Teenage Acne

[sue52]

My daughter, aged 14, is suffering from teenage acne which is causing her great distress. So far over the counter remedies, as well as both topical and oral antibiotics, have had no effect. She wants me ask her GP to prescribe her Accutane. I have done research on this and although the results are impressive, I have concerns about the side effects. I would be grateful for any feedback on this as we are seeing her Doctor on Tuesday. Thanks.

I took Roaccutane (same thing as Accutane) for a year or two in my teens. The only side effects I got were very dry lips and inside of nose (meaning nose bleeds quite often). No depression etc, though I hear that can happen.

I must admit it didn't help my acne much - but I am in a minority here.

Personally, I'd suggest trying a couple of other options before trying Roaccutane. I have found Benzoyl Peroxide cream very helpful. Also Dianette works for many people.

Poor her. I remember my skin at that age, it was terrible and I spent a lot of time hiding behind my hair and feeling miserable.

On a non-medical note, is she good with makeup? Good concealer has helped me a lot (I highly recommend MAC Select Moisturecover). A very gentle face cleanser helps too - often the ones aimed at spotty skin can be overly drying.

Thanks Minipie. I will order some MAC foundation and concealer so I hope that will help her confidence. She has tried Benzoyl Peroxide cream with no improvement sadly. Can I ask if Dianette made you put on weight? I've read good reviews about it but DD is obsessed with her weight.

No I don't remember putting on weight with it.

best of luck to her.

I took Roaccutane when I was 19. It's so powerful that they will only prescribe it if the acne is beyond a certain threshold of severity, because of the risk/benefit profile.

In my case, it worked absolute wonders BUT at a price - my eyes dried out permanently, so I was never again able to wear contact lenses comfortably, and was stuck with specs. So I ended up having laser surgery many years later which went wrong (I nearly lost the sight in one eye altogether), and I'm bac in specs.

Bit tangential, but my point is, you can't predict how an individual will react to it, or what the long term effects may be.

In my case, my acne returned just a year later, and I went onto Dianette. It took about 4 months to kick in, but after that I was acne free for as long as I was on it (13 years on and off!) I'm only off it now because I'm TTC, and would go back on it tomorrow if I could.

So with hindsight I wish I'd at least tried Dianette (no side effects, NO weight gain) before putting something as powerful as Roaccutane into my body. The irony was that they make you take Dianette (or at least the pill) while you're on Roaccutane, because it's teratogenic.

RunLycraRun What a bad time you have had. I had read that dry eyes were a potential side effect but that sounds horrendous. Do you remember what dose you were on by any chance?

That's a tough question Sue as it was 15 years ago! I vaguely recall it being the lowest dose for my body weight, if that makes sense.

It dries everything up. As minipie says for her it was inside her nose, for me the eyes, and I remember a girl at the clinic who had repeated ear infections because it had dried her ears out too. On the plus side I didn't have to wash my hair for a week at a time! I also recall the skin on my lips peeling off in sheets, and going to bed with a half inch thick layer of aqueous cream on my face, which had entirely disapeared by the morning.

I guess all of that might be worth it, if it worked forever - but it wasn't worth it for just a year of clear skin.

I do sympathise hugely with your daughter, it's a cruel joke that you get it at a time when looking your best is absolutely crucial to you. She's lucky to have a sympathetic mum who takes such an interest - mine just repeatedly told me that I "hadn't inherited it from her" - which looking back on it seems rather irrelevant, a bit bizaree, and entirely unhelpful!

Hi there,

So sorry to hear your DD is having such a tough time of it!

I too had pretty bad skin, I was a bit older - about 17 but it then turned to adult acne.

I have been on Roaccutane also - I only saw an improvement after I stopped it - this can be common. However, while I totally agree it is a last ditch attempt, I know a number of people who have been on it and the side effects have been limited - drier skin (treatable with moisturiser) and dry lips (always used Carmex to help) - so I would recommend it rather than the torture that is extreme acne! Only you and your daughter can know wether it is right for her! Also - please don't take my word on it, there are plenty of site which chat about it!

Anyway - that was a slight tangent! I would firstly recommend getting a good, understanding Dr on side, acne is a try/test issue and if your Dr is good and willing to listen and test things then it is half the battle! Posssibly request a referal to Derm as early as you think - appts can take a while!

RE: Dianette - I would certainly try this before Roacc (you also have to be on birth control to take Roacc so either way it helps!) I read up on & spoke to my GP about the 'weight effect' of BC pills inc Diannete and found that it can often be a placebo effect - or it can increase cravings, however if you monitor your diet (which by the sounds of your daughter she does) then you can limit any weight increase on Diannette as it is not the full pill. Also - I consoled myself with the fact that if I did notice a weight increase I could stop.

What I would seriously, higly recommend though - is to moniter her diet! I was recommended recently to cut out milk from my diet as this can heavily increase the acne. I cannot tell you the difference this has made! I drank quite a lot of milk also, so that would explain the huge improovement. I also try to limit my cheese/ yogurt intake too - but I believe milk has made the biggest difference! I have 2 friends who also have skin problems and I mentioned cutting out dairy to them and they have both tried it - and both have also seen a big improvement!
Also if you said she is worried about putting on weight she may not be eating very well and it could be something in the way she's eating causing the acne to flare up!

This may not work - and is obviously anecdotal but it is surely worth a try! I believe it is recommended to give it up for 4 weeks, amd you should see an improvement by then if it will work at all!

I'm sorry this is so rambled- I am at work but just wanted to share my experience!

One more thing - if her confidence is taking a knock - why not take her into a store with a make up department and explain to them the problem (MAC or Estee Lauder are usually best) and let them try some stuff on her, concealer/ foundation etc. I always find they work miracles and it may make her feel much better and means she will have the make up for 'feeling rubbish days'. My Mom did this with me and it was a great day and I was so happy. Obviously this is budget dependent, just thought I'd suggest it!

I do hope this has helped - if not feel free to ignore!

Thanks Run. The reason I am so anxious is that I went to the Doctor with acne at the same age and was put on valium, not what you need at 14. I am ultra cautious with DD and just want as much information as possible.

Thanks Whatsthis DD has already cut wheat out and is vegetarian, if she cuts dairy I don't know what she'll exist on apart from beans and rice. Dianette seems to be getting a good review here. I hadn't thought of this before as it's a contraceptive but I'm going to go and look it up now. Any more advice will be gratefully received.

What are her periods like?. My guess is the underlying cause is hormonal in nature. She may actually be advised to use the pill as this has anti androgenic qualities. BWT too Dianette is not recommended for long term use as it can cause problems with the liver.

Treating the symptoms is one thing, finding the underlying cause is quite another!. You need to find the cause of the problem.

BTW these problems have nothing whatsoever to do with consuming dairy products. She should not cut this food group out as well, she needs the calcium as much as anything else.

Many women who present with adult onset acne actually have a condition called polycystic ovaries. This can in some women cause an excess of androgens to be produced thus causing the skin problems.

Attila - I appreciate your opinion - are you a docter (Not sarcasm BTW- genuine Q).

I understand what you are saying, and I firmly believed for 6-7 years that my problem was hormonal, the Drs never suggested a change in diet and I refused to believe it was that. However, I have tried everything else - with varying results. Cutting out milk has made a massive difference for me.

I am not pushing 'natural' over medication or anything - I just wanted to offer my opinion - and for you to rule it out completely (with no explanation) is quite harsh I feel.

I have been tested for PCO - it is highly unlikely I have it.

Again, has your DD spoke to the Dr about the foods she is restricting? Are they medical needs, or does she worry about her weight so has cut these out? If not medical perhaps a Dr could advice her on what vits & supplements she should be taking - wether for her skin or not (as it may well not be related to diet) this could be effecting her in other ways.

Thanks Whats and Attila. DD does worry needlessly about her weight, she attends a girls school where I suspect but cannot be 100% sure, that competitive dieting goes on. I do ensure that she takes supplements for vegetarians. I don't want to suggest limiting milk as I do worry about her dropping her calorie intake. Her GP hasn't spoken about PCOS but I will bring it up on at our appointment on tuesday.

I understand your worrying about her weight - I too had issues with my eating and weight and know that it can be a big stress! To be honest I think that's why your OP struck such a chord with me, sound very similar to me except I was slightly older!

I think the most important thing is really just being aware of different option and possibilities, it's great your looking into things for her!

Best of luck on Tuesday and I hope she finds something useful for her!

Hi there. I have suffered with acne for twenty years now. I have tried most of the treatments over the years, both topical and tablet form, but with relatively little success. In my teens I was on Dianette - this is worth a go. I was also prescribed trimethoprim (usually for urine infections) by a consultant dermatologist six years ago which improved things, but had to stop this as I wanted to conceive.
I tried trimethoprim again last year but it upset my tummy (doean't take a lot) and was ineffective, so I stopped that. Have just been prescribed a tetracycline and, it's only been two and a half weeks, it's definitely having some effect. My doctor said this is what I need to do before I am referred back to a consultant if there's no long term improvement- this is apparently what they try before accutane anyhow (?)
I too have heard about cutting dairy but, like your daughter, am a vegetarian who is also wheat free - it's too limiting!

I had heinous acne from age 17 until about 22. I tried lots of treatments bar accutane.

Antibiotics worked wonders for me but only while I was taking them so ultimately no use unless you can find a doctor who will provide permanent antibiotics.

Drying/peeling creams do not work in my experience - and they make your skin look awful.

Dianette is good. I expect that the GP will suggest this.

In my day you couldn't get accutane from the GP, had to be from a dermatologist.

The thing that made a massive difference to me, it sounds a bit old wives tale-ish but it's true, is to stop absolutely and completely from touching my face apart from to cleanse and apply make-up. Spot squeezing should be limited to blackheads and those spots that are absolutely 'ready' and the face should be cleansed afterwards. I was religious about this as I used to touch my face a lot and I made myself cleanse every time I touched my face and grew out of the habit. I believe it made a huge difference. I also stopped using a drying cleanser and switched to a cream or lotion with cotton wool rinsed off with water.

Thanks Emmas and HonestyBox. I think that Dianette looks like it's worth a try. I didn't think a GP would prescribe it for a 14 year but it seems I was mistaken. I've just taken DD for a shop at the MAC and Benefit counters which has cheered her up. The MAC concealer seems to cover anything.

mac concealer is magic.
i have terrible acne since i was 12. i had my first course of roaccutane at 14. i have had 2 subsequent courses post babies in my 20's. dianette worked the best for me. and a strict washing routine with eve lom cleanser and benzoyl peroxide 10% strength. if i missed on night i would wake up with a break out.
sorry about typing feeding baby.