Acne in Adults

Parent Q&A

  • Hello Berkeley parents!

    I've decided it's time to seek professional advice for my adult acne, I'm pretty sure it's no longer related to being pregnant or nursing :) so I'd like to look into some treatment options. Do any of you have recommendations on a dermatologist (preferably in the Albany/Berkeley area) that does a great job treating adult acne and giving recommendations for adult skincare (since I'm in my 30s I hear it's time to kick up the skincare routine and I don't know what that should include). 


    If you're willing to travel a bit further, Oakland Acne Specialists on Piedmont Ave is amazing. They've transformed my skin and their products are fantastic.  

    I suffered painful adult cystic acne for two decades and tried every regimen. Every topical. Accurate twice. Antibiotics for three years straight. The only solution that solved the actual root problem was giving up dairy. An acupuncturist suggested I try going DAIRY FREE for three months, on the basis of nothing but anecdotal evidence. I’m so glad I did. I saw a big improvement in just that short period of time and I was convinced to keep going. It was so glorious to eventually feel my skin smooth and not feel compelled to wear cover up. Now I no longer cringe when someone brushes my cheek or looks at me for en extended period. Having acne is so discouraging, and I am so grateful for that acupuncturists suggestion. 

    10 years later, I have occasional dairy without adverse side effects. Milk with cookies. Or pizza. Shredded cheese on tacos. Ice cream. But this is after a period of strict avoidance and very clear skin. 

    in the last few months, I’ve been taking high doses of biotin to treat hair loss, and this started causing cystic acne again. After some research, I added pantethine and acetyl L-Carnitine to counteract the biotin’s acne-causing side effect, and my skin is clear again. I mention this bc you might do your own research and try this too, but I’d strongly suggest limiting confounding variables so if your skin clears you know what’s working. Go dairy free first and then once you see positive results add supplements.  

    I cannot recommend Acne Specialists of Oakland (located on Piedmont Ave) highly enough. I've been seeing them for 6 years since I hit 30 and realized my hormonal acne was only getting worse, especially once I went off birth control. They've kept my skin looking great through many changes including pregnancy, and nursing on a restricted diet for a baby with intolerances, and then going back to a full diet again. It was so incredible to work with folks that were able to clear my skin by changing up my products/makeup and without just going to putting me on prescriptions. So many products are "organic" or "non-clogging" these days but are actually full of lots of things that trigger acne, and by tossing all of them and sticking to my ASO routine, my skin has been 90% clear for years! They even managed to properly diagnose a skin condition I developed early in the pandemic after 2 dermatologists failed to get it right over video visits. They are just incredible, and I hope you'll take a bet on them!

Archived Q&A and Reviews


Painful adult cystic acne

March 2010

I am a 40-year old woman who has been dealing with painful adult cystic acne for a decade. As background, I use ProActive, I am Retin-A and Benzoil Peroxyde interolerant, and I have been on and off acne-related antibiotics. After a recent bout, my dermatologist has recommended I go on the generic form of Accutane (Accutane was pulled from the market last summer, but generics are still available). I would love input on the following:

Accutane (Isotretinoin): There are numerous proven and claimed side effects to the medication which make me hesitant to use it, despite the praise as an acne miracle drug. La Roche claims it pulled Accutane b/c the generics were eating into their profits, but I suspect there is more to the story given the $25 million verdict awarded this week to a man who developed ulcerative colitis from Accutane. Please share your experience w/ the drug. What side effects did you have while taking it? How long did it keep your acne away? Have you had any conditions/issues occur after taking the drug which you suspect are linked to the drug?

Accupuncture/Alternatives: I am exploring alternatives to the drug, and I would love to know of a good accupuncturist with experience treating acne or other skin conditions. I am open to other treatments as well.

Acne isn't supposed to come with wrinkles and saggy breasts... Bumpy

I took Accutane twice (at 20 and again at 23) and it was the only thing that truly stopped my acne. I hated to resort to taking such a harsh drug, but I was to the point where I didn't want to leave the house because of how I looked. People who have not suffered from terrible acne rarely understand this. I followed dr.'s orders and was extremely vigilant about birth control and sunscreen, and did all the regular labwork recommended. I suffered no ill side effects from Accutane besides dry lips, and now at 39 only rarely get even a pimple or blackhead. no more acne

After trying many options (retinA, benzoyl sp? peroxide, tetracyline, etc.) from 7th-11th grade, I went on Accutane in high school. I have only positive things to say about the results. Yes, my hair and skin are not as oily as they were pre-Accutane (but for me that was a positive) and while on it I had really dry skin and lips, but I didn't have any other side effects.

I did go on a briefer stint in college as some acne had returned, but it was never to the adolescent state. Again, no side effects.

Let's just put it this way: I got a comment that I had a 'peaches and cream' complexion. I NEVER thought I'd hear that.

I don't know if the kind of acne makes a difference with regard to outcome, so I'd talk to your MD about it, but I would use Accutane again in a heartbeat given my previous experiences with it. thankful to be post-acne

Dear Bumpy, I had multiple rounds of Accutane treatment in my teens. my family has a horrible history with acne and my mother and younger brother also went through rounds of Accutane. For me, it was the most painful experience and I would seriously urge you to consider all other options. Unfortunately, I don't have any experience with accupuncture in this area or any other solutions that you haven't tried already. I quit smoking cigarettes and tried to follow a stricter regiment with antibiotics and topical solutions, which has kept my skin very clear recently and I am so thankful to whatever it was on my path of medication and topicals that ended up working. From what I remember of my time on Accutane, it very much felt like I was taking something very dangerous into my system. The pills would come in individually partitioned foil sections with a piece of paper you would have to pop out bearing an image of a pregnant figure with a red line through it. Scary image, but I kept on taking it. My skin dried out so much that I developed cracks in my lips and the skin on my face would flake off. I had multiple nosebleeds in a given week and I suffered from extreme embarrassment from the flaking of my skin. I was in high school, after all. I made it through one course and had somewhat recovered from the side effects but still had very painful, severe acne. My doctor offered another course of the Accutane and I agreed, feeling like I was at my wits end. After the whole ordeal, I really felt that I had suffered major depression as a side effect. In fact, there were several lawsuits that surrounded the suicidal feelings some people felt as a side effect of the drug. I would strongly caution you to be careful with generics. This is a dangerous drug. I'm sorry I don't have any suggestions for you otherwise, but I hope that there is something out there for you that alleviates the struggle that you are going though. Good luck.

My daughter took accutane last year (a generic) and I went in with a very cavalier attitude that the mental health claims surrounding Accutane were all a result of a coincidental suicide of the child of a prominent person. My daughter began a normal dose for her body weight and within two weeks began to have severe mood swings with odd suicidal overtones. She also suddenly stopped eating and became super skinny. She had Never had any depression or mood swings prior, nor had ever had any eating issues. I discontinued the med and watched her closely. The depression abated a few weeks after stopping. Meanwhile, I researched a bit of the 'evidence' that has not fully borne out the claims that people become suicidal on this med even though it is on the package insert. I was loathe to completely discontinue the medicine as it really worked and gave her truly beautiful skin. I reintroduced accutane on very very low sporadic dose and her skin has remained really clear and she has not had a recurrence of mood swings or suicidality.

There are some that theorize that depression can be triggered and abated by shocks to the brain system (an abrupt change in homeostasis). For whatever reason, I KNOW that this med did trigger this severe reaction in my daughter. I'm not sorry that we used it but I would suggest that you have really good support and really monitor your mental health. Anon

I feel your pain. Don't live with cystic acne anymore! I did accutane twice, many years ago. No difficulty with depression or any of that, only very dry skin and worse acne for a few months. The first time I did it didn't really improve, but I did a second course and the acne greatly improved for a few years at least. Over the years I've had ups and downs with my skin through pregnancy and such. However I have now found a light therapy, blue light with levulan. It definately clears up my skin for several months at a time. It takes a few treatments the first time but now I just do a maintenance tx every 6 to 12 months. Look into it, I think it's great. good luck

I also had adult cystic acne that was incredibly painful not to mention unsightly. I was put on Acutane for a 5 month duration, and looking back, I would not do it again. I developed night blindness, which affected my ability to drive, I had recurrent nose bleeds, amongst other bleeding areas like cracked skin between fingers and corners of the eyes... 10 years later, my eyes are extremely dry where I have to use eye drops daily. I had a feeling of bone pain upon waking in the morning. It felt like when I stepped out of bed my bones would shatter. I also developed elevated liver enzymes. My skin was SO dry Vaseline was needed but didn't help. Yes, my acne went away, but to this day, my skin is still extremely dry. It wasn't worth it for me. I wish I would have been able to manage my skin through professional facials ( think European facials with extractions), diet, and natural means like herbal remedies. Good luck! J S

Believe it or not, I had success with a homeopathic solution I got at Whole Foods. Cheap, no side effects. Vitamins (especially B vites) helped, too. KC

My sister and I both experienced rather severe cystic acne as adults. After Retin-A didn't work for me, my dermatologist recommended Accutane. I was too afraid to take it after seeing what happens to a fetus if you get pregnant while you're on the drug, so I went with a very strong dose of antibiotics instead. The antibiotics worked for a while but the acne came back when stress in my life ramped up again. It finally went away after I went on birth control. My dermatologist would have required me to be on birth control before prescribing Accutane for reasons mentioned above, which led me to wonder if some of Accutane's effectiveness is really due to birth control leveling off the hormones.

Then my sister started taking Accutane without taking birth control (she wasn't in a relationship at the time and convinced her doctor that she wasn't at risk for becoming pregnant). It eventually worked for her but she experienced severe dryness while she was on it - dry lips that no amount of chapstick would relieve, dryness on the inside of her nose, etc. She also still has scarring on her cheeks.

Neither of us had tried acupuncture, but since there aren't side effects it's probably worth a try. I've heard that oregano oil capsules can help with acne and hormone imbalance but haven't tried that either.

I had horrible cystic acne since I was a teenager and I went to Bina Jangda, LAc who has been the only person that could do anything about it. I've tried everything. Literally everything. Acupuncture worked. Her herbal knowledge is impressive. She hand-made an herbal toner and a nightly herbal mask which helped control the acne between acupuncture sessions. I could see visible reduction in the size of the acne after each treatment. Treatments are 1hr and 15min to 1 1/2 hrs long. She accepts insurance which covered most of the expenses for me. The herbs were out-of-pocket. I'd give her a try. Her number is 510.393.7565 RL

Ugh, tough decision. Accutane is scary, but cystic acne is truly, truly awful (and physically painful too!). I was on accutane for about 6 months in 1997-98. Prior to accutane, I'd had horrible cystic acne on my neck, shoulders, back and buttocks. Accutane made it all go away, and it has never come back (12 years later). I don't remember any particularly bad side effects. My skin did dry out, and I had to be extra-vigilant with sunscreen (which I am anyway).

I did not take birth control while on accutane. I was celibate at the time and convinced my doctor let me skip birth control if I came in once a month and took a pregnancy test. I also have some hormonal imbalances (low thyroid)... all of this is to say that I suspect that with further research, they will discover that there is a hormonal component to some people having depression and other bad side effects and other people doing fine on the drug.

At the time I was on accutane, none of the depression/suicide risk was known (or at least I didn't know about it). If I were deciding whether or not to go on it today, I think I would probably really work at exhausting all my other options before making the choice to try accutane. Hope you find a solution...

Acne back after stopping the Pill

Oct 2008

I'm suffering through adult acne after stopping my birth control pills for about 6 months. I used to have a bad case of acne when I was younger, and then my skin was under control (because of the pills, I guess) and now I'm going through it again. (I'm 45.) I hate seeing acne and acne scars on my face. Help!! Should I go back to the pills? What over-the-counter products work for adult acne (hormone-related, I think)? Murad? Proactiv? And what product can help with the scar? If you have success with certain dermatologists, I'd appreciate hearing about that as well. Thank you! Anonymous

Laura Cooksey of Face Reality Skin Care in San Leandro is an esthetician who has specialized in acne for years. She came to this specialization when she started experiencing her own acne as an adult, and I was surprised to learn that people come to her clinic from all over the Bay Area (as far as Santa Rosa!) and consult with her from places around the world regarding the products she provides. She has been a godsend to me - literally no one would even suspect I had ever had a serious problem with adult acne. You can reach her at 510-351-1842. Her website at also has a lot more information, including useful articles about acne. L H

elizabeth at alexander pope works great with adult acne she helped with mine!! pinkisses

Products that help with adult acne?

Sept 2008

I'm looking for recommendations, especially products to help with teen acne or adult acne? Leslie

Hi, I had terrible acne when I was in my early 20's. The best thing I've ever used(that wasn't RX) was the Pro Active Repair Lotion and the toner.( They have a cleanser that has scrubbing beads but that was too rough on my skin and caused me to break out worse). I've noticed at the Hilltop Mall they have a vending machine where you can buy the products individually. I would just use the Repair Lotion at night and in the daytime use an oil free lotion (Neutrogena makes nice ones that don't break the bank). If you have health insurance that pays for a dermatologist I would take advantage of it , they could prescribe a retin A cream that would help clear up the acne and help with any scarring. Both of these methods helped me a great deal. Acne free now and happy

I have had acne on and off since I was a teen (mostly chest, back, and neck). I did a course of Accutane when I was 18 and again when I was 33. Since then (3 years), I have been able to control it with an over the counter lotion from Neutrogena, called ''Oil-Free Acne Stress Control,'' applied once daily (twice a day is too drying). I buy it at Longs. My 13 year old daughter started using it too when she developed the same type of acne and it seems to be working for her as well. We didn't see results until we had been using it for about two weeks. We use a similar foam cleanser in the shower. The active ingredient in both is salicylic acid; you can find other products that contain it. Good luck.

I have found the Murad line to be very effective and affordable. They have different lines depending on how aggressive of a treatment one needs. I had tried many things and at the risk of sounding cliche this was what truly worked. If treating light acne I would suggest their ''gentle acne treament'' as the regular one is very strong and can be a bit irritating if your acne is not too severe. However the regular line is excellent for severe acne. Best of luck. anon

Tried everything for my acne

May 2007

I have been suffering from acne for 20+ years--I am now a 36 mother of two and tired of bad skin. I have tried everything-- from Accutane to Tetracycline to Mario Badescu to Proactiv. I am looking for a good dermatologist in the East Bay area (preferably Lamorinda/Walnut Creek) and/or product recommendations. Tired of Teenage Skin

I also am a 36 year old mother of two with relentless acne! Accutane and everything else didn't help much. I saw Dr. Melinda Meyers on Ygnacio Valley Rd. in Walnut Creek for two sessions of blue light treatment with levulan. It held my acne at bay for 14 months, at which time a new round was necessary. Anyways I think this is a really effective treatment, Dr. Meyers is very knowledgeable about the procedure and other cosmetic acne procedures. It doesn't last forever, but no acne treatment does, unfortunately! pretty clear now

Acne fighting on the cheap

April 2006

I have been fighting mild to moderate acne since I was a teenager (I'm 22 now). Recently my acne has flared up quite a bit although it's not horrible enough to do something drastic such as Accutane or Proactiv. I need some advice on a)finding cheap products that work for acne or b)finding a dermatologist that sells cheap products that work. Thanks Sara

One product: PROACTIVE! God this stuff is good, and it really works. I rarely break out anymore(I'm 40 yrs old!), and I just tried this product on a whim. You just have to be consistent with it. On top of that never scrub your face with a wash cloth, use LUKE warm water and pat dry. Dr. Rodan(see below) told me I was washing my face the wrong way all these years.

Proactive costs about $38 for two months, but I've been able to stretch my treatment package to 3-4 months(and I use it everyday).

Call Katy Rodan's office in Oakland at 510-763-2662 (she's the proactive dr) and see if you can buy the package straight from her office without an appt. Then you don't have to pay shipping and handling. It's about $39, a bit more than you want to pay, but worth it. Clear skin

Some years ago, my primary care physician prescribed a topical ointment I think was called Differin (not sure of spelling) which helped my mild case of adult acne. He said it was mild enough for his twelve year old daughter to use. It worked well on my oily skin. During the past couple of years, I have also started to wash my face morning and night with Prescriptives' Purity face wash which seems to have been keeping any breakouts at bay Anon

Proactiv is just 2.5% benzoyl peroxide. There are other products made my Cosco and Neutrogena that have the same ''system'' that Proactiv touts. The only thing that is over-the-counter that works for acne is benzoyl peroxide, some people believe that salicylic acid also is effective. Otherwise you need a perscription for retin-A type products, topical antibiotics, or oral antibiotics...not all of which are expensive. It is very difficult to get accutane these days, even for those with cystic acne Pediatrician

I have had a lot of luck with the Clean and Clear line (at Target, Long's, etc). They have both benzoyl peroxide meds, and salicylic acid ones, so you can pick which one irritates your skin less (I like the s.a. ones, because they don't bleach my clothes!).

You don't say what kind of skin you have, whether it's dry or oily or what, but my normal-to-dry skin breaks out less if I make sure it's well-moisturized, and that I clean it only with stuff that doesn't strip my skin. So: no harsh soaps, only Cetaphil in the morning, and I use Noxema pore-refining cleanser at night, before night cream. Good Luck-- Donna

Oral antibiotics are the most effective, and don't cost much, although I am concerned about the long-term effects after I took them for years. I wouldn't call Proactive ''drastic'' - the active ingredients are the same as in other over-the-counter acne lotions (either benzoyl peroxide or salycylic acid, I'm not sure which) but in lower doses and with moisterizers. Lotions only work if your acne is very topical and you use it constantly. Otherwise you'll need to take something orally. If you don't want to take antibiotics, some versions of the birth control pill can be helpful, but certainly not cheap unless you have health coverage. And there's accutane - one course of it will last 10 years! But not a good idea if you are prone to depression or have any chance of getting pregnant anonymous

I have had good luck with the Neutrogena On-The-Spot salycilic acid gel that is supposed to reduce redness in 8hrs. I have also had good luck with this sulfer based ointment that the aesthatician at Azul Spa recommended to me; it is sold at the spa but I haven't seen it anywhere else.

Other than that, I highly recommend seeing your dr. I had a two year bout with what I thought was cystic acne, but being a mom I never made time for myself to go to the dr to have it treated professionally. Then this last spring I developed bacterial pneumonia. It was treated with a pretty strong antibiotic that cured the pneumonia quickly... and seems to have had the very happy side effect of clearning my acne. I'm sure they don't normally prescribe this medication for acne, but who knows what else they are using these days! spot free for 3 months!

Try Paul Penders Herbal Citrus Fruit Exfoliant. It is a product you apply twice a day, leave it on, and it results in very effective exfoliation, much better than I was able to achieve using scrubs, or standard hydroxyacid lotions. It really changed my skin dramatically- cleared out old buried blemishes and very few new ones appear. It is ~$13 for 2oz which will last a couple months- you should see results in that time if it is going to work for you. Signed, Acne-free finally!

The only thing that has ever worked for me is birth control -- ortho tricylen. Unfortunately, I never found any other product to work. I went off the pill for 6 months hoping to control it some other way but I wasn't able to even with a dermatologist's help. Acne runs in my family -- my mom (50) still struggles with it! So, at least for me, it's definately hormonally- related and not something that can be fixed easily with topical stuff anon

A few years ago I had a terrible case of acne and tried everything over the counter. The only thing that really worked was the Clean and Clear Continuous Control acne wash ($4-5 at target). Its benzoil peroxide so it will make your face a little red and bleach your clothes. I would just use it at night as a cream on my zits and leave it on all night (not as directed on bottle). My acne went away in a few weeks (maybe a month). Now I only occasionally get zits on my chin so I use the Clean and Clear Advantage saliclic acid cleaner daily. I wash the rest of my face with a regular cleanser and just use this on my zit prone area.

I've been acne free for over a year (even through a pregnancy) I only get a zit or two when I don't use the cleanser. Its good stuff.

I would also recommend drinking lots of water, not touching your face at all, and make sure the phone doesn't rest on your chin when I'm talking. Also, you should use a separate towel to dry your face after a shower or washing. (Its probably not good to dry your face with the same towel you dried your armpit with the day before) anon

Blue light treatment for acne?

March 2006

A dermatologist, Christine Avakoff, recommended I have 2 treatments of Blue Light Photodynamic Therapy to treat my acne, acne scarring, and red skin. I am in my mid 30's and have had acne since I was a teen. I am ready to do more than over-the- counter topical solutions. I have used Retin-A for years, with very little success. My searches as to the pro's/con's of Light Therapy have led me to advertised website only; I have not been able to locate any cautions/dangers of this type of treatment. I am looking for input from those who have any experience with photo light treatment for acne, or any other useful treatments for acne, acne scarring (mild), and rosacea. Anon

I haven't tried blue light therapy, but I had tremendous success getting my sometimes uncontrollable acne under control with Laura Cooksey. She has a skin care clinic in San Leandro, but it is worth the drive. She is an esthetician who specializes in controlling acne, and can offer a combination of in-office treatments with at-home products (not over the counter stuff) that are very effective. She has a website at that talks more about what acne is and how she treats it. Lysa

I have done 3 courses of the blue-light therapy over the past three years. I have also suffered from acne since my teens. In the past some accutane courses held off the acne for years at a time but eventually wore off. While nursing my first child my acne returned three years ago and I did a blue light course in SF. It worked immediately and my skin was clear for nearly a year until I became pregnant with my second child.

Don't know if it was the pregnancy or if the effects just wore off eventually. My acne came and went during pregnancy and again returned when nursing my second child. I did another round of blue light at a different clinic and it had no effect this time. I then learned about a new procedure that uses the blue light with a chemical called levulan that is supposed to be much more effective. I did 2 treatments of this last fall and my skin has been basically clear since a month or so after the second treatment. What they do is scrub your face, apply the levulan, it's in a stick form like deoderant, then it incubates for about 1 hour, then they put you in front of the blue light. You're not pretty for about a week. Your face is red, really sensitive, swollen then it peels like a snake. You can also experience breakouts and lots of whiteheads during this time as everything is coming out. But the results are great. It also helps with fine lines and discoloration. I highly recommend it and will do it again if my acne returns. I did it with Dr. Melinda Meyers of Walnut Creek. It's $250 a session. Good luck! happy now

My daughter has done the blue light treatment at The Laser Center of Marin. They suggested an 8 treatment regimen which we did. Her face has cleared wonderfully and we now go back every couple months for a followup treatment. They are in Corte Madera (415-945-9314) or Taylor

Sudden cystic acne at age 22

March 2006

I have a combination skin (oily aroung chin and nose and dry on the cheeks). I usually get acne like one or two would appear right before my period and would disappear in a day or two but since last month I am getting cystic acne on my cheeks. I have never had cystic acne before. It is painful and ugly and takes like a month or more for it to disappear. I am not sure why I got it suddenly at this age. I haven't changed my diet or my face wash (proactive). I am guessing that it is because I am too stressed this semester as I am taking the MCAT, working and a big course load. I still eat healthy and get at least seven hour sleep every night as usual.

Did anyone else have a similar experience with sudden cystic acne breakage? If yes then what did they to to cure it. My dermatologist recomended topical retinol, oral contraceptives, and/or accutane. I have never used any of these before and am aware of the side effects. Has anyone used these and have gotten good results? Has anybody gotten steriod injections or have them removed surgically?

I am avoiding coffee, chocolate, sweets and any fatty food. I have heard and read that diet affecting acne is a myth. Is there anyone who thinks that diet makes their acne worst? Also does cystic acne leave permanent scars r bumps? Help !! MM

definitely related to stress.

adult acne happens. and cystic acne is most common starting at 20 years old.

as you are pre-med, it would probably be best to consider going on birth control (pills or vaginal ring) to regulate your periods, so you can skip periods for finals, and spring break, etc... most MDs (women) I know are regulating themselves to as few periods per year as possible e.g. 1 or 2 using continuous cycling of birth control pills, or the vaginal ring.

cystic acne definitely scars! get it treated. after birth control, I would try oral antibiotics and if it is bad enough then accutane... Sophia, adolescent medicine MD

I developed cystic acne at 24. It took me ten years to decide to use accutane - ten years of mild to moderate acne, antibiotics, benzoil peroxide, and more and more scars. Accutane is the only drug that permanently helped me. The first course improved my face a lot, but after about 3 years I decided to try another. That course improved my face even more. I then tried another course after that, about 2 years later and have had virtually no problems since. You may be told that additional courses won't improve your acne, but this was not my experience. During the teatment my lips got severely dry, so dry that they blistered. But a good dermatologist who has experience with Accutane will know how to treat the side effects. I went to UCSF.

It seems that doctors in the US are more reluctant than doctors in England and Europe to prescribe Accutane. An article out of England that my husband found said that doctors there treat even mild cystic acne with Accutane because of the psychological distress cystic acne causes. Ellen

Hi, I have cystic acne, though mine did not come on suddenly. First for the bad news: I'm 40 and I still have it. The good news: There are many effective treatments for cystic acne. You should also know that you are not causing it! No, you aren't. No, it's not what you're eating. And no, it's not necessarily from stress. It's a hereditary disease.

In terms of your course of treatment, Accutane is kind of like the nuclear bomb. It will work, but you might want to try milder options first. I wholeheartedly recommend combining topical Retin-A and oral birth control pills. I definitely have cystic flare-ups around my period. When I was taking BCPs I didn't have them much at all, but for other reasons I can no longer take BCPs and now I get a cyst or two every month. When I get them, I get a same-day appointment with my dermatologist (if your derm is serious about acne, he/she should have same day appointments available) and I get a steriod shot. It's not the world's most pleasant experience, but it's not like childbirth either, and the cyst is gone in 1-2 days WITHOUT a scar. In short, the shots are great.

In terms of Accutane: I did a long course of it in my 20s and it cleared me up (mostly) for a decade, but the effect does wear off after a while. In exchange I had the most unbelievably scaly skin - my lips were literally peeling off -and joint aches that kept me awake at night for my entire course of treatment. Hence my nuclear bomb analogy.

Retin-A: Takes some time to get used to. You may be red and itchy with some flakiness at first, but your skin, especially at your young age!, will become accustomed to it over the course of a few weeks. And you know, it's good for preventing wrinkles too, though you're probably not concerned about that now.

Lastly - don't get microdermabrasion. It seems like such a good idea for those of us with acne scarring, but it's really not. First of all, cystic acne scars are deeper than anything microdermabrasion can reach. Secondly, and most importantly, the procedure can cause dormant cysts to become more active.

Hope this was helpful. I feel your pain! mostly clear

At 22 years, I too had a bout of cystic acne. I was in grad school at the the time and under quite a bit of stress. One of my classmates took me aside and told me that there were many new treatments available to treat acne (this was in the late 1980s). B I remember being quite taken aback by her frankness because I didn't think my complexion was all that bad. Anyway, she gave me great advice and I consequently went on Accutane for six months which resulted in gorgeous skin until I got my first real job a year later. The working environment was so stressful and I had enormous self doubts about my abilities. The cystic acne returned with a vengeance and much to my mortification, I overheard my boss gossiping about my skin at work! I decided to go back to Accutane for another six months and the second course of treatment really did the trick. Over the next 15 or so years, occasionally I would still have breakouts but they were so much easier to manage. I also think with maturity I have learned to be more confident and to handle stress better. Hope this helps. Been there too

I would definitely re-examine what you are eating. Are you eating enough greens, less white flour, etc? Resting? I read somewhere that when your internal organs are overloaded with expelling toxins and wastes your skin is the next stop. For me too much sugar, caffeine, and bad oils are the culprit. Check the types and quality of oils you use in your food (rancid oils do a lot of damage to our system). EVO and coconut oils are the best things for skin. Stress is another skin spoiler, but you have a heavy load and unfortuneately it comes with the territory.

I would definitely say that because you live a stressful and busy life you need to take extra good care of your self through eating, exercise, and relaxation. The prescription stuff never worked for me and I have really managed my acne with the above. Check out nutrition tips from the book ''Nourishing Traditions'' by Sally Fallon. Cystic acne no more.

I haven't been ''officially'' diagnosed with cystic acne, but mine sounds just like yours. The only thing that I have found consistent about it is that if I eat gummy candy (jelly beans, gum drops, etc.) I will surely break out. Not that I don't break out other times, and not that it doesn't go away for a few months at a time. I used to think sunlight helped, but it doesn't seem to any longer. I'm not willing to use accutane, and can't take birth control (though I still had it when I was) so I just try to keep my face clean (I swab with rubbing alcohol) and not touch my face or eat the offending candies. And that seems to keep it down. Spotty

Accupuncture for Acne?

August 2005

I've battled acne for years now and have done many many conventional treatments, most of which have not helped. It seems to come and go but has been pretty present the last five years, and I'm in my 30's! Has anyone tried accupuncture and if so what were your results? I'm ready to try anything, I'm so sick of this! Thank you in advance. anon

Sara Rankin of Alma Acupuncture in Oakland specializes in ''Facial Rejuvenation'' which works really well for many skin conditions (wrinkles, blemishes etc.). She has a lovely office close to Piedmont and Broadway in Oakland. She takes insurance for medical conditions (Alta Bates and Kaiser Plans for example). Reach her at: 510 593-7514. Melanie

Although I don't suffer from acne, I had another skin problem for several months for which I consulted an acupuncturist. It went away after a few weeks. I saw Dr. Robert Zeiger, a great acupuncturist and doctor of oriental medicine that I can highly recommend. His contact info: (510) 843-7397, 3031 Telegraph Ave., Suite 106. Good luck! Believer-in-alternative-medicine

Sorry to say I tried acupuncture for over a year for my adult acne with no results. I kept at it because my insurance covered the treatments, so I wasn't paying out of pocket. I just started taking tetracycline (again) and using tazorac (a new retinoid cream). Its too soon to say if these will deliver the results I am looking for, but so far better than the more natural routes I have tried over the years...

I don't know anything about acupuncture for acne, but I will share our experience. My son is now almost 16 years old, and he had struggled with acne as soon as he hit puberty. Then last year, when he joined the football team, he developed an awful facial rash, no doubt exacerbated by the sweaty helmet and chin strap. He had tried all the antibiotics and face creams perscribed by several dermatologists until it looked like accutane, a medicine not without significant risk, was our final medical option. Not wanting to go that route, we looked into unconventional approaches. After doing some internet research, it seemed that some people benefit from removing sugar from their diet. My son decided to try it at the encouragement of his medical researcher dad, and--what do you know--his face cleared up! He still has quite clear skin 3/4 year later (and yes he is doing football this year again). He eats no sugar or honey or molasses, etc. When he wants a sweet he eats no-sugar-added ice cream or cookies with no sugar. Thanks to the popularity of Atkins Diet, you can find lots of substitutes. He still keeps his face very clean and showers twice a day and uses the topical creams. He feels he is happy to give up sugar to have normal skin. Hope this helps. I know what a frustration it is. Sugar free mom

I haven't tried acupuncture for acne, but I'm a student of Chinese Medicine. A teacher at my school, Dr. Yu, is supposed to be great. She specializes in dermatology (and teaches it). She teaches at ACTCM 415.282.7600. I'll try to get her # and post it for you. Best, anon

Dr. Yu is a dermatologist (Chinese Medicine - acupuncture and herbs) in San Francisco. Her number is 415-337-0308. I hear she's great. anon

i've had wonderful luck with Proactiv for the past 10 years or so. it really works. anon

How to control acne since I went off the pill?

July 2003

In my previous life when I was on 'the pill', I did not need to worry so much about regular break-outs on my face. I then went off the pill to become pregnant and the break-outs were uncontrollable! Then during pregnancy my skin was soooooo happy again! But now I've given birth and the teenage-like acne has returned. I have my hands full with a 2 month-old and don't have time to do anything more than just wash my face in the shower (when I get one!) I'm currently using Neutrogena daily face wash but I guess I need something stronger. Any recommendations for something I can use on my face that won't dry it out but will control the blemishes? My skin doesn't seem to be either dry nor oily nor combination. I'd call it ''normal'' except I keep breaking out. I really don't have time for anything more complicated than what can be accomplished in the shower....
too old for pimples

I have also had problems with adult acne and have resorted to trying many different things. Currently I have been using an acne bar from Clinique and also being a sometimes showerless parent, only use it in the morning. I have had very little breakouts since I started using this line early in my pregnancy. To help prevent dryness I also use their moisterizer which can be put on quickly after I shower. Both products can be a little pricey but they last a very long time so in the long run are not much more than what you are currently using. anon

Hey there. I don't think you necessarily need something stronger to take care of your acne, especially if you have normal skin. why don't you try something less irritating than a traditional acne control wash. my skin cleared up when i stopped using a daily scrub stopped washing my face with a soapier product. Instead, I use Cetaphil twice daily (sometimes three depending on my activity) and moisturize with an Aveeno product. Then, I only used a facial scrub once a week. This regimen has worked very well. I too am experiencing acne related to my pregnancy and got a prescription from my primary care doctor for topical Eurithrimycin pads - they look a lot like stridex pads, but they don't dry out your skin. basically, it's applying antibiotics to combat the bacteria in your skin. It works very well and i bet you could get several months worth that should help you until your skin returns to normal post- pregnancy. Good luck! Jen

I had the same problem you did. Pretty good skin before pregnancy, glowing, gorgeous skin during and then rotten skin and hair after giving birth (and for about a good 8 months afterwards). Realize that your body is going through hormonal changes that affect your skin and hair, usually it seems for the worse postpartum. These things do seem to normalize eventually.

When my skin was at its worst I got desperate and actually ordered Proactiv after seeing the infommercial and I LOVE it. It doesn't dry my skin out and the three step system has been easy and really effective. I also take 400 mg of vitamin E every day and that seems to help, too. You can order Proactiv online. Check it out... heidi

I'm sorry to have to say it, but what you need cannot be done in the shower. Washing your face is not enough! You need something to put on your face *after* you wash that will kill the bacteria that cause the acne.

I have had persistent acne since I was in my teens. While it's not as bad as it was then, I still break out, even though I am now 35! Well, I *would* break out, that is--I don't now. However, the ONLY thing that works for me and my stubborn acne is a BENZOYL PEROXIDE product. Here's the thing a lot of people will probably recommend something with salicylic acid. The problem is that salicylic acid works only on acne causing bacteria that are not very far beneath the surface of your skin. I know for me, salicylic acid did NOTHING and I found out that this is because only Benzoyl Peroxide (BP) gets the DEEP bacteria.

Ok- you don't want your skin dried out, and BP is rather on the drying side. The thing to do is to STAY AWAY from regular, over the counter products (like Clearasil and Oxy). These products tend to have WAY more BP in them than you really need. It turns out that a 10% BP product (usually labeled ''extra strength'') isn't any more effective than a 5%, which isn't any more effective than 2.5% !! The only difference is that the 5% and 10% BP products will dry your skin out much more than a 2.5% BP solution. Also, over-the-counter products tend to have a bunch of other ingredients in them that *I* think are bad for your skin (aluminum derived ingredients, tints and other stuff - yuk!).

After much searching, I found a terriffic BP product that is pretty much nothing but a water based cosmetic gel with 2.5% BP. It works GREAT, and it doesn't dry out my skin as much as the other stuff. Of course, I do also put on a moisturizer - but I would do this anyway as I DO have combination skin. I would recommend staying away from those acne treatment *systems* (entire lines of products - face washes, toners, creams, gels, etc. etc.) especially if you want to avoid drying out your skin. Besides, these are often overkill and may take up more of your time than you need. Of course, if your acne is bad enough, you might NEED an entire system to treat it, but I have found that I really don't need all that stuff, and my acne is pretty bad if it goes untreated.

The product I use is ''DDF'' (Doctors Dermatologic Formula) Benzoyl Peroxide Gel. I buy it online from a local cosmetologist (based in Orinda), Mary Gilespie. She has an e-store She ships very quickly and her stuff is reasonably priced (the BP gel costs pretty much the same per ounce as what you would pay for over the counter products - you pay more by the tube because they hold twice as much), and she give great customer service. I couldn't be happier! acne free!

I too have adult acne which recurred after I went off the pill and got better while I was pregnant -- and afterwards I was right back to being the only adult in the room with pimples. I have no plans to go back on the pill and don't want to do tetracycline, but I did find a skin-care product that has helped tremendously. I get my brows waxed at White Rose in Oakland (on College near Claremont) and the owner there recommended the Karin Herzog Vita-A-Kombi cream (she gave me samples first and then I went back and bought it). I am usually quite skeptical of any ''skin care system'' that promises great results and then at every stage tells you that you must buy yet another product; however, she recommended one thing and said that was all I needed. My hormonal surges are sometimes still stronger than this lotion, but it is far more effective than anything I've tried and I am so happy to be done with Clinique, Origins, etc. (The only downside is that it has hydrogen peroxide in it, so when I'm not careful the tops of my eyebrows get a little bleached.) J.J.

I have suffered from mild acne my whole life (like you better when on the pill or pregnant). Acne medications like benzoyl peroxide and Retin A make my skin peel horribly. The last dermatologist I saw suggested using an over the counter facial soap with salicylic acid (2%). Aveeno and Neutragena have these products although they are sometimes hard to find (I have purchased them at Walgreens). I have also found generic brands as well which are a bit cheaper (Rexall pharmacy in El Sobrante). The liquid face soaps have 2% salicylic acid while the bar soaps only have 1%. Initially I was washing my face twice a day with the liquid soap, and it was a bit drying. Now I wash once a day (in the morning), and my acne has disappeared. Good luck! Cindy

I feel your pain. I've had bad skin since I was 15, with flare ups depending on the time of month or how many hormones were surging through my body. My skin was glowing and perfect during my first pregnancy, and alarmingly acne-riddled during my second. I was then diagnosed with acne rosecea (hey, wrinkles AND acne!). There are several routes you can take, but some of them are best left until you wean your newborn. After I weaned my son at 9 months, I started a low-dose course of antibiotics and Metrogel lotion, prescribed by my dermo, which got my rosecea under control. What you can do now is try Eucerin pore-cleaning gelwash every night. It's non-drying and seems to be keeping my skin under control. Also, make sure you have a good skin cream/sunblock on every day, as sun exposure also seems to affect adult acne. Again Eucerin prodcuts are good and affordable. Good luck! Julie T.

I have absolutely been there, so you have my sympathy. I tried facials (for me, a total waste of money) and all sorts of expensive and inexpensive products, and the only thing that really ever worked for me was Benzoyl Peroxide. If you haven't already, consider the Proactive line of products, which uses non- irritating amounts of Benzoly Peroxide. I used the cleanser, repair lotion and mask and got great results (I did not, however, shell out the money for the daily moisture lotion, figuring that the Oil of Olay that my dermatologist had recommended was good enough). I should warn you that after a few years on Proactiv, it stopped working (apparently, my skin adjusted), so I switched to a lotion with a higher percent of Benzoyl Peroxide, and it did the trick. One more question Now that you have your baby, have you considered going back on the pill? Good Luck! Amy

Definitely try Proactiv Solution ( I was skeptical but tried it when nothing else worked, and I'm still amazed at what a difference it has made. Safe during pregnancy and nursing,too. Really, it works. Good luck! anon

Go see a dermatologist. None of the over the counter stuff works very well. I saw my first dermatologist when I was 16 after years of acne. I've had it under control ever since and never felt better. Leslie

At 41 I also still have acne (the horrible undergrounder-painful type). Thought it was gone for good after undergoing Accutane treatment 20 years ago, but no, it recurred several years ago. I currently use two different kinds of cleansers and a topical medication prescribed by my dermatologist... but had not reached a completely zit-free state till I discovered the wonders of Vitamin A and Zinc! If I'm starting to break out (like around my period) taking a zinc supplement (just the RDA dose) and drinking carrot juice for a couple of days really puts a halt to the breakout. Works for me... anon

Acne, scars and pregnancy

Nov 2005

Hi. I'm 5 months pregnant and have acne. I know it's hormonal, but it has NOT let up and I don't remember it being like this with my firstborn! I am trying Proactiv (for a month or so) and it helps some, but I am experiencing acne still and have significant dark/red scarring. I don't wear makeup, and anyway, it seems to draw even more attention to the problem when I do apply. Can anyone recommend pregnancy safe treatments - for the scars in particular?? I have heard about facials, aestheticians, laser treatments... but I know nothing of these things. I also don't have an unlimited budget. I live in Alameda and would appreciate a nearby recommendation. THANKS! Ugly Momma

I had luck with products including alpha and beta hydroxy acids, not benzoyl peroxide, specifically the neutrogena acne patches and olay ''age defying'' cleanser. the zits stopped being so huge and raised after the baby was born, but the red spots remained for awhile, but were helped almost immediately by the age defying wash. anon zit mom

Hi - please check - I am pretty sure Proactiv has retinol and therefore should NOT be used during pregnancy. I am also pregnant and have acne. I went to see Francesca at Alchemy Skin Spa in North Berkeley in Walnut Square and she has some fabulous all natural products that are totally affordable and are working really well. Her number is: 981-9881. She is also a mom and is really gentle and highly professional. Suzanne

Hi -just wanted to add - I had increasingly bad acne in both my pregnancies - and to my dismay after my second stopped breast feeding it got worse - I went to several ''top-notch'' dermatologists, went through two rounds of antibiotics, a ton of creams and gels all to no avail - zits, some large and painful but - especialy rash-like, small bumps all over my cheeks, forhead and neck persisted - both derms suggested accutane.

Last weekend we were at a wedding and the woman next to me mentioned she'd had this problem and it turned out to be a dairy allergy - I'd had a dairy sensitivity after my first was born but it manifested as stomach cramps, gas etc.. - I didn't have those symtoms with the second so never considered the allergy possibility (strange that the docs didn't either) - the happy ending? After only 5 days dairy free my face is almost completely clear! - no kidding after 7 months of creams, lasers, and pills - I stop the cheese and milk and presto - I have my face back - of course this may not be your situation but just something to think over, your body changes so much during pregnancy who knows what can happen- wish I'd tried it sooner.

Treating Acne While Pregnant

May 2003

I have terribly acne caused by pregnancy and would love to hear what safe remedies others have used for this problem. What products did you use, and can anyone recommend a dermatologist who knows how to safely treat prenatal acne? Thanks! Anon

I also had a lot of acne when I was pregnant. Try the Proactiv acne products. I have been through all sorts of acne treatments, including Accutane multiple times, and Proactiv was very effective for me! Good luck... and congratulations! beth

When I was pregnant, my back broke out pretty badly. My acupuncturist suggested that I take acidophilis and it really helped to clear it up. I bought the most potent (and most expensive) kind from her, but it was well worth it! anon

Hi, although I don't remember all the details of your original post, I want to warn you about using Retin-A, Retinol, the generic version Trentoin, or its derivative Accutane, during pregnancy, especially in the first 12 weeks. It has been proven to cause birth defects, most likely to the ears of the fetus. If you have any doubts, do a google search on ''retin-a & pregnancy''. Also, COQ-10 isn't safe either. All this highly chemical stuff, even though it's just applied externally, does get into your system and cross the placenta. My dermatologist who prescribed this for me never mentioned it, by the way. Wrinkly Pregnant Lady

Hi, I wanted to respond to the pregnant woman asking about help with acne I HIGHLY recommend Proactiv Skin care. can be ordered online:

Having battled acne myself, I have tried EVERYTHING. this was the only long term solution for me. Results start to show in a week.... Best of Luck

Postpartum Acne

Sept. 2003

My baby is 10 months now and everything is fine except for the severe skin problem that I've had for at least 4 months already.I didn't have anything like that even in puberty. My doctor blames hormones and suggestes to ''wait and see'' ( she did thyriod hormones testing - seems to be fine) but I wonder if Moms out there had the same thing and how did they handle it? Will facial help? Homeotherapy?

I had really bad pre-natal acne and couldn't (and still can't due to breast feeding) use Retin A so I started using Proactiv Solutions. It seems a little pricey but the bottles of products last for a really long time. They have a really cheesy website ( that you can order from and you can become a member (like the Hair Club for men). The membship is a lot more flexible than it sounds on the site and you can call the 800 number and talk to someone about the options. It is working for me and I hope it works for you too because acne whatever the cause is a bummer.

My prenatal/postnatal acne did not go away until I stopped nursing. If you are nursing, this might clear up when you stop. Good luck! Jill

There are 2 natural products which some people have found very effective for acne formulated by Dr. Berman -- Aboriginal Gold and Dr. Berman's Mineral Mask. I have a validation from a Beverly Hills/Hollywood esthetician named Lyn Bresnahan about both products which I can email to you if you would like to read it. Her cystic acne was cured with Aboriginal Gold. Also, Dr. Berman develeoped the Mineral Mask to treat his teenage sons' acne. I can also provide more information about both products if you email me. Linda

Proactiv for Adult Acne

June 2003

I have been struggling with adult acne since I was in my early 20's. I've tried everything and it just seems to get worse as I get older (I'm 35). My last dermatologist told me it probably would continue in this manner until I was 40 (ugg). I'm so sick of it! The worse part is the break outs on my arms and back. The face stuff has been controlled moderately with Retin A. I'm considering using Proactiv on my arms and back. Has anyone had success with this? How long did it take to see results? Should I give up using Retin A on my face and just go with Proactiv? Where do you buy it for the best price? Thanks in advance! fed up

The dermatologist that created Proactiv, Dr. Katie Rodan, has an office in Oakland. I found ProActive was helpful, but I needed more help and she is quick to find whatever solution works for you. (She may coordinate the product with something else, or help you find a new product altogether) It can sometimes take a few weeks to get a first appointment, but in my case, it was definately worth it. She is located at 3300 Webster st. The number is 510 763-2662. Lisa

Another product you might want to consider is Obagi NuDerm products. They are used in conjunction with Retin A and have been wonderful in controlling my acne. I'm 35 and have been plagued with acne and hyperpigmentation since I was about 18. I've also used Retin A on and off for many years with some success but this stuff has done wonders. I originally started to use Obagi for my skin discoloration but, to my surprise, my acne was gone in about 3 weeks. I've been using it for about 7 months now and have had about 3 blemishes the entire time (where I used to break out about every other week). It's expensive stuff but it goes a long way. The 2 month supply really lasts about 5 months. Dermatologists will try and hawk the stuff but the best prices I found were on the internet. Check out Best of luck to you ! - acne no more

My aunt does a lot of research in the cosmetics field and she turned me on to Paula Begoun, ''the Ralph Nader of cosmetics'', who's written several books about skin care and beauty products (reviews and a good deal of debunking) including ''Don't Go to the Cosmetics Counter Without Me'' which you can probably find it at the library. She rates pretty much every cosmetic and skin care product under the sun, from drugstore to department store to info-mercial product lines. I've learned to trust her research, and her take on most of the ProActiv line is that it's overpriced for what it is.

Meanwhile, one of the problems with Retin-A is that it's in a *cream* formulation, the base of which can actually clog pores and cause break-outs. (Pretty smart, huh? What are these people thinking?) I believe they're working on a gel formulation, but don't know when this will become available.

In her book ''The Beauty Bible'' Begoun discusses skin care issues and may have some more viable suggestions for you. Have you considered Accutane? It's an oral medication and I would think of that as a last resort, but the results are often amazing. (Do not even CONSIDER Accutane if you are thinking about becoming pregant as it causes severe birth defects.) I've had horrible acne most of my life and it cleared me right up about ten years ago. When it started to flare up again recently, along with Rosacea, I began taking Jasmine oral contraceptives and that's made a huge difference both in the acne on my face and on my back. Another acne sufferer

I have been reading up lately on PCOS, which is polycystic ovaries syndrome (or ovarian syndrome)- and one of the phenomena that goes into the diagnosis of the syndrome is persistent adult acne (in women) that responds poorly to treatment. PCOS is often treatable. It might be worth checking out with an endocrinologist, instead of a dermatologist, if this could be contributing to your acne. Just a thought, because PCOS is on my mind! Anonymous

I had stubborn, ''not terrible'' but painful and constant acne starting into my teens, which (contrary to what I'd been advised) did not abate well into my twenties. When Accutane came out, having tried every topical treatment available at that time (the 80's), I jumped right on the bandwagon. What a relief; by the end of the course of treatment, about six months as I recall, the acne was gone, and I have had great skin ever since. So while I have no information about Proactive (sounds, from the website, like it's pretty effective stuff), I can certainly recommend Accutane in case Proactive doesn't work for you. Accutane does interfere with embryonic development, so you have to take care not to become pregnant while taking it; otherwise its side effects are mild in most people (I experienced dryness of the eyes, for instance). If I had it to do over again, I'd still try every topical agent available first, though. Good luck! Katherine

I swear by Proactiv. After 17 years of trying every prescription, over-the-counter and department store acne treatments, this was the only product, aside from Accutane, that actually worked! I have had acne my entire life along with extremely senstive skin. I had seen the infomercials but always dismissed them as a lot of hype. When my skin flared up again after my daughter was born, a friend recommended this product. I was skeptical but after a week of use, my face was totally clear. I started to get compliments on my ''perfect complexion''. It was a dramatic difference with no side effects. I use the cleanser 2x daily, the toner 1-2x and the lotion as needed. I can sometimes get dry or a bit irritated with the lotion so I cut down on the use. I have been using this for a year and aside from occasional monthly zits (1 or 2 only), this is still working wonders for me. I use it just on my face but assume it will work just as well on other parts of the body. As far as I am concerned, it is a miracle. Nicole