My battles with adult acne – an update

Many of you have contacted me personally to share your stories and advice regarding your battles with acne, and I thank you.

As you know, since the end of competition season my immune system has been under attack, which resulted in a lovely break out of cystic acne on my forehead, jaw line, neck… you name it! Just as one painful bump starts to subside, another will manifest elsewhere on my face. It's been an ongoing struggle since last November.

I went to my doctor to discuss my options and was preparing myself for the dreaded, but much-loved, Accutane. Many of you told me about your love-hate relationship with the acne wonder drug, and I listened. I went for blood tests, a pre-requisite to even be considered for Accutane, and in December I was told my dermatology appointment was set for February 6.

Sooo far away.

I was actually worried my skin would clear up by the time I got my appointment, and the dermatologist wouldn't believe me when I tried to explain just how bad my skin was. I was put on a waiting list, should an earlier appointment arise, and one did! Unfortunately my skin was just as bad as ever, with a nice big cyst on my neck, just under my chin (never had one there before!), and a new zit by my nose. Perfect, she'll see just how bad my skin is and will agree that an aggressive attack is the only solution to problem free skin!

My appointment lasted a total of 5 minutes. Seriously, it was the quickest consultation I've ever had. Did she even hear my plight? Did she really understand the gravity of the situation? Who knows.

Instead of Accutane, I was prescribed antibiotics (doxycycline 100mg) and Tactuo gel, which is a slightly different formula of the popular Differin gel. Apparently this is the new super acne-fighting duo. She gave me a three month supply, and a follow-up appointment in April.

1 Week in

I'm expecting my skin to get worse before it gets better. The active ingredients in Tactuo gel are adapalene and benzoyl peroxide, which renews skin cells as it unplugs pores from the inside out.

I've been on this regimen for about a week now, and initial observations are as follows:

  • irritated skin with a slight burning sensation when I apply moisturizer/sun screen (non-perfumed)
  • flaky, itchy skin – especially around my mouth and nose
  • slight gut-rot if I take the antibiotics before bed

So far, my skin is the same, with a new breakout every day. There are horrible red marks along my jaw where the cysts are/were, which I have to cover with a load of makeup – which of course ends up all over the collar of my shirts and jackets. Lovely.

What a long journey ahead of me…. I'll keep you updated.

Have you tried this combination of drugs to treat acne? Please share your story with us below…



30 thoughts on “My battles with adult acne – an update

  1. Sorry to hear you’re struggling with it so much. Just in case you have never tried this approach; I get terrible acne when I drink milk. I’m not lactose intolerant or anything, but as soon as I stop drinking/eating dairy my skin clears up pretty quick. I hope the new regime helps though. And make sure you are getting some hefty probiotics to counteract those antibiotics! Hope it goes well 🙂

  2. Hey Lisa, I have had the same acne. It was really bad about a year ago, but as already mentioned milk did seem to make it worse. I used Proactive and that helped a lot even though cystic acne is usually more hormone related from what I have read…. Mostly I think I it helped with inflammation… so I still get the lumps, but they don’t get as angry and red… easier to cover and less painful. I use it half as much as directed otherwise I get very dry flaky skin. Mostly I think the exfoliating cleanser helped. Hang in there! you’ll find what works for you, like working out… and consistency will be the key 🙂

    • Yeah, I agree. I’m only a week in. As I say about building lean muscle: slow and steady wins the race. I believe the same applies here. Patience and consistency.

  3. Hi Lisa! I share in the ongoing struggle of adult acne. Mine was more cystic in my teens and I went through every product in the derm’s office! I got frustrated with my initial derm who didn’t seem to believe my acne was ‘all that bad’ after turning my face into a raw piece of meat. I switched to a new derm who instantly said nothing but accutane would help my type of acne (he is listed as one of the top 100 docs in the US). Two rounds later, I’m enjoying relatively nice skin. Better in the summer when I see more sun and worse in the winter when I’m dry and flakey and have to load on the moisturizer. Overall, accutane was well worth the pain in the butt monthly appts. Antibiotics only ever made me nauseous and ruined my immunity.

  4. I too suffered with this problem during adulthood. I had been on birth control pills since my early teens due to my whacked out cycle. Then at 28’ish I tried to get off them. Bad idea! I had never had an acne problem, but when I got off those it looked like an explosion took place on my face. My dermatologist prescribed doxycycline and it worked amazingly well! Now, he also gave me some sort of cream and my face reacted much like yours. So, I decided (without consulting the dr) to stop the cream and just use the doxycycline. Amazing results! No external aside effects at all. But, if you go out in the sun during summer…beware! You may (like me) get sunburned very quickly. In summary, I would reccommend doxycycline to anyone with this problem. I personally would steer clear of the creams though, but that’s just me. I wish you the best.

  5. I had a sudden break out of adult cystic acne out of nowhere. I went to see a dermatologist and they first put me on minocycline which made me naseous and gave me severe headaches. I then was switched to doxycycline 50 mg a day for several weeks with no improvement whatsoever. I then found a new dermatologist that I felt I trusted more who changed it to 100mg a day. I did this for 12 full weeks along with duac and differin. These made my skin excessive dry and peeling. I saw a very slight improvement but continued to get new cysts :(. Finally my dermatologist agreed to let me start Isotretinoin (known as accutane). I am in my 3rd month of this now. My face is clear of all cysts currently with only an occasional pimple here and there. My only worry now is the remaining scars and marks from all of the cysts that were there. What a horrible painful process to go through both physically and emotionall.

    • Did you find you got stomach aches (severe cramping) and constant nausea? I’ve been on it a week now, and just yesterday started with these symptoms.
      I understand doctors are cautious with Accutane, but isn’t one pill better than lotions, potions and other drugs?

      • I did not get stomach cramps or nausea from accutane. I did experience that with the minocycline. Accutane is the only thing that is working for me. Besides the extreme chapped lips I have no other symptoms except mild joint pain. Are you taking it with food?

      • I meant side effects from doxycycline. I’m on that. My derm hasn’t prescribed Accutane yet, we are dong a 3 month run of the regimen I mention in the post, then see what happens after that.
        I heard about dry lips with accutane. So weird.
        I am taking the doxy with a full meal, but still getting the side effects.

      • I never had any side effects for doxycycline . But unfortunately after 12 weeks it never helped me. I do hope it works for you . If not beg the dermatologist for accutane because that started to work very quickly for me . Good luck to you

  6. Such luck i landed on this! I was perscribed the same two meds (tactuo and doxycycline 100 mg) too. I started this regimen 4 days ago and have a follow up check up in march. I was also perscribed to switch birth control pills from alessa to yaz. Apparently this bcp helps with acne ..albeit im skeptical about yaz but we’ll see. So far im experiencing that purging stage initial break out. Tonight is the first night it started to feeling like its midly burning my face. Alot of the reviews stated that all of this is normal for the first 4 weeks. So i am going to stick with it for now. A very good moisturizer is necessary ..its super drying. I add a bit of pure argan oil to my clinique moisturizer gel for extra moisture. Its helps

    Good luck with your (our) journey! Love to know how your results come along as well

    • I’m glad you found my blog and I’m really glad you shared your story.
      An update: I stopped using the tactuo day and night and only use before bed, that seems to have stopped the burning. I was getting a really bad stomach ache from the doxy, but that’s calmed now too.
      Still having breakouts, but no new cysts.
      Fingers crossed!

  7. I’m 49 and have cystic acne and small white bumps nothing works for me i,ve been on accutane 4 times it always came back. Now I have depression. It is terrible I think it is hormonal

  8. Hi there,

    I’ve been suffering from cystic acne for 4 years now. Today I was prescribed the same antibiotic and the Tactuo gel. Despite the fact that I’ve tried pretty much every antibiotic known to man, every cream, cleansing system and scary treatment (lasers, UV, levulan) I hold out hope that this will work. Fingers crossed!

    • Hi Sam,

      I was just taken off the doxycycline – I broke out in a rash all across my chest and shoulders. I can only attribute it to the antibiotics. In exchange, I was prescribed Clindets – which are antibiotics topical wipes. I am still using the Tactuo gel at night, and the wipes in the morning. Second day in, and so far so good. I’m expecting a break out because I’ve stopped the oral antibiotics – everyone says you usually get an onslaught of acne when you come off them. Ugh.
      Let me know how your regimen goes!

    • My derm is pretty adamant about not putting me on it. I’m off the doxycycline now, using clindet wipes instead. No change noted. 😦

  9. Hi Lisa,

    I totally understand the battles your having with your acne. I have also suffered from acne from a really young age. I went on Accutane when I was 14, I was on it for a long long time – too long a cycle IMO. Do I still get breakout now 15 years later- yes but I dread to think how bad it really would get if I didnt take accutane. Do I think it was worth going on it – probably yes. I had really bad back and chest acne also. But I think it is definately a last resort due to the severe side effects. It does make you break out initally, its gets worse before it gets better. If your acne just deveoped after your last show, i would probably look at things you changed in your diet since then, Dairy is probably a big culprit, Skin products also worth looking at.Hormones are also a massive contribution to breakouts. I hope it all works out for you and you find a solution!

    • Oh yes, I forgot to mention following other posts… Having read product information about Tactuo, it should only be used once a day, and 4 small pea sized amounts a day (1 on forehead, 1 on chin, and 1 on each cheek). Using more than this can cause irritation. Using more doesn’t make it more effective.

      Best of luck – wishing you the best!

  10. Sounds hormonal-location and type of acne. Try Spironolactone (sp)-its a diuretic but off label it decreases testosterone. Works for me. Never used antibiotic.

  11. My doctor has just prescribed me Tactuo and Teva-Minocycline for my back acne..i get severe cysts on my back, face and neck which are sore to touch and sometimes i cant even sleep on my back.. i’ve been suffering with this for at least 7 years and now i,m hoping this helps…She did refer me to a dermatologist so now i just have to wait for my appointment to see what they hoping these 2 combined will help my back clear up..i have ugly scars from previous cysts but its a small price to pay if my back finally clears up for good…

    • Sarah, thanks for sharing your story.
      I have been on Tactuo and a mild antibiotic (can’t remember the name of it right now) for a few months now and have not had any cycts at all. The few small pimples that pop up are gone within a day or two. Next phase will be skin resurfacing or something to make it more smooth.
      I wish you luck with your prescription duo. Let us know how it goes!

  12. 10 days ago, I went on doxycyline and tactuo before bed only twice a week. I had been to a dermatologist when I first got acne not too long after my first period, but all I remember is a gel that made me very dry and not much else. 15 years later, I finally went to a dermatologist again. I have bad scarring and still get painful cysts in addition to pimples, blackheads, whiteheads, and a very very shiny face. Remarkably, I haven’t gotten anything new over those 10 days, quite unusual for me, and the only pimple left on the bottom of my chin is pretty dried up just taking its time disappearing. Though it has been a short time, I’m very happy with the results right now. I think I got lucky and was prescribed what I needed 🙂 I guess the lesson is keep trying because it is very individual and ignoring it can lead to more scars.

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