Experiences with acutane or an alternative?

[busymama7]

My 20 year old son is still struggling with acne.  We feel like we have tried everything.  He is permanently off dairy. Gave up sugar for 3 months with no change.  Every wash and cream available over the counter (are there prescriptions?).  He's on a mission for our church but coming home in 4 weeks.   He tried a medication that blocks testosterone(?) and that didn't work.  Apple cider vinegar as a wash.  Tea tree/melaleuca.  Washes face 3x a day and changes pillowcase daily.   

The acutane is expensive and now is really not the time for an extra expense like that. My dh still has a job but took a pay cut.  Son has a job waiting for him at home but the company is currently closed mostly although his department is partially open. We aren't exactly sure what will happen when he gets here but also he has college in the fall to be saving for as well. 

Any other things to try over these 4 weeks before he gets home or warnings about acutane? 

[PeppermintPattie]

One of our kids used acutane as a teen, and our only regret with it is that we waited so long. It really does work. 

Before we tried that, we used a facial wash that was prescribed by the doctor. I don't remember the cost, but I'm sure it was less expensive. 

[EmilyGF]

My sister and I used accutane. It worked for me and also made it so my hair wasn’t oily within a few hours of showering.

[busymama7]

Okay so while doing some more research this am I realized that we may be dealing with DRY skin and not oily. Since he is far away I can't confirm until I speak to him next Monday but this past Monday he said he thought the thing that worked the best was coconut oil with melaleuca when he first started getting it.   We quit that and moved to washes and such. But he does have very sensitive skin, is allergic to sunscreen etc.   So it is making me wonder.  

[regentrude]

20 minutes ago, PeppermintPattie said:

One of our kids used acutane as a teen, and our only regret with it is that we waited so long. It really does work. 

This. I regret having wasted all the time on topical and oral antibiotics because I had reservations about the accutane. 

[busymama7]

2 hours ago, regentrude said:

This. I regret having wasted all the time on topical and oral antibiotics because I had reservations about the accutane. 

That is really good to know. I'm having such a hard time swallowing $180 a month for sixish months when we are out income.  Sigh.  

[Beth S]

We (both ds & I) remained totally wary of acutane.
After years of unsuccessful dermatologist appts, he had total success with acne.org products.
www.acne.org
We were most wary of the mental health side effects of acutane, but for some sufferers, it's worth the risk.

[saraha]

We are in the middle of these treatments with my 20 ds who is a red head with sensitive dry skin and it seems to be working pretty well. He hasn't reported any significant side effects.

[Ottakee]

Has he seen a dermatologist?   My daughter is having good success with Keflex twice a day, a cleocin T lotion am (RX) and Differen gel (RX strength) pm.

[busymama7]

54 minutes ago, saraha said:

We are in the middle of these treatments with my 20 ds who is a red head with sensitive dry skin and it seems to be working pretty well. He hasn't reported any significant side effects.

Im sorry I can't tell what you were replying too.  Acutane or other treatments?

[CTVKath]

I'm in my 50s now but have taken Accutane twice, once in my teens and once in my late 20s. Both were after exhausting topical remedies,  steroids and antibiotics, as well as over the counter products. I'm glad I took it both times and haven't had a problem since the 2nd time. I was scared of taking it both times but both times I had reached the point of scarring and didn't want to go anywhere or been seen by anyone. I regretted having waited so long both times.

[Plateau Mama]

I have taken Accutane twice, once at 14 and once in my 30's.  It works amazingly well but the side effects are horrible.  The first time I only remember the super, super dry skin.  As in if you moved your face it cracked and bled.  The second time I took it I also has the worst aches.  Every bone in my body hurt and some days I just could not move.  That being said the best, non-medical results I ever had were going gluten/sugar/dairy free, basically Paleo.  I have never had better skin than when I am on a strict Paleo diet.  If I had know that would help I would have gladly done that over Accutane.

[Corraleno]

Has he tried Differin? It used to be prescription only but is now available over the counter. I would try that before resorting to Accutane. My son did six months of Accutane and it ddid clear up his skin, but as others have mentioned, the side effects were really bad. His lips were swollen, cracked, and bleeding, his skin was so incredibly dry and itchy, and the sensation of the dryness/itchiness made him pick at his face even more than usual, which made his face look waaaaay worse for a while. Accutane makes your skin more susceptible to injury and it takes much longer to heal, so just absentmindedly scratching at a zit would result in a wound with a big purple bruise around it that would sometimes last for weeks. His face looked MUCH worse for several months, before things finally started balancing out. After six months his skin was pretty clear, although there was still some residual scarring, but within a year the acne had come back (although only about half as bad as before). He chose not to go back on Accutane, and just used the Differin cleanser, gel, and moisturizer every day, and eventually that cleared the rest of it up.

One thing you mentioned that is a particular concern is that your son is allergic to sunscreen. You really MUST use sunscreen while on Accutane, it makes your skin extremely susceptible to sunburn. DS got several significant sunburns, with very short exposures, while he was outside without sunscreen. Can your son use 100% mineral sunscreens instead of the chemical ones? 

If we could do it over, one thing we would do very differently is have DS take a lower dose for longer. It's not the daily dose that matters, it's the total cumulative dose and, from what I've read, taking a lower dose for longer is just as effective, while allowing you to avoid many of the nasty side effects. So if your son decides to go ahead with Accutane, I would do some research on that and discuss that option with your dermatologist, especially if he has very sensitive dry skin to begin with.

[busymama7]

37 minutes ago, Corraleno said:

Has he tried Differin? It used to be prescription only but is now available over the counter. I would try that before resorting to Accutane. My son did six months of Accutane and it ddid clear up his skin, but as others have mentioned, the side effects were really bad. His lips were swollen, cracked, and bleeding, his skin was so incredibly dry and itchy, and the sensation of the dryness/itchiness made him pick at his face even more than usual, which made his face look waaaaay worse for a while. Accutane makes your skin more susceptible to injury and it takes much longer to heal, so just absentmindedly scratching at a zit would result in a wound with a big purple bruise around it that would sometimes last for weeks. His face looked MUCH worse for several months, before things finally started balancing out. After six months his skin was pretty clear, although there was still some residual scarring, but within a year the acne had come back (although only about half as bad as before). He chose not to go back on Accutane, and just used the Differin cleanser, gel, and moisturizer every day, and eventually that cleared the rest of it up.

One thing you mentioned that is a particular concern is that your son is allergic to sunscreen. You really MUST use sunscreen while on Accutane, it makes your skin extremely susceptible to sunburn. DS got several significant sunburns, with very short exposures, while he was outside without sunscreen. Can your son use 100% mineral sunscreens instead of the chemical ones? 

If we could do it over, one thing we would do very differently is have DS take a lower dose for longer. It's not the daily dose that matters, it's the total cumulative dose and, from what I've read, taking a lower dose for longer is just as effective, while allowing you to avoid many of the nasty side effects. So if your son decides to go ahead with Accutane, I would do some research on that and discuss that option with your dermatologist, especially if he has very sensitive dry skin to begin with.

 Yes there are some sunscreens he can wear like the zinc ones and organic ones.  It's probably a chemical and not exactly"sunscreen" in general.  Thanks for the information!

[Plateau Mama]

Yes you become super sensitive to the sun.  You will burn just thinking about going outside.  One of the things I did the 2nd time was timed it so that it was late fall/winter while I was taking it.  Living in Seattle there is no sun that time of year so I really did not need to wear sunscreen often.

[saraha]

18 hours ago, busymama7 said:

Im sorry I can't tell what you were replying too.  Acutane or other treatments?

Sorry! the Acutane

[Tenaj]

Be wary of the mental side effects.  My oldest took accurate and he had made me promise not to let his younger siblings take it.  Despite the screening questions, he remembers those months as very dark.  We did not know until later and I don't think he really recognized it until after the treatment.

[J-rap]

Has he actually seen a dermatologist?  There are prescription meds they'll probably try before accutane...you usually don't jump from over-the-counter creams to accutane.

My dd had very severe acne.  We started with typical OTC creams, then moved on to Proactive and major diet changes.  She finally saw a dermatologist and she put her several prescriptions:  an oral antibiotic (that was temporary -- 3-6 months I think?), tretinoin, benzoyl peroxide (which I believe can also be over-the-counter), and I think clindamycin.   Her dermatologist hoped to see results within 3 months, or else was planning to move on to accutane, as a last result.  I was really nervous about accutane (because of side-effects), so pushed to keep her on the other routine for longer than 3 months even though there was absolutely no improvement.  At the 4-month mark, her skin finally started turning around.  And by 6 months or so, it was pretty much cleared up -- truly amazing. 

But after all that, if it had not cleared up, we would have moved on to accutane.  My dd's skin was that bad.  Having clear, beautiful skin made such a difference for my dd.  It turns out that cystic acne does run in the family...  A couple of her cousins (boys) ended up needing to use accutane.  It was fine.  It cleared up their skin and they were glad they used it.  From what I understand, you're usually only on it for 6 months maybe?  (Because of side-effects.)  Then you're off of it until it flares up again, and then you're put back on it again.  At least that's how it was with my nephews.