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acne - again


AngieW in Texas
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My 17yo is getting really frustrated.

 

She has had problems with acne since she was about 11yo.  We know that she produces a ton of oil. In order for her hair to not look greasy by the end of the day, she has to use Walgreen's T-Plus Salicylic Acid shampoo (which I discovered from this board).

 

Over the years, she has used the products that I have listed below. Some worked for a few weeks, others never did anything. Nothing worked for more than a few months.

 

Neutrogena sonic wave - did nothing

Acne-Free - helped a little for a few weeks

honey - did nothing

apple-cider vinegar - did nothing

zinc - tried this for over one year, but it did nothing

bentonite clay - did nothing

Queen Helene's Mint Julep mask - much easier to deal with than the bentonite clay, so we did it 2x/week for a full year, but it did nothing

Neutrogena rapid clear 7-day acne intervention kit - This was the first thing that had any positive effect for her, but it only has enough in it for one week and costs $20

acne.org - This did more for her than anything other than the Neutrogena product above. It didn't work as fast as Neutrogena had, but it kept her clear for about 6 months. Then it gradually stopped doing anything for her at all.

epiduo (prescription from dermatologist) - was wonderful for the first month, then stopped working

doxycycline (prescription from dermatologist) - was wonderful for the first month (started it after epiduo stopped working), but then stopped working

She used epiduo and doxycyline together for about 4 months and then stopped the doxycycline because that's a heft antibiotic to take when it is having no effect whatsoever.

 

Please help.

 

She gets almost no dairy products. It takes her about one month to go through a box of ice cream bars and that's the only dairy she has aside from butter used in cooking.  She doesn't drink milk or eat cheese or yogurt. She did try going one full month with no dairy products aside from the butter that I use in cooking and saw no change. She has a very healthy diet and eats lots of fresh fruit and raw vegetables every day. She is my dd who managed to turn the palms of her hands and the soles of her feet orange from eating too many vegetables (and it wasn't through juicing, she just ate a LOT of raw vegetables).

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Gosh, how frustrating. We did several months of a cream that was benzoyle peroxide and erythromiacin (sorry for the spelling errors). It was compounded by my pharmacy. It worked pretty well, but not really on my son's cystic backne, as he called it.

He used Mylanta every night on it and saw good results after a while--but he also had a round of antibiotics to clear up some infection there. The Mylanta kept out clearer.

Would you consider Accutane or something heavy duty like that?

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If I was you, I would go the BCP route at this point. Especially since your daughter is so frustrated, and she's tried so many other things. One other idea is to try Aczone. It is prescription only, but has worked well for one of my kids.

-Laura

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My son had severe cystic acne and we used many of the products listed above.  Finally he started using accutane.  It has made a huge difference for him.   Has your dermatologist recommended it? 

 

When I was a young adult (early 20's) I had bad (not cystic) acne, mostly on my back.  Birth control pills cleared that up well. 

 

 

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Does she have regular cycles?  If not, I'd consider the possibility of PCOS (irregular cycles and excess testosterone - which often but not always causes acne - are the primary symptoms).  Treatment would start with a lower-carb diet and/or metformin.

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Her cycles are pretty regular.  I have never heard that BCP could help with acne.  I have no problem with trying that.  It just isn't something that I've ever heard of before.

 

My 15yo is really frustrated too.  She was very lucky in that she didn't have any problems with her skin at all until around January this year. Suddenly her skin got really bad really fast. We don't know what caused it, but we haven't been able to make it go away. She was already taking zinc before and is still taking it now because it stops her lips from cracking at the corners. While my 17yo has very excessive oil production, my 15yo is generally very dry. She has always had to use shampoo for dry hair and needed to moisturize every day. Doxycycline just made her sick. She only took it for three weeks because she was sick those entire three weeks.  She was careful to take it with a meal and far away in time from any dairy and from her zinc.  The epidou didn't help her either.  She is currently trying acne-free.  Her cycles are not at all regular. We have actually discussed BCP to regulate her periods.  She will sometimes go several months between periods and then she'll have a killer period that lasts 10 days with pain so bad that she just stays in bed. Then she'll have her period show up like clockwork for the next 6 months.  She seems to have one long skip happen about 1x/year and one really short interval (about 2 weeks) about 1x/year. I had wildly erratic periods up until I started on BCP at 20yo.

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Are both girls using a good moisturizer twice a day?  I know that sound off for the one with oily skin, but a good cream moisturizer (we use Cera Ve but there are lots out there) will actually reduce the oil production - look for one that says "noncomedogenic". 

 

DD19 was able to keep her acne in check in high school using BCP and moisturizer (we tried all the other things in your list above too).  Unfortunately, when she went off to college, she went off the bcp figuring she had "outgrown" the acne.  Very wrong - her hormones went right out of whack and she developed much worse cystic acne.on her face.  We are not battling it with Accutane and that is getting it under control, slowly but surely.

 
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Does she have regular cycles? If not, I'd consider the possibility of PCOS (irregular cycles and excess testosterone - which often but not always causes acne - are the primary symptoms). Treatment would start with a lower-carb diet and/or metformin.

I agree. Her symptoms are very similar to mine as a teen and I have PCOS. I now eat paleo and work out like crazy in an attempt to control it. I'd really look in to it.

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