Persistent adult acne off meds and even on dutasteride

[Questions]

I’ve tried everything, diet, supplements, topicals, dutasteride, etc. everything except accutane which I’m kind of scared of considering the risk of worse hair loss. I will say reducing sugar (almost never eat sugar or high glycemic foods now) helped a fair amount, but the acne is still here and noticeable. Diet is only part of the solution for my skin.

I thought if anything, Dutasteride would help with the DHT (re: inhibits 50% of type 1 which is predominant in skin - assuming that data from past posts is correct). The acne stayed pretty much the same, maybe slight improvement if anything. My skin is still pretty oil, acne all over, etc. for years ever since I was a teenager, which is of course when the hair loss started.

Thankfully the meds have done okay for the hair, but I think all of these issues show a high sensitivity to DHT, and I don’t know what to do. Apparently doubling the dose of dutasteride inhibits more of the 5AR type 1, but I don’t know how much it could really do. I feel like there are no options really since Accutane would probably work but at the cost of bad side effects. I wish there was a systemic oral medication that could nuke DHT receptors forever (well, most of us do I suppose).

Does anyone have tips, thoughts, etc.?

 

[Moz5x]

I’ve tried everything, diet, supplements, topicals, dutasteride, etc. everything except accutane which I’m kind of scared of considering the risk of worse hair loss. I will say reducing sugar (almost never eat sugar or high glycemic foods now) helped a fair amount, but the acne is still here and noticeable. Diet is only part of the solution for my skin.

I thought if anything, Dutasteride would help with the DHT (re: inhibits 50% of type 1 which is predominant in skin - assuming that data from past posts is correct). The acne stayed pretty much the same, maybe slight improvement if anything. My skin is still pretty oil, acne all over, etc. for years ever since I was a teenager, which is of course when the hair loss started.

Thankfully the meds have done okay for the hair, but I think all of these issues show a high sensitivity to DHT, and I don’t know what to do. Apparently doubling the dose of dutasteride inhibits more of the 5AR type 1, but I don’t know how much it could really do. I feel like there are no options really since Accutane would probably work but at the cost of bad side effects. I wish there was a systemic oral medication that could nuke DHT receptors forever (well, most of us do I suppose).

Does anyone have tips, thoughts, etc.?

I struggled with persistent cystic acne from 18 to my early 30s so you have my empathy. My dermatologist put me on accutane when it was a new drug and it worked really well…for a while. My hair texture changed a bit but I did not experience any progression of male pattern baldness nor significant noticeable shedding. I did enjoy getting a relief from a lifetime of oily skin/scalp. Nothing else is as effective at reducing sebum. The worst side effect was the depression but I didn’t even connect it to the drug because it wasn’t even listed as a potential side effect back then.

In my late 20s, another dermatologist suggested I do a second round of accutane (not unusual for some patients) but I refused to because I feared the depression/suicidal ideation. I just tried to manage it with diet, topicals, and frequent doctor visits for injections in the face to reduce the inflammation of the cysts. Removing dairy, avoiding sugar and high glycemic index foods, and getting proper sleep helped a lot.

I don’t blame you for avoiding accutane but unfortunately it does seem to work for most who take it. It’s a tough call to make. Similar to Mr Slaphead’s advice…I think if your current hairloss situation is stable and your hair density is good and Norwood pattern is low, you might be able to ride out the effects of accutane and recover. If you wait until you are older your hair may not be as resilient (less density, advanced Norwood, fewer shorter cycles left) to withstand it. You could also just wait until you age out of the acne like I did but who knows how long that will take. Not ideal if you are in your “prime” years.

 

[SnortingFinasteride]

There are no "DHT receptors". There are "Androgen receptors" and they function for all androgens (Testosterone included), not just DHT

Anyways, if your acne is such a big deal, visit your local dermatologist and hop on Accutane for a bit. Your oily skin will dry out like no tomorrow (DO NOT SELF MEDICATE WITH ACCUTANE, VISIT A DOCTOR AND DISCUSS THIS WITH THEM. ACCUTANE CAN BE A DANGEROUS MEDICATION)