Painful Cystic Shoulder Acne That's New

[Orius]

For the first time in my life (including adolescence) I have shoulder and upper back acne. Deep, painful, cystic acne that takes forever to form a white head. Then I can pop it and get some relief from the pain, but it takes forever to heal. There are always maybe 3-4 cysts at a time. Once they are a dealt with, new ones form in totally different locations, just as painful. My upper back and shoulders look scarred now.

I'm coming out of an ulcerative colitis flare. I'm NOT here to talk about colitis. I'm already getting that under control. But it's relevant because I'm currently coming off of prednisone and I'm at 2.5 mg (down from 40 mg). I'm also taking 25mg DHEA and 50mg pregnenolone. I realize the DHEA dose is high, but it's commensurate with prednisone use because the adrenals are totally taken offline by this awful corticosteroid.

A new feature with this acne is that I have shoulder hair growing that was never there before. I'm 35 and I know new hair growth can come with age, likely due to a change in estrogen/testosterone balance? I have a history of seborrheic dermatitis on my scalp, eyebrows and beard -- anywhere there's hair, basically. I fixed this by changing the fat ratio in my diet and reducing PUFAs. Even then, it wasn't cystic acne, so I don't see a relationship.

I'm trying to hone in on the cause of this acne, here are some ideas:
1) Too much fat or improper fat ratio in diet.
2) New hair growth on shoulder and back, and overproduction of oil in those follicles.
3) As prednisone dose decreases, this mimics a cortisol drop, and this could cause skin barrier problems leading to acne.
4) As prednisone decreases, my own native cortiol production is coming back online, which may have an additive effect with the remaining prednisone that causes too much cortisol, leading to acne. (The opposite of #3)
5) The DHEA itself is causing the acne, although in my entire history of DHEA use I've never had acne from it at any dose, even the absurdly high doses I took at the beginning.
6) My body is toxic somehow and the acne is a symptom.

As you can see, most of my guesses pertain to hormones. But why the shoulders and upper back only? Why not the face, or somewhere else? I change my pillow cases and wash the bed sheets regularly. No new soaps in my life, etc.

Your thoughts and advice are MOST appreciated! My doctor just gave me benozyl peroxide and salicylic acid creams and they did nothing.

 

[Rinse & rePeat]

Have you healed your painful cystic acne yet Orius? If not have some some suggestions for you.

 

[Orius]

Have you healed your painful cystic acne yet Orius? If not have some some suggestions for you.

It's better than it was before, but I have not completely healed it. I have major scars on my back from last year's acne that look terrible. I found out I have SIBO -- all three kinds (hydrogen, methane and H2S). Doing a kill protocol for that helped the acne a bit, but it's not completely gone. I am also balding at the vertex and growing shoulder hair, so I am very suspicious that my DHEA use is causing this. The reason why I have stuck with DHEA for so long is because prednisone takes DHEA offline and I am afraid of prednisone side effects like bone density loss.

One thing I do is that I don't wash my back and shoulders with soap every day. This seems to preserve the skin barrier and reduce the acne, but I still have tiny white heads everywhere. It's infuriating.

If you have any other ideas I'd love to hear them.

 

[Rinse & rePeat]

It's better than it was before, but I have not completely healed it. I have major scars on my back from last year's acne that look terrible. I found out I have SIBO -- all three kinds (hydrogen, methane and H2S). Doing a kill protocol for that helped the acne a bit, but it's not completely gone. I am also balding at the vertex and growing shoulder hair, so I am very suspicious that my DHEA use is causing this. The reason why I have stuck with DHEA for so long is because prednisone takes DHEA offline and I am afraid of prednisone side effects like bone density loss.

One thing I do is that I don't wash my back and shoulders with soap every day. This seems to preserve the skin barrier and reduce the acne, but I still have tiny white heads everywhere. It's infuriating.

If you have any other ideas I'd love to hear them.

Glad to hear some of it it is improving Orius, but what a frustration to gain new issues! Well the washing your skin everyday is one of my suggestions, but doing a very cold rinse at the end of your shower on the affected parts was SO helpful to my soms who dealt with acne. I have been doing it gor 20 years and it gives me a beautuful complexion, and no more large pores. My grandfather had deep holes in his face from cystic acne and I dealt with some around my jawline until my late thirties. I bough a hair skin & nail vitamin for my hair because I was having a lot of thinning and breakage in the back and to my surprise it cleared up my cyst issues. I don't know what exactly is in it that my body must have needed but here is the brand i used. When my health food store was backordered on it I tried a couple of other brands and they did not get rid of my cyst like this one did. I wouldn't care if it is "Peaty" or not because it is much cheaper than going to the dermatologist to get them injected and feel with the scarring. The good thing also about this brand is that it contains MSM which is very effective for minimizing those scars.