Is there anything you can do for teenage acne other than roaccutane?!

[Fadedchintz]

Dd has really bad skin. It flares, and at the moment is looking really spotty and sore. She says she isn't bothered, there's nothing she can do and she definitely doesn't want a) the pill (tried this a couple of years ago for 3/4 months and it made her feel miserable) or roaccitane (dc1 took this as the side effects were punishing although it did work in the spots). So she uses a le Roche posey face wash and I think that's it. She's 18. Just to make life more complicated, she has fair, sensitive skin which gets very dry and sore with benzoyl peroxide.

Is there anything else that can be done? As I say, she says she isn't bothered, and I love the fact she's not at all vain, but at the same time I've been noticing her using make up to cover them, so clearly she is a bit bothered.

Any advice welcome. I did think about a dermatologist but as she's adamant that she doesn't want roaccutane I'm not sure what they could do.

As a teen I had terrible acne which I coped with until my early 30's then had roaccutane. It was life changing & nowhere near the awful experience others sometimes have. I was really careful, used dermalogica products, worked full time as a lawyer in a big commercial law firm - nobody would've known

Go see a dermatologist

Hi OP, yes, there's lots you can try before Roaccutane. Our dermatologist prescribed various ointments which I think were antibiotic-based. What finally sorted DS was something called tretinoin - only available on prescription

Yes, there are other things on prescription that are usually tried before roaccutane. Various creams. gels and antibiotics. They helped for a while but my oldest did use roaccutane in the end. The side effects aren't always bad, just dry skin and a few nose bleeds here. Our dermatologist said when it's bad, often roaccutane is the only thing to clear it.

You could ask for differin, similar to tretinoin. Niaminicide serum helps to just calm everything down a bit.

https://www.cultbeauty.co.uk/p/cosrx-the-niacinamide-15-serum-20ml/13949681/?srsltid=AfmBOopsydupWd_rPkPaLUsqwCfK0JaTd9sAx_BvUFKauZkSOZIIM-eZ

I would do

Oil cleanser
foaming cleanser
Niacinamide (wait for it to dry)
differin/tret (then wait for 30 minutes, I found this reduced peeling)
moisturiser.

In the morning
Foaming cleaner
Niacinamide
sun screen (la roche do a dry touch one, it’s ok)

There’s also spironalactone that can help with hormonal acne.

Blue light therapy is good, there's a handheld device called Lumie-clear that works well. You can buy them second hand on eBay quite reasonably (use alcohol wipes to clean) as I think they have gone up in price a fair bit since I bought one.

DD was on Duac cream for years (far too bloody long), it worked at first but she became allergic and they changed her to a different gel, that hasn't worked and now she is on an 8 week antibiotic regime.

Ive been pushing her to ask for a dermatologist appt as I know there is a waiting list, but so far she won't (anxiety, would be a lot easier if I could go with her, but she's an adult now). I think if that doesn't work it will be the pill, and then god only knows. I think she would agree to roccutane but I'm not sure if the docs can prescribe.

How is your DDs diet? I think my DDs acne is most likely hormone driven, but I do wonder about the amount of sugar she eats and whether that has something to do with it (she would say she was a recovered anorexic, but I can see that her diet is dreadful now - lots of 'good' foods, no junk, but she eats sugary things almost constantly - when she was really ill her skin was totally clear)

Her diet is good, she's quite healthy. She has just started a gap year job in a kitchen though and apparently they feed her cheesy chips every night 🙄 but she doesn't eat much sugar. She's gluten free as she finds gluten makes her really bloated.

I note that she tried "the pill" but it didn't go well. DD's first pill was no good, but then she changed and all was well. You need to find the one that suits.

DD did a complete cut back on all her products. She has extremely sensitive skin too. So no alcohol, or perfumes, or colourings, or acids. Nothing. As basic as you can go, and that includes shampoos and conditioners too.

She used Body Shop Aloe products until they discontinued, now uses The Ordinary and Roche Posey.

My Ds has weirdly started using bicarbonate of soda (saw it on TikTok apparently). Mixes it into a paste with water. I buy four tubs a week, cheapest there is in Tesco, and he uses about a third/half each time. He leaves it on for about twenty minutes. It's definitely made a difference.

Worth going to see a dermatologist. I ended up taking roaccutane in the end when I was 21 and it was one of the best decisions I made. I had regular check-ups with the dermatologist while taking it and to be honest the worst side effect was very dry lips (unless I used Carmex throughout the day, which I didn’t mind).
It was only my face that felt dry while taking it.

Dairy made my acne a million times worse, she might want to reduce it

also seconding looking at her food. I have similar very sensitive skin and I notice sugar/dairy/fat makes me flare up.

There are many strategies that will help. Oral antibiotics, topical antibiotics, benzoyl peroxide used less frequently, adapalene, nicotinamide and salicylic acid or more likely a combination of the above. She should arrange to see her GP if she wishes to have treatment. Obviously at her age it is her choice but roaccutane is far from being the only thing g that works and as you said above can cause nasty depression.

It's probably worth considering if she's got any indications of PCOS. That (undiagnosed till I TTC many years later) was the cause of my acne. For me the solution was 'the pill' - but there are so many different types! Dianette (often particularly prescribed for pcos/acne) made me depressed but microgynon and Marvelon were fine.

Hi Op,

My DS had terrible spots at 14. It wasn’t quite terrible acne, but it was nasty. I didn’t want him to have Roaccutane as he has had at times some anxiety, so I didn’t want to take the risk.

I took him to my beauty clinic, which I rate highly, and we set the starting point of him having a hydrofacial to clean his face. I was then recommended the range Biretix, from Cantabria Labs. It’s a bit pricey but I don’t care as his skin has significantly improved. He only flares up a bit when he doesn’t do the routine. I was told it was a very good alternative to Roaccutane and it has been great. I’m taking my son for another facial tomorrow to give it a good old steam and clean. He loves it!

You might want to look it up and see if anyone stocks it near you and have a chat.

I took my DS to the GP as all the usual stuff you can buy off the shelf hadn't worked. I can't remember the names of what they gave him but they worked a treat.
Your GP would probably want to try a few things before referring to a dermatologist. Roaccutane is a last resort when nothing else has worked.

Has she tried Epiduo? It’s having a noticeable impact for my DD. It needs to be prescribed but our usually crap doctor was happy to

Yes, definitely. I will share my routine for my acne if that helps:
Morning:
Using water to wash your face,
Sebamed clear face gel,
Garnier spf
Evening:
Merit or LRP moisturizer,
Tretinoin (0.1) from skinorac
Sebamed clear facial gel

Did the benzoyl peroxide help her acne, when she did try it? Aside from the side effects? Putting in on for a very short amount of time (literally minutes does the job) before washing off can give most of the efficacy with much less chance of irritation

Wondering the same

Any advice welcome. I did think about a dermatologist but as she's adamant that she doesn't want roaccutane I'm not sure what they could do.

To be honest, there are quite a lot of things to try before you get to roaccutane - almost too many, can be quite draining to go through the trial and error to find the right things for you.

Firstly there's so many types of 'skincare' before you get to the treatment side. Different ingredients do different things that all may help acne-prone skin - gentle acids like glycolic acid or salicyclic acid are often found in cleansers. toners etc, as they exfoliate the skin, leaving less dead skin cells to clog pores. Niacinimide is another common ingredient, think it helps reduce oil production and inflammation. You'll find a whole range of products that includes these and others in various combinations, and you might find that one is just the trick to help a lot.

In most cases of acne (rather than the odd teenage pimple) you're going to need some actual 'treatment' - I'd imagine a doctor would go to benzoyl peroxide as first line, because it's well studied and proven to kill the right bacteria that causes the acne. (it does this incredibly quickly too - you can leave it on your face for a matter of minutes and it will kill 99%, and then wash off - this reduces the side effects, amd the risk of bleaching all your necklines) Another one you can get over the counter rather than prescription is azaleic acid, might be an alternative to try if she really doesn't get on with the BP.

Prescription creams you're looking at antibiotic ointments, retinoids, or sometimes combinations. These are stronger, so more effective but also more side effects. Anything topical you're presumably going to have to use until your skin naturally changes - as she's young she might grow out of the acne and only need for a relatively short time, or she may just have to keep using the treatments longer term.

Oral medication options are antibiotics - can be effective but obviously longer term antibiotics aren't ideal generally. If the acne is hormonal, then the pill, which she's already tried (again, can try different varieties but not much fun testing them out) or there are things like spironolactone which also control hormones but might be tolerated better (or worse) than the pill. And then there's roaccutane. She's obviously seen the side effects of this and decided it's not for her, which is fine, but there's not much denying the efficacy of it.

So there are options, many of them! A derm might be able to help her pick, or there is enough info out there online to try some of them for herself before going to see a pro. There's a small part of me, as someone who's still looking for that magical combination of lotions and potions at nearly 40 though that says, maybe don't rule out the accutane just yet... It shouldn't be the first option by any means, but if she's still struggling after trying the rest, it might be preferable to decades of feeling self-conscious

Good read

Son had Roaccutane but had bad side effects on it. They suggesting opening up the pores and cleaning them. Was monitored well on Roacc just did not suit him at all.

DD has found this brand helps her - she has very sensitive skin as well as acne - https://47skin.com/. But this has helped reduce the flare ups without drying out her skin.