What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place, because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.
I am 33 and having cystic inflammed acne on my face, back and chest. I had fibroids, one of the big one now removed but couple of them still existing. My acne is related to hormonal imbalanace as I have facial hair on my chin, which I have to thread every couple of days. My dermatologist said if I’m trying on having a baby, I should not be taking any medication, in the past that helped were birth control pills and spirnolactone ( this caused me bad pain in my kidney area, but helped clear out acne right away). Also, drinking baking soda wth fresh squeezed lemon juice helped clear out my skin, but can’t have it everyday since it can cause low BP and I felt light headed when I take it. My acne becomes active during the monthly cycle. I understand that ACV is acidic, my body is already acidic – would it help?

Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
Retinoids and retinoid-like drugs. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It works by preventing plugging of the hair follicles.
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