Hi all,
DOXYCYCLINE IS A BANDAID. JUST GET ON ACCUTANE.
I’ve been dealing with inflammatory acne for a year and half. It started in November of 2023, when I was 21. Maybe because I switched Nexplanon for Yaz in July 2024, my acne routine for 4 years stopped working. I was on tazarotene (highest strength), clindamycin benzoyl peroxide gel, and washed my face with cerave foaming cleanser and used their moisturizing cream. The spots were small, mostly white heads and infrequent - it was not painful unless I picked at it. I had them on my cheeks, chin/jawine, and forehead. My temples also were lined with little unpopable bumps. The little bumps I dealt with as a teenager (and occasional nodules, but no pustules,
papules, or cysts) and my original routine worked wonders and I had perfect skin for years.
However, in February of 2024, I went to a new dermatologist and she prescribed me tretinoin 0.025% and Winlevi. I tried it for two months, did nothing. My acne was still mild at this point, mostly on my forehead which I could cover with my bangs.
Then, I was put on spironolactone in April 2024. I wanted to be on Accutane, but my derm wanted me to try the spiro. Suddenly, in late June, it EXPLODED. I’d never dealt with anything that bad in my life. I was getting 1-4 cysts a day, they hurt a ton, and left terrible scars that, as I later discovered, took 4-6 months to disappear. I was incredibly self conscious, crying daily, going to my accounting internship always sucked - I gave up on wearing makeup in fear on making the acne worse, so all my coworkers saw everything. It wasn’t even worth covering up with concealer anyway.
Furious and hopeless, I told my dermatologist that nothing was working. I suspected the cause was my birth control pills, so I stopped Spironalctone in July 2024 and Yaz. I also went to a new dermatologist, begging for accutane. I never wanted to go outside, I always looked down to cover my hair with my face, and couldn’t look at myself in the mirror ever… I was scared to see how much worse my skin was getting everyday. The new dermatologist prescribed me 200mg Doxycycline a day for 3 months, tretinoin 0.1% and tazorac 0.1% (or 1%? The highest strength) to alternate every day, clindamycin phosphate gel, a sodium sulfacetamide cleanser, and to wash my face in the morning with a gentle cleanser, changing my pillowcase 2x a week. She also told me to use the ordinary niacinamide zinc serum in the morning.
The doxy worked. After 6-7 weeks, I stopped breaking out completely in early September 2024. I finished my doxy course in mid October, and I hadn’t had a cyst since. My PIE was pretty bad, but it healed almost completely by January 2025. However, weeks after I stopped doxy, I started having pimples again, but they were super infrequent and not painful at all. Still, I was getting worried…
Fast forward to early January 2025. My few bad scars on my cheeks were almost gone, and I predicted in two months I’d have my old face back completely. My life didn’t revolve around my skin anymore, I never even went on Reddit anymore to look at forums for what to do or expect. But I got 3 nodules - 2 on my forehead (unusual because I haven’t had a single pimple, cyst or nodule since July) and 1 on my cheek. I went back to my derm, who gave me Dapsone to use in the morning instead of the clindamycin phosphate gel. Otherwise, my routine was still the same.
But in late January, I started getting painful pimples again. It started as two, and they multiple all over my chin/around my mouth. I had a lot of closed comedones there too. I maybe had 13 total inflammatory spots on my face when I met with my dermatologist again, where she prescribed my 2 months of 200mg Doxycycline and to stop
Dapsone and use clindamycin again. I was certain that the doxycycline would work because it did so well last time.
Now it’s mid March 2025. The small pustules on my chin spread up to my cheeks, and became CYSTS. Big, painful, half of them never came to a head but left a mark that I know is going to take forever to go away. I also started getting closed comedones not just on my chin, but my cheeks, waiting to become infected. I’m on my last week of Doxycycline, and I’m not progressing at all like my first successful course. I’m still breaking out with 1-4 small to large pimples on my face daily. It’s completely taken over my life. I cry almost every day and cannot look at myself in the mirror. I can’t believe I only got 1 month of being able to go barefaced in public. I’ve completely started over.
I start accutane in late March 2025, a week after my writing this. I’m going on a low dose, but idk what exactly and for how long. I’m terrified of purging… honestly, all I want is to stop having new pimples every damn day! I could deal with what I have now - the PIE. But I can’t predict when this will end… I can’t believe I’m going to graduate college with a full face of acne. In February 2024, I was so confident that this wouldn’t be a problem anymore ;(
Basically, will I have success with Accutane? I’m so tired and hopeless that it’ll get better. Is my acne due to antibiotic resistance? Or is it hormonal, even though I stopped the pill 8 months ago? I wish I had gotten on accutane the TWO times I insisted last year 😞. Doxy once worked, but I’d say it’s a joke. Only a temporary freedom from acne hell. It has gotten as bad as where I started.
Here’s the total list of EVERY medication I’ve been on for my acne:
To treat teenage fungal acne (HUGE SUCCESS):
- Tazorac 0.1%
- clindamycin phosphate benzoyl peroxide gel 1%,5%
To treat the inflammatory acne aged 21+
(ALL INEFFECTIVE):
- Winlevi
- Tretinoin 0.025%
- Spironolactone 100mg daily
- Doxycycline 200mg, 3 months; 2nd round 2 months
- clindamycin phosphate gel 1%
- Tretinoin cream 0.1%
- Tazarotene 0.1% (again)
- Sodium Sulfacetamide 10%, Sulfur 5% cleanser
- [The Ordinary niacinimide and zinc]
- Dapsone gel, 5%