What's going on with my face, do I have adult acne? Accutane did not work and I'm not sure I was diagnosed properly. (Photos)

Question

Diagnosed with Pyoderma Faciale in 2015, was put on Accutane for a year (I took my max.) It calmed my face down from when I initially came in but by 2016 my "acne" bumps were not cleared and still are not to this day. I have flares to where they get worst than the picture, but this is what it normally is. Bumps all over my face, very dry, very sensitive (I can only use products with natural ingredients.) Face is sometimes itchy and sometimes get eyelash dandruff (?). I can not see a derm.

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Thomas Adrian, MD · Answer

From your pictures alone it is difficult to definitively diagnose your condition however given the papules associated with centrofacial and nasal redness I would tend to lean towards your condition being on the rosacea spectrum. I would recommend seeing a board certified dermatologist for treatment options.

What's going on with my face, do I have adult acne? Accutane did not work and I'm not sure I was diagnosed properly. (Photos)

Answers (2)