My daughter, 15 has severe back & upper arm acne (covers entire back), milder acne on face, chest, lower arms & thighs & very rough skin everywhere.  She has hyperhydrosis(armpits) that is under control with Maxim deod.  She is usually very cold (esp. feet) even during summer months.  She has difficulty falling asleep-in bed by 10:30 during school but often doesn't fall asleep until 1-2am & up at 6-6:15am...obviously then fatigued by late afternoon & has mild headaches 2-3 times a week at that time, also. She is mostly a straight A honors student who is pretty calm & laid back.  Because of her severe skin problems she is unable to wear short-sleeved tops let alone a swimsuit so I know she misses out on alot with friends-considering this she seem to have very good self-esteem. Her menstrual periods began 3+ yrs ago...after the first year they became regular at 35-40 days.  In the past year she has skipped 1 period & to date hasn't had a period since the end of Aug.  She has fairly light periods that last approx. 4-5 days.  She is hungry in the am but feels that if she ate "too much" she knows she would become nauseas.  She normally has yogurt with granola, orange juice & fruit(melon, berries, banana, etc.)  She eats a much healthier diet than 90% of most teenagers. Could this be an endocrine problem?  Her twin brother has fairly severe acne on his face.  Topical solutions have had little long-term effect.  They have been taking Derma Cleanse capsules for a year(liver cleansing herbs). Don't know if they would be worse without them or not. Will not use Acutane. Please help.