DS - Acne

[gerardsbutler]

DS is unfortunately suffering from acne on his face and occasionally on his neck and back. He’s 13. The Dr prescribed antibiotics to be taken twice a day. They were a right pain to take due to timings and food but they did work a little. His skin fought back though so after 3 months, he was changed to another antibiotic that hasn’t worked at all. It’s a shame, his face is covered just now.

Before I call the surgery when it opens on Tuesday, does anyone have experience of what I should ask for next? I only got to speak with the nurse practitioner and he didn’t give me much confidence when I spoke with him over these two sets of tablets.

So sorry he's going through this - I have battled with cystic acne for 18 years, I'm only 30! Tried everything.

After all the creams/antibiotics I was prescribed roaccutane eventually and although this cleared my skin (temporarily) it left my skin so thin and brittle, my mental health spiralled, and left me with severe scarring due to a big purge in cysts. If he gets put on this please be so careful it's not a drug to be messed with!

I was told all my life my acne was due to pcos.. I'm now on day 14 of no dairy and I don't have one single spot!

It's different for everyone, just need to find what works for your son.

Thinking of him xx

I know your question is more about what to ask the Doctor, but wanted to mention that the Dermalogica Clear Start range helped my DD’s skin massively.

Also using a clean flannel to dry her face each time and fresh pillow cases very frequently.

I hope you can get something sorted as it’s such a shame when this happens.

@gerardsbutler

DS is unfortunately suffering from acne on his face and occasionally on his neck and back. He’s 13. The Dr prescribed antibiotics to be taken twice a day. They were a right pain to take due to timings and food but they did work a little. His skin fought back though so after 3 months, he was changed to another antibiotic that hasn’t worked at all. It’s a shame, his face is covered just now.

Before I call the surgery when it opens on Tuesday, does anyone have experience of what I should ask for next? I only got to speak with the nurse practitioner and he didn’t give me much confidence when I spoke with him over these two sets of tablets.

When it got this bad for my ds he was referred to Dermatology and put on Roaccutane which is quite a horrendous drug, but it did work amazingly well. He was around 14/15 when he was put on the Roaccutane. He is almost 21 now and the acne has largely stayed away apart from on his chest.

Stick with the antibiotics but ask for a retinoid cream (adapalene) to take at the same time. It will take a bit of time to take effect so stick with it.

I would be very wary of roaccutane - is widely known to cause severe mental health issues, sadly with devastating consequences for a few families I have known. That is an absolute last resort IMO and I personally wouldn't touch it, no matter how bad my cystic acne got.

When I was a teenager I was prescribed a topical lotion called dalacin t. I had awful acne and it worked miracles! As an adult I've learnt that if I have too much citrus I get large spots, so might be worth looking at diet as well.

Ref to dermatology. I took roaccutane for 4 months and it cleared my skin up. I was waking up at night in pain from new spots forming.

With my son, we had to go through all the topical creams and several antibiotics before finally, after 3 years, getting a referral to dermatology.

His skin was badly scarred at this point and they were still reluctant to prescribe Roaccutane.

However, they eventually did and it worked. No detriment to his mental health or mood. Yes, do research but don't believe the horror stories apply to everyone.

If it's bad enough to affect his confidence, ask to be referred to a dermatologist and to be considered for Roaccutane. It's not an easy drug to take but it changed my life, and that of my DD.

Next step is dermatology referral and Roaccutane. Not to be taken lightly, but effective.

Another one here suggesting a referral to Dermatology.

I had acne on my face, neck, chest and back as a teenager. When under the Derm, I was prescribed a number of treatments before going down the Roaccuatne route and they wanted to wait until I was late teens, with exams etc out of the way before prescribing.

It isnt a nice drug and does have nasty side effects so there is close monitoring (or was at least in my case)

Thanks everyone for your help. He has a cream but we don’t use it that often mainly because to cover everything, he would need to use it like I would use a Moisturiser so all over. That concerned me but may be we should give it a try?

There are a lot of myths and scare stories about roaccutane. There is actually no proven link between it and mental health issues. Most side effects are extremely rare and it really is a miracle drug. It does cause dry skin - so you have to follow a regime of special lip balms etc - but it’s so worth it. My dd went from having constant breakouts and being really depressed about it to being complimented about her skin.

I took roaccutane in 1988 and it was an absolute game changer.

Not pleasant to take but you should get regular check ups with a dermatologist to monitor things.

I also took roaccutane. For about 6 months. I was 20. Had to stay out of the sun and use moisturiser and lip balm. It worked really well and changed my life. I had to sign a disclaimer to say I would not get pregnant

If the cream is duac, I use to use it all over no problem! Will bleach pillow cases though so get some white ones!! Make sure he has a moisturiser to use in the morning after the duac at night as can make skin dry! Best of luck to him with it, it’s horrible isn’t it?

May not be greatest as things sound pretty bad but a salicylic acid soap may help a bit. Got rid of back acne for DS.

Ask for him to be referred to a Dermatologist (hospital, probably a waiting list). There are effective treatments that only a Dermatologist can prescribe - ROACCUTANE is the most effective, although it has to be given with caution because of the side-effects.

What are your concerns using cream? I would be more concerned using oral antibiotics as some for acne (Lymecycline) can permanently stain teeth.

Unfortunately there is no one single treatment that works for everyone. DUAC cream in the evenings, acnecide in the mornings and the Effaclar possay salicylic acid face wash twice a day worked well with ds. He did need to use it consistently for 9 weeks before it really started to work. His skin was sometimes dry with it but acnecide moisturer helped when needed.

The NICE guidelines for acne treatment will give you an idea of treatments your gp might try. Click on the flowchart and read the notes on each step..

www.mumsnet.com/Talk/teenagers/4324711-Teenage-Acne-what-can-the-GP-do?msgid=112489634 you might find some further advice on this thread.

I second reading the NICE guidelines. He does need to use his cream daily (maybe twice a day) and yes use it wherever the spots are! We are about to go to the GP for our 13 year old ds skin, we've read the guidelines and but I'm determined to avoid oral antibiotics if possible (long term antibiotic use makes me uncomfortable) and we dont want him on roacuttane.
I'm dithering over buying him Dermalogica facewash or the Effaclar one.
Good Luck!

I also suggest getting a dermatology referral. I suffered with acne for years and regret being fobbed off for years with ineffective antibiotics. Eventually I was referred to the dermatologist, prescribed roaccutane and my skin was clear within a couple of months. The only side effect I had was not having to wash my greasy hair everyday! Not one other side effect for me.

My dh takes an antibiotic every single day and will do for the rest of his life.

It doesn’t harm you.

@Fluffycloudland77

My dh takes an antibiotic every single day and will do for the rest of his life.

It doesn’t harm you.

No but I guess it depends on what you class as harm though. Antibiotics can change gut flora which is why if you are on them long term you need a prebiotic. There is also the issue of antibiotic resistance. Obviously for some people it's not a choice, its just something we want to avoid if at all possible.

@MissyB1

I second reading the NICE guidelines. He does need to use his cream daily (maybe twice a day) and yes use it wherever the spots are! We are about to go to the GP for our 13 year old ds skin, we've read the guidelines and but I'm determined to avoid oral antibiotics if possible (long term antibiotic use makes me uncomfortable) and we dont want him on roacuttane. I'm dithering over buying him Dermalogica facewash or the Effaclar one. Good Luck!

Ds uses this Effaclar - micro peeling for face and body one and it works well for him, better than just the Effaclar cleansing gel and he uses in shower on shoulders too. He has one in the shower for mornings and one in the bathroom for night and likes the pump dispenser. Anything to encourage him to use it!!!

That’s caused by people like my sil who take three days of a 5 day course. It allows evolution, they can’t evolve if they’ve been killed.

They don’t all affect gut flora either. That tends to be the penicillins if you can take penicillin. Acne’s a deep infection, you can’t get that far down with topicals to kill the bacteria so the option is orals or roaccutane to starve the bacteria of food.

Men are at an disadvantage anyway because they can’t manipulate their hormones with oral contraceptives like us or take anti androgens the way we can.

I was on oral antibiotics for years before roaccutane because I didn’t want to take it after reading media scare stories which is how I’ve ended up with scarring from cystic acne that will be there if I live to be a 100. Every time I look in a mirror I see that red scar from cystic spot zero as I nicknamed it.

My son was 12 when he started with acne, it was awful and he was put on topical antibiotics they helped but it gradually got worse. He was then on oral antibiotics for 2 years. Our pharmacist was unhappy with him getting high doses of antibiotics for years. Eventually we got a referral to dermatology and he went on roaccutane. It worked but 2 years later it started to flare up again so 2nd course. Ten years later he still has clear skin.

Roaccutane isn't easy but for my son it was really worth it. All the eating a healthy diet, keeping your skin clean etc was useless.