to the NHS website they’re known to be very effective within 7-10 days but can cause side effects including skin sensitivity, headaches, general pains, nose bleeds, depression and it’s extremely dangerous to become pregnant whilst taking them . They’re supposed to be prescribed for “severe acne” as a last resort yet I was offered was a referral to an NHS dermatologist for Roaccutane. Whilst I was unhappy with my skin I definitely did not fall into the severe category and, in my opinion, given that antibiotics and now topical retinoids have worked for me I think this was a real error in judgement.

Things I found extremely helpful throughout my journey:

Doing research before a GP appointment. Having some background knowledge of what may work for you can be really helpful e.g. having blood tests to check hormone levels or allergies, considering contraceptive pills, topical medication etc.
Pharmacists’ Advice – After having a bad reaction to a combination of Zineryt, Adapelene and salicylic acid I was recommended a cheap, really effective moisturiser that helped in days. I was also told to stick with Adapelene in lower doses if it was really working. This advice saved me from my GP’s next option of 12 months of antibiotics or a Roaccutane referral that I didn’t want. They can provide really helpful information about medications that aren’t always covered in the leaflets.
Estee Lauder Double Wear Foundation – non comedogenic, huge range of colours, didn’t make my skin worse, made me happier to leave the house. One bottle lasts me 18 months when used as concealer daily.
Cetaphil Rich Night Cream for Sensitive Skin – non comedogenic, cheap, works well with prescriptions drying out skin.

*Medications I refused after deciding they weren’t right for me and products that have made a huge difference to me*

In summary, be patient and if you do go down the route of prescription medication don’t be afraid to refuse things you’re not comfortable with. Sometimes trialling a few GPs can be beneficial but ultimately stick with it, don’t despair and don’t pick your skin!