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I have suffered from acne most of my life. I had it as a teen early in high school, when I started on the pill, into adulthood and I am now 33. There has only been two periods in my life where my acne has resolved, and it was during my two pregnancies. My second child is now 9 weeks old and it's back! I have tried many topical treatments, most prescription, and I took Diane 35-ED for many (possibly 10) years before my first pregnancy in 2008/09. Please give me some advice so I can go to my GP and tell him what I need (i.e. not another lotion).

  I would suggest you request a referral to a dermatologist for appropriate assessment. From the history you give it seems you have quite resistant acne and you require a detailed review. You may require a combination treatment regime encompassing diet modification, topical therapies with oral therapies. Of course if you are breast feeding then this will need to be taken into account when the dermatologist prescribes treatment for you.  

  My son has had cystic acne since he was a teenager. Had all the treatments including dermabrasion and ingrown hair treatment. He has excessive oily skin and scar tissue. The problem is very painful for him. This is located only on both cheeks. It also has a putrid smell and leaks continuously. He is very depressed and will not socialise outside of work. Please help.
  Unfortunately another consequence of severe cystic acne is its psychological impact.  Studies have linked it to depression but the good news here is that studies have also shown that as the acne improves, so does the person’s mood. It’s important he gets medical help ASAP. Your son will firstly need to see a GP.  He needs to inform the GP of his acne and its impact on his mood. The GP may provide a referral to a dermatologist for a prescription medicine.  It may be isotretinoin, which is a very effective medication for severe acne that works by reducing oil production in the skin.  A dermatologist will also be able to discuss various scarring treatment options.

I recently found a product that a friend recommended from the USA as her adult daughter had severe cystic acne. She told me it was a non benzyol peroxide product mostly from herbs. She has advised it works incredibly well and she even took the product to her doctor to check its ingredients who gave it a big tick. I want a more natural treatment for my daughter who has suffered for years with acne. I can’t find it here but I can buy it from the USA . Do these types of formulas work? Darrin, Qld

  There are many effective treatments for acne and if your daughter has longstanding acne, we would recommend that she sees a doctor before she has any permanent scarring. Over the counter products help a lot of people with mild acne but as she is still suffering from acne over a number of years, it might be time for a medical assessment and advice. There is only limited evidence that some natural and alternative remedies can be useful for acne. There are also of lot of products which have no research supporting their use. All will have some risks which have to be weighed against likely benefits. We encourage people to be very careful if ordering any treatments from overseas. It seems to be a big gamble when we have so many good quality options available here.

I am 28 yrs old and I have had acne for over 15 years, this is perhaps because I will not resort to harmful oral medications like Accutane. Can you help me as I refuse to take such medications????? I am desperate :(

  There are many treatments one can do before progressing to isotretinoin (Accutane/Roaccutane). The dermatologist will work out what the most appropriate medication is for your type of acne.   Simple measures include: a low GI diet; a diet that is high in fresh raw vegetables; decrease your low fat diary intake; decrease stress levels. You also may need to have your hormone levels looked at and other investigations performed depending on what is found in your assessment. Creams lotions and other topical agents are used initially and if these do not clear your acne then oral medications need to be considered. Oral medications include antibiotics but sometimes female patients need hormonal treatments and in the more severe cases isotretinoin is required.   Isotretinoin is generally considered the most effective treatment for severe types of acne.

 When switching from Benzac to Differin does there need to be a break? William, NSW

  If there is irritation from the Benzac, let that settle down first and then only commence Differin. If there is no irritation, there doesn’t need to be a break.

I am 24 and have struggled with bad skin for the last 10+years.  It got particularly bad when I was about 16 or 17, with acne not only on my face but parts of my body.  My GP put me on Juliet which cleared it up right away.  I stayed on Juliet for a few years and decided to take a break from it.  In the last 12 months my skin has got really bad again but only on my face this time.  My GP put me back on Juliet but this time it has done nothing.  I have also been put on other medications such as doxycycline but nothing is working.  I have a very healthy diet and have tried all sorts of products. Is it best to just request a referral for a dermatologist? Kate, NSW

  If your condition is not responding to your GP's treatment then specialist (dermatologist) management is warranted. Isotretinoin (Roaccutane) may be required.

This general information does not replace the advice of a medical professional. We can and do strongly recommend that you see your doctor regarding any questions or concerns that you may have about your acne or that of a family member's acne. The All About Acne team cannot provide recommendations or referrals for a medical practitioner.

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