My story with acne has been a rollercoaster, and in this post I’ll share what has worked for me, what hasn’t, and what I’ve been doing to keep my oily skin under control.

The pimples showed up early, just part of that natural teenage phase. Nothing unusual there — who hasn’t been through it? But in my case, the problem was never just the pimples. The real challenge was something called dermatillomania.

It’s a disorder that makes you compulsively pick at your skin, to the point of causing wounds and scars. It’s not just a ‘bad habit’ or a lack of self-control — it’s a mental health condition, classified under obsessive-compulsive disorders (OCD).

I’m living proof that when oily skin, acne, and dermatillomania come together, the result is nothing short of disastrous. My skin has suffered a lot from this combination, and even today I have to stay super vigilant with it — no wonder skincare is a topic I’ve become so passionate about.

The (Temporary) Relief of Oral Contraceptives

After collecting hundreds of scars, it was the pill that finally stopped the breakouts and gave my skin some relief — because no pimples means nothing to pick at.

But I have to make a side note: the relief was relative. There were times when, even with clear skin, I wished for just one pimple to pick at and release the stress (the human mind really is a dark comedy sometimes) — that’s how powerful the mental relief this condition brings can be.

In the end, I realized that keeping my skin healthy was the only way to keep the OCD under control. But the side effects of the pill started to weigh on me, and I decided to drop the artificial hormones and see how my skin would react without them.

Without the pill, it didn’t take long for my skin to spiral back into chaos — but going back to hormones was no longer an option for me, so I decided to try isotretinoin (the infamous ‘Accutane’) for the second time.

Back and Forth with Isotretinoin

My first attempt with isotretinoin had been years earlier — a nine-month treatment at 20 mg a day. It worked well; I never again had those huge, inflamed breakouts, but I was still left with plenty of small ones that could easily turn into monsters in my anxious hands.

So I decided to give it another shot. But my second round with isotretinoin lasted only three months. This time I had side effects — the headaches were unbearable — so I stopped the treatment and surrendered to hormones once again.

But that didn’t last long either. Even though my skin started to look better, the side effects reminded me exactly why I had quit the pill in the first place. I reached a point where I had to choose which side effects I preferred to live with. My choice: I quit hormones for good.

By then I had already improved my diet a lot. I cut down heavily on refined sugar and even tried to give up dairy — but that didn’t last, because honestly… life without cheese just wouldn’t be the same!

That’s when, after researching more about the subject and all the possibilities, I went back to isotretinoin — but this time I asked to try a microdose for a longer period. I took 5 mg a day for a full year (in 2024). And for the first time, I managed to control my acne without the pill. The treatment was a success, but I want to make three notes here:

Things Worth Pointing Out

• A lot of people don’t consider isotretinoin as an option, despite its high success rate in treating acne, because of its side effects. For women especially, the biggest concern is that it’s highly teratogenic — meaning it can cause severe birth defects. Since I had no plans of getting pregnant, this was never an issue for me.
• On the microdose of isotretinoin, I didn’t experience any side effects. On the contrary — my skin just kept getting better. And in that sense, my skincare routine was essential to making the treatment a success.
• I never had any changes in my liver enzymes or triglycerides. It helps that I work out regularly, eat well, and don’t drink alcohol.

So I didn’t rely on isotretinoin alone to treat my acne. It’s not a miracle on its own. What really works is the combination of habits that support each other. The treatment with isotretinoin is much easier if you already have good habits in place, which is why it may not be the right path for everyone — even though it’s very effective.

Finding the Skincare’s Holy Grail

Today I use tretinoin (vitamin A in cream form) every night (check out my nighttime routine here). It’s the most potent retinoid out there, which is why you need a prescription to use it. And it doesn’t just prevent acne — it also boosts collagen production and significantly reduces fine lines (there are thousands of scientific articles about it) — tackling two things in one go.

With tretinoin, I also had to introduce it gradually into my routine. I started using it once a week during the first month, then moved up to twice a week, and so on. There were times when I had to stop because of irritation, but whenever my skin calmed down, I picked it up again.

Today my skin has built up a really good tolerance to tretinoin. The secret is using it ‘sandwich style’: applying a moisturizer before and after tretinoin, and keeping the skin well hydrated and protected from the sun. I’ve noticed that rosehip oil (wrote about it here) really helped build up that tolerance. Rosehip oil already contains vitamin A naturally, but in my experience, it has never interacted badly with tretinoin.

Final Thoughts

If you or someone close to you deals with acne, you know how much it impacts self-esteem and mental health — especially when OCD is involved. I’ve lived it on my own skin (!), through countless attempts, mistakes, frustrations, and discoveries. A process that stretched over 20 years.

What did I learn? That there’s no magic pill. What really matters is finding the balance between treatments and habits that make sense and actually work for you.

In my case, it was the microdose of isotretinoin combined with a skincare routine, more mindful eating, and regular exercise (skin + mental health). It might be worth talking to your dermatologist about this — but remember: no treatment works on its own.

Good luck on your own path with acne — you’re not alone in this.

With love,

Note: This text is only a personal account of my experience and does not replace medical advice. If you have any questions or curiosities about what I’ve shared, feel free to leave a comment or send me a message.