Teenage cystic acne out of control

[KingofQueens]

My poor son is 15, and has had acne that has been getting worse and worse since being under the GP.
They say he has to persevere with oral antibiotics and Acnecide, but his skin has got so much since starting with them. We're desperate now. I'm so worried about his mental health and long term scarring.
Has anyone had a child with skin like this who has had anything work for them?
He's such a lovely boy, never complains, but I can see him becoming a shadow of himself.

Thank you so much again to everyone, I'm so overwhelmed by everyone's kindness.
I've spoken to a private dermatology clinic and they are seeing him next Thursday. They did have a cancellation for this Friday, which would have been ideal, but unfortunately we're at Great Ormond Street with my eldest on Friday.
(Things don't get easier as they get older do they, just different!)

Definitely accutane he does not need to keep suffering like this. My dd took it and I had to push the doctor for a referral, I went in to the appointment after he told her to just stop wearing make up he then referred her.
I was very worried about the mental health aspect of it as she did have mental health issues and was on fluoxetine but in the end she was fine. Her skin cleared up beautifully and now (9 years later) it’s still beautiful with no spots ever.

If the doctor had not referred her I would have gone private.

I’m so pleased you’ve gone for a private dermatologist, accutane was the only thing that helped my DD, and your lovely boy deserves to have this issue fixed asap now.

Sending solidarity to your DS. I felt emotional at your post and pictures, as this was me at 18. I was broken by it, it really affected me.

I kicked up a big fuss at GP and got referred to the dermatologist who put me on roaccutane. Yes it's a difficult medication in some ways but people who warn about the side effects often done understand the anguish caused by skin like this. The side effects were nothing to the relief I felt seeing my skin finally clear. It took about a year and I can honestly say it has been clear ever since.
All the best to you and DS, you're a great mum X

Please contact your GP and insist on a face to face appointment

This isn’t just a few teenage spots; it’s full on severe acne and he needs a referral to a Dermatologist

It’s certainly not just the physical side of things and concerns re scarring but like you say, the mental health side of things

Good luck to your son, I really hope he gets treatment that works for him very soon. If you can afford it, definitely consider going private for this

I’ve now had a proper read through the threads

OP that’s so great he’s been booked into see a private dermatologist next week

Good luck

@AAAAYY it's nothing to do with the GP. Dermatologists won't see patients who haven't done months on antibiotics. Please don't slag off GPs without knowing the protocol.

Thanks for posting this.

The NHS will reject any referral to dermatology for acne unless a list of treatments have been tried first.

This is the GP doing their job properly not being useless.

This is where it’s so useful if you can go privately - none of this gatekeeping and you can get straight in front of a dermatologist.

Oh bless him, I had cystic acne all over my jaw after childbirth and it was awful. I had Duac cream which worked sometimes and a low dose antibiotic which did nothing and was in discussion over roaccutane(?) which is no joke due to the side effects.

Weirdly enough, I had an injection of Botox near the area which disrupted it entirely and it’s never come back. Would be a weird thing for a teenage boy to try but it undoubtedly works.

As I said up thread, with my second child suffering (a word I use advisedly) with acne, we specifically said we didn't want to faff around with different antibiotics (we explained how little help they'd been to her brother, and how bad his skin had got).

She saw a dermatologist and was on accutane within a couple of months. And honestly, her skin wasn't that bad - just getting worse all the time.

This was NHS.

Hi, if you pay privately for a dermatology appointment, they will put him on accutane which in three or four months will change his life. One appointment for about £200, and £40 a month for a prescription. It’s utterly life changing medication. There is no clinically proven linked between low mental health and accutane . I highly recommend it.

Accutane. I am glad you made an appointment for that.

Hi OP, how is your DS getting on?

Roaccutane.

Its harsh but a miracle drug.

I went through this with my DS. After years of being fobbed off by the NHS with years of antibiotics I took him to a private dermatologist, who put him on roaccutane immediately. It took six months for him to be totally clear. It was expensive but not as expensive as I’d feared and definitely worth the money. I wish I’d done it earlier instead of waiting for the NHS.

My daughter had low grade acne but private dermatologist agreed to try roaccutane at a very low dose* . 5 months in and her skin is beautiful

• It should be half the child’s weight in kg as mg. Eg a 50kg teen should be on 25mg. Our consultant opts for lower doses for better tolerance. Dd is 49kg and takes 20mg. Zero side effects.

As someone who suffered with acne from 13 right through into my twenties I wish my parents had put me on accurate, although this was a long time ago I can understand concerns over side effects but really the psychological effect of acne can be just as damaging. I honestly believe I would have done so much more in my personal life and education if I hadn’t been so self conscious about my skin. It’s not just physical scars it leaves. I wish him all the best!

Hope it's all going well. My dd is on Accutane - her consultant prescribed it with an antibiotic she hadn't yet had to stop any initial purging, so you may want to ask about that (erythromycin).

The posters above are right re; GP protocols - to be eligible for Accutane you must have tried topical creams and also two different antibiotics first. Highly recommend the woman dd sees, if anyone in London or Bristol wants a recommendation (not sure if I am allowed to post it here).

Gosh poor boy, it looks so painful.
A lazer/chemical peel might help here, many clinics so them now.

Thank you so much everyone.
He's had three appointments with the dermatologist so far. They said they could do Roaccutane straight away or try a different combination of medication and prescription creams, plus mesopeels and light treatment first.
He was a bit nervous about Roaccutane after they have him the info and wanted to think about it, so we're giving it four weeks with the other treatment and then if he wants to he'll go onto Roaccutane.
So far his son is improving, so we'll see where he's at in a couple of weeks and decide if he wants to carry on or go with Roaccutane.

Great news, OP 😊

has he tried cutting out dairy?

my DD’s bad, on her face and all over her shoulders and back. We tried everything, next step would have been roaccutane but like your son she was reluctant.

i was doubtful but agreed to a two week trial. Well proved me wrong as 3 days later there was a noticeable difference. 3 weeks there were few new spots, mainly old ones. 3 months and so much better! Took a year I’d say before all the redness and marks went away but now it’s just the odd teenage spot.

worth a try? It’s not going to do any harm cutting it out for a few weeks.

That's fantastic news, OP. My dd is a very cautious / anxiety-prone person and was exactly the same. Her consultant very kindly took about half an hour going through and countering all her worries about Accutane (ie all the scare stories she'd watched on TikTok 🙄) - it has been a wonder drug for her.

My children both had roaccutane. In fact my daughter had a second course aged 31!
Your poor son. It's such a difficult thing and as my son said ...he can't hide it with makeup like his sister did.
My daughter said her mood was slightly low on the drug but honestly once her skin started improving so did her mood.
I really hope things work out for him.