Recurrent acne - does anything work?

[Pleasedontdothat]

Dd (18) has had acne since she was 11 - she’s been back and forth to the GP and was given the usual topical treatments, then antibiotics then pill but nothing worked until she had a dermatology referral two years ago.

She had one course of roaccutane which worked brilliantly - she had completely clear skin until she’d been off it for about 3 months when the spots started creeping back. Her GP sent her back to dermatology and she got a second course of roaccutane which again cleared everything up. This time it took a little longer so we thought this time it was properly sorted, however two months ago her acne came back with a vengeance and it’s now the worst it’s ever been.

She’s scrupulous about keeping her face clean without using harsh products, her diet is very healthy, she doesn’t drink or smoke and she has a job which means she’s outside for several hours a day.

She’s extremely shy and this is ruining her self-confidence - is there anything that really works long term if roaccutane hasn’t knocked it on the head? Is there any point in asking for another referral to dermatology or is there anything that people have found works when roaccutane doesn’t?

She’s not doing anything wrong so no need to feel she is.

My derm nurse took roaccutane 3 times so it can be done, she had beautiful skin. Was she taking a long low dose? I’ve heard that doesn’t work as well.

I was only on it 4 months but I’d do it again in a heartbeat if it came back.

A friend of mine ended up taking Roaccutane on and off for 18 months, and with steroids for the last few months. Really did the trick, he'd had it for over 20 years before he found a good dermatologist. It's not returned in the 10 years since he stopped taking the medication.

I've been using Skin & Me and it's the only thing that's worked apart from antibiotics, which you're not allowed to stay on. Have a look, it's very good.

I was actually thinking about starting an almost identical thread about myself! I’ve had multiple courses of Roaccutane and it really hasn’t worked for me. I go through stages where my skin isn’t so bad but I do still really struggle with acne on the whole. I’ve got a friend who had awful acne as a teenager, but when she got to about 22/23 it cleared up and never came back (we’re in our 30s now). I really hope your dd’s clears up- it really is awful to have to deal with

Thanks - she was on a relatively low dose as she was only 16 when she started and very slim (it was calculated by weight). It seems that there are a few factors which mean it’s more likely to come back - being younger, female and not having many side effects while taking it (apart from dry lips she had virtually no side effects at all) and unfortunately she ticks most of those boxes.

@therearenogoodusernamesleft Skin&Me looks interesting - I wonder if it would work though as it seems to be mainly antibiotic-based which didn’t work for her at all

My dermatology nurse mentioned spironolactone the other day, as an option to try instead of roaccutane. I think it’s definitely worth going back to dermatology and trying another course of roaccutane/ something else.

Bit left field but maybe taking some probiotics will help? If your gut health is not tiptop it can manifest in all sorts of ways, causing or exasperating issues, including acne. Might be worth a shot in addition to more traditional acne treatments.

Following this thread as my 13 year old has had had acne for 2 years. Is on yasmin pill now, its better than it was but still significant imo.
My14yr son is getting bigger spots mainly on his head but not taken anything for it.

I think it’s definitely worth going back to the dermatologist. They’re the skin experts. My friend needed 3 courses of roaccutane to be ‘cured’.

She’s rather lost faith in the dermatologists - not sure I blame her really! They kept cancelling appointments at the last minute and the last few were all over the phone - how you’re supposed to evaluate the progress of acne when you can’t see it I’m not sure …

Can you go private?. Their usually very attentive when your paying £200 an appointment.

How long is the “course” of roaccutane? My ds has been on it for 6 months now-2 of them at max dose and will be for at least another couple of months to “switch it off”.
We ended up going private as the wait for NHS was about a year and ds’ skin was horrific.
I’m just wondering if the course she’s getting isn’t long enough due to NHS rationing

Our derm costs £160 for the initial appointment, then £120 every 2 months, and the medication is £200 ish every 2 months

It’s not nhs rationing it’s them trying to avoid side effects and patients stopping taking it early. It’s a waste of money when a treatment doesn’t work.

Accutane can be a shit drug to be on but it’s 4-6 months out of a hopefully 80 year lifespan.

I had awful acne for years when I was a teen, had roaccutane which didn't do much, went on dianette pill which turned me into a lunatic.
Coal face soap from lush has completely saved my skin, I have used it for 15 years and my skin has never looked better. The charcoal and licorice combination seems to work for me. Might be worth a try??

Lymecycline worked for me, alongside a dermatica prescription and La Roche Posay cleansers and moisturisers.

Check out Caroline Hirons for cheat sheets too and I think she may have just brought out a teenage skin care kit.

Spironolactone.
Or another course of Roaccutane. Has she been taking i

Has she been taking it with fatty food? It doesn’t get absorbed otherwise so you think you are getting the cumulative dose but in fact you end up with 50-60%. Needs to get to at least 150mg per kg per course. Uk derms sometimes stop at 120 which affects rates of relapse.

Re spironolactone, you’ll have to take it forever (not course based)

@nvcontrolfreak no one ever mentioned taking it with fatty food .. and she doesn’t have a lot of fat in her diet so that may well be an issue

She’s going to ask to be referred back to dermatology but as she’s been discharged it’s going to be months before she sees them sadly

Unfortunately lymecycline did absolutely nothing for her so there’s nothing the GP can do apart from refer her

Having babies cleared mine up. I’m nearly 50 now and people are often surprised to find out my age, as they think I’m younger. The trade off for teen acne is that your sebum production holds up as you age. My 40s skin is a lot nicer and less wrinkly than many of my peers’. It won’t comfort your DD now, but acne prone skin isn’t all one way traffic.

I rate Dermalogica products for acne prone skin. They have a clearing range but their general ranges are also good, especially the daily microfoliant and oil free moisturiser which are gentle on ravaged skin.