Openseason,
In less than a month, I'll have my biology degree, so I know what I'm talking about. Although it's true, if it makes you happy we don't have to talk about diet anymore because it's obvious we're not going to agree on this matter. However, that doesn't mean we can't discuss other treatment options. Based on what you've said and not said on these boards, I'm guessing you haven't tried many other oral treatments, especially medications, outside of antibiotics. Would this be correct?

If the above is true, WHY haven't you seeked further help for this by seeing an Endocrinologist? Haven't you read other males posts on this board? Haven't you noticed that just because you are a male, that doesn't mean there aren't still treatment options available to help you. I'm not talking about just Accutane (an antiandrogen), but other there's also other:

Antiandrogens - Spironolactone, Flutamide, Betasitosterol, Green Tea (EGCG), Curcumin, Zinc, Pyridoxal HCL (B6)

Glucocortiocoids - Dexamethasone, Deltasone/Prednisone (antiandrogen & anti-inflammatory, especially if you have adrenal disorders)

Thyroid Medications (especially if hypothyroid)

Insulin Sensitizers Avandia, Glucogaphage/Metaformin, NAC, R-ALA, Chromium GTF, D-chiro Inositol (buckwheat farinetta)

Anti-inflammatories - Zinc, Fish Oil, Neptune Krill Oil, GLA (antiandrogenic), Nicomide (prescription supplement & antiandrogenic), Boswellic Acid

Fat Metabolizers - Nicomide, B5 Therapy, Guggulipids, Glucommanon Fiber

Of course, ALL of these and other drugs & supplements that doctors prescribe or you see different members raving about usually work by being Direct or Indirect Antiandrogens and/or Anti-inflammatories. I believe you've said this several times, when you mentioned accutane (antiandrogen) and antibiotics (anti-inflammatory), that this is the ONLY way to relieve cystic acne. Well, if you truly beleive this, how many of the above have you personally tried???

Also, I have another question for you, several actually and I'm hoping you'll answer these if not for me or yourself, for other members of this board to identify with, as you have dodged similar questions. So, does your father or mother have any sort of health problems? High Cholesterol, Wieght Issues, Digestive Issues, Thyroid or other Hormonal disorders? Do you have any other health problems or symptoms you think may be related or unrelated to your acne? Of course, how many years have you been dealing with acne?

Take care

Quote from grape_of:

SweetJade, do you think we need to use an anti-androgen drug, or dietary changes are enough? Some people, like prometheus are against any use of drugs. Don't know if they're right..

Hey =)

Honestly it's not up for me to say, as your body will decide what approach is THE best one for you. My personal motto is "happy, healthy, & clear" and so I aim to do what I can as naturally as I possibly can (which still isn't "perfect"), but not everyone practices the same belief. Some people believe that they shouldn't have to "sacrifice" their diet for clear skin and well, if B5 Therapy or Spironolactone will clear them, then I guess they were right ;-)

On the other hand, if taking anti-androgens such as Accutane, Birth Control or Spironolactone isn't enough, like it wasn't for myself, then one would hope you would press on until you found a much more effective solution. Therefore when it comes to finding that solution, I really encourage people to see a specialist (Endocrinologist, Allergist, Naturopath). In fact, all acne sufferers, especially chroniic (5, 10, 20 years plus) sufferers, should definately see an Endocrinologist. This is a medical doctor that specializes in metabolic & hormonal disorders and he/she will be able to test you and help determine the underlying or the root source of your acne.

Now, considering that acne can stem from allergies, intolerances, or toxins/chemical sensitivites, that's where an allergist would come in handy. A naturopthic doctor if he's licensed, will be able to run blood work and determine your nutrient & hormone levels, just like a regular doctor (or nutritionist) can. Yet with an Endocrinologist, they specialize in helping you determine if your acne stems from a nutrient defficiency, a (benign) tumor, a metabolic disorder such as Insulin Resistance, or some other type of enzyme defect. Therefore, while DHT is primarily produced in the skin's androgen receptors for those that are just "sensitized", supposedly 10% of acne sufferers have a hormonal imbalance where they actually produce too much androgens overall as a result of a defect in one or more of the following: ovaries, testes, adrenal gland, thyroid gland, pituitary gland, (liver or pancreas). Although, considering that other health problems are on the rise, I'm guessing that the number of acne sufferers with actual hormonal imbalances is slowly increasing as well...

I see that you are a newbie, yet you mentioned Prometheus so I guess you've been reading around =) She is definately brilliant on her quest for a "human diet" and even I didn't think that I could be as sensitive to certain ingredients until I decided to check my diet against her list. I knew that gluten was a problem, my biggest problem, but there were other aggrevators that were less obvious and were the reason I was getting sporadic cystic acne still. On her list was avoidance of refined sugars, something I hadn't given up entirely. I was still consuming high fructose corn syrup & corn syrup in usually less obvious foods (roasted chicken & sausages, cracker jacks, ketchup, sauces, etc) and my poor brain didn't fully connect the dots until I thought about my reaction to soda. See, I had been avoiding soda for over 10 years and my skin never improved so once it did, I thought I could start consuming soda again. Well, nope, soda gave me cystic acne so I immediately stopped, but I never bothered to check what was used to sweeten it, LOL. Usually, unless you go to an organic store, most sodas & non-100% fruit juices will be sweetened with HFCS..Acck.

Anyway, something you may have noticed is that our diets vary. Since, to some extent, we vary genetically it makes sense that not all of us will or must follow the same exact diet to acheive results. As such, there are foods even on prometheus's good list that cause me problems and foods (eggs) on her avoid list that I've yet to determine to be a factor either way as I rarely consume them.

Regardless, the avoidance of certain foods work for us because we are either avoiding the allergen or we are reducing the amount of fuel needed to help our body produce hormones & inflammatory products. A Low - Moderate Carbohydrate diet will produce less androgens than a High Carb or Carb Loading Diet, yet for some of us it's not about the glycemic index/load but about reduction or avoidance of grains, refined sugars, trans fats, (and sometimes certain fruits, nuts, & dairy). However, this is usually enough to help most people eliminate most symptoms, but if you have more "sensitive" symptoms such as hirsutism, then you will also need to add an Androgen Blocker or DHT Inhibitor (supplement or a drug) as the same rules don't apply (unless you cease ALL production of DHT).

So once again, you can decide whether to take a natural (supplements or diet) approach or a medicinal approach, but in the end, your body will tell you which is the most effective for you. Sometimes it may be all natural focusing on diet only or diet and supps. Sometimes it will be diet & medication or medication & supps, etc There are many combinations here, but if you happen to have a health problem that is giving you acne, then from what I've noticed from other's regimens, those that don't go on a "hormonal balancing diet" to the extent that some of us do or not at all, tend to be on several medications AND several supplements and sometimes even at high doses. =(

That's not meant to scare you into any direction but when you are fighting a preventable disease with medication, but you are still feeding your body foods that encourage the disease....it's an uphill battle. That's also the reason Spiro nor Avandia (insulin sensitizer) didn't work effectively enough for me. However, I fully believe that these drugs and other supplements can and will continue to do good for others.

So, with that, do you have an idea as to what is it that you would prefer to do? Have you been to doctor to see if you have a hormonal imbalance? Does anyone in your family have obesity, diabetes, heart disease, thyroid problems, digestive problems, allergies or any other health problems? Do you show signs that you may have something more than just acne going on? Of course, are you a male or a female as, it's usually a lot easier for a female to get tested, diagnosed, & treated than it is a male. Yet if you are, you shouldn't give up, you should check out posts by Joeh & Karl or stuff on B5 Therapy as there is still hope.

Take care