Cystic acne

(56 Posts)
ILoveSparklers Wed 21-Nov-12 19:45:38

I had a few cysts in my chin the last couple of months. Really hurt, used to get tem occasionally but now one constantly. Anyone else suffer? What treatment do you recommend?

MrawMraw Mon 26-Nov-12 21:46:11

Pretty much anything which is properly effective for cystic / severe acne will have unpleasant side effects.

Antibiotics strip your body of good bacteria and can cause digestive probs, candida overgrowth, resistance and all sorts of other problems, and are incredibly over-prescribed so much so it's seriously worrying.

Roaccutane has liver risks yes, and is teratogenic but if carefully monitored and no chance of pregnancy I'd say it's a good bet for the chance of a cure. Does cause peeling of skin and sun reactions too I believe. Derm will prescribe.

Anti-Androgens are good for some people (totally worked on me) , however are also teratogenic to the male fetus and some studies have suggested a link with Spiro and cancer (lab rats given Spiro showed a higher incidence of tumours, however they were given a HUGE dosage to body weight compared to humans). Spiro is actually a heart failure / blood pressure medication but has the side effect of reducing androgens. For effective treatment you need 100mg - 400mg a day, which is a high dose and will almost certainly cause symptoms such as constant visits to the loo, dizziness etc. I take 100mg only because I am quite small with low blood pressure as it is and I certainly feel the diuretic effects and have to follow a low potassium diet. An Endocrinologist or PCOS specialist (repro medicine) will prescribe this, but a GP will look at you as if you are crazy if you request it (been there done that grin). The pill Yasmin has an ingredient which is an analogue of Spiro (equiv to about 25-50 mg Spiro a day) , that's why it is known for no bloating , no weight gain etc.

I also take Gedarel 20/150 (Mercilon) pill which seems to help too. Marvelon it's big sister pill in terms of oestrogen helped better but I had oestrogen withdrawal syptoms in the break week which were hellish even if tricycled the packs. But different pills suit different people. Popular acne pills are Dianette (I decided to try the safer pills first), Yasmin (my PCT won't prescribe as too expensive), Marvelon, Cilest. Worst theoretically are the mini pills (Cerazette in particular), Microgynon, Brevinor. But again, everyone is different.

The herbal remedies Agnus Castus and Black Cohosh are very very good for regulating hormones (Agnus Castus if you have too frequent periods or for conception, Black Cohosh if too few periods and menopause) but not good to take along with the pill as they work against it's action (ie they promote fertility rather than suppress it)

x

Speedos Mon 26-Nov-12 21:03:44

Programme on bbc3 now on acne!

litquot Mon 26-Nov-12 19:26:12

Yes, but antibiotics DID work for me but GP says they are not a long term solution. Roaccutane seems to be the main alternative.

msrisotto Mon 26-Nov-12 18:26:07

Yeah antibiotics never worked for me either litquot. Have a read upthread, there are plenty of alternatives.

litquot Mon 26-Nov-12 18:20:31

I was put on Duac at the beginning of the year and it was a marvellous revelation, finally after 25 years I had clear skin. I totally loved its drying effects. However, my GP told me that I couldn't keep using it because it was an antibiotic and gave me Differin to try. I've had it for nearly 3 months and it is nowhere near as good. I have been told to persevere for 3 months to give it a full try but I'm hating it. So the alternative would be....

msrisotto Mon 26-Nov-12 12:34:14

Thanks for your advice Lurking. It's certainly given me a lot to think about.

lurkingaround Mon 26-Nov-12 11:53:48

Yes, mrsr GP referred me. My skin wasn't awful (I thought) at the time, but derm was horrified I hadn't been treated sooner with Roaccutane. She (derm) considers scars from acne to be unacceptable. Most dermatologists are very clued in, so while I get what you say about your skin being fine on dianette, I think they would know from you skin, scars etc, whether you need Roaccutane. Maybe I'm wrong, worth a consultation tho. Nothing to lose. And a consultation would give you a chance to ask about dose and side effects and all of that.

I told my derm I was fine on Dianette, but she still tut-tutted the fact I hadn't been treated with Roaccutane.

msrisotto Mon 26-Nov-12 11:36:51

Gosh, i've never even thought of that. How would I be able to tell that it was working though? I have good skin whilst on Dianette but it deteriorates whilst off it so if I was to take roaccutane whilst still on the Pill, you wouldn't see any results.... Also, a GP may not refer me whilst my skin is good. Did your GP refer you to a specialist for the roaccutane Lurking?

lurkingaround Mon 26-Nov-12 10:06:10

mrsrisotto Would you consider going on Roaccutane while on Diannette? You have to be on contraception while on Roaccutane so you could go on it and get it over and done with? Like I said before, but I can't say it often enough, my only regret with Roaccutane is that I didn't do it earlier. I only needed 20mg, (usually dose is approx 60mg I think) and I did get dry lips, and slightly dry skin (oh the joy, fantastic), but that was all.

Tough time dontmix, sympathies, it's awful isn't it. I had a vicious outbreak after one of my mc. I disagree with your GP, I would be asking for a referral to discuss, can't see the point in waiting, only leaves you with more marks.
Cystic acne is cystic acne, whatever the reason.

msrisotto Mon 26-Nov-12 08:19:30

MrawMraw Thanks for that post, very informative.

I've been on Dianette for about 10 years, I still take it....I reckon i've fallen through a net somewhere by staying with my GP and just getting repeats from the pharmacy. I haven't been able to move GPs because no one else will prescribe it to me! So I have to travel back to my parents home to pick up prescriptions. Nevermind. I don't plan on coming off it for now (you can also buy it over the counter abroad) but when I do, I will seek an appointment with a dermatologist. I have come off it in the past in favour of Microgynon and Yasmin but they didn't work and the acne came back. Interested to hear about anti-androgens. I am concerned about the risks of roaccutane although hopefully with lower doses it is better?

dontmixthecolours Mon 26-Nov-12 07:05:47

Thanks so much sparklers, you may have saved the day

AlreadyScone Sun 25-Nov-12 23:02:59

Could be perioral dermatitis? My new GP took one look at my chin and diagnosed it about a month ago. Antibiotics prescribed, working so far...

ILoveSparklers Sun 25-Nov-12 22:53:46

http://www.phase-eight.co.uk/fcp/product/phase-eight/Dresses/Rhona-Lace-Dress/201813050

Phase 8 do loads of dresses that cover well smile

ILoveSparklers Sun 25-Nov-12 22:51:16

Not a pointless post at all. I have a blue lace dress that covers everything...and I love it... Will see if I can find a link.

dontmixthecolours Sun 25-Nov-12 21:26:32

I'm in the same boat. Saw GP this week who told me I need to be on antibiotics for 9 months before she'll consider anything else. She says this is because my body has been through a lot recently (3 miscarriages in 14 months). Dianette worked brilliantly for me but I can't have it now because of an increased risk of stroke.

I know it sounds silly but i can't get anything I like to wear for Christmas that'll cover me up enough and it's getting me down

Sorry, that was a pointless post

ILoveSparklers Sun 25-Nov-12 21:10:52

Messing with your hormones does have an impact doesn't it. I feel much more confident off it. Like it somehow "dumbs" me down... Can't explain it. Would rather put up with the cysts than go back on it... Might see if the differin gel helps.

LtheWife Sun 25-Nov-12 21:03:34

Doesn't sound silly at all Sparklers, whilst taking dianette I was very emotionally unstable. I went from almost homicidal rages to suicidal depression and everything inbetween. Very unpleasant and it didn't even help my acne.

ILoveSparklers Sun 25-Nov-12 20:41:12

Thanks everyone. I was on diannette for 10 years... It worked but you know it may sound silly... But I feel more emotionally stable and capable when I'm off it.

FairPhyllis Sun 25-Nov-12 02:16:06

Mraw is right that if it is hormonal you have to do the drugz. Mine is hormonal in that I have "normal" levels of testosterone, but my body for some reason is very sensitive to even very low levels of it, so I have some PCOS symptoms without actually having it.

Roaccutane and Dianette didn't do much for me, but Yaz (think it is called Yasmin in UK) has pretty much stopped any breakouts, and I had laser treatment for scarring and redness. Since then I've been able to keep things more or less under control with clindamycin and Differin.

I'm not sure that acne and oily skin (hence fewer wrinkles) inevitably go together - I am becoming increasingly convinced that I actually have quite dry skin.

However if you haven't had Roaccutane then I would strongly recommend giving it a shot, especially for cystic acne, because so many people do get really good results with it. It is so frustrating and demoralising to still have it as an adult - I always thought there would be a day when it magically cleared up by itself, but that hasn't happened yet.

MrawMraw Sat 24-Nov-12 23:11:23

I have cystic acne, caused by hormones (PCOS). I sympathize, it is actually painful and I have scarring. I wish more HCP's would take it seriously.

I started treatment with Benzol Peroxide gel, which does help a bit but doesn't stop my cysts from actually forming.

GP offered antibiotics but I refused as I get stomach problems on Antibiotics (strips the good bacteria, and the acne is causing pain but not internal probs).

Eventually a blood test for other issues found the underlying cause - hormonal acne due to PCOS, so I was referred to a specialist, who told me the only ways to really shift acne caused by hormone imbalance are -

1) Dianette
2) Roaccutane
3) Anti-Androgens such as Spironolactone, Furosemide, or Cyprotene Acetate.

However, all of the above have side effects which could maybe outweigh the benefits of using them.

Dianette has all the usual side effects and risks of the pill, and then some!

Roaccutane the liver risks and other associated risks , Cyprotene has this risk also.

Spironolactone is a diuretic and will make you pee A LOT at the doses needed to make a difference, can have the problem of raising potassium blood levels too much which is possibly dangerous, and has been linked to cancer in rats (but not proven).

All need monitoring.

Spironolactone (what I was given) has completely solved my acne altogether. However it will stop working as soon as you stop taking it, so if I stop taking it I will consider Roaccutane.

I put up with the acne for years just as a fact of life, wore heavy concealer, hid my face a lot in public, but it has been great to be rid of it.

Speedos Sat 24-Nov-12 22:05:25

I had laser treatment combined with a glycolic peel and even after one session my skin was so much better, well a week later anyway.

I've had 2 follow up peels only and my forehead is completely smooth.

I've never tried Roaccutane so can't comment on that.

lurkingaround Sat 24-Nov-12 20:04:20

P-Wench! Sorry got the name wrong!

lurkingaround Sat 24-Nov-12 20:03:21

There is a topical version of Roaccutane, P-Witch. It's called Retin A. It's good, but can be hard to use as it can cause a lot of redness and peeling. It's probably on a par with Duac or Differin (more so Differin). Depends how bad your acne is, I suppose. Having been there done that (repeating myself) I'm all for going for a cure with Roaccutane for cystic acne.

ILoveSparklers I love your optimism! I know one of the reasons I went on Roaccutane at 40 was that I just couldn't bear the thought of still having spots AND getting wrinkles (sad to say they were starting). Whatever about having one or other, both was just NOT FAIR!!! grin

ILoveSparklers Sat 24-Nov-12 19:50:17

On the plus side... Generally if you have acne, you are less susceptible to wrinkles? Please tell me there's a benefit there somewhere?

PragmaticWench Sat 24-Nov-12 11:57:53

I just asked my sister (she's a pharmacist) and apparently there is a topical version of Roaccutane, a gel I think, that can be used instead. Might do some research.

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