My Story: Synopsis and Update


This will be somewhat long but I will do my best to keep it concise and I’ll include pictures.

Quick history
I’ve basically struggled with regular, persistent, possibly hormonal type acne most of my life from puberty into adulthood. I had tried many different prescriptions and other recommendations over the years.
Then out of nowhere around 2017 or 2018 I started getting the dreaded oozing crusties. I was prescribed a combination of Spironolactone and Doxycycline on two separate occasions. I tried Soolantra, but I didn’t find it helped the oozing (I’m glad many others on here found success) and it didn’t help my acne.
Desperate, I tried Accutane because I was getting married and was terrified of breaking out with the crusts on my wedding day. The Accutane actually helped a lot, my skin looked great while I was on it and thankfully I didn’t have any negative side affects. However, a few months after I discontinued it, both my acne and the crusts returned.
This was the point I was put back on Spironolactone and Doxycycline and I was told that I could try another round of Accutane if that didn’t work. I really didn’t want to do Accutane twice and I don’t like being on prescription medication in general. So, over the last several months I’ve done a lot of research on skin care and treatments and gone through a lot of trial and error. Below are some things I’ve landed on that seem to work for me.

Topical Treatments:
The thing with accutane is that it dried my skin out and caused it to produce less oil. Once I stopped taking it I got more oily again and then shortly after is when my acne and crusts came back. So, I ended up adding some ingredients into my skin care that helped reduce oil production. The first product is the CeraVe SA cleanser which contains a small amount of salicylic acid, a very common ingredient to help with oil and acne. The next product was niacinamide (I love this), I use this daily in the morning which helps the oil production but also still keeps my skin moisturized. Finally, the big guns I think, was getting a prescription strength retinoid from my dermatologist. Now this can really dry your skin out at first so I started using it just a couple times a week and have now increased to almost every night depending on how my skin is handling it.
If the thought is that these crusties are caused by demodex mites, then I have a suspicion the treatments I’ve been using may work in a similar way to “kill them off”. In addition to helping with the crusties, my acne situation has improved again. Bonus points, these products help with anti-aging, and the general appearance of my skin has really improved. I also made sure to get a good moisturizer, I like the daily moisturizer from CeraVe. My dermatologist approved of all of these, but do your own research and check with your dermatologist as well.

One other BIG contributor I decided to try was to cut out dairy from my diet. Dairy is inflammatory and has long been considered a direct cause of hormonal acne. I will still have a small amount of dairy on a rare occasion but overall mostly cutting out dairy from my diet has been easy for me to do and has seriously helped a lot with the regular acne and the crusties. I’m actually really annoyed I didn’t do this sooner.

Another thing I am doing is I’m taking supplements. However I’m still in the experimental phase with this right now so I’m not sure what I like the best. Additionally, there are a lot of suggestions out there so I’m only incorporating a few at a time to see if I notice a difference. Currently I’m taking a probiotic, vitamin C, and D3. Some research suggests being deficient in any of these can contribute to problems with skin and acne. I’ve also tried Zinc and have just recently cut it out. I’ve also cleared what I’m taking with my doctor/dermatologist to ensure the dosages etc. are safe.
*Side note: I’m also taking collagen which can help with skin but that’s not specifically for the crusties.

Active Crust Treatment
Lastly, on the rare occasion when I do get a crusty, or start to feel it coming on, I put a “Compeed” patch over it. Now this is actually very interesting because these patches are normally used for cold sores. I bought them only to cover up my crusties when I go out so I feel more comfortable…but oddly enough I discovered that these actually make the crusties go away a lot faster. I can even keep it from oozing at all if I apply it fast enough when I feel one coming on. So weird! But a life saver now and you can get these on Amazon.

Summary for treatment:

  • Salicylic acid in a cleanser
  • Niacinamide
  • Retinoid
  • Cut out dairy
  • Possibly supplements
  • Compeed pacthes when crusties are present

I’ll attach pictures of my 3 favorite skin care products, the patches, and also my skin before and after (as of today)

. I love what I’m doing now because not only does it help with my crusties, but it helps with the overall appearance and texture of my skin and also my dietary health.

I hope this helps someone and if I discover anything else I’ll post an update.


Thanks for sharing your story! I was wondering if you were still using retinoids, considering you got married and chose to have kids. Retinoids are a big no no for me since I’m trying to conceive and it’s the only thing keeping my hormonal acne at bay.

My pleasure!
At the moment I am still using retinoids, my husband and I are still a few years out from trying to have children. However, in my research I found that Azelaic Acid has similar benefits and is safe in pregnancy! I will be looking into switching to that when the time comes. If you have a dermatologist or OB/GYN I would inquire about using this. Here is a link to a YouTube video that discusses many different skin care treatments and touches on Azelaic Acid around the 7:12 minute mark.

Thank you for your detailed story! :+1:

The photos definitely look like the oozing lesions that most of us here have. But I do wonder why Soolantra didn’t work. Did you apply it all over the face, even on clear skin, or only at active lesions? (It should be applied all over the face, except close to the eyes and mouth.) Did you notice anything while using Soolantra? Like a worsening of the symptoms?

I did try cold sore patches similar to Compeed, but the fluid excreted by the lesions would cause it to fall of the skin, or let it stick halfway on the skin. So I couldn’t use it. I likely also tried cold sore cream (aciclovir), but that also didn’t work, and blood test is negative for cold sores.

I’m just so glad I found this forum to share my experience!

To be honest I don’t have a great memory as it was a few years ago when I tried the Soolantra. I recall that I applied it to my entire face, even when I didn’t have an active breakout. I know I used it for several weeks but I don’t recall the specific duration anymore.

I’ve had tests done twice for cold sores and it’s been negative as well. I’ve definitely experienced the fluid leaking out of the Compeed patches, I usually have to apply it as soon as possible to avoid this. I usually know when one is about to form because I tend to get a certain sensation in the area. I carry the patches with me in my purse so I have them available.

You could also try the hydrocolloid patches, I really like them for regular pimples if I get them but they help some with the crusts also. They were originally intended for use on blisters because they absorb fluid.