Cystic acne

[ILoveSparklers]

I had a few cysts in my chin the last couple of months. Really hurt, used to get tem occasionally but now one constantly. Anyone else suffer? What treatment do you recommend?

[PragmaticWench]

I had years of different antibiotics, dianette, creams, gels and even liquid antibiotics that smelled of vinegar from the GP! Whilst they worked to some extent, nothing shifted the acne completely and I had it on my face, neck, shoulders and chest. The impact on my self-esteem and relationships can't be underestimated. I was eventually referred to a dermatologist and took two courses of Roaccutane in my mid twenties. The difference was incredible!! Yes, there were side effects but I honestly didn't care once my skin cleared, and stayed clear afterwards. Low cut tops were a revelation, in lots of ways!

However, I'm now in my early thirties and the acne on my chest and on the back of my neck has crept back (I had to have a high-necked wedding dress). I'm not taking anything as I'm pregnant and am really worried about people seeing my chest when I breastfeed. I think that I'll ask for another low-dose course of Roaccutane once I'm done with breastfeeding.

Good luck with your GP OP, I think everyone has the right to request a referral to a consultant? It is definitely worth explaining the impact it has on you emotionally and that it hurts.

[cathyandclaire]

I think it's a good idea to take pics on your phone of all the bad days...then you can show the doc because sod's law says your skin will be fab on the day of the appointment!

[LtheWife]

If your GP is hesitant to refer you ask them to have a look at the map of medicine. Anyone who suffers with painful nodules or cysts should be referred to a dermatologist to be seen soon (not as an urgent case, but quicker than someone without nodules or cysts). They should do a blood test first however. You can see the flow chart they should be working from on the nhs website healthguides.mapofmedicine.com/choices/map/acne1.html

[FairPhyllis]

Worth trying Roaccutane. NB - it doesn't work for everyone. It didn't work for me, but I'm happy it's helped so many other people. What helped for me was laser treatment.

[ILoveSparklers]

Pics on phone is a brilliant idea :)

[PragmaticWench]

I just asked my sister (she's a pharmacist) and apparently there is a topical version of Roaccutane, a gel I think, that can be used instead. Might do some research.

[ILoveSparklers]

On the plus side... Generally if you have acne, you are less susceptible to wrinkles? Please tell me there's a benefit there somewhere?

[lurkingaround]

There is a topical version of Roaccutane, P-Witch. It's called Retin A. It's good, but can be hard to use as it can cause a lot of redness and peeling. It's probably on a par with Duac or Differin (more so Differin). Depends how bad your acne is, I suppose. Having been there done that (repeating myself) I'm all for going for a cure with Roaccutane for cystic acne.

ILoveSparklers I love your optimism! I know one of the reasons I went on Roaccutane at 40 was that I just couldn't bear the thought of still having spots AND getting wrinkles (sad to say they were starting). Whatever about having one or other, both was just NOT FAIR!!!

[lurkingaround]

P-Wench! Sorry got the name wrong!

[Speedos]

I had laser treatment combined with a glycolic peel and even after one session my skin was so much better, well a week later anyway.

I've had 2 follow up peels only and my forehead is completely smooth.

I've never tried Roaccutane so can't comment on that.

[MrawMraw]

I have cystic acne, caused by hormones (PCOS). I sympathize, it is actually painful and I have scarring. I wish more HCP's would take it seriously.

I started treatment with Benzol Peroxide gel, which does help a bit but doesn't stop my cysts from actually forming.

GP offered antibiotics but I refused as I get stomach problems on Antibiotics (strips the good bacteria, and the acne is causing pain but not internal probs).

Eventually a blood test for other issues found the underlying cause - hormonal acne due to PCOS, so I was referred to a specialist, who told me the only ways to really shift acne caused by hormone imbalance are -

1. Dianette
   
2. Roaccutane
   
3. Anti-Androgens such as Spironolactone, Furosemide, or Cyprotene Acetate.
   
   However, all of the above have side effects which could maybe outweigh the benefits of using them.
   
   Dianette has all the usual side effects and risks of the pill, and then some!
   
   Roaccutane the liver risks and other associated risks , Cyprotene has this risk also.
   
   Spironolactone is a diuretic and will make you pee A LOT at the doses needed to make a difference, can have the problem of raising potassium blood levels too much which is possibly dangerous, and has been linked to cancer in rats (but not proven).
   
   All need monitoring.
   
   Spironolactone (what I was given) has completely solved my acne altogether. However it will stop working as soon as you stop taking it, so if I stop taking it I will consider Roaccutane.
   
   I put up with the acne for years just as a fact of life, wore heavy concealer, hid my face a lot in public, but it has been great to be rid of it.

[FairPhyllis]

Mraw is right that if it is hormonal you have to do the drugz. Mine is hormonal in that I have "normal" levels of testosterone, but my body for some reason is very sensitive to even very low levels of it, so I have some PCOS symptoms without actually having it.

Roaccutane and Dianette didn't do much for me, but Yaz (think it is called Yasmin in UK) has pretty much stopped any breakouts, and I had laser treatment for scarring and redness. Since then I've been able to keep things more or less under control with clindamycin and Differin.

I'm not sure that acne and oily skin (hence fewer wrinkles) inevitably go together - I am becoming increasingly convinced that I actually have quite dry skin.

However if you haven't had Roaccutane then I would strongly recommend giving it a shot, especially for cystic acne, because so many people do get really good results with it. It is so frustrating and demoralising to still have it as an adult - I always thought there would be a day when it magically cleared up by itself, but that hasn't happened yet.

[ILoveSparklers]

Thanks everyone. I was on diannette for 10 years... It worked but you know it may sound silly... But I feel more emotionally stable and capable when I'm off it.

[LtheWife]

Doesn't sound silly at all Sparklers, whilst taking dianette I was very emotionally unstable. I went from almost homicidal rages to suicidal depression and everything inbetween. Very unpleasant and it didn't even help my acne.

[ILoveSparklers]

Messing with your hormones does have an impact doesn't it. I feel much more confident off it. Like it somehow "dumbs" me down... Can't explain it. Would rather put up with the cysts than go back on it... Might see if the differin gel helps.

[dontmixthecolours]

I'm in the same boat. Saw GP this week who told me I need to be on antibiotics for 9 months before she'll consider anything else. She says this is because my body has been through a lot recently (3 miscarriages in 14 months). Dianette worked brilliantly for me but I can't have it now because of an increased risk of stroke.

I know it sounds silly but i can't get anything I like to wear for Christmas that'll cover me up enough and it's getting me down

Sorry, that was a pointless post

[ILoveSparklers]

Not a pointless post at all. I have a blue lace dress that covers everything...and I love it... Will see if I can find a link.

[ILoveSparklers]

www.phase-eight.co.uk/fcp/product/phase-eight/Dresses/Rhona-Lace-Dress/201813050

Phase 8 do loads of dresses that cover well :)

[AlreadyScone]

Could be perioral dermatitis? My new GP took one look at my chin and diagnosed it about a month ago. Antibiotics prescribed, working so far...

[dontmixthecolours]

Thanks so much sparklers, you may have saved the day

[msrisotto]

MrawMraw Thanks for that post, very informative.

I've been on Dianette for about 10 years, I still take it....I reckon i've fallen through a net somewhere by staying with my GP and just getting repeats from the pharmacy. I haven't been able to move GPs because no one else will prescribe it to me! So I have to travel back to my parents home to pick up prescriptions. Nevermind. I don't plan on coming off it for now (you can also buy it over the counter abroad) but when I do, I will seek an appointment with a dermatologist. I have come off it in the past in favour of Microgynon and Yasmin but they didn't work and the acne came back. Interested to hear about anti-androgens. I am concerned about the risks of roaccutane although hopefully with lower doses it is better?

[lurkingaround]

mrsrisotto Would you consider going on Roaccutane while on Diannette? You have to be on contraception while on Roaccutane so you could go on it and get it over and done with? Like I said before, but I can't say it often enough, my only regret with Roaccutane is that I didn't do it earlier. I only needed 20mg, (usually dose is approx 60mg I think) and I did get dry lips, and slightly dry skin (oh the joy, fantastic), but that was all.

Tough time dontmix, sympathies, it's awful isn't it. I had a vicious outbreak after one of my mc. I disagree with your GP, I would be asking for a referral to discuss, can't see the point in waiting, only leaves you with more marks.
Cystic acne is cystic acne, whatever the reason.

[msrisotto]

Gosh, i've never even thought of that. How would I be able to tell that it was working though? I have good skin whilst on Dianette but it deteriorates whilst off it so if I was to take roaccutane whilst still on the Pill, you wouldn't see any results.... Also, a GP may not refer me whilst my skin is good. Did your GP refer you to a specialist for the roaccutane Lurking?

[lurkingaround]

Yes, mrsr GP referred me. My skin wasn't awful (I thought) at the time, but derm was horrified I hadn't been treated sooner with Roaccutane. She (derm) considers scars from acne to be unacceptable. Most dermatologists are very clued in, so while I get what you say about your skin being fine on dianette, I think they would know from you skin, scars etc, whether you need Roaccutane. Maybe I'm wrong, worth a consultation tho. Nothing to lose. And a consultation would give you a chance to ask about dose and side effects and all of that.

I told my derm I was fine on Dianette, but she still tut-tutted the fact I hadn't been treated with Roaccutane.

[msrisotto]

Thanks for your advice Lurking. It's certainly given me a lot to think about.