Avatar universal

New Treatments for VERY Old Cystic Acne?


I am a 53 yr old female. I had great skin until I turned 21, at which time I developed severe cystic acne. I was on Accutane when it first came out, I've been to tons of dermatologists over the yrs, I've had steroid injections into the cysts, I've had surgery to try to "de-bulk" them - you name it, I've done it.

So here I am, 32 yrs later, & I still have deep, hard, scar-filled cysts under the skin on my face - that are still actively cranking out nasty gunk on a daily basis. I have a huge one (about 1.5" X 3/4") just above my left jawline, one about 1/3 that size about 1" above that one, & one about the same size as that smaller one, on my right cheekbone area. The larger one on the left, particularly, is still very bad - bad enough that, when I simply run my hand across that part of my face, I can *smell* the stuff coming out of it.

Needless to say, even after 32 yrs (or, especially *because* it's been so long), this makes me very self-conscious, not only because of how I look to myself, but also over how it looks/smells to others. It makes me look older than I am, as it weighs down that side of my face, being that it's at the jawline.

I'm currently on no treatment for it, as nothing's worked so far & it's all been a waste of money. I use a mild cleanser (Aveeno Positively Radiant cleanser) & a mild moisturizer (Olay Complete) 2 or 3 times a day (just depends on what I've been doing), the occasional exfoliating scrub (Burt's Bees), don't wear makeup unless it's a special occasion (less than 10 times per yr), & am otherwise pretty healthy.

Short of taking a knife to my own face & suffering the consequences, is there *anything* that can be done for me?

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Avatar universal
Hi There:

No, I have not been to a dermatologist in awhile, so I have not looked into laser therapy. I guess this forum is my way of doing some research before I go that route again, so that I have some ideas of what is/isn't out there. I will look it up.

I'll also check out that link you sent.

Many thanks for the tips!
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Avatar universal
Hi there,

I'm sorry to hear about your experience - nightmare. Like you I've done the Accutane thing and whilst it did get results at the time, when I came off it I'd get similar flare ups.

Have you tried laser therapy like N Lite?

There are also a couple of holistic programs that have been in the media for their success in treating serious cases - there are some reviews at acnefreerelief.

Hope this helps
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Avatar universal
Hi Eloise:

Thanks for your suggestions.

I did do 2 courses of Accutane way back when it first came out. Guess I didn't clarify that. While it stopped further cysts from happening, the ones that were already there never left & have remained active all this time. That's my problem. I'd like *those* gone (or at least not producing all the crud they do), too. They're old enough to drink, drive, vote, & own their *own* home, fercryinoutloud!  :-)

I use Dermablend, as well, on the rare occasions I put makeup on. While I don't like the cream foundation (it just feels too heavy on my skin), I do use the concealer & setting powder, along w/ Bare Escentuals powder make up all over to even things out a bit more. The problem, however, is that the cyst along my jawline is so large, it actually weighs that side of my face down - even though the actual color of that area isn't that far off from "normal", it's noticeable cos it sticks way out above the rest of my face. I've actually heard people say "who's the lady w/ the lumps on her face?" I've even tried using some theatrical makeup techniques to try to camoflage it (I danced for many yrs - Ballet), & that just doesn't work in normal light. It looks like, "hey there, I'm trying to hide something right here on my face!" Also, when I had that cyst operated on to try to remove some of the underlying scar tissue & stuff, a stitch blew right towards the end of the healing time, leaving a hole in the middle of the whole mess, about 1 1/2 times larger than the head of your average sewing straight pin.

I'm sure I've had my androgen levels checked somewhere along the line, although I don't specifically remember what they were. I was never put on any meds for that, though. It might be worth asking my family dr if he can do that test & see what it says. Thanks for that idea.

More ideas or suggestions are most welcomed. I was wondering if there was any new treatments (injections, whatever)  that could stop the production of oil & yuk in those cysts. Even if I could achieve just that, I'd be a lot happier than I am now.
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309783 tn?1271958229
Have you had your androgen levels checked? It is unwise to prescribe anti-androgen birth control pills to a patient over 50, but you could take an anti-androgen medicine like Spironolactone.
Would you consider taking Accutane again? Why was a second course not prescribed after the initial one resulted in failure or relapse?
I wear Dermablend make-up by Vichy. It offers full coverage without looking false (see my pictures).
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