Dermatologist for acne — advice

[niccig]

Wearing a mask has made DS’ acne worse. Prior to the pandemic, it wasn’t that bad. It also cleared up some over Winter Break, so I’m thinking the mask is part of the problem, it’s mostly on his chin and jaw line. I think he needs to try something else other than over the counter wash and cream. I’m taking him to a dermatologist tomorrow. Any advice? A friend said to try creams first before trying medication. She said their dermatologist wanted her daughter on Accutane. DS is 17. I’ve got no idea what would be best treatment

Thanks


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[acmom]

My DD is having similar issues with the mask increasing the acne issues, especially around her jaw line and chin (some on her mid-cheek where it hits too). We went to the derm, but ended up not sticking with their regime. They had her on several am / pm creams and washes and it was just too much for her. Plus she has sensitive skin so didn't tolerate them well (had some burning and redness, which dr said would probably happen). Meds were really $$ so we didn't refill and she is just continuing the OTC stuff. She didn't see much improvement with the prescription stuff, but they said it would need 6-8 weeks to see any improvement and might get worse first. She stopped before that point.

No real advice...just commiserating.

ETA: The dermatologist said there was good news/bad news with DD's acne (she has mostly whiteheads/blackheads but a lot of them - no cystic type acne). Good news was that it wasn't usually a type that caused any scarring. Bad news was there isn't any easy fix - no oral meds and need to be very persistent with topicals to see results. Said hers should also improve with age and will also improve some when she isn't wearing a mask as much (along with some face guard sports equipment she wears that also could be making it worse).

[jgenie]

Please report back. DS1 is having lots of acne. I had hoped it was mask related but it didn’t clear up during winter break and he wasn’t wearing a mask at all then. Can’t get in to see his dermatologist after school until March.

[niccig]

My DD is having similar issues with the mask increasing the acne issues, especially around her jaw line and chin (some on her mid-cheek where it hits too). We went to the derm, but ended up not sticking with their regime. They had her on several am / pm creams and washes and it was just too much for her. Plus she has sensitive skin so didn't tolerate them well (had some burning and redness, which dr said would probably happen). Meds were really $$ so we didn't refill and she is just continuing the OTC stuff. She didn't see much improvement with the prescription stuff, but they said it would need 6-8 weeks to see any improvement and might get worse first. She stopped before that point.

No real advice...just commiserating.

This could happen with DS too. I don’t think he’s doing what the pediatrician suggested. And if it aggravates him, I can’t see him sticking with it either.


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[niccig]

Please report back. DS1 is having lots of acne. I had hoped it was mask related but it didn’t clear up during winter break and he wasn’t wearing a mask at all then. Can’t get in to see his dermatologist after school until March.

DS’ didn’t completely clear up over winter break but he appeared to be better. I’ll let you know what they suggest


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[AnnieW625]

Accutane is amazing for cystic acne but honestly it should be the last resort, but at 17 it might be a good option. There are side effects that can last a lifetime too (dry skin, sensitive skin, nasal passages are super dry…..my nose only runs when I am sick). I took Accutane at 18. Dd2 is having acne issues and Mario Badescu’s pink drying lotion and buffering lotion seem to be working well for her. She is 11 (almost 12) but has yet to see a dermatologist, but I will probably ask for a referral at her 12 year old well check visit. Good luck with your son.


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[bisous]

Accutane is amazing for cystic acne but honestly it should be the last resort, but at 17 it might be a good option. There are side effects that can last a lifetime too (dry skin, sensitive skin, nasal passages are super dry…..my nose only runs when I am sick). I took Accutane at 18. Dd2 is having acne issues and Mario Badescu’s pink drying lotion and buffering lotion seem to be working well for her. She is 11 (almost 12) but has yet to see a dermatologist, but I will probably ask for a referral at her 12 year old well check visit. Good luck with your son.


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I agree with this. Paula Begoun used to have this great list of "battle plans for acne" that I wish I had screenshotted. It was basically a step-by-step process of trying interventions from the simplest (washing your face) to the most extreme which would be Accutane. I have lots of friends that used Accutane with great success but IME it isn't the first line of defense. I'd start with gentle cleansing, exfoliation with a good BHA and benzoyl peroxide. Or if you're going to a derm anyway, maybe Differin? I've had great success with Retin-A but many find it highly irritating. Good luck!

[Kindra178]

My ds is on low dose oral dox and will take an extra high dose dox (100) for 3 days during a flare. He does Cereve face wash and Onextin for treatment. He started doing a series of diamond facials at the derm's office; we will see how that goes. Note: they are covered by insurance. We will absolutely consider accutane in the next year or two as needed.

Niccig, face washing morning and night is key. The Cereve has been great; it's easy to find everywhere and doesn't break the bank. The doctor also recommended micellar wipes immediately following all sports and exercise.

ACmom, why doesn't the derm recommend either "acne surgery," which extracts the blackheads/milia or diamond facials?

Masks don't help at all, they all wear them on their chins for practice and games so it literally becomes a soaking wet bacteria laden chin covering.

[gatorsmom]

DS1 had moderate-bad acne. He mainly had it around his hairline and into his hair but eventually spread down to his chin and cheeks. We tried several different things which I can't remember now. One of them was Sodium Sulfacetamide 10% & Sulfur 5% cleanser and we tried Epiduofortegel. They all did a little something, but weren't totally successful. The one thing we tried which had a dramatic result was 90 days of antibiotics. The dermatologist recommended sarecycline but I was nervous because it was a relatively new antibiotic so they gave DS1 something in that family. It might've been doxycycline or tetracycline, I can't remember. But it helped TREMENDOUSLY. Now he only gets pimples when he's been resting his head or chin in his hands OR when he's stressed about finals. But even then they don't come back with the same ferocity that they did before. The doctor said the pimples could come back again and DS1 might have to go on another dose, but the doctor didn't expect it.

[ang79]

DS1 had moderate-bad acne. He mainly had it around his hairline and into his hair but eventually spread down to his chin and cheeks. We tried several different things which I can't remember now. One of them was Sodium Sulfacetamide 10% & Sulfur 5% cleanser and we tried Epiduofortegel. They all did a little something, but weren't totally successful. The one thing we tried which had a dramatic result was 90 days of antibiotics. The dermatologist recommended sarecycline but I was nervous because it was a relatively new antibiotic so they gave DS1 something in that family. It might've been doxycycline or tetracycline, I can't remember. But it helped TREMENDOUSLY. Now he only gets pimples when he's been resting his head or chin in his hands OR when he's stressed about finals. But even then they don't come back with the same ferocity that they did before. The doctor said the pimples could come back again and DS1 might have to go on another dose, but the doctor didn't expect it.

Just finished with a derm appt. for DD1 and came here to see if others had experience with antibiotics for teen acne. Glad to hear it helped your son! DD1 has had ongoing issues with acne for about 1.5 years. She started using Cureology about a year ago and it helped a lot but not all the way. She felt mask wearing made it worse so we started seeing a derm last fall. He prescribed tetrinoin topical cream, which in combination with the currology has helped some, but it seems to have flared up with getting her period a few months ago. Today he suggested doxycycline. I asked about other antibiotics mentioned here. He said the safe cyclone is still new and very expensive, Tetracycline is not used as much anymore but that doxycycline is still pretty common treatment for the redness and inflammation that some acne has. I think
We will try it and see if she has any trouble with it (he mentioned nausea as a common side effect).


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