Doctor for Acne

I recently had a basal cell carcinoma removed by dermatologist. While he was busy with the minor surgery I picked his brains about roaccutane as DD has just started in it. He was so nice, I wish we had known about him and got referred there instead of the time wasting that has gone on with NHS in DD's university town.

He said it's a brilliant drug that is absolutely life changing for the improvement it brings. His (25 year) experience is that it is very safe and he thinks the mental health issues are overstated, he said he's not had any problems in 25 years of prescribing it. His opinion is that some people will have mental health problems independently or occasionally related to poor self esteem and so on due to having poor skin. When something happens bereaved relatives/parents look for something to blame and roaccutane has had a bad press because of this.

DD has been on it about six weeks now and already her skin is vastly improved. I asked her about side effects and she says she's not aware of any except for a bit of dryness. Mentally she is feeling upbeat and positive thanks to the improvement in her skin.

We are using private online SkindocUK - I'm so impressed with them. Daughter sees same dermatologist (online 1:1) who is very sympathetic and encouraging. Just emails any queries and gets a prompt response. Very clear information sheets. She feels really well taken care of, regular blood tests and pregnancy tests (it's teratogenic so mustn't get pregnant while taking it). It's quite affordable, initial appointment was £170 and subsequent are £130 with extra for blood tests and prescriptions.

I second @snackprovidersupreme recommending roaccutane, and really wish I had paid to get DD sorted much sooner.

It’s a myth that diet (sugar, dairy, carbs, etc) causes acne. The only way it can is if you eat something greasy and leave it smeared on your face clogging the pores.

If he cleans up his diet his skin should improve massively. Sugar causes terrible breakouts. Dairy can sometimes be a trigger too.
Id work on the diet before giving him strong medication, especially antibiotics.

Please think about roaccutane. The reported side effects put me off for a decade, but it was life changing and cleared things up permanently for me. The side effects were ok for me and you can stop at any time if it is too hard. This was after a whole heap of different treatments that didn't work and also had awful side effects. Acne is brutal - so painful and it really affected my self esteem for years. Sympathies!!

Sorry just re-read and see he's been on it 8-9 weeks. I would definitely get on to GP to see if they want to change his treatment.

Skin tends to get worse before it gets better with some treatments. It could be due to 'purging'. But I would perhaps ring GP in case it is a reaction to benzoyl.

Duac is benzoyl combined with antibiotic. DS didn't have a flare up - purge or reaction. I'm not sure if the anti b made the difference / reduced inflammation that you can get with benzoyl.

Your GP will advise to either continue with benzoyl or switch him to something else.

DS 17 is getting fantastic results on Duac prescribed by GP. Our GP doesn't go straight to oral antibiotics or refer for roacctutane as first port of call. Which DS is very happy with.

DS was on quite the regime but now GP has said just go with washing with Cerave am & pm. Duac PM. Light oil-free moisturiser with SPF AM.

I've been on everything including oral antibotics and roacctutane (that worked for me until pregnancy) for my hormonal acne but thankfully topical Duac is working well for DS.

Good luck. If no results keep pressing on and going back to GP. There's always options.

Roaccutane was life changing for me, don’t dismiss it.

Roaccutane worked for me back in the very late 80s early 90s.
My son then ended up on it for acne 4 years ago.

It's was only for a few months and it's transformative!
Side effects were a few aches and very dry lips.

I think you should reconsider or more to the point your son should have the option to try.

Did you think about the face mask with red and blue led light? Use once in morning and put on Nivea soft before bed.

I'm 44 and still have major bacterial breakouts due to not having protective 'film' on my skin. This two things have it almost fixed in 2 days.

Red and blue leds kill the bacteria. The nivea soft acts as a replacement barrier for my skin.

Please don't dismiss roacutane, it changed my 17yr old sons life. He's 41 now, no spots and no side effects!

1.5 rounds of roaccutane was great for me.

If he's developing cysts He really needs some proper treatment such as antibiotics and a referral to dermatology for further treatment considerations. Please take photos to the GP. Both my kids had roaccutane. My daughter had it at 15 and 31. My son said he'd rather have side effects than the horrible acne which made him really low.
I've looked after lots of people who went on roaccutane never had any with serious side effects. The dermatologist my daughter saw when 15 said that she felt kids were more depressed due to the acne and once they saw the improvement with roaccutane their mood improved.

5% Benzoyl peroxide in face wash and cream is very strong and could be irritating his skin. The pattern of seeming to help and then suddenly going worse is typical when the % is too strong or the skin is sensitive to any amount.

I would use one or the other.

Take photos of his skin when it is flaring up to show the GP.
Ask for a referral to dermatology while the GP prescribes something a bit gentler.

You want to be thinking about the skins barrier as well OP. Benzoyl peroxide is pretty strong stuff. I would try a nice cream like La Roche Posay and a light weight spf for day time to give it hydration.
Your other option would be to look at a topical retinoid, it will require him wearing spf everyday (which we all should anyway) but it can be very effective. Boots have a service where they can prescribe it online but not sure if that would be the case for under 18’s.

Accutane attracts a lot of negativity I took it and didn’t off myself. Organic anything isn’t going to help a bacterial infection.

if the face wash has benzoyl peroxide in it it’s too much and you need to choose face wash or cream, check the useage instructions.

When we went to the private dermatologist, the Dr said this too, it normally not about diet and cleanliness it is hormonal so there is little you can do in those areas. There are so many OTC products to try but most won't work.

When you get to the GP they will try oral and/or topical antibiotics as the next stage. They worked for a good while for ds (until they took him off DUAC which was working really well) before we went down the Roaccutane route.

Keep an open mind, as once it gets to that stage you might change it when you see the impact it has on their confidence and socialising. If you do change your mind act quickly to prevent scarring - there are huge waiting lists on the NHS, it was 9 months by the time ds was contacted. We went private and even then there was a 6 week waiting list and the acne was so painfully out of control and getting worse each week I was phoning every day to check for cancellations.

ds(20), who is generally very open, always insisted it didn't bother him even when it got so bad his neck, chest and shoulders were covered in acne too, it was a form of self defense, he never admitted it until it was gone.

Are you changing his pillowcase every few days? No good cleansing your face then laying on a pillowcase that’s not very clean. When my son had spots I changed the pillowcases every day , just bought a load of white cotton ones.

My son has severe acne, same age as yours. He has tried literally everything apart from Roccutane which he doesn't want because of the side effects. We have tried a private dermatologist on Harley Street who gave him Lyymocycline which worked for a bit but now back under the NHS. All the insta acne treatments like 47 skin didn't help, although I am sure they do some people.

His skin is clearer at the moment (I would say mild acne rather than the usual severe) and he has totally changed his diet. I know evidence is not really conclusive but he eats lots of fruit, drinks only water, never has sugar, won't eat bread or drink skimmed milk and has gone onto Doxycycline after a break and started a dermologica cleanser. Tbh I think it's a combination of all that that has helped it but not cured it.

Acne is so horrible, my heart breaks for the teens suffering from it as when it is severe its not just a case of good skincare like some people think. It really affected his confidence and wellbeing and I hope your son gets an improvement soon.