Teenage Acne - what can the GP do?

[Tarrarra]

Poor ds is really suffering with acne. We’ve tried lots of skincare, most recently the nip+fab teen range but nothing is shifting it on his face or back. Is this something that the gp can help with and if so, what shall I be asking for? Thanks!

@vivariumvivariumsvivaria

Thanks JamesWilby

Also, thanks for your abs.

I spotted this the other week which looked good and they do sachets for trial

https://lifejacketskinprotection.com

Forgot to say that Duac is a topical antibiotic cream (prescription only).

@Ticksallboxes

My son's acne disappeared at 15 and never returned after he started using Acnecide cream (Benzol peroxide), which we got on prescription.

It took a few months to work but has been amazing.

It didn't work so well on my DD but she switched to something called Duac cream, also on prescription, which has been better for her.

@Ticksallboxes ds just started on DUAC yesterday after using acnecide for a few weeks so 🤞🏼the additional topical antibiotic part of it works for him too.

Was your dc acne similar to this or less/more? This is it healing after a flare up a couple of days ago, it varies how bad it is.

MissLucyEyelesbarrow
Yes of course, people need to be aware of all side effects and this should obviously be discussed with the dr before any referral is made.
As with any medication there are side effects of using roaccutane but I was highlighting that for both of my children there were none.
Our dr was in my opinion sympathetic as she understood that teenagers are sometimes self conscious about their skin and she acknowledged at this time of their lives when they should be having fun and socialising, staying home because you feel embarrassed can also have a negative impact on them.
She referred us to the hospital where they again went through everything and I was warned to keep an eye on their mood.
Personally it was the best thing I could have done for them. They’re 23 now and my daughter still talks about how she cried before her prom as her skin was so bad.
Some drs are not as sympathetic and just keep giving out pills and potions. I imagine roaccutane is used as a last resort as it involves hospitals and numerous appointments.
Do what works best for you.

@WeAllHaveWings my DD14 is more t-zone smaller spots but more of them.

Do you mean your DC is using Acnecide plus Duac?

TBH I don't think my DD gave Acnecide a chance and may have used it sporadically before she said it wasn't working. Duac is making them less bad on her, but in comparison Acnecide worked miracles for my DS, but he's a lot more diligent with skincare.

He's had perfect skin for about two years and I can't believe he just grew out of it - definitely think Acnecide is amazing.

Duac worked for my DCs as well. DC17 still uses it.
Also got from GP as a regular medication.
It is both benzoyl peroxide plus antibiotic clindamyacin...switch pillow cases to white ones as it bleaches cloth.

@Angel2702 change to a GP that does offer prescription treatment for acne - your poor DS can easily get help!

As per my other posts, I found Acnecide (benzol peroxide) cream worked amazingly on my DS and Duac topical antibiotic is also really good. Both on prescription.

@pbdr

There are lots of treatments available. First line treatments are usually topical ones like benzoyl peroxide or antibiotic creams/gels. If that doesn't work there are options of oral antibiotics, or at the extreme for really stubborn acne that isn't responding to anything else, sometimes roaccutane is used (although usually only under dermatology advice and supervision).

Exactly what happened with my son, the topical antibiotics helped for a while, the oral antibiotics helped for a while. Ultimately roaccutane sorted it out. It isn't easy though, quite a rough few weeks.

I was worried about roaccutane, I spoke to a consultant psychiatrist I know and she felt my son's acne was so bad that his mental health was probably more at risk from that than from roaccutane. Obviously we kept a close eye on him but his main issue was the lining of his nose was so dried out he kept having nose bleeds. He felt it was worth it.

[quote Ticksallboxes]@WeAllHaveWings my DD14 is more t-zone smaller spots but more of them.

Do you mean your DC is using Acnecide plus Duac?

TBH I don't think my DD gave Acnecide a chance and may have used it sporadically before she said it wasn't working. Duac is making them less bad on her, but in comparison Acnecide worked miracles for my DS, but he's a lot more diligent with skincare.

He's had perfect skin for about two years and I can't believe he just grew out of it - definitely think Acnecide is amazing. [/quote]
He has been using Acnecide for the last 5-6 weeks twice a day. Strangely his t-zone is mostly clear, just the occasional white head, he gets it worse on his cheeks and jawline.

Dr prescribed DUAC to use once a day in evening. Ds is planning to continue using the Acnecide in mornings - don't see any harm doing this as it is same benzoyl peroxide % as DUAC and his skin is already used to it.

Really hope if he keeps persevering for a few more weeks it works as well as it did for your dc! Will report back in a few weeks with hopefully a clearer picture!

I imagine roaccutane is used as a last resort as it involves hospitals and numerous appointments

Sigh. No, it's a last resort because of the potentially serious side-effects. The fact that 2 people (your DC) happen not to have had side-effects is neither here nor there.

After trying virtually everything we went to the GP and they referred DS to a Dermatologist who has been super supportive.

My only regret is that we didn't go the GP earlier as he has some scarring.

@MissLucyEyelesbarrow Most people here may not have your professional expertise but they're perfectly entitled to speak about their own experiences.
I had the usual teenage spots but, due to a reaction to hydrocortisone, as an adult suffered a hideous outbreak of acne that none of the topical products touched. My GP just told me to put nothing on it - not even make-up and it was honestly traumatising. Spent ages and a fortune seeing 3 different dermatologists privately.
Had a course of Lymecycline and Dianette that made me ill but it did clear and Yasmin maintained my good skin.
I think too long was spent trying all the different options for my DS1. He was on Lymecycline long term, which isn't great either and stopped having any effect after a while. I too was wary about Roaccutane but DS now has perfectly clear skin as a result. Obviously you have to keep an eye out for anything concerning but I would have welcomed hearing others' positive experiences even if it is worth trying everything else first.

[quote WaitinginVain]@MissLucyEyelesbarrow Most people here may not have your professional expertise but they're perfectly entitled to speak about their own experiences.
I had the usual teenage spots but, due to a reaction to hydrocortisone, as an adult suffered a hideous outbreak of acne that none of the topical products touched. My GP just told me to put nothing on it - not even make-up and it was honestly traumatising. Spent ages and a fortune seeing 3 different dermatologists privately.
Had a course of Lymecycline and Dianette that made me ill but it did clear and Yasmin maintained my good skin.
I think too long was spent trying all the different options for my DS1. He was on Lymecycline long term, which isn't great either and stopped having any effect after a while. I too was wary about Roaccutane but DS now has perfectly clear skin as a result. Obviously you have to keep an eye out for anything concerning but I would have welcomed hearing others' positive experiences even if it is worth trying everything else first.[/quote]
Of course, everyone can and should speak about their own experiences - when have I said otherwise?

What is intensely frustrating and worrying, though, is when posters are given the message that Roaccutane is the best treatment for all and that, by implication, if your GP doesn't refer you for that straightaway, you are somehow being fobbed off. As I posted above, referring everyone to secondary care (hospital) is not the mark of a conscientious GP, but of a lazy one who can't be bothered to try less risky treatments first, and who doesn't care how long waiting lists get.

I explained in some detail about the risks of Roaccutane - and no one needs to take my word for it, just Google - yet @Cassimin still thinks that patients aren't referred for Roaccutane because doctors think it's too hard work.

@MissLucyEyelesbarrow You are right - Roaccutane is a very serious last resort. It changed my life and I was very lucky that the side effects that I suffered on it were not the worst you can have - but still impacted me severely during the course I was on (not helped by a nurse who refused to readjust my dose after I lost 8kg due to the side effects so I was on a very heavy dose for the last 5 months).

You sound like a very sympathetic GP. From my experience and talking to a lot of other people who have had severe, disfiguring and chronic forms of acne (cystic and conglobata like I had) there are a lot of GPs out there who take no interest in (or appear to take no interest) in helping those struggling with the psychological impact of acne.

I guess what I was saying was that it's easy to give up after your 5 or 6 courses of antibiotics don't do a thing and you've tried every over the counter option and the GP just shrugs. You feel completely abandoned and resigned to a life of misery. But there are options out there that I don't think many people know how to access - in my experience you have to push for it.

That being said, I wasn't at all suited to being on roaccutane as a teenager - mentally I couldn't have done it. But as an adult I was capable of coping with it and it genuinely changed my whole life. Just being able to wear backpacks, bras with normal straps and fitted tops after 15 years of pain, infections, and loose dark clothes to hide blood stains is truly remarkable.

I am in support of lucy here. I am a GP and my three DC had scarring acne.Roaccutane is a fantastically effective treatment for acne but has significant side effects. DD's skin is lovely but her mental health and confidence took a beating and I would always encourage young people to try the alternatives first. My middle DC didn't go for it , having gone through the options as per NICE guidelines , still having bad skin but seeing his previously rather alpha sister having panic attacks. DC3 has other medical conditions. He is very assiduous with duac and nicam and keeps his skin as good as it can be without roaccutane. He also has reached the thresholds for roaccutane treatment.As yet he doesn't want to risk it. It isn't always the best solution is all I would say. See your GP , follow the pathways and listen to your DC.

I live in Australia where private services are easy to access and there isn’t GP gate keeping. My DD wasn’t prescribed Roaccutane in the first instance, neither was I expecting it to be.

Her routine involves basic cleansers and moisturisers, topical Retin-A and some of the nip+fab wipes. She had moderate acne to start with, now there’s just the isolated spot.

“To start with” was only a few months’ worth though, her skin went from pretty good to terrible around the time of her first period.

I had terrible acne as a teenager and well into my twenties. It utterly crushed my self esteem as a teen. I would definitely echo the advice of people here who advise not to go too hard with the harsh cleansers : looking back i am sure I made mine worse by over washing and scrubbing, as well as dolloping on high strength benzoyl peroxide . Gentle is good! I was prescribed various things by the GP (tetracycline antibiotics, the pill, Retin A) which worked well for a short time but tue acne always come back. In the end Roaccutane (two courses: one in my teens and one in my late 20s) did the trick . Luckily I had no side effects from it apart from dry eyes.

I'm in the same position with DD.

We've been prescribed Zineryt in the past and it didn't make a dent in it tbh. We're now on Duac and whilst her forehead acne has calmed, her temples, cheeks and chin seem to have gotten worse. We use a gentle Cerave cleanser before hand.

I feel awful for her, she starts high school in September and I don't want her to be self conscious.

I had my ds at the dermatologist and tried all sorts. I started getting him regular facials with my facial lady and she used Dead Sea salt soap on him. I bought some and he uses it everyday along with a once a month facial and his skin has never been so clear

What a great informative thread! Thank you

For those who have not had luck with other treatments, I'd like to recommend a zinc + niacinamide gel.

Of course, acne is very individual, and what works for one person may not work for others. But it's the only thing that has made any difference for me in 22 years of trying various treatments. (I've had acne since age 11, am 33 now, and even roaccutane had no effect for me. It's not completely gone now, but it is greatly improved.)

Absolutely take him to the GP, there are lots of treatments as you can see by this thread. But do expect it to be a long road as you go through the different levels of treatment to find the one that works for you.

I have 4 kids, one has perfect skin, lucky him, two had moderate-severe acne that responded to oral antibiotics plus topical retinoids, and one has just started roaccutane having failed to respond to anything else. His skin is horrendous right now - he’s firmly in the “gets worse before it gets better” stage which the dermatologist warned him about. Side effects not too troubling so far, but he’s only a couple of weeks in.

It’s important to go through all the stages of treatment though to find the least “invasive” (in terms of effect on the body) one that works.

I have adult acne and the antibiotics didn't work. I was given these first.

Duac was a godsend, my skin cleared up in a week. Buy white pillowcases they get duac because it bleach's everything.

I keep reading duac was a lifesaver for so many but it's bit making much of a difference to my DDs. 😢