Acne

Dear Dr Ryen, I'm 28 years old, married with two young children, and I’ve been struggling with bad skin (acne… ugh… I hate that word) since my early teens. Yesterday I broke down and cried when I saw myself in the mirror. Sometimes I don’t even want to go out in public. I’ve tried nearly every face wash at the pharmacy and eliminated greasy foods and chocolate from my diet. I even went on birth control pills, but they made me go crazy. Nothing helps. I keep breaking out, especially around my period. Is there anything I can do? Money’s tight, otherwise I’d go see a dermatologist or something. Please help!

- Samantha, Fort Worth, TX

Samantha. I’m so sorry to hear about your skin trouble. Nothing can ruin self-esteem like bad acne. Sounds like you’ve already tried many of the conservative methods for improving your skin, including non-prescriptions products, diets, and birth control pills. Here are a few other things to try.

Over-the-counter (non-prescription) acne creams can be somewhat weak, so you may want to chat with your doctor about prescription-grade ointments for lesions as they show up. These typically have an antibiotic and a peroxide in them to blast lesions when they arrive. The earlier applied the better.

Minocycline is an antibiotic taken daily that reduces the amount of lesion-causing bacteria on the skin. It helps somewhat - good for mild or moderate acne. The most common side effect is photosensitivity - you could get a sunburn more easily.

The strongest acne medication available is isotretinoin. It reduces oil production in the skin and can be quite potent, reserved for severe cases. Bloodwork is required to monitor liver function. It often causes dry skin as a side effect, but the dose can be reduced. The biggest issue is that it’s very bad for developing babies, so you must not get pregnant while on isotretinoin. It’s prescribed for up to 3 months, which can sometimes put acne into remission forever. As long as you’re on highly effective birth control, this may be a good option for you.

The other thing to keep in mind is the type of makeup you use. Many makeup products are used to cover up lesions, but they may actually predispose you to get more. Always buy products that say NON-COMEDOGENIC. This means they won’t clog pores to cause acne lesions. 

Hope that helps, Samantha. Acne eventually goes away on its own, but sometimes it can take a frustratingly long time.

© D. B. Ryen Incorporated, May 2021.  

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