I'm having a problem that is difficult to talk about online, and sometimes with doctors and dermatologists too, because it's either uncomfortable for people to talk about seriously, it brings up certain biases or beliefs that have nothing to do with actual empirical evidence, or it's simply unresearched due to the low frequency of claims...
My problem is this:
If I ejaculate (masturbation OR sex, doesn't matter) more than 1-2 times per week, and especially if we do it more than once per day (i.e. closer together in frequency), I experience a higher rate of acne cysts, nodules, pustules, whiteheads, etc. 1-2 per week seems to be the threshold, approximately.
The logical inverse is also demonstrably true - if I refrain from ejaculating, my acne diminishes *substantially* to the point of being virtually nonexistent.
The only outside factor that I've found to be non-negligible is illness. If I am experiencing sinus problems, cold, mild throat/nose infection, etc. I tend to get smaller acne that is greater in number but typically smaller in size.
I've considered food intolerances, but haven't been able to be disciplined enough to hold certain food types as control variables.
If these two problems occur simultaneously (that is, illness & excessive ejaculation frequency), it's like two waves that come together and amplify each other - the acne is not only deep and painful, but it's also numerous, occurring in more locations over my body.
I experience the acne in the typical areas - along my spine, shoulder blades, neck, shoulders, nose, outside of nose, jawline, ears, hairline, etc.
From age 13 to 23, I masturbated almost daily. I had acne starting around age 13 or 14, as far as I can recall. Around age 23, I started wondering whether there was a connection between ejaculation and acne. I tried many other things before that, but finally reached this idea and gave it a try. To my amazement, I finally had a cure! But wait... this means... I can't do it whenever I'd like? I can't have a sex life that allows me to do what many people do - have sex multiple times in one day? I can't have sex 4-5+ times over the course of a VACATION if I wanted to, and come out of it alive without red, bumpy, scarred skin?? This is messed up.
I've read a little about DHT, androgens, testosterone, hyperkeratinization, etc.. but everything I read is amateur conjecture with very little evidence backing it up.
I saw a dermatologist in Los Angeles who told me: 1) The science isn't quite there yet, we don't know why this happens, and 2) "Just do as the spirit moves you". So one minute, she's acknowledging my problem, and the next she's throwing caution to the wind, in a sort of anti-Puritan sentiment of individual freedom and expression, as if that's what I need most right now. Look, I am an atheist, somewhat of a hedonist. I live morally, but I live life for myself. You don't think I already have the inclination to "do as the 'spirit' moves me"??? That's why I went to her in the first place!!!! To find out how I could achieve that without breaking out and being embarrassed and physically uncomfortable!
She recommended minocycline, but I was reluctant to take a drug prescription from somebody who wasn't at least willing to have an adult, intellectual conversation about it and actually explain why she thought minocycline was a good choice. Maybe she was uncomfortable talking about it, who knows..
She told me accutane was overkill, and I agreed with that.
Is there ANYTHING that can be done in this situation? I'm 28 and this is very frustrating... my sex drive is higher than my skin will tolerate, and I'm worried that this will continue to be disruptive to my sex life for the foreseeable future without reprieve.