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First appointment with dermatologist for acne - what to expect?

(29 Posts)
WankersHacksandThieves Sat 18-Mar-17 23:08:22

DS has been suffering with acne for several years, he has an appointment with the dermatologist next week, anyone been there and done that and can give me an idea what will happen?

MollyHuaCha Sat 18-Mar-17 23:14:15

Might be offered Roaccutane (isotretinoin). Good idea to read up on this medicine in advance as it has a lengthy list of possible side effects, some of them serious.

msrisotto Sat 18-Mar-17 23:15:19

Sure, I had an appointment with a private dermatologist once and she asked what treatments I'd had before, I think they generally expect all the varieties of antibiotics, the pill for women and topical treatments like Retin A. I had, so the only other option she gave me was Accutane, or Roaccutane. Can't remember the name but it's one of those. She called it a miracle drug and downplayed the side effects (which if you don't know about you should google, they are serious and a gamble that you'll want to be fully informed about before taking.).

WankersHacksandThieves Sat 18-Mar-17 23:20:15

It sounds like it would be a good idea to try to list all the creams he has used then and the antibiotics too. Will the dermatologist not already have this info or don't they see his history?

I've heard of Roaccutane and that it has serious side effects but we are getting to the point where nothing has worked, he is in a worse position than he was when he started seeing GP so I'm not sure if it might now be the time for that.

Did you take it msrisotto?

msrisotto Sun 19-Mar-17 11:32:00

If it's private then they won't have your medical records, if it's NHs they might, but they might not...

I didn't because a special pill worked for me. I went to the derm because I wasn't allowed to stay on that pill (long term risk concerns) but I went on acne.org and found something else which mimicked the chemical make up of that pill. As a male, your DH's options are more limited. I think the side effects can be minimised by better titration of medication from small to gradually larger doses while monitoring side effects. They do regular blood tests too I think.

WankersHacksandThieves Sun 19-Mar-17 11:43:31

Thank you. It is NHS but I'll try to see if we can remember everything. I'll prepare him for a possible blood test too. Roaccutane isn't really a route I'd choose to go down but I think we may have exhausted all other options and his skin is still a mess. Not that I'd say that to him.

msrisotto Sun 19-Mar-17 11:45:48

I think there are a lot of scare stories around for Roaccutane but lots of people use it and get by ok, worth asking about. I had a colleague who had it and said it was the best thing he ever did.

Shnorbitz Sun 19-Mar-17 13:12:14

My son was finally prescribed Roaccutane after trying lots of other creams.

I was worried about the side effects as he was also depressed at the time.

He was fine and his acne cleared up within 9 months.

WankersHacksandThieves Sun 19-Mar-17 14:37:02

Thanks both for the positive stories. He'll be 17 this summer so this has blighted most of his high school years. I have DS2 who thus far has refused to go to the GP with his skin but is going this week so I'm hoping his is more receptive to treatment.

OnlyEatsToast Sun 19-Mar-17 15:45:41

Agree that you should be informed about side effects but I took roaccutane (twice actually) and for me it was a miracle drug. It works well for many.

WankersHacksandThieves Sun 19-Mar-17 15:49:50

Thanks Only why did you need to take it twice? Did it not work the first time or did your acne come back?

OnlyEatsToast Sun 19-Mar-17 16:16:10

If I remember correctly it works in about 2/3rd of people. And out of those 1/3 will need a second round of treatment at some point. No idea if those nos are still correct but my point is that some people will need to take it again at some point. It truely transformed my acne though. Over the next 10 years I would still have breakouts but much milder and totally manageable. I know others that's it's totally cleared their acne up for. It is an intensive treatment though, regular blood tests will be needed. Hope he finds something that works. Another tip is to check out caroline hirons fact sheet - lots of advice on skincare that helps

OnlyEatsToast Sun 19-Mar-17 16:17:15

Sorry should have said yes it did work first time but returned maybe a year later? Second time round I took a lower dose for a shorter period of time

WankersHacksandThieves Sun 19-Mar-17 17:22:17

Thanks again. I will check that fact sheet out.

steelchic Mon 20-Mar-17 12:39:53

Roaccutane is like a miracle. Acne seems to run in my family. I had it all my teenage years and finally was prescribed it when I was 25 I had to have 2 courses. My brother also got it in his 20's. My oldest daughter got it at 16 as her skin was a mess and I was determined she wasn't going to go through years of misery. My middle daughter has just finished it. The good thing about starting it young is that it will minimise scaring. Apart from dry skin and nose bleeds we were all fine and the Dr does regular blood test to make sure your liver is coping. Also pregnancy tests for girls. X

finagler Mon 20-Mar-17 12:42:53

The dermatologist will ask if you want roaccutane. Say yes! It's amazing. You have to have been off antibiotics for two weeks also they will want to check he has taken two types of antibs for 3 months each.

Dd1 had roaccutane. I will be honest and say her skin was beautiful 2 months in, but a year after and she's got quite a lot of pimples back. However, antibiotics and topical treatment now works when it didn't before.

finagler Mon 20-Mar-17 12:43:50

And she is happy with her skin - the few spots are like normal teenage skin iyswim.

WankersHacksandThieves Mon 20-Mar-17 18:11:18

Thank you for that info finagler and steelchic. It looks like he wont get the Roaccutane immediately regardless of whether that's what they recommend as he hasn't been on the 2nd antibiotics long enough (he was on the first one for nearly a year).

I'm really glad to hear how well it's worked for everyone and sounds like it's what DS1 needs. I think it's probably where DS2 will end up as well but he isn't anyway into any treatment yet though his face is already pitted and scarred - possibly more than DS1s. DS1 has it on his T zone and chest and back but his cheeks are relatively ok. DS2 has it all over his face, chest and back and the top of his arms. He probably has an equal amount of spots but they are more spread across his face.

finagler Mon 20-Mar-17 18:51:53

Talk to the dermatologist about your dc2. She will probably recommend you get him started on treatment straight away.

WankersHacksandThieves Mon 20-Mar-17 18:57:31

Thanks finagler We have the GP the next day with DS2 as he has thus far said he didn't want to go. It's the same GP who has seen DS1 the past two appointments and is the one who arranged for an emergency referral to the Dermatologist for DS1 so I feel we have someone who is really on the ball this time. Appointment came through for DS1 within days. I just feel we've been footering around with DS1 for too long trying different stuff after different stuff. The thing is you sometimes think it looks a bit better and others that it looks worse, the upshot is that probably there is no change or it's gradually worse. Wish I'd thought to keep taking photos to track it but we are where we are...

WankersHacksandThieves Tue 21-Mar-17 19:48:06

He'd barely got is bum on the seat and she was saying he needs the roaccutane as he has nasty active acne. He has still to get blood tests but she is happy for him to start it anytime he wants, presuming he wants to start it, but has said it can interfere with concentration so if he wants to wait until after his exams that might be a thing to consider. She gave him an information leaflet that has 4 A4 pages covering the drug - at least 2 are listing the side effects. He's away to go and read it and we'll be guided by what he wants. She's suggested that the GP should just make a referral tomorrow when he sees DS2 as given that there is a strong genetic link, DS2 is likely to have similar poor results on anything else. We'll obviously need to see what he says tomorrow.

finagler Tue 21-Mar-17 20:03:18

Exams in June? He'll be feeling fine and almost spot free by then!

finagler Tue 21-Mar-17 20:04:17

Be aware it gets worse before it gets better. Dds was horrendous 2 weeks into taking it. By 6 weeks every single spot had gone shock

WankersHacksandThieves Tue 21-Mar-17 20:20:22

Our exams start in May - mostly finished by mid May but he has one almost at the end. So, we are currently in study mode. These exams are the ones that determine his Uni entry and he is on course for straight A's. On the other hand it would be brilliant for him to have clear skin by the time he goes back to school after the holidays.

Before she said the concentration thing, my head was thinking that he could get the "worse before it gets better" thing done with during the Easter holidays or during exam leave, now not too sure.

mymatemax Wed 22-Mar-17 00:42:47

My Ds is nearing the end of his treatment. We were very worried about side effects especially so they increased his dose slowly. He has been fine, very dry lips & some dry skin patches but no psychological side effects which was my main worry. He sees a specialist nurse every few weeks. On the first visit we just discussed what treatments he had tried. We were sent for blood tests, fasting bloods were needed. This is just to check liver function & fat levels.
He had to have two weeks clear of antibiotics before starting the new medication.
As well as alcohol you also have to avoid things like body building protein drinks, basically anything that is hard on the liver. After 6 months we are starting to see an improvement and his skin is looking so much clearer. My dis is 17, wish we had gone sooner.

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