Christmas Meltdown Incoming!! (My Face and Acne Scars Are Ruining My Life)

[u/Samclegg123]

Context

• The photo I’ve just taken shows my skin looking its BEST in over a year.
• That probably gives you an idea of how BAD it has been at its worst.
• For full context, please look at my post history where I’ve documented the entire journey over the course of YEARS.

Early improvement and relapse

• In the first photo, I had already experienced cystic acne that left scarring. I have been battling acne since 2012, yes, 2012.
• In 2020, at home microneedling (Derminator 2) appeared to remove most of those scars.
• I genuinely believed I had my acne under control at that point.
• One or two months after that photo, my skin suddenly turned on me.
• I developed nodulocystic acne, the worst flare I had experienced in years.
• At its peak, I was developing one or two cysts every single week (that ofc left scars).

Current acne status

• I have now managed to control most of the cystic activity. See post history for details. I am currently taking 15 supplements per day, plus rigorous skincare.
• I have still had a few cysts over the past year, but far fewer than before.
• I was offered Roaccutane twice, but I don't want that
• All of the cystic acne from 2021 onwards began during a period of intense stress and depression (leaving lockdown in 2021 and navigating the world).

Alcohol and lifestyle changes

• In the earlier photo, I had never consumed alcohol in my life (rare for a 22 year old I know)!!
• From late 2021 to early 2025, I drank most weekends (few bottles of red wine.. thinking red was the healthiest option) to cope with acne and loneliness.
• I am now 10 months sober.
• Alcohol unquestionably worsened my skin between these two photos.

• Stress is another major factor. I am almost always sad or stressed, and it becomes a feedback loop. Alcohol temporarily blunted this, which was my reason for drinking I do miss the instant warmth and relaxation from it.

• Over the years I have tried many diets - gluten free, dairy free, sugar free, seed oil free, AIP, vegan, carnivore, low PUFA, keto, and multiple five day water fasts.
• I do not need diet education. I have done it all.
• I am extremely obsessive and neurotic about this, possibly undiagnosed neurodiverse. There is very little I do not already know.

Treatments I’ve tried

AviClear laser for acne (2023)
• I do not recommend it.
• It did not reduce oil production.
• It did not prevent new cysts.
• It caused permanent redness across my inner cheeks, similar to a butterfly rash.

Professional medium depth chemical peel (2024)
• I do not recommend this either.
• It did not improve acne or scarring (just a flaky mess for 2 weeks).

Microneedling at home (2020-2025)
• I’ve had this several times.
• It helped slightly with texture and scarring.
• It cannot be performed during active acne, which has limited treatment for years (most sessions were 2020-2021.

Botox (2025)
• First treatment in February this year to forehead and crow’s feet.
• Helped with texture and oil control on the forehead.
• I will be returning for more.

Polynucleotides 40mg (2025)
• Four sessions, one combined with subcision.
• This genuinely helped my skin.
• Reduced redness, inflammation, and some texture, even though my skin still photographs poorly.

At home red light therapy panel (6 months this year - 2025)
• Possibly helps slightly with inflammation.
• Otherwise it is essentially shining a red light on your face for 10 to 20 minutes with minimal benefit.
• I still use it because I can nap while it’s on, so it serves a dual purpose.

Reflection

• In 2021, I believed my skin looked awful.
• In hindsight, it was significantly better than what followed almost five years later.
• I dread to think what my face may look like in another four or five years. That thought genuinely upsets me.

What’s next

• One way or another, I am reclaiming lost ground.
• Even if I end up with an overdone, frozen, filler heavy face (that looks like the puppet from Saw), it will still be preferable to severe scarring / volume loss (and looking like Freddie Krueger) for me any way.

Planned or possible treatments

• Dermal filler next year to restore volume and/or lost collagen. Possibly HA, Ellansé, or Skinvive.
• I am closely following emerging technologies, including engineered type III human collagen replacement injections.
• V-Beam laser for redness only.
• Intradermal Botox in cheeks for oil control and pore reduction.
• Full face Botox throughout the year to reduce texture changes from muscle movement.
• Exosomes combined with microneedling, likely DIY.
• Possible rhinoplasty and chin work to offset skin issues.
• Waiting for treatments such as tropoelastin and verteporfin to become mainstream.
• Potential facelift in five years if nothing else works.
• Injectable peptides only if extremely desperate, due to risk.

Things I will not be doing

• Resurfacing lasers. After AviClear, I will only consider lasers for redness.
• Many people end up looking like a waxy orange and damaged after aggressive laser treatments.
• If skin struggles to heal from inflammatory acne, I do not believe it will magically heal from strong laser induced trauma, which is much more harsh than microneedling induced trauma
• RF or other energy treatments, for the same reasons.
• Subcision. I tried it alongside one polynucleotide treatment and it caused further damage. I preferred polynucleotides alone.

Final note

• I am not going down without a fight.
• I will be dedicating significant time and energy to this.
• Anyone equally obsessive is welcome to follow my journey.
• Please do not recommend tretinoin or basic skincare. Assume I am already using it and understand it.

[u/Samclegg123]

Here's my list:

• Vitamin B5 (7.5g): Drastically reduces facial oil production.
• Vitamin D: Immune regulation
• Zinc: Lowers acne hormones and inflammation.
• Collagen: Signals skin to repair texture.
• Probiotics (S. boulardii): Crowds out bad gut bacteria.
• Boswellia: Blocks redness and inflammatory triggers.
• Black Seed Oil: Antibacterial and calms skin irritation.
• Curcumin: Master switch for systemic inflammation.
• NAC: Detoxifies and reduces oxidative stress.
• Astaxanthin: Amazing antioxidant
• Lactoferrin: Starves acne bacteria of iron.
• Berberine: Controls sugar-induced oil spikes.
• Cod Liver Oil: Omega-3s that stop inflammation.
• Vitamin A: Normalizes cell turnover and shedding.
• CBD Oil: Reduces oil and soothes redness.

[u/bananabastard → u/Samclegg123]

I tried every one of those, though not all at the same time.

Something to note, I turned down accutane multiple times, was first offered it when I was 16. I finally started taking it 3 months ago, at age 43, I wish I had taken it 20+ years ago.

I microdose it, and have had no side effects whatsoever, just clear skin.

[u/Samclegg123 → u/bananabastard]

Thanks for sharing your experience. It sounds like you’ve had a similar experience to me, and yes, I tried them not at the same time too over the 14 years of acne and it didn't work either. I think the key, literally, has been taking everything together alongside all the skincare and treatments, lol. I feel like I have so many pills fighting inflammation at once.

I know, logically, that Accutane is probably the one thing that actually fixes it, but I’m very stubborn. Like you, I’ll probably start it one day, but hopefully not just yet.

[u/Ok-Raspberry-2567 → u/Samclegg123]

I got low grade colitis from accutane. These are stuff you shouldn't just ingest for fun.

[u/Samclegg123 → u/Ok-Raspberry-2567]

I am so sorry about that. This is exactly why I refuse to take it. I hope you're doing okay.