Sudden Itchy Painful Cystic Acne

[Amatista13]

Help!
I'm 33 years old and not too long ago broke out in this insane, dark red, inflamed cystic, pustules, white heads, black heads, everything ALL OVER cheeks and jawline!
Too many to even try to count! More every second.
It itches SOOO bad! It hurts and I get these sharp, shooting pains in my face. Face hurts when I move it-talking, eating, or trying to move it instead of scratching. If I scratched, it would hurt and be all bloody. I did it and it was horrible!
I had moderate acne before this happened (about 1.5-2 months ago) that bothered me, but now would be welcomed.
Thought my skin couldn't get worse, but it has been spreading and getting worse, so guess it could and did get worse.
My t-zone (especially nose and upper cheeks by nose) is clear. It looks like I put a mask on because the clear skin doesn't even match the cheeks and jawline.
I am on doxycilin, clindamycin and retin a. Nothing has changed.
Any advice would help! My derm and doctor said accutane is recommended but both say they are unable to prescribe.
So...I spent my rent money to buy accutane online from India.
2 months worth will come in 3 weeks.
I am at a loss and desperate!!!

[Bhupinder Kaur, MD]

Hello,
This itching can be due to irritant contact dermatitis. Avoid using any lotions and creams over the face for the meantime. Wash your face with a mild cleanser with moisturizing properties like Cetaphil. Pat your face dry. Then apply a good hypoallergenic moisturizer over the area and see if this improves. If the symptoms still persist then you can apply mild steroid like dermacort.

If the irritation persists then please get it evaluated from a dermatologist. For acne, treatment includes topical and oral antibiotics, topical retinoids, hormonal therapy, dermabrasion , phototherapy and laser resurfacing. Normally a combination of treatments is followed and if nothing proves effective then dermabrasion and laser therapy are useful. You can discuss these treatment options with your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Amatista13]

Thank you for your reply.
My face is still VERY itchy and I take aterax several times a day and 3 at night. Even so, it still itches so much. Also is painful.
I now am seeing a dermatologist who has said that this is not just acne, but some kind of reaction to either something physical that I did (picking, applying several kinds of oils and daily honey) or possibly gram negative folliculitis.
He sent a culture out but the results are not in yet.
Also, that depending on the results of the culture, he will either give me cortizone pills or an appropriate antibiotic.
I had previously gone to a dermatology clinic at a hospital and, without asking me any questions, prescribed doxycycline. I am still taking 100 mg twice a day. It has done nothing as far as my skin is concerned. I has made me constipated and nauseous and have a yellow tongue. My tongue has a thick white coating and is swollen always, but now it is also yellow.

Anyway, my dermatologist said that accutane will help true acne but says what I have is not true acne. He had me stop absolutely everything topical except aquanil cleanser. Says he sees minor improvement with that. I don't though.

He also said that once this is cleared away, then my regular acne will be there (my forehead and nose are affected by this) along with extensive dark brown PIH which is already apparent in some areas. He says he will then treat the regular acne when it is there. (mentioned retin-a)

I ordered accutane online through an Indian pharmacy (has not arrived yet) but now am not too sure. I spent my rent money on it (I know, bad idea) and am now facing possible eviction. Great, more stress on top of the mountain of stress that my skin causes me. :/

[Bhupinder Kaur, MD]

Hello,

Treatment for such acne like bumps includes topical and oral antibiotics, topical retinoids, hormonal therapy, dermabrasion , phototherapy and laser resurfacing.

Normally a combination of treatments is followed and if nothing proves effective then dermabrasion and laser therapy are useful. You can discuss these treatment options with your dermatologist. Till then follow the treatment that has been prescribed to you and use Accutane only under medical guidance. Avoid going out in the sun while taking Accutane.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.