My History With Cystic Acne

I remember getting my first pimple when I was… eight? nine?

It’s been so long I don’t know my exact age then.

I just remember this weird bump showing up on my face and my mom telling me it was a pimple. It was sore and I didn’t like it. She popped it for me, and I didn’t like that either.

But that was it. No more pimples appeared and my one, little scar faded.

The Onset of My Cystic Acne

But middle school was a different story. I think my skin started to get truly bad when I was in seventh or eighth grade, around the time I turned 13 or 14.

I started to get pimples on my chin, my forehead, my cheeks, my jawline, you name it. Many of them would be small little blackheads, but some of them would show up as large sores under the surface of my skin. They never came to a head, so I couldn’t really pop them, and I had no idea how to treat them.

To be fair, I didn’t know much at all about caring for my skin and acne back then. (Most days, I still feel like I don’t know enough about it.)

My primary method of “treating” my pimples was to pop them (*cringe*) and vigorously rub a salicylic acid or benzoyl peroxide treatment on the open sores. It burned like a mother but I took this as a positive sign. Kind of like a “the burn means it’s working” approach.

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When I got a cystic breakout, which usually happened up on my cheeks, I would stand in the bathroom and try to force the pimple to come to a head by squeezing it mercilessly. The intense pain didn’t matter; I just wanted to relieve some of the pressure under my skin.

I vividly remember going so far as to cut into one cyst to try to get some of the fluid out. I don’t remember what I used to cut my skin, but it wasn’t clean — like a thumbtack or needle or something like that. Honestly, its a miracle I didn’t end up with a horrible infection or a huge, permanent scar.

And, for the record, cutting my face didn’t drain the pimple either. It just made my face bleed and left me feeling frustrated as ever.

Until I was probably about 15 or 16 I used over-the-counter acne treatments like Oxy Pads, Clean & Clear acne washes and cleansers, Biore face masks, etc. and none of them really helped. I also used them with a pretty heavy hand, which just led to red, irritated and dry skin… that also had acne.

I never went anywhere without makeup. We lived only feet from the post office and I would still put an entire face of makeup on to go get the mail.

My family and relatives seemed to always be commenting on my skin. One particularly sore memory I have is of an elderly “aunt” coming to visit and saying (in front of a room full of people, might I add) “Oh honey, what’s all over your face?” to which I could only mutter, “They’re pimples.”

Yeah, did not feel good.

Somewhere around this time I convinced my mom to let me try Proactiv. She was extremely skeptical about it, since it cost something like $40 — $60 dollars for one kit of the stuff, and we didn’t have a lot (read: any) money.

My Results with Proactiv

At first, Proactiv seemed to help me. It took a little bit to start working but, when it did, I remember it cleared up almost all of my smaller pimples. My skin looked — for the most part — clear.

However, the many small pimples Proactiv healed were replaced with more enormous, cystic pimples. Before I finally gave up on using Proactiv, I probably had about five active cystic pimples on my face. These were all extremely sore and, somehow, even larger than the past cystic acne I had experienced.

To be clear, I don’t think this is necessarily a side effect of using Proactiv in general. I just think that my skin, in particular, didn’t respond to the treatment in the best way. I have cousins who used Proactiv in the past, too, and it worked wonderfully for them. So, if you haven’t tried Proactiv, I’m not saying you should write it off just yet. It simply didn’t work for me.

So, heartbroken, I stopped using Proactiv and went back to using over-the-counter acne treatments. Of course, my acne also flared up again, but the instances of major cystic pimples decreased.

Getting Professional Advice

I think it was as I was getting closer to turning 17 that I was finally able to see a dermatologist.

The area where I grew up is quite literally the middle of nowhere so, in addition to the 40-ish minute drive to the dermatology center at the hospital, my mom and I also had to wait five months or so just to get an open appointment with a dermatologist.

I left that first appointment with an official diagnosis of having cystic acne, as well as a prescription for some antibiotics and a topical gel treatment. I was also forbidden to drink coffee, which I had developed a massive addiction to over the last year or so. At my worst, I was drinking three pots of coffee — yes, full 12-cup pots — getting very little sleep, and passing out on the couch immediately after high school.

My dermatologist theorized that, while the large quantity of coffee alone might be negatively affecting my skin, the lack of quality sleep I was likely also a key factor in my terrible skin. So, no more coffee. I quit cold turkey that day.

A month later, the gel treatment I was prescribed was swapped for some kind of cream treatment (I don’t remember the name but I remember it had to be stored in the refrigerator), which actually worked quite well.

The End of Acne in Sight

With the combined antibiotics and topical cream, along with my new zero coffee rule, my acne slowly but surely disappeared.

I still had scaring but, for the first time in literal years, I didn’t have any active acne. No cysts, no blackheads, nothing. My self-confidence improved (as you can imagine, being a teenager with acne doesn’t really make you feel great) and I finally felt like I might be normal, like the other non-acne-ridden girls in my grade. It was the least stressed out and happiest I had been in years.

However, I eventually made the decision to go on birth control. And, while my dermatologist assured me that going on the pill could be an effective way to prevent hormonal acne, this meant I had to stop taking the antibiotics. (If you weren’t already aware, taking antibiotics when you’re on birth control can make your birth control ineffective.) It’s also worth noting that it’s not good to be on antibiotics for an extended period of time anyway, so this departure was kind of inevitable.

After an initial adjustment period when my body had to get used to A: no more antibiotics and B: a new hormone-controlling substance, my skin still stayed relatively clear. I did get a few more pimples than I had had when I was on the antibiotics but, for the most part, the topical cream did the job.

All the Life Changes

By this time I was 17, pushing 18. I got accepted to college, graduated high-school, and prepared to move out of my mom’s house that August. I was working at McDonald’s part-time (I’d been working there for maybe eight-ish months or so) and counting down the days until I turned 18 in July. As if all the other life transitions I was going through weren’t enough, I broke up my my high-school boyfriend and, not too long after, started dating my now-husband. Big summer.

So, it wasn’t that much of a surprise when my skin started acting up again. Especially after I moved into the dorms at school and started washing my face and showering in a new town’s water, my acne came back. I kept up with the topical cream I was on for a little bit, but it eventually became too expensive and I stopped using it. I stayed on the pill for a while but found it hard to remember to take it every day, so I asked to be put on the Depo-Provera shot.

From freshman year in 2009 to the time I graduated in 2013, my skin was what I might describe as “okay.” It definitely wasn’t good; I got breakouts frequently and wouldn’t dream of going to class without makeup, but it also wasn’t as bad as it had been in high school. So I still considered that a win.

After graduating college, I got a paid internship with a digital marketing agency. I wanted to work for this company more than anything else in the tangible world, and chose to take the internship in hopes of getting hired full time, rather than look for a different full-time job. I was elated to be working there, but my husband (we had gotten married the year before) was still in college and my internship income was our main means of support, aside from my husband’s refund checks. We lived in a small, two-bedroom apartment with one of our close friends, who split the rent with us. I can look back fondly on that year now but, at the time, I was extremely stressed out. Like, constantly.

Combined that year, I think we made about $15,000.

And, in this year, my acne really came back. My chin, cheeks, and forehead were breaking out, I didn’t feel very outgoing or confident at work, and I often felt self-conscious even around our very close friends.

My Results with Bitter Gourd Acne Cream

I think I offhandedly mentioned something about my skin to one of my new co-workers, who told me about an acne treatment routine she was using that had worked really well for both her and her sister. Her advice was to wash my face with CeraVe’s Foaming Facial Cleanser and apply this bitter gourd skin treatment to my breakouts in the evening.

Amazingly, this cleared up my skin tremendously.

I used this acne treatment routine for several years, until it seemed to not be working for me anymore. That just seems to be the case with me: something will work on my acne for a while, until it doesn’t.

Of course, a lot of other life transition-y things happened around this time too: I got hired full-time at the marketing company I was working for (and where I still work today), my husband and I moved into a townhouse with a new roommate, my husband started grad school, we got a dog, etc.

And, with all the excitement, changes and new stresses, my skin flared up.

I don’t remember exactly when I stopped using the bitter gourd cream, but I think not long after I stopped using it I started looking for a dermatologist in our area. We had moved into a much more populated area about 30 minutes outside of the state capital, so I expected to have quite a few options. Sadly, that’s not the case.

Apparently, it doesn’t matter if you live in the middle of nowhere or not, dermatologists are perpetually booked.

My Results with Online Dermatologists

This was just around the time when the gig economy and telemedicine was really starting to become well-known and, in early 2016, I discovered the website DermatolgistOnCall.com. I’m not going to get into the details of the site here, but you can essentially upload pictures to this website and a licensed dermatologist can give you prescription acne medication (as well as medication for a host of other skin conditions, too).

So, using DermatologistOnCall, I got on another round of antibiotics and a new topical cream (trentinoin). This worked okay for me, but wasn’t as effective as the antibiotic/topical treatment combo I had been on in high school.

Furthermore, after I quit taking the antibiotic (because immune systems) my acne flared up again. In part, this was likely also due to the fact that I had stopped taking birth control (I had switched back to the pill long ago). Not being on birth control gave me a chance to reset my hormones after years of having them regulated by a drug but, unfortunately, my natural hormones are more conducive to acne.

So, with this new onset of breakouts, I decided to drop the trentinoin and try Curology instead. I had seen some ads for it around Instagram and, since each formula is custom made for you depending on the specifics of your skin condition, it seemed promising.

My Results with Curology

Curology did help my skin more than the trentinoin had been, but still didn’t quite get me to clear skin. I experienced fewer breakouts, but still continued to get pimples around my lower cheeks and chin (hormonal acne 101). I stayed on Curology for about eight months before canceling my subscription.

Which brings us about up to date.

I’m freshly off Curology as of writing this, and am trying a combination of lifestyle changes as well as another round of antibiotics. I’ve also been trying out some new vitamins and supplements said to help acne, but one of them has actually given me the worst breakout I’ve had in years.

I Have Acne and That’s Okay

So, while my acne is still god awful at the moment, I’m hopeful about the effects my lifestyle changes will have on my skin. Even if my skin never completely clears up, I’m also determined to become more comfortable living with acne.

This last bad breakout has made me see that my acne before, though absurd for someone inching closer to 30, really wasn’t that awful. If my skin only ever clears up that much, I feel empowered knowing that I can live with that and be confident and happy.

What’s your acne story? Tell me in the comments or send me a message.

Originally published at My Acne Journey.