I took Epuris (high quality brand name isotrentinoin) for 9 months @ 40-80 mgs/ day. For several months in th start I used 120-160mgs/ day. I had bad case of acne and deregulated sebaceous glands since teen years. I'm 36 now. $200/month out of pocket. If you are wondering how I got a Dr to prescribe the higher dose... I ended up getting two Drs, a specialist and a family, and just bounced between the two, unbeknownst to them. Desparate measures, but I didn't think the low dose regimen desired by the dermatologist was going to cover it, and from extensive research, I learned that high dose accutane over an extended period of time is the most likely to create total remission.
Acne is connected to a whole slew of issues and triggers. I've done more research, experimenting, and testing, that I care to have done.
I had every conceivable type of acne possible, from small white heads to full blown cysts with nothing to pop for months. Unfortunately I was pretty scared. Head, back, chest, legs, buttocks, ect. Ya.
So, in the end, its not just "one thing", or two, ect that is causing acne and keeping it going.
There are several ways it gets treated, and its all on a spectrum of strengths.
They think now its not either testosterone, or estrogen, or prolactin, or progesterone. Its the RATIOS of those numbers. If DHT/ testosterone causes raised sebum production, then the skin panics, folliculitis sets in, and estrogen and progesterone begin a inflammatory response to try and heal what it precieves as an attack from skin bacteria feeding off the sebum.
So when I started using HCG at about 1200-1500/ week ect, off endogenous testosterone levels would raise, in conjunction with elevated estrogens. Even on Epuris, acne would begin, on my back, between my legs, ect. I noticed JUST before this cascade, that I would feel anxiety, weepy, ect.
Acne will present, a hair follicle will become slightly inflamed with minimal sebum, because off after 9 months of higher dose isotrentinoin (vit A - go figure), a large pimple would form. So, I'm wondering if its the elevated estrogen - progesterone in RATIO with the Testosterone, that is triggering an over reactive immune response. Clearly our bodies are covered in the same types of bacteria, yet some people are never effected. So, there is a genetic basis, beyond the obvious environmental causes (personal hygiene, diet).
I'm picking up some letrozole, Ive used extemasane before, but I'm wondering if my body just aromatizes very well? Because at this point, it seems something other than the testosterone is causing the problem, as sebum has been nearly eliminated from my skin, dry me up!
And it had been shown in research over the decades that even with elevated levels of test in blood, people were not getting acne, with some people at very normal levels. I think a lot of what is being presented online, in a dozen industries, is bias towards testosterone as being the culprit of bad skin, and not estrogen and progesterone - as they are the hormones that are creating an inflammatory response and allowing it to continue in time - cytokine triggering, ect.
And it stands to reason for me, because when I go on a nandrolone, tren cycle, if I don't PCT afterwards, I once got a CRAZY estrogen rebound that lasted for about 2 years. Acne came at that time with a vengeance. BTW can't get gyno - I had the glands removed.
Don't know, there is just so much more to this story that meets the eye. I envy guys who don't have this issue. :/