Teenage daughter and acne

[nelehluap]

My eldest DD is coming up to her 16th birthday. She was on the contraceptive for a couple of years due to quite heavy painful periods. She was taken off the pill earlier this year because she was getting daily hot flushes. Once off the pill the flushes stopped. But her skin has now become quite bad on her face. We have tried various creams and potions, some off the shelf and some over the counter, nothing seems to help. She has been to the doctors today and has had an anti biotic prescribed called tetralysal. She is to take one a day for two months to see how she gets on, she's to have a blood test too to check on her hormone levels.

I must be honest I would far rather she wasn't on an anti biotic long term....the doctor did mention if the tablets work that she will remain on them until she has gone through puberty.

Is there anything else she can try? We had ploughed through the Body Shop products and she is currently using quinoderm and femoderm as well as pretty much all the clearasil etc products. She drinks lots of water, eats a very healthy diet (she is also gluten/wheat free)...I feel so sorry for her.

Any ideas? Thank you.

I feel for you both. I had/have this, antibiotics didn't work for me. Topical treatments neither so I can't advise on that.

Exercise should not be underestimated and junk food with high sugar and greasy fats too.

Roaccutane might be suggested if nothing else works but there are associated health risks that need serious consideration. It is however, a powerful cure and I'll probably end up doing it but each to their own.

www.acne.org - take a look

Hi, thanks for your reply. She has to eat a healthy diet, she doesn't eat greasy foods and rarely eats dairy. I'm not keen on her staying on anti biotics. To be honest the doctor didn't seem too interested. Have you or anyone else tried quinoderm? It's anti bacterial wash and we can also get the cream. It seems to have helped but just wondering if we should give it longer to have a better effect, she's been using it for just over a week. I really don't want her put back on the contraceptive either.....but I guess, at almost 16, she's going to start making her own decisions!!?!

tea tree oil, witch hazel?
I had terrible acne in my late twenties and early thirties and found some tablets in Holland and Barrett that reallly worked.
sorry but I cannot remember what they were but might it be worth asking there?

She's been using tea tree products from the body shop....and she's tried witch hazel too....no real benefits. I'll have a look on the H and B website x

Was she only ever on one type of contraceptive pill? Did your GP discount other types?

DD was prescribed Isotrex for her keratosis, but it can also be used for acne. It's one of the retinoids - maybe worth asking the GP for it?

Also - you can ask to be referred to another GP or dermatologist if you feel your DD is not being taken seriously

nelehluap

You need a diagnosis first and foremost.

Would your DD be at all willing now to see a gynaecologist; quite heavy and painful periods need to be investigated further to ascertain the cause - and there always is a cause. Has she had such problems also since she started menses?.

The pill is known for its anti androgenic qualities; this is likely why it was also prescribed as well as trying to treat the heavy and painful periods. She may well have a condition called polycystic ovarian syndrome which is causing the spots and PCOS is mainly hormonal in nature. Junk food and sugar are not in themselves causing all this to arise.

If GP is unhelpful and or not all that interested change GP practice.

I would give H and B a wide berth and seek further advice from a gynae and or an endocrinologist. You need to know why this is happening before you can start treating it.

Both my DC have had roaccutane in their teens ,worked wonders which long term antibiotics didn't ,I hope your dd has more success with them . I would try a simple antibacterial soap and steer away from all the preparations ,that's what the dermatology nurse told my dd .

A lot of friends and my DH have had great success with Freederm. Worth a try!

What anti bacterial soap would you recommend? And yes she was only on the one pill....it was Yasmin which helped her periods enormously...they became regular and so much lighter and easier to deal with. She's finding the quinoderm wash really helps but whilst it tackles the spots she has it doesn't seem to stop new ones forming. I wish we could find something that helps but also prevents.

She uses the freederm gel which really dries her skin out.....she ends up peeling with it!

I have polycystic ovaries amd had terrible acne as a teen. I tried EVERYTHING from prescribed medications to popular shelf brands. Nothing shifted ANY spots except for antibiotics. However after a few months my bodies own defence system would over power them and I'd be back to square one. I exhausted all the antibiotics on the market before I was finally referred to a specialist when I was 19. I was put on Roaccutane and went on the contraceptive Dianette often prescribed to female acne sufferers... and they changed my life.

Roaccutane is a horrible horrible drug, I won't lie, lots of side effects, but it was worth every single miserable moment that only lasted 8 months. I had to have regular consultations and blood tests as it can cause liver problems and depression so monitoring is crucial.

But Im 32 now and the only time I had any return of acne was when a training doctor decided I'd been on Dianette long enough and put me on Cerazette (despite me crying in her office begging her not to). Cerazette is the worst pill for acne sufferers and within a couple of weeks it began again. I demanded to see a different doctor who put me on Yasmin and that cleared it up.

I still get the odd breakout but nothing major. The trick is not to bother with all those clearasil/oxy spot related products because all they do is strip oik from the skin and then the skin just overproduces more oil and encourages more spots. Just use a moisturing face wash, then a bit of micellar water on a cleansing pad all over the face, then use a moisturiser with zinc in it. As the skin has been cleansed but also moisturiesd it won't overproduce oil, and zinc is good for keeping oil to a minimum. And a clay mask once-twice a week will also help.

ps. Might be worth asking for an ultrasound scan of her ovaries, I had very heavy painful periods too, and even ovulation pain. She may also have PCOS

We were recommended Cidal , now that she is off the roaccutane my dd uses SBC Jasmine and Evening primrose gel that also works well .

Did cidal help?

My DS swears by it and he has been off the roaccutane for 5 yrs .

I had acne on and off in my teens, twenties and thirties. The contraceptive pill was the only thing that cleared it up. Can she go back to the Dr?

I may consider her going back on the pill but the GP has sent her for a blood test first, to check on her hormone levels, which she's having done tomorrow morning. If she does go back on the pill we're going to avoid Yasmin.

agnus castus

Self medicating with AC is not a good idea because it can make some underlying hormonal problems like PCOS worse. If you really want to go down that route the advice of a medically qualified herbalist should be sought re dosage.

Your DD needs a diagnosis first and foremost. You need to find out what is causing the adult onset acne (its usually PCO unfortunately) and if it is polycystic ovaries, treating the hormonal imbalance is the priority which will hopefully then bring about an improvement in her skin. I would agree that an ultrasound scan may prove very useful.

I note she took Yasmin; that was often prescribed to women with PCO as well.

What hormone levels are being tested and on which cycle day?. Testing the wrong hormone levels on the wrong day will just bring about a meaningless result.

PCOS is not associated generally with pain of any sort. I also had painful and heavy periods and PCOS was not the cause, that was all due to endometriosis so I eventually received two diagnoses. If your DDs periods are consistently heavy and painful in nature this should be investigated now by a gynae to ascertain the cause. I state a gynae as many GPs are simply not up to speed when it comes to such issues.

OK, so I will give you the benefit of my 15 year fling with acne:

You can only really knock it on the head by combining treatments. That means pill + topical retinoid + topical antibiotic. Don't let a GP waste your time by trying them all separately (bear in mind most GPs don't really have an interest in acne so it is often difficult to get across to them how much it is affecting you). I also don't think long-term internal ABs are a good idea - better to have something topical containing an AB, like Duac, which combines clindamycin and benyozl peroxide, both of which kill the bacterium. The retinoid makes your skin cells regenerate faster, which means pores are less likely to get clogged, and the pill moderates sebum production. All three together in a three pronged attack give you the best chance of stopping it in its tracks.

Also the trick with the topical retinoids and Duac is to build up very very slowly. Too fast and you think it's making it worse. And it will take about 4 months to be much better.

Some pills are better than others for acne - Yasmin and Dianette. If Yasmin helped her periods could she try it again?

Also look at her make up and skin care - she shouldn't put ANYTHING on her face that isn't explicitly marked non-comedogenic and that includes make up. La Roche Posay and Vichy products are non-comedogenic skin care products, available in Boots and not super expensive.

Attila - totally agree. GPs have given me the run around for yrs, failing to acknowledge that a hormonal imbalance was the cause and took an old fashioned view of 'teenagers get spots, don't worry you'll grow out it!' And made me feel like a silly little girl. However, although you say pcos doesn't cause pain I didn't have endometriosis but still had heavy painful periods, Sometimes so strong I'd collapse. Its only after one of these collapsing episodes that my pcos was finally diagnosed because I absolutely insisted that something just wasn't right down there! Tbh I think they just sent me for a scan to hopefully shut me up. But pcos was discovered, I was referred to a gynae and I finally got the right treatment for my skin in coordination with a dermatologist

I'm so sorry to hear your daughter is going through this. It cannot be underestimated how stressful this can be. My brother had awful acne for years and it was incredibly debilitating for him (and obviously the pill wasn't an option for him). Eventually we found a beeswax based, natural cream which seemed to work. He was on roacitane for a long time and still suffers from depression which I'm sure is linked to the drug. If you can find a natural remedy I would strongly urge this as a remedy. Don't use body shop though as since Anita Roddick sold it's no longer a natural business - they use loads of chemicals which will only irritate her skin.
Since then, my cousin has started to make this which has really helped a few friends with their children's skin (and also conditions of their own) - www.justbeepure.co.uk/shop/skincare and has had really good results from friends/family with skin conditions. They're pure and won't irritate.

Update.....as regards periods...she's not had a period for last 6 months. Her periods were ok, ish, prior to going into Yasmin but fairly heavy and sometimes a little irregular. She was put on Yasmin to help with their heavy flow, stomach pain and her skin. Yasmin was an absolute godsend in that respect but she was taken off Yasmin 6 months ago because she kept getting daily hot flushes. Since coming off Yasmin she's not had a period. Since coming off Yasmin her skin has become pretty awful.

We've decided not to take the anti biotics prescribed to her yesterday because I've googled them and yes they help but once off them the acne will return. Plus they have some fairly strong side effects the main one being stomach upsets and Indigestion and for a child who has had IBS in the past and is gluten/wheat intolerant I'm not keen to rock the boat with an already sensitive stomach. She is continuing with the face wash quinoderm, plus using quinoderm cream at night and freederm during the day. I have also bought her cidal soap which I'm told is a very good anti bacterial soap. She had her bloods taken today....hard to determine what stage of her cycle she's at because obviously with absent periods its impossible to know. I gather to test (my husband took her) was for a hormone level test, full blood count and renal activity.

I've been at work all day, not long got home. I can see she isn't wearing make up and already her skin on her face is beginning to look slightly better...I firmly believe if she can keep make up to a minimum it'll help....she uses good quality foundation but just wondering if there's also a foundation for sensitive skin?

Got to say...thank you SOOO much for all the replies too....I honestly do appreciate them. Not easy having teenagers eh? and to think I have another DD to get through this stage too.....can't wait!!!

OK I just looked at what freederm and quinoderm are. The quinoderm cream is probably OK but I would ditch the face washes for something like LRP. I would also use the quinoderm in the day, not at night, as it will just be rubbing off at night - wear a sunscreen over it.

I think the first thing is to push for a gynae referral to find out what is causing the problems with the periods and the flushing. One you have done that, you may be in a better position to choose a pill that will help the acne too. Cilest, Femodene and Cerazette are other options that can help acne.

With the quinoderm, be careful not to go overboard with it or to use it in too strong a concentration. If she has sensitive skin, acne can often be made worse by using products that are too harsh (I had this problem). So it sounds paradoxical, but use concentrations that are low - so the 5% quinoderm cream, not the 10%. You can always build up to the 10% if needed. Don't use anything exfoliating.

Other practical things that can help - don't ever touch the face unless you have washed hands, keep mobile phone clean, use a clean flannel every time you wash the face, change pillowcases frequently.

In terms of makeup, look for a foundation that specifically says non-comedogenic.

nelehluap,

Yasmin has anti androgenic qualities associated with it so am not at all surprised that her skin improved whilst on it and has got worse whilst off it.

What hormone levels have been tested today, do you have any idea?. TBH if they have tested LH and FSH (there is usually an imbalance of LH to FSH if PCOS is present) on the wrong day the test result for that will be meaningless.

I think fwiw there is an underlying hormonal problem here like PCOS (they should do an ultrasound) and that is the root cause of her problematic skin and sometimes irregular periods.

Prescribing Yasmin did help but unfortunately it is still going to take something along those lines to keep this all in check. Otherwise it could still lurk in the background.

She does need a diagnosis first and foremost and regardless of the results I would see if she is willing to see a gynae. Many GPs are simply not up to speed at all when it comes to such issues and they do impact. Prescribing pills as well only treats the symptoms and does not even go near addressing the actual cause.

You need to find the CAUSE of all this and you will both need to be very persistent indeed in order to get answers. I can see the two of you being messed around as I was when I was not all that much older and my mother had no idea what was wrong with me. So it all continued and I had years of painful and irregular periods. I would not wish what I went through from my late teens till my early 30s in terms of gynae problems on my worst enemy.

Does her IBS get worse up to and including menses; I ask this as well as endometriosis can be sometimes misdiagnosed as IBS in the first place.

PCOS is not normally associated with painful periods, do bear that in mind. However, endometriosis (as I was eventually diagnosed with a lot later) can only be diagnosed through keyhole surgery because ultrasound scans and blood tests do not detect it.