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What is going on with the skin on my face?

I'm not sure I have acne now, but I'm a fifty-five year old woman with a skin problem that keeps me from engaging in nearly all social activities.  My skin has always been oily and acne prone/extremely sensitive to plant contact, with large blistering and inflammation. For acne, antibiotics worked well, for six months, then acne returns.  At about age 45 I began to develop deep painful cysts that cortisone injections had no effect on.  As an artist and perfectionist I did all the wrong things - desperately trying to extract very deeply seated infectious material.  Accutane did not work.  I did notice that after several microdermabrasion treatments bumps occurred, not containing pus, but spread in a sort of symetrical alignment across my cheeks, nose, and down to the chin-line.  I am losing all hope of successful treatment.  Sometimes I think about not living, and I have three wonderful daughters!  I wonder if the bumps that appeared after microdermabrasion - which is lightly debriding the skin with tiny plastic pellets - can sometimes cause infection?  Are the pellets changed after each patient?  I have serious scarring and loss of pigmentation and several dermatologists have shamed me in asking, "What are you doing to yourself?  You need to see a psychiatrist".  And I have seen several.  But I'm afraid to go to another dermatologist.  Perhaps I have a skin inflammation gone awry and I wonder if an intravenous injection of cortisone and one of Penicillan would help, as it did in my teens, when I had severe reactions to irritants and plants.  I don't know what to do.  I let lesions heal for months, and inevitably, they return red and raised and . . . I'm desperate.  I'm losing touch with all I love and love me.
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309783 tn?1271961829
Hi. I completely understand. Late onset acne, adult acne and Rosacea are becoming more common in women. I have several thoughts I hope will be helpful:
You must not try to extract pimples. This seldom improves their appearance and, as you know, can lead to scarring. If counselling has proved of limited benefit, consider medication for depression or anxiety. I was very depressed about my acne and was reluctant to consider anti-depressants. Research shows that, unsuprisingly, people with acne or rosacea are more prone to depression and anxiety. I take Venlafaxine, and very occassionally Diazepam.
A good camoflague make-up will cover your blemishes and scars until you successfully treat them. My favorite is Toleriane compact make-up by La Roche-Posay. La Roche-Posay also make a great range of products for acneic skins, rosacea and damaged post-laser treatment skin.
I empathise with your reluctance to see another doctor or dermatologist, but diagnosis is essential for correct treatment. Hydrocortisone (topical or IV) will help with an allergy to plants/irritants but can make acne vulgaris worse.
An oral antibiotic such as Oxyetracycline is effective against many types of acne, including rosacea and peri-oral dermatitis.
A topical synthetic retinoid such as Retin-A will help with acne and scarring, and it can be used in conjunction with an oral antibiotic.
If you are still getting acne/greasy skin at your age ask your doctor to check your hormone levels, and prescribe hormone replacement if necessary. Acne is caused when androgens (male hormones found in both men and women) stimulate the sebaceous glands to produce oil. This oil mixes with bacteria on the skin, leading to acne. The most effective remedies therefore target one or more of the primary causes of acne: hormones, oil  and bacteria.
20% of Accutane patients, including myself, require a second or third course. I then had stubborn scarring removed with microdermabrasion. You must wait 6 moths after Accutane therapy before having microdermabrasion due to the increased risk of scarring.
Please see my pictures in my profile. I am 32 and had acne for twenty years, but there can be a happy ending to the story.
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