Hi everyone,
I’m looking for input from people who understand acne, hormones, gut health, antibiotics, and/or more natural approaches.
I’m a woman dealing with painful inflammatory acne on my back, with red bumps/pustules and some deeper sore spots. I do not have acne on my face — it is mainly/only on my back. It affects my confidence a lot, and it can physically hurt when new spots form.
I’ve struggled with acne for a long time, and I’ve previously been on tetracycline antibiotics on and off for several years. Now I’ve been prescribed Tetralysal / lymecycline 300 mg twice daily for 1–3 months, then 300 mg once daily for another 1–3 months. I took one capsule, but I’m very conflicted about continuing because I’m worried about long-term effects on my body — gut microbiome, yeast/Candida issues, histamine reactions, digestive problems, resistance, etc.
I am not currently trying to get pregnant, but I have anxiety around fertility/ovaries because I went through an unwanted abortion in the past. I’ve read that tetracyclines are mainly a concern during pregnancy rather than being known to damage fertility, but I still feel scared because I’ve taken antibiotics many times before.
Current acne routine:
- Benzoyl peroxide wash on my back
- Aklief / trifarotene
- Cerave moisturising cream
- Gut-supportive diet
- Very little dairy
- I cut out lactose a long time ago because lactose/dairy has clearly triggered painful under-the-skin acne for me before
Despite this, I’m seeing little improvement.
Hormone situation:
- I’ve had hormone blood tests done
- Everything was apparently normal except slightly low SHBG
- I have regular periods and I believe I ovulate
- My periods can be light
- I get thicker/darker hair on my chin and upper lip
- I suspected mild PCOS, but my hormone tests don’t clearly point to PCOS
- I noticed improvement in chin/upper lip hair when I took inositol, which makes me wonder if insulin/androgen sensitivity is involved even without classic PCOS
I do not want isotretinoin/Accutane. I know it helps many people, but I’m personally not comfortable with the side-effect profile, so I’m looking for other options.
I’m considering whether blue light therapy or red/blue LED therapy could help, possibly alongside the lymecycline if I decide to continue it. I’m wondering if it can be useful for inflammatory back acne, or if it’s usually too weak for deeper painful lesions.
My main questions:
Has anyone had painful back acne improve without isotretinoin?
Has anyone used lymecycline/Tetralysal short-term while protecting the gut successfully?
Did probiotics, fermented foods, prebiotics, or specific gut-supportive strategies help reduce side effects from antibiotics?
Could low SHBG + normal hormones + chin/upper lip hair + acne still suggest androgen sensitivity or mild insulin-related issues?
Has anyone improved this type of acne with inositol, spearmint tea, zinc, omega-3, berberine, diet changes, light therapy, or other more natural approaches?
Could this be partly folliculitis/Malassezia rather than only acne, especially on the back?
Any advice for deciding whether to take the antibiotic as a short “fire extinguisher” while building a longer-term non-antibiotic plan?
I feel exhausted from researching and frustrated because the medical help I’ve received has mostly just been prescriptions without much explanation or long-term strategy. I’d really appreciate thoughtful experiences or suggestions, especially from people who have dealt with hormonal-ish acne, back acne, gut sensitivity, or antibiotic concerns.