This week, the article “Managing Teenage Acne” interested me the most because I can relate to this article. Acne has been my biggest insecurity and it still is. I had painful acne since I started middle school. I would always try to cover my face with my hands and I also hated taking pictures because it makes me think im ugly. I would get jealous of people who has clean and soft skin. I’ve tried and spend a lot of money on many acne products, but my acne would just get worse. I had acne all over my forehead and a bit on my face. It made me feel horrible about myself. At those times, I really wanted to wear makeup and cover everything up, but I heard that if I wear makeup it would just get even worse. I continued finding products that would help me cure acne. After four years, my acne finally calmed down. My skin is better after drinking lots of water and using products that helped my skin clear up.
This week, the article “Managing Teenage Acne” interested me the most because I can relate to this article. Acne has been my biggest insecurity and it still is. I had painful acne since I started middle school. I would always try to cover my face with my hands and I also hated taking pictures because it makes me think im ugly. I would get jealous of people who has clean and soft skin. I’ve tried and spend a lot of money on many acne products, but my acne would just get worse. I had acne all over my forehead and a bit on my face. It made me feel horrible about myself. At those times, I really wanted to wear makeup and cover everything up, but I heard that if I wear makeup it would just get even worse. I continued finding products that would help me cure my acne. After four years my acne finally calmed down. My skin is better after drinking lots of water and using products that helped my skin clear up.
I had horrible acne from my early teens to late 20s. In my 20s I also experienced GERD and was advised to eliminate added oils and oily foods (cheese, butter, nut butters, etc). It helped the GERD but also totally cleared up my skin within a month. Ultimately I was able to add back those foods eliminated but the acne did not come back- I guess I broke the cycle.
Unfortunately, even decades later the information passed on from most dermatologists regarding acne has not updated. It is still wrapped around outdated dogma that was never quite accurate in the first place. In fact, information such as 'diet does not have much of a connection to acne,' needs to end. I am a Licensed Acne Specialist and own a thriving Acne Clinic in Albuquerque, New Mexico. We teach our clients the truth about diet, and simple lifestyle habit to change in order to clear skin fast. Clearing acne, even the most severe stages is easy, if you know the steps. Once you stop feeding acne, it flattens out and drys up quickly. Additionally, it is important to use the right type of birth control method, in spite of what your gynecologist may suggest. Low estrogen versions actually create oil production in the pores, including hormone-free Paragaurd IUD. For men, breakouts in the beard area can often be triggered by the use of electric shavers, razors with the moisturizing strips and the use of pore-clogging shaving gels. For both men and women breakouts on the forehead, temples, back, shoulders, and chest, tends to be from pore-clogging ingredients found in hair products. Another pattern is to take notice which side of your face you may be breaking more out than the other, usually by the mouth, and cheek line, this is typically from pressing phone to the skin. Along with triggers such as these mentioned, there are many foods that feed and support the breakouts.
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@Kimberly Lovato I’m curious what board licensed you?
Dermatologists are licensed by their state medical board and certified by the American Board of Dermatology only after completing medical school and three years of specialized dermatology residency and sitting for a rigorous examination.
How long does one train to be a Licensed Acne Specialist? Is this a state license in New Mexico, equivalent to a medical license?
What you discuss are integrative approaches to management of acne which most dermatologist do incorporate. You may have not seen the recalcitrant cases that don’t respond to your lifestyle interventions because they likely don’t follow up with you. Dermatologists treat acne effectively and have the data to back it up. Please present your data rather than conjecture, or your “hunch” about how to treat acne.
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@Kimberly Lovato
In the era of trumpism and misinformation, I’m not surprised that someone without a medical degree claims to know more about a specific disease than the well educated medical specialist who has dedicated their career to a complete study of this topic. The only recognized “licensed acne specialist” in medicine is a dermatologist (a physician who went to medical school and completed 4 years AFTER school to study skin disease”). If this does not apply to you, and it is evident that it doesn’t as you mistake folliculitis for acne, please do not call yourself an acne specialist, or otherwise conflate your qualifications while giving advice to the public. It is unethical and misleading, and your advice is missing relevant context, meaning it is wrong. For starters, there are many different types of acne. Acne vulgaris, acne conglobata, nodulocystic acne, acne excoriee, acne fulminans, acne rosacea, etc. The treatment (medically proven, not based on anecdotes as you imply) will depend on the type of acne. So, being able to identify acne and the type is the first step of providing efficacious treatment, which of course will vary depending on the type of acne. If you really do wish to become a licensed acne specialist and treat and advise the public, please go to medical school, do a dermatology residency, pass a dermatology board licensing examination first. Otherwise, please preface your commentary with your actual qualifications, which should always matter.
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@Human Being If you are implying only a dermatologist is capable of clearing acne, then you are wrong. We have a thriving clinic in Albuquerque, New Mexico which has been clearing every case we work with for several years; including Acne Inversa, Acne Conglobata and all stages and types of acne.
It is unfortunate that many physicians are more concerned with certifications rather than results.
Over 73% of our clients were once with a dermatologist who did not clear their acne. Most have taken at least one to five rounds of Accutane, however, acne often returns because the root cause was not eliminated. This program is not based on a 'hunch' or just managing acne. The absolute fact is we clear them 100% and help teach them how to manage their acne moving forward. The program is about empowerment.
Many of our clients suffered from disfiguring, long term acne which never abated with the efforts of their dermatologist. Again, the only resources they had to offer are antibiotics, topical prescriptions, laser treatments or Accutane.
With our program, EVERYONE clears. I cannot emphasize this enough. We have the proof, we have the results. This is what you should be most concerned with.
Rather than question my credentials, look at our proof and hundreds of 5 Star Outstanding reviews at ABQAcneClinic.com
My daughter asked her doctor to prescribe Accutane to clear up her acne. Women have to go through pregnancy tests before the treatment and every time the script is refilled. Her lips bled as a side effect. Her skin looked fantastic after 10 months. The doc stopped her treatment. Two years later her acne returned and just as bad. I suggest other treatments and use Accutane as a last result only.
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@Sharon O’Malley Unfortunately most dermatologists are unaware of the connection between diet and acne. They are only hitting the tip of the iceberg when they mention dairy. There are many 'healthy' foods that trigger acne as well. Additionally, women who take Accutane are typically given low estrogen birth control methods which increase oil production in the pores. This includes methods such as the hormone free IUD Paragaurd. It has a copper tip that triggers acne as well. So, once you stop Accutane, soon after acne starts up again. The bottom line is, your daughter started breaking out again because she is still unknowingly feeding acne. I am a Licensed Acne Specialist in Albuquerque, NM and own a thriving Acne Clinic. We teach our clients how to control acne quickly and for life, with simple food swaps and lifestyle changes. Just be aware Sharon, dermatologists rarely have the answer when it comes to acne. They are only taught the use of medications. Lastly, they don't even realize they prescribe medications such as Retin A Cream or Tretinoin which contain Isopropyl Myristate, its rated a 5 on the comedogenic scale (which is the worse rating), its a pore clogging ingredient. Don't believe me, check it out yourself. They will tell you the 'skin is going to get worse before it gets better', or 'it may take months for it to start working'. It rarely does, instead it just drys out the skin and irritates it.
@Sharon O’Malley
As a counterpoint- I took it, experienced all these side effects, but the acne never returned. I'm extremely grateful for accutane.
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@Camille You luckily were one of the fortunate ones. We have worked with thousands of clients who have taken Accutane and they did not do well. Many are currently suffering with severe IBS, depression and sexual difficulties. Some clients had family members who had taken Accutane and committed suicide. This is why they found us and learned how to manage acne easily for life. The point is, why even chance it when you do not need to?
I had horrible acne on my face chest, back and a rare type of acne on my stomach. This affected me greatly growing up. The only thing that worked was accutane which virtually cured it for about 5 years. It's come back slightly especially on my neck but nothing that's all that big of a deal.
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I didn't have acne until I became an adult. I have very dry skin so my pores clog very easily. Went through the recommended prescriptions with the dermatologist, antibiotics, etc. But there is now great non-prescription stuff. I swear by the acne.org products for the last 5 years (I am not anyway involved with them, just greatful for their products. It is also a .org which I believe is because the founder just wants people to be acne free whether or not you buy his products). The products are super gentle and moisturizing and very reasonably priced for the amount you get. The main treatment is a low concentration benzoil peroxide lotion that. I still get ocassional blackheads and whiteheads (mostly because I might skip a nightly wash) but they clear up so much faster. My teenager just introduced me to the new spot patches made of hydrocolloids that are great for those flare ups. I will battle this until menopause, I expect.
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@Ms B
Bad news: my own still flares at about age 72. Good news: it's mild, not like in the past. I suspect that one of the problems is old damage to the pores which tends t make them clog, because they are now in patterns. Very controllable, but now dry, not oily, skin aggravates s treatment. Good luck!
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I had severe acne all through high school and well into my 30's. It was physically and psychologically painful. Today, I'm left with scars on my face, back, and chest. I remember being bewildered and in awe of others with near flawless skin. How did they do it? It seemed so unfair. I did get treatments here and there (retinol and benzoyl peroxide creams) but they were never miracle cures, only making things slightly less terrible.
In hindsight, I realize counseling would have been tremendously valuable for me as young adult male. It may have helped me sort out my own feelings about myself and the condition and how I believed other people saw me. Unfortunately, I wasn't aware of the benefits of such services.
I can only imagine how teens with acne are faring today, with the "selfie" and social media. No amount of filtering, Instagram or otherwise, would've hidden my acne. This must be so hard on them. I hope treatments are improving and parents are more aware when it comes to getting support.
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At age 27 I still had a face full of acne and pain. The helpers arrived, unbidden, with suggestions of suppositories, chiropractics, fasting and exercise. How crazy, it seemed, but I was desperate to find a solution, to have an adult face!
The fasting and cleansing of my overburdened intestinal track and body did the trick over the course of a few years. I had new skin and, luckily, hadn't scarred despite the cystic acne that plagued me since early adolescence. It's not an easy fix, it takes determination and guts, but it is a lasting one that changed my life into one of healthy living and vegetarianism. I consider the acne "a problem with a gift in its pocket" as I am now 70 years old and quite a healthy, fit specimen for my age.
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@nysandi I’m very interested in what you did to cleanse your intestinal track. Would you mind sharing more specifics? I have a hunch this would benefit my daughter who has tried everything. She was most recently taking antibiotics which were prescribed by her dermatologist but I suspect only worsened her gut health. TIA!
@Andrea Have you read the recent article in the NYT regarding fecal transplants for gut health, as well as other maladies?
https://www.nytimes.com/2019/01/18/well/live/what-is-a-fecal-transplant-and-why-would-i-want-one.html
My daughter began having acne troubles at age 14. We first worked with a dermatologist who tried various topical creams and then advised she take Minocycline. She presented it as a temporary plan, and as it turned out, only led to suggesting we increase the dosage... I was really hoping to avoid long term oral meds unless a last resort. At that point, we went to her pediatrician (an integrated doctor) and expressed a desire for a holistic approach. After 9 months, she's now really showing improvement. This has meant a focus on gut health. My daughter has always had on and off issues with dairy. She eliminated it entirely along with gluten and eggs. She takes probiotics, a multi vitamin, fish oil, and triphala (Aryuvedic herb). Uses one topical medication. She sees an aesthetician monthly and I buy more expensive facial care products and make up for her than I do for myself. I'm grateful we can afford to do so, as it has been very difficult for her at times and she had become withdrawn from social activities, etc. It's an ongoing process-- doesn't mean she'll never eat regular bread again, but it's a plan of focusing on diet, exercise, good sleep, etc. and in the process, hopefully balancing hormones. I'm proud of her commitment to trying.
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My son just started isotretinoin and has to jump through all the same hoops, except for a pregnancy test, as girls. Although it is definitely a pain, especially figuring it out while he is away at college, I read all the potential side effects, including depression, and I would rather he have a monthly check. Nothing has really worked for him so far including long courses of antibiotics, diet changes, topical treatments. He doesn't seem to care about it disfiguring his face and back, but he suffers from the pain of the cysts. I bought him topical probiotics with hopes that this would make a difference but it didn't. I'm interested in how the microbiome plays a role in acne and hope there will be more research in that area.
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I had just enough acne consistently throughout high school and early college to make me an anxious bundle. I tried birth control, prescriptions from bored dermatologists, gentle cleansers, and the over-the-counter creams all mentioned here. Nothing really made a difference (yes, even after properly using it for 6 weeks - 3 months).
As an adult, I began getting regular facials (about one every 6 weeks) and using the products my estheticians recommended (usually a cleanser, toner, serum, and moisturizer from just one or two brands). This has made a HUGE difference for me! I'm finally comfortable in my own skin.
If you're trying all the things mentioned in this article and still not seeing results, you're not alone. Acne, and skin in general, is tricky and constantly changing with age, season, travel, etc. I would highly recommend visiting an esthetician with good Yelp reviews at least once or twice to get their recommendation.
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Diet is absolutely a factor in acne and treatments like antibiotics create risks of even more adverse side effects down the road. Very sad that this article strongly tells readers otherwise. Antibiotics deplete the microbiome of healthy bacteria, not just acne causing bacteria, and should really only be taken in very serious instances - but of course that's not the widespread practice in our country's medical model that wants to throw a pill or prescription at every single malady.
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The connection between diet and acne is real. Refined sugars and caffeine both encourage our seb glands to work overtime. (For teen and adult women--they also contribute to insulin resistance, which encourages androgenic hair loss in some.)
A lot of teens develop a waxy feel to the skin of their faces and back, and a waxy buildup on their scalp. This waxiness is characteristic of seborrheic dermatitis.. It is a fungal (yeast) overgrowth on the skin, supported by the oily conditions. It contributes to redness and itchiness, and varying degrees of flaking. (Some sufferers have a lot of "scale," while others might just look like their skin wants exfoliating.) Facial cleansers with zinc, charcoal, and sulfur can help a lot w/ seb derm, b/c these ingredients are antifungal. Zinc and aloe are good for the scalp, which should be combed (w/ a fine-toothed comb) after each wash to remove scale (from scalp, not hair). Cleansers w/ these different ingredients should be used in rotation to avoid resistance.
Again, do not underestimate the diet connection. B/c it takes commitment and time to see results (not less than 30 days), many patients never get far enough to believe the connection is real. If they eschew caffeine and commit to fiber and foods with a low glycemic index they won't be disappointed. (Well, they will probably feel disappointment at first because they'll miss sugar, but that fades!)
Finally, a lot of acne sufferers also benefit from applying witch hazel to their skin.
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I suffered from disfiguring acme beginning at age 13, and continuing through my 30s. Accutane was prescribed in my 30s, and it was truly miraculous for me. I still break out occasionally, but at 67, I have no wrinkles at all. Truth be told, I believe diet played an important part, and the diet in our household was very high in sugar - muffins at breakfast, cookies with our lunchtime sandwich, and a homemade dessert every dinner. While we all enjoyed that a lot, I could see that whenever I visited my mother's home, I began to break out again. These days, my skin seems to break out with tiny while pimples just under the surface - perhaps a diet of no carbs is the solution, in addition to a multi-vitamin every day to provide the B vitamins that I may be missing. I have been infertile all my life - maybe there's a connection there to be researched?
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@MicheleP There's a disorder called PCOS (polycystic ovarian syndrome) that is linked to acne and infertility. It often accompanies excessive hair growth. It is also treated by metformin (nd n-acetyl cysteine) which is a drug used in diabetes/insulin management. Certainly for some people, sugar metabolism and acne are related, and in some cases infertility as well.
I found that for me, pregnancy caused adult onset acne, and found some research that suggested zinc supplements could help. They did, tremendously.
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@Tracy Thank you, Tracy,for that feedback. I have found that B-vitamin supplements helped tremendously. It's a little late for me to worry about being infertile, but I have always been grateful that I lived at a time when women had value in addition to being solely mothers.
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I developed acne at the age of 14. From the first, I wanted to see a dermatologist, but my mother wouldn't spend the money, saying I only had "adolescent bumps," which, in her deluded mind, were not as serious. Finally, at 16, I was diagnosed: acne. It kept getting worse and nothing worked. My mainstays were salicylic acid and benzoyl peroxide, with the occasional sunlamp treatment. Years later, I used several products with retinoids.
At age 28, I was prescribed my first course of Accutane. For the first time, I had clear skin. The dry lips, a common side effect, were worth it. It knocked out the acne for about 18 months. I did three courses by the age of 40, at which point it became difficult to obtain because of the lawsuits brought by pregnant women who did not follow the very clearly set out instructions. I feel sorry for their children, but the possibility of birth defects was well explained to patients.
At 45, the acne finally began to burn out. I have no doubt that my life would have been much improved had I had disease-free skin during my adolescence and youth. I always felt ugly, dirty, nasty, and inferior. Teenagers being what they are, I'm sure some of my clear-skinned peers would have agreed with me.
At 61, my skin is relatively unlined, one of the few benefits of having had oily skin.
Acne is not a mere "cosmetic" problem. It's time that the medical establishment, including health care insurers, understood that.
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@Former Acne Sufferer
Medical specialists who study skin, understand this. It is however hard to challenge public misconceptions about acne and how to treat it. Most medications, including acne treatments have side effects. They are also highly effective. Since the endpoint is to prevent scarring, which is disfiguring, permanent and not covered by insurance, treatment may escalate to accutane/isotretinoin if other topical treatments have not worked in completely eliminating acne. In a small percentage of people (5-10% of acne sufferers), multiple courses of accutane may be needed. The side effects can be managed and the patient is followed carefully to monitor the note serious and rare side effects. Dry skin is common on accutane, which can be treated by use of moisturizers and chap stick. It would be nice if we could cure acne by simply changing our diet, or using a single cream for a day. There is no other cure for nodulocystic acne other than accutane- a well studied drug, with side effects that can be managed and should be monitored (by law). If there were, it would be published in a medical journal and would become standard practice. Thank you for sharing your story.
The totality of these and testimonials make it clear that treating acne is both highly individual and challenging. I can relate—I had intermittent acne from age 14 until menopause.
My mother grew up in post-war Malaysia and never personally experienced acne. No one in her family had it and she was baffled by my skin. Given that acne was rare when she was growing up, it's striking to see how prevalent acne is today in Malaysia. I see it *everywhere*.
It's frustrating to see that customizing treatment is often a years-long process. In my mid-40s, after years of unimpressive results with Retin-A, I finally tried improving my nutrition. I started drinking 2 liters of water/day, slept more, minimized dairy and ate more meat and vegetables. My new diet and sleep regimen worked brilliantly. Until it didn't. The last two years of perimenopause brought painful cystic acne on my chin—something that I'd only experienced a couple times in the previous decades of my life.
I was distraught because my face hurt all the time and was further stressed by my GP who shrugged that "a lot of her patients had the same problem. Ride it out until menopause."
Menopause actually did bring respite from the cystic acne. My own situation was mild by comparison to the testimonials shared here. But did it have to be this way?
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Male adolescents with severe acne should be aware of the growing evidence that severe acne in males is correlated with a substantial increase in the risk of prostate cancer (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838533/).
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Age 43. Two rounds of accurate. Still acne. I take spirolactone to keep things at bay. And Kate Somerville sulfur wash. But acne won’t go away even with diet, peels, meds.
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I hope people with stubborn acne try spironolactone first---no side affects (for me), and the only thing that worked.
Two treatments of Accutane in my late teens didn't work, and the treatment was a horrendous experience psychologically.
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@SLBvt
At one point I was considering taking spironolactone for fibroid issues. But the list of potential side effects scared me. They included permanent facial hair growth and lowering of the voice. Accutane did not seem nearly as scary when I took it decades ago.
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This is no cure, but on a new cystic lesion, if you cover it at night with a blister hydro seal "Bandaid", it will often drain it. It will not disappear, but it will reduce its size and perhaps eliminate the pain.
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I have PCOS and acne is a common problem for women with this condition. A course of minocycline, birth control, and a couple of topical ointments did the trick. Now that my acne is under control I use a salicylic acne wash and a hypoallergenic face lotion and that's it. I'll sometimes go back on minocycline for a couple of weeks or months if I have a bad breakout that I cannot get under control. I don't want to become resistant to any antibiotics so I take the absolute minimal dose possible. Overall, I try to keep my regimen simple so that I stick to it.
Clear skin has become just one more conspicuous and prestigious social status achievement for kids. The rich kids, who have health insurance, get on Accutane and have clear skin. The poorer kids, or those without health insurance, have to endure the stigma of acne. It's a very sad situation.
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I'm an orthodontist always looking for great content for my practices's FB page. This article goes up this AM.
Thanks
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There is a mostly unknown brand called Evologie that uses a combination of high performance non-toxic naturals including Azelaic Acid -- i am very anti-benzoyl peroxide as it severely strips skin and allows for more bacterial penetration over time & thus bigger lesions (not for everyone but for a lot of people like me). A very challenging cycle i think people should avoid -- recommend Evologie 3 piece system but in particular the cleanser and blemish serum.
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@celestelee
Azelaic acid didn't work for me. My complaint about benzoyl peroxide is that it didn't work and it bleaches fabric. I ruined some clothing because of it.
Accutane worked.
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I was put on Accutane in 1982, when it first came out. It drastically changed my appearance and cleared my skin. It's a miracle! In addition, I suffered from severe depression that of course, the acne probably made much worse; however, I do not blame the acne for the depression. It took me decades to put together the right treatment for depression (in my case two drugs). So, my gratitude goes out to a fabulous dermatologist who prescribed the Accutane in '82 and another great team of doctors that helped with the depression.
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@Bea Dillon — the Accutane made the depression worse. It’s a well-known side effect.
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@PL this is not a factual statement that is borne out by any evidence, at all.
@PL
Not true at all. There is NO evidence that accutane causes or worsens depression despite many years of studying this possible link. Please do not spread misinformation.
Proactiv Solution (the original, not the new system) actually did the trick in my case. I didn't tolerate antibiotics well, and no other combination of topical ointments and cleansers worked, even when prescribed by a dermatologist. Just thought I'd share as discovering Proactiv has been such a relief for me.
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I had cystic acne from about 14 until 28. Tried it all - topical creams and gels from the dermatologist, proactiv, clean eating (including 3 months in India eating vegetarian and very low sugar or processed foods), urine therapy (does dry out some pimples, actually!). Finally, Accutane. Low dose, 6 months. Monthly doctors appointments to check blood/liver. Side effects included dry skin and mouth, but luckily no depression. And IT WORKED! 32 and acne free. Very thankful for Accutane.
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Agreed that accutane works extremely well for many, but for girls and women, the requirements (blood tests, online questions, timing requirements, pledges, etc.) are beyond over-board. My daughters were extremely angry that a prescription is basically just handed to male patients, while they had to jump through flaming hoops of fire just to fill the darn prescription. It's more than just blood tests - the doctor's office has to trigger the online system at just the right time, the patient has to log in and answer questions at just the right time, the pharmacy has to have the meds in stock and fill at just the right time, the patient has to pick up the prescription at just the right time, etc. One mistake (including mistakes made by the clinician's office or pharmacy) and everything (including the blood test) has to be redone. We jumped through all the hoops with one daughter, but for the one in college several states away - the complexity is an insurmountable barrier.
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@Paul — see the recent article in the Times about how the well-being of even a potential fetus is given higher priority than women, who are increasingly treated as mere vessels.
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@Paul sorry, but boys have to jump through the hoops as well. my son has to go to monthly appointments before his prescription is filled, he has to fill out questionnaires, most definitely the pills are not just "handed to him". As I write, I am looking at his pledge.
All that being said, Accutane is a known teratogenic. Thank goodness precautions are being made to ensure no baby suffers birth defects because of Accutane.
As a dermatologist, I want to thank you for drawing attention to this common medical problem, that can cause great distress, and both physical and psychological scarring. I find acne sometimes to be a "subtraction problem", sometimes an "addition problem", and sometimes both. Avoidance of "picking", smoking, alcohol, sugary foods and drinks, whey supplements, and white starches may help. Getting adequate sleep, enough whole plant foods, and maintaining sensible hygiene practices may also. Thorough evaluation, including an evaluation of the psychological impact, is critical. Adherence to a topical regimen (there's the rub with many adolescents AND adults!) is often highly effective over time, but isotretinoin (fka Accutane) can be dramatically so, thank goodness. Best to beware of acne imposters, too, like rosacea and folliculitis.
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@Jennifer Goldwasser, MD, FAAD Ultimately Accutane is a temporary, and costly, in terms of health, option for all acne sufferers. I say ALL, because if you are aware of all the foods that feed acne by increasing oil production in the pores and inflammation in the body, you have won a big part of the battle. This information is not taught in medical schools, more specifically in the area of dermatology. The focus is primarily on the use of medications such as antibiotics, Accutane and topical prescriptions. In fact, products such as Retin A Cream and Tretinoin contain an ingredient called Isopropyl Myristate. On the comedogenic scale rating from 0-5, it is a 5 out of 5 for being one of the worse pore clogging ingredients on the market. Again, dermatologist and most medical professionals are completely unaware of this fact. Instead, they follow the protocols taught in medical school and rarely go beyond to consider information that is outside the box. We clear the most disfiguring acne daily at my clinic in Albuquerque, New Mexico without any type of antibiotics, topical prescriptions, Accutane or laser treatments. If you truly understand the root cause of acne, all stages and types are easy to clear if you know the steps. I do not mean any disrespect, however, we prefer to deal with real facts, not an antiquated school of thought. Check out ABQAcneClinic.com and you will see for yourself.
@Kimberly Lovato
We learn from research studies. So if you have a great treatment for acne that is better than any of the well studied efficacious treatments, please publish your work so that the medical specialists can review and potentially learn. This is a lot more ethical than claiming the doctors know nothing, then in the same breath, directing people who are suffering to your clinic and offering treatments (as a non-doctor) that have not been studied or proven and which insurances probably doesn’t cover (meaning more profits for you).
To the public: beware of charlatans.
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@Kimberly Lovato
Isotretinoin is an imperfect treatment, in that it does not always produce a durable remission, and it has potential side effects. On the other hand, based on my twenty-five years of firsthand clinical experience, I would say the vast majority of patients have excellent results with this medication. My undergraduate degree was in nutritional biochemistry, and I have great respect for the role of diet in disease, but I beg to differ with you when you suggest that the use of topical and oral retinoids is "antiquated".
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Several mentions of Accutane and the successful course of treatment that often accompanies it. Please pay close attention to the side effects - our elder son had no issues other than dry skin and it cleared him up nicely; our younger son experienced the joint pain, but worse than that was the depression. After roughly two months, he asked to stop using it because the depression symptoms were so bad (he was 15). We agreed and his symptoms cleared up after stopping the Accutane; over time his acne did clear up. I would urge anyone, especially parent to listen to your kids concerns - if they exhibit or share that they are feeling the mental health side effects, get help and take action. Depression is not to be take lightly and doesn't just go away, it is a serious mental health issue.
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@nvguy I had a very similar experience to your younger son. Unfortunately I didn't stop the treatment. Luckily I didn't suffer long term damage but I fear that I easily could have. Now that I'm a parent I wouldn't let my children use Accutane and I'm glad parents such as yourselves are paying close attention.
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I had a similar experience with Accutane. Never had any depression in my life, even when my skin was terrible. but on Accutane, even when my skin was finally clear, I felt very down. Once I stopped the pills, within 2 weeks my mood was back to normal. I do think the Accutane-depression link is real.
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Spironlactone for girls/women is very effective and relatively cheap. It has side effects, and is a prescription medicine. I think it is safer than Acutane in regards to mental health.
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My persistent cystic acne, which deviled me from 13 to 25, cleared up completely and quickly when I started putting a thin film of zinc oxide cream (yes, diaper rash ointment) on the acne-prone areas every evening. It’s inexpensive and does not require a dermatologist to try it. I’ve recommended it numerous times since and it works for most (not all) people.
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Interesting. My acne persisted into my 30's and cleared when I started taking zinc supplements. It's worked for many friends as well. It worked much better than antibiotics.
4
Zinc oxide is great for problem skin. I used a Shiseido sunscreen with a high percentage of zinc oxide and it controlled my oily skin and acne. It’s been reformulated but there are many with high percentage of zinc oxide - google or search reddit for suggestions.
Also good old fashioned sulphuric soap. Some people are allergic to sulphuric, but if you’re not it can be effective.
Many remedies are cheap and not going to be suggested by dermatologists.
Before going for big pharma, review your shampoo and conditioners,these can be huge culprits in causing breakouts!
Paleo and very low-carb/ketogenic diets have been reported to work for lots of people. This could be due to their strong anti-inflammatory effect and greatly lowered insulin levels. They are at least worth a try.
8
Dear Jane. This is a very important article. As a Dermatologist, with a particular interest in the treatment of people with acne, I believe that they do not get the treatment they deserve. 90% of people with acne never see a dermatologist and buy random “one size fits all” products in drugstores or the web. The ones who do try to treat themselves, frequently fail due to lack of commitment. A new, free, mobile app, MDacne, solves many of these problems with computer vision and artificial intelligence. Take a selfie and the app analyses your acne (physician-free). Based on the analysis subscribers receive to their home a full kit of FDA cleared medications personalized to their acne severity and skin type (same as a good Dermatologist would do); at a fraction of the time and the cost). Taking selfies during the treatment and the free finetuning of the products provided by service, increase the commitment and efficacy of the treatment significantly. I believe that it’s time to democratize medical services and provide a more affordable, effective health service, starting with acne.
11
I captained multiple sports teams in high school and dated the prettiest girls. There were still days when I faked sick because I was so embarrassed of my acne.
I dread finding out whether I passed that on to my three young daughters - I can’t imagine what that’d be like for a girl in high school, where they’re (unfairly) judged for their looks above all else.
10
A Friend I grew up with had the most severe case of acne I had ever seen. Lesion on top of lesions. He was a unexpected youngest child and 14 years old youngest in his family. In addition the parents never provided skin care for him, granted the time frames was 1964 -70. I done think there was much available at the time, but my poor friend ultimately committed suicide, and acne was another of the burdens that his life had and IM sure it contributed to it.
10
@Franpipeman
The psychological dangers are real. An extraordinary friend of my son died by suicide ...which the parents linked to his acne treatment at the time. His outlook on life went from sunny to eclipse-dark. His family and friends were devastated. I truly hope that effective medicines respecting the physical AND psychological components of these precious young lives are developed...stat.
5
@Même Poivré
That was not the point of @Franpipeman's comment, which discussed the dangerous effect of NOT receiving treatment for acne.
4
It's really baffling to see a doctor state in the NYT that the link between acne and food is spurious. The reason people believe they're related is because the relationship is easily observable. It's just individual and based on how each person processes food, so you can't equivocally say X food causes Y result. If I eat chocolate I get a few skin issues. If my wife eats chocolate, she doesn't. That doesn't mean I should eat chocolate.
11
@Dan so you know more than a board certified dermatologist about the mechanics and etiology of acne? science isn't based on individual reactions. it's based on large-scale studies.
10
@Robin
My dermatologist told me some people find they have reactions to certain foods, others don’t. It’s just not common or consistent enough to generalize that “certain foods cause acne.” He said if something seems to make it worse for you, don’t eat it.
5
@robin Dermatologists and other doctors go by the books. They don’t make money when they recommend not eating dairy, sugar.
Diet plays a huge part of your skin conditions. Eat sugar, cause wrinkles glycerin. Eat bad oils get bad skin. Body ph can throw off your skin and make it prone to all kinds of skin ailments.
Only a very enlightened derm will recommend turmeric capsules and purslane to fight inflammation in the body.
1
I am a 49 year old woman who has suffered with acne since I was in my thirties, I have tried everything and nothing works, I believe it is genetic, both my parents have had issues but not as bad as me. I tried to get accutane when I was in my late 30s, but birth control is not safe for me with my high blood pressure and heart issues and trying to get to the doctor for a pregnancy test was next to impossible as I was running a small business with no one to fill in for me. Jump start to now, I am in the process of getting cleared for a hysterectomy, there is no way I can carry a viable pregnancy. I thought maybe the doctors would let up on me, since this was my situation. When the physician's assistant handed me the 60 or so pages Ipledge booklet, I said I am not sexually active because of my female problems, but if by some crazy incident I became pregnant couldn't I get an abortion? She hit the roof and said don't you bring your political issues into this office. When I took the Ipledge booklet home I was amazed to see it stating that if I didn't want to take birth control pills, if the doctor would let me I could practice abstinence, but it would be easier to be abstinent if I joined a religious organization. I want to sue over this inclusion of religious proselytizing in a government ordered publication, but I don't want anti-abortion nuts coming to my door. Women's health is being held hostage.
44
@baroque22
I don't even know how they can justify this approach. Are you a candidate for an IUD or diaphragm, or do they INSIST that the protocol for Accutane include the pill? This is another example of female-abuse in medicine. I'm so sorry to hear this.
13
To add one more thought...
Charles Bukowski wrote very eloquently about the onset of his cystic acne in "Ham on Rye.". I burst into tears the first time I read it, and the second time...
5
It is different for everyone. Some do well with topical prescription medication, some do well with oral prescription medication. Some must do Accutane to achieve clear skin. I say do whatever it takes!
14
My beautiful skin -- inherited from my mom. - is my standout feature in an otherwise plain face. It has allowed me to avoid or be lazy with make-up many a time. I can understand how hard it must be to have serious acne.
Let this article also be a reminder to those who would restrict insurance coverage for contraceptives for women They are used for much more than birth control.
34
@ms
Thanks, Ms. And incidentally, it's worth remembering that in the pre-Accutane years, doctors would sometimes prescribe certain types of birth control pills to teenage boys and young men with severe cystic acne.
7
Oh my god. Yes. The insurance plan for state employees in North Dakota is ‘grandfathered’ in for the ACA. It Does Not pay for any birth control if that is the purpose it is prescribed for. Luckily I have a couple of fibroid tumors that made my periods painful; therefore my prescription is for a Medical Reason, and I get partial coverage. I’ve had acne since my early teens and now I am over 50. Birth control finally reduced my acne by maybe 95% in my 40s. Now I dread having to get off of it!
4
I suffered from acne for years. But sometime in my 50s I hit on apple cider vinegar, which seemed to both ease the pain and balance the chemistry of my skin. I use it after cleansing whenever my skin shows a red spot coming on. And I repeat as needed. Also keep your hands off your facial skin. Sometimes hard to do with our “computer postures.”
5
Birth control did the trick for my daughter. Hated having my son on anti-biotics. Stopped that after too many months! The prescription topical worked OK. Was too concerned about accutane to try it. I’d suggest reading up on how it works. I believe it destroys sweat glands. That didn’t sound good for physical health down the road. I also read about people having increased permanent aches as they grew older. Anyway, I wish the best for those who have acne.
5
What about laser treatments?
2
@Margo Greene, laser treatments worked for me. Very expensive, though.
Really, the most helpful thing was learning to wash my face properly. Mild cleanser (Cetaphil), a (fresh each time) washcloth rubbed over skin, warm water rinse. The washcloth insures complete removal of sunscreen and makeup, and sloughs off dead skin. I used to overtreat my skin with spot remedies and dry it out too much, which made my skin issues worse.
Wash pillowcases often, keep hair out of your face, don’t poke at spots, wear sunscreen and don’t get too much sun. Get enough sleep.
6
Eat liver. It contains vitamin A and clears your acne.
4
@dan h
Thank you! I was going to post this, as it will be the best remedy for anyone.
2
@dan h
Any Vitamin A food works wonders- sweet potatoes, pumpkin, egg yolks, etc. Sulfur products work great too!
Oily skin and enlarged pores starting in elementary school (1960's), pustular and some cystic acne from jr. high through my fifties. Lots of harsh soaps, scrubs, astringents. Only started using gentler methods well into my forties. Most of the zits cleared up, but then I got the "permanent" wart-like bumps of sebaceous hyperplasia. Never had confidence to believe that I deserved to look ok - researched treatments online, but never followed through.
Then was diagnosed with AML in 2014. After multiple chemos and bone marrow transplants, my skin is clear and dry (even sebaceous hyperplasia is gone). Told my oncologist, "Every cloud has a silver lining."
14
@barbara c—"Every cloud has a silver lining." Congratulations on your survival! As a lifelong acne sufferer, this made me bark with laughter.
Though menopause has brought changes I'm still struggling with, clearer skin has been my own silver lining.
3
My daughter has moderate acne and what we learned is that everyone has different triggers: for some it's hormonal, others have food sensitivities and then there is product and topical sensitivities. Of course they can have some or all of those triggers. There are both internal and external factors. We tried various treatments at the dermatologist but her skin did not tolerate the harsh prescriptions well at all. The best luck she had was seeing a regular aesthetician who was able to fine-tune her treatments and products. She also treated her with ultraviolet light. For teen girls, the first thing I would recommend is throwing away all the makeup they are using and buy some recommended mineral products. Makeup seems to aggravate acne even though it does a great job of covering it up. It can be emotionally debilitating and I wish insurance would cover alternative treatments like facials.
16
Thank you for this important piece. I had severe acne as a teenager to young adul. My family was uninsured and unable to afford the “big-gun” Accutane (isotretinoin). Thus, I suffered with painful acne and poor self esteem throughout high school and college. I remember bursting into tears while getting a haircut once at the mall when I was 13 because - to her best efforts - the hair dresser couldn’t create enough bangs thick enough to hide my forehead. I even think my acne contributed to my eating disorder in college as I was terrified to eat certain foods for fear of making my skin worse. Fast forward to the present: my skin is clear, but when my 15 year old son started with the same familiar cystic acne last year I wasted no time. A wonderful dermatologist at Strong Memorial Hospital in Rochester, NY (Dr. Kathryn Somers) took his family history of acne very seriously and after short, failed trials of topicals went quickly to Accutane. A few side effects (extremely dry lips and sore joints) were hard on him for a few months since he is a hockey player, but we stuck with it and now at the 5 month mark he is almost 100% clear. Dr. Somers is wonderful at monitoring him monthly (Accutane can cause serious side effects and needs close monitoring by doctors and parents) and he should be off soon (possibly for good!) I am so thankful my son did not have to endure years of emotional (and physical) pain to get to this point. Accutane is truly a miracle drug in my watery-Mom-eyes.
43
@Caurie Putnam Hi, my son suffers from acne too and we have debated Accutane. Our doctor has said that there "may" be a link between Accutane use and stunted growth because I guess there is speculation that it might impact the growth plates. Did your doctor mention this? My mom is adamant that he won't go on it until he reaches his full height which may be 3 years away still.
@Caurie Putnam Hi, my son suffers from acne too and we have debated Accutane. Our doctor has said that there "may" be a link between Accutane use and stunted growth because I guess there is speculation that it might impact the growth plates. Did your doctor mention this? My son is adamant that he won't go on it until he reaches his full height which may be 3 years away still. We are so torn.
Other than Accutane, which saved me from awful acne in my twenties, avoiding soap was amazingly beneficial. Even today, in my sixties with an oily T-zone, I notice that using soap on my face always makes things worse, particularly if I’m breaking out. I believe there really is something to the idea of maintaining a natural, protective skin biome, which soap just strips away. And I think of all the years and dollars I spent on products to cleanse, exfoliate, and scrub away the “dirt” and germs . . .
4
@Spudz00005 Yes! I really wanted to mention this! In my late teens I learned about Dr. Hauschka cleansing creme which is basically ground almonds in oil which you pat on your skin and then rinse away. I used it for years and years. Now in my 50's I just use a washcloth with hot water and then moisturize with some kind of skin oil. Soap just gives the message to the skin that there isn't enough oil and then the skin goes into overdrive to make more oil! So using a cleansing oil or even just a warm washcloth will let the skin relax and then have less pimples than with cleansing soap!
4
I can only imagine the suffering of a young person, who is still developing their self image, caused by severe acne. I had mild acne (my brother had severe, my sister had none). I developed a program in my late teen after a famous skin-care specialist (Christine Valmy) visited the all-girls business school I was attending. She said, "American women treat their faces like the kitchen floor," and it was true. We tried alcohol, scrubbing, all sorts of things that dried out the skin, causing the sebaceous glands to produce yet more "oil." I also based my regimen on the Ernest Laszlo program. Here it is: 1) In the morning, wash your face with a very gentle soap (like Neutrogena). Use water that is comfortably hot, do not use a face cloth (which holds bacteria), splash your face with clear water to rinse 30 times, using only your hands. Apply a lightweight, non-comedic moisturizer. 2) At the end of the day, remove your make-up using a simple soap wash. Then a batter-operated skin brush, which will not damage your skin (if you press too hard, it will stop spinning). Do you entire problem area with this brush. Do not use a non-battery-operated brush, as you could easily damage uour skin. Rinse again as in the morning, 30 times with comfortably hot water. Use your own towel for gentle drying. Apply a lightweight, non-comedic moisturizer. That ended my acne (except for an occasional blemish). I received many compliments on my complexion in my twenties. Hope it helps.
5
I had mild/moderate acne that *felt* major. My bigger problem was an utter compulsion to "pop" . . . I lost hours and hours playing "search and destroy" an inch away from the mirror. I'd encourage parents to keep in mind that, at least for some teens, the underlying concern might be psychological (more than skin deep, if you will). On another note, acne seemed to be the exception rather than the rule at my preppy highschool, and I'll never forget the "lightbulb moment" I had when a well-off classmate confided she had monthly professional skin treatments. I had Clearasil! :) Today I still have lapses at the mirror (I'm a hair puller too) but things got better and I wish the same for all!
5
I had cystic acne for years, from mid teens to early 20's. I had heard about Accutane, but didn't have health insurance. Once I got a job that offered it, my dermatologist put me on it. It was a true miracle. In less than a week, the acne was gone. So was the constant disappointment and shame of something I could never really control or change. The scars are still there, but I'll always remember the relief I felt from the disease dissapearing.
25
@Jeff
And the good news is, there's treatment for the scars. I dated the LOVE of my life in college, who had severe acne -- and he always smelled of sulfur medicine -- (liquimat -- we all used it) and it didn't matter.
Good luck. Be happy, and know that it's the least important thing about you (the scars).
3
I had chronic acne as a teenager and was prescribed Roaccutane. It led to severe depression which disappeared when I finished the treatment. It cleared my acne but I would strongly recommend that any parent who allows their child to be treated with Roaccutane monitor their mood and behavior very closely. For me, the side effects far exceeded the benefit of clearing my acne and undoubtedly preventing any adult scarring.
5
@Simon accutane has many very bad side effects..
8
@Jim
Jim, an aggressive condition requires an aggressive response. For most of us, the side effects of Accutane--and not everyone gets all of them--dry eyes, peeling lips and skin, rashes , stiff joints, hair loss--go away after the course of treatment ends.
I think most people commenting here who have used Accutane will testify that the benefits outweigh the risks.
4
I had cystic acne from age 13 to 46. Tried antibiotics such as tetracyclin, which i used for three years, every day. Back then no one knew that antibiotics compromise the immune system. At age 56, i developed a few autoimmune problems, and it was the antibiotics from my acne years that did it.
The best thing was drinking plenty of water, even if it meant peeing more each day. This took care of most of my problem. Eventually, the acne went away. I never developed any scars because I never once picked at my skin.
Three lessons: 1) Drink plenty of water (after three days you should notice a difference), 2) Try to stay away from medication which might hurt your immune system later in life as it did mine, and 3) Do not pick at your blemishes so you can avoid the scarring and cratering. No one needs those.
1
@Bill: good advice. Please keep in mind that scarring can occur whether or not one "picks at" acne cysts.
2
Take COLD showers. Avoid HOT showers like the plague. Thank me later. Your skin will be glowing.
4
As many here have said - Accutane. It’s basically a miracle drug. I spent years wasting my time with antibiotics, Retin A, etc. One three month course of Accutane and I’ve had clear skin ever since. Yes, there are side effects, but they are worth it.
20
Yes they are!
8
My son was put on Acutane at age 16 or 17. He had used various presscriptions which did not help him. I took him to a new dermatologist that recommended the then controversial Acutane. The doctor stepped out so my son and I could weigh the pros and cons. He said "Mom, my face hurts." That was enough for me. Acutane was a miracle drug. That was 18 years ago and my son's complexion is beautiful with zero scarring.
22
I've had acne since I was 12. I am now 38 and despite having tried everything, including accutane, I still have serious acne. The stuff on the face is not too bad, but the chest and back are terrible. My dermatologist told me there was nothing left to try.
I am worried sick for my kids.
12
@A
A, sometimes people benefit from a second course of Accutane. You might seek out another opinion from a different dermatologisgt.
9
@A please try Evologie cleanser and Intensive Blemish Serum. it's doctor formulated, made with high performance naturals and actually works. don't give up.
Hi A, I did accutane at 27 and once after. Both times helped for awhile. I never wanted to use hormonal birth control but finally had to in my late 30s or early 40s for a uterine fibroid. Cleared up my acne for the first time since I was 13. Still using it. Don’t give up on Retin A tho if prescribed. I’ve been using it since I was 20 and I look at least 10 yrs younger.
2
I am so sorry for sophia . . . "chronic keloidal acne with extensive cystic scarring on back and chest." so I heard from both the air force induction and exit physicians. Iwo "rechecks" with possible rejection of service. this phrase was placed on my military records which I still have. I could hear their "wince" as they examined me. 1966. they had given so much tetracycline well . . . I was given Accutane. large mgs. quantities finally in the eighties. the acne was still so insistently present and disfiguring I can recall verbal exclamations and insults even now. it is a horrible, disfiguring condition which the public is unforgiving. Accutane stopped the active acne but I have almost complete scar tissue from neck to waist. several compromising "social situations" involved questions about my possible "disease" the first girlfriend and love of my lifeI many more followed. I grew a full beard. when i finally shaved after years, close i thought, friends who knew me and were horrified. the expression "ewwwww" still echoes. only in my seventies have I just thought I am tired of all of skin appearance and such. much sympathy to all who have "cystic" acne. the world can be very cruel.
William wilson dallas texas dallas press club 1981
43
@william wilson
These actors have / had acne. All have scars.
Ray Liotta
Eric Braeden
Richard Crenna
Brad Pitt
The world can be cruel. But these are not people you want in your life.
3
@william wilson I'm sorry you had such a hard time. My heart goes out to you.
2
I had terrible acne as a child. I am in my late 60's and have had to do many things to minimize the scarring. Accutane helped me tremendously, but prior to that a lot of damage had been done. So I had dermabrasion, 2 cosmetic surgeries. It's better but still noticable. It took a psychological toll on me in many ways.
When my son started having cystic acne, I got him on Accutane right away. I did not want him to have to go through what I did.
He had multiple treatments and it made a world of difference.
I share this because I want folks to know there is helpful ways to manage this. Don't give up.
31
No mention in these posts of what helped me in my 20s and 30s: going on an antidepressant. Better than any skin care routine.
3
This is a very basic article to a complicated problem not just teens.
Are you using cosmetics that contain Shea or cocoa butter, and coconut oil?
Look online for cosmetic ingredients known to aggravate acne.
Huge culprit shampoo and conditioners- try switching to more natural ones and those without silicones.
Benzyl peroxide is terrible for acne. It will dry the top part of the acne area and then prevent the rest of the acne issue
To clear up. Disaster!
Retin A works start at low dosage to prevent flakies, and use on a regular basis. 6 weeks is minimum and you may look worse before skin looks better. It helps skin turnover quicker and keeps it clear.
Diet! Ditch the sugars and white flour products. Drink lots of ware, seltzer, plain green tea,
Cleansing oils. Yup these are great for bad skin. They emulsify the oils on acne skin and wash them away better than soap which can
Overdry and then skin reacts by producing more oil!
Teens who are lazy can use micellar waters to do fast skin clean ups. Most are very gentle and use good ingredients.
Also as someone else mentioned bentonite clay with Apple cider vinegar works. It’s very potent combination but it kills bacteria and the clay is a very drawing clay removes debris from pores.
Birth control pills can cause cystic acne. They must be prescribed by a doctor. You will see ads for birth control on Instagram. Do not buy any hormones without a real gyno helping you.
5
my cystic acne cleared up by the
elimination gluten, sugar, & coffee.
years of being told diet was irrelevant did me a grave disservice and caused much unnecessary suffering
16
I'm very skeptical of the diet connection. My sister and I had completely different experiences despite eating the same diet. She lucked out with clear skin (despite following a punky, heavy makeup lifestyle) and I had cystic acne despite being scrupulous about cleansing and eschewing makeup. My mother, also scarred by cystic acne, was unhelpful - she just thought it was just the luck of the draw. It wasn't until I went away to college that I received help at the student clinic. First tetracycline and birth control pills which helped a little bit, but too late to prevent severe scarring. (In high school a nasty teenaged boy called me "crater-face" but I refused to bow to the insult). Finally Accutane in my late twenties when it was finally approved for use was my miracle. Such a relief it put a total stop to it, although the old scars remain forever. There still aren't good enough options for scar removal. Hopefully researchers will devise one as it would make a huge difference in people's lives - plus insurance should cover it. There is terrible prejudice against those who do not have "perfect" skin, in jobs and life in general. Takes a lot of strength and self-confidence to rise above it. As for those experiencing it now, I would say get to a doctor and be sure to use salycylic acid products night and day to put an "acid mantle" on the skin to minimize breakouts before they begin, and the benzoyl peroxide products to treat the breakout after it appears.
19
I seldom see mention of the role of iodized salt in acne...for myself and people I have known, eliminating iodized salt cleared up skin dramatically. Pass it on!
2
@Britt La Gatta I am 71 years old, first visit to dermatologist for acne when I was ten. Treatments were obnoxious back then (brown smelly sulphur liquid that got all over my pillowcase, severe skin drying that I now know worsened oilyness) but he also advised eliminating iodized salt. I have never used it since. We do live near the coast and fish and seafood are common in our diet, so goiter is not a threat. Sensitive oily skin was a curse for decades but my complexion gets compliments in these elder years (no wrinkles) when it matters less.
I am 56 and had severe acne as a teenager. Among other treatments I was prescribed various antibiotics, which I am absolutely certain caused significant IBS for many many years of my life starting at age 18. I am sure my gut was shredded by those meds, and I was misdiagnosed for a long time with "ulcerative colitis". Not sure the years of intestinal troubles were worth the acne "cure".
12
Go to the best cosmetologist you can afford. I took antibiotics throughout my high school years, stopped taking them at 19 and developed cystic acne overnight. No dermatologist could fix me. I suffered through injections that left me bleeding onto my pillow for 3 nights following each treatment. I was put on birth control pills that did no good. For my 23rd birthday my mother took me into the big city to visit a well-known skincare cosmetology expert. My skin cleared up in 6 weeks. Now in my 60s, I still have scarring, which the cosmetologist said was caused by dermatologists injecting my facial cysts over the years....The pain I felt at the time, physical and emotional, is impossible to describe.
7
@Madge Do not go t0 a cosmetologist - go to a dermatologist that is reputable.
16
Salt water facial sprays and witch hazel are beneficial.
And absolutely no fried food, especially deep fry, ever.
Refined sugar is also known to be a culprit for some.
Yet of course some people should definitely consult with a dermatologist if it is chronic or severe.
Personally, a sauna or steam bath does wonders for my complexion. As does swimming in the sea.
BTW, I had awful skin problems as a teen and young adult.
1
About a week after the birth of my first child at age 32, my hormones went totally berzerk. It was the worst cystic acne doctors had ever seen. I had very painful lesions all over my face, neck, back, scalp and even some on my legs. My back acne was so painful, no one could hug me. I avoided looking in the mirror, and when a business trip took us to Orlando, teenagers at Disney World pointed me out to friends in horror. The head of dermatology at Yale New Haven photographed me (with my consent) for research. Since I knew we wanted more children, and the warnings about birth defects scared me, I was unwilling to go on Accutane. I used some heavy duty antibiotics which were not very effective.
After the birth of my second child, when the cystic acne returned, I couldn’t bear the pain again. After two weeks, I weaned my baby and went on Accutane (even though I had just given birth, the pharmacy would not give me Accutane without a negative pregnancy test. Seriously.) Bottom line- Accutane made a huge difference. Although I still had some acne, it was nowhere near what I experienced after birth #1. And here’s the best part of Accutane: three years later, after birth #3, I had no acne. Could it have cured my acne?
8
Accutane was the miracle drug that cured my acne, but it returned some years later and I took a second course of Accutane. Changed my life.
9
It's not P. Acnes, it's Staph A. that causes cystic acne. Dermatologists are clueless. Equal parts calcium bentonite clay and apple cider vinegar masks for a month to draw it out.
Yes this sounds weird, but I've often thought acne scars on women's faces are attractive. I'm not sure why. Perhaps because a bit of misery pitched one's way as a teenager often makes for a more complex and interesting adult?
7
This is generally well-written and informative, but I wish it considered ultra-violet light as treatment - even if just to say it hasn't been tested. I don't have acne now, but my teen son does mildly, and (yes, it's anecdotal) I have noticed, in the summer, when he's outside in the bright sun, he has less acne than he does this time of year. I've heard that the ultra-violet light can kill the bacteria, and see ultra-violet emitting masks in the drug store acne product area. What's the science on it?
6
As bizarre as this sounds, both my kids cleared up their moderate acne issues by giving up the use of all cleansing products on their faces and hair. They use their fingers to exfoliate their scalp before showering and "wash" their hair and face with only water. They don't smell. Their hair is always clean. Their skin is clear. I wouldn't have believed it if I wasn't living with it. It took about 3 weeks for their face and scalp to normalize. (That part was hard and required some faith in the new regimen.) It also, apparently, requires drinking a lot, lot of water every day. I'm not suggesting this for the kind of terrible acne this article is describing, but I think for most people, the cleansing/acne industry actually keeps young people's faces oilier by not letting the body regulate itself. The very few friends they've been able to convince have had the same results, but one shampoo starts the process over, apparently.
9
My young teen (13) stumbled onto the hydration solution quite by accident.... If she can consistently drink ~70 Oz. Of water a day her acne clears up quite nicely. Its more effective,than all the cleansers and topicals reco'd by the dermotologist.
12
Here's the cheapest and best solution available: Use "baby shampoo" to clean the face. It's about as gentle a cleanser as possible and it very gently cleans the face. Afterwards, apply a light face moisturizer.
For myself as a teen, any of the store-bought "face cleansers", regardless of how gentle they were supposed to be, severely damaged my skin.
1
I became interested competitive swimming and spent a fair amount of time training. I've always attributed my acne clearing up to the chlorine.
4
If it’s a social problem, then why see a psychologist? And yet, no one ever recommends of anything that maybe you should go see a sociologist about it.
1
Suggesting that diet play no role here is bad advice. Diet effects everything in our health ... including skin health. Read "The Beauty of Dirty Skin" by Dr. Bowe (Dermatologist) as I would not give this point justice in a short post and she does a good job explaining the connections. https://drwhitneybowe.com/beauty-of-dirty-skin-book/
5
I grew up with an occasional pimple but no real acne. My wife, a woman with literally supermodel looks, suffered from acne in her teens and throughout her 20s. In her mid 30s, she now has it mostly under control but has had to have had the physical scars treated.
Before meeting her, I was completely oblivious to how emotionally scarring acne can be. Throughout our 20s, I watched the raw emotional pain my wife would experience when her face flared up. She saw a number of dermatologists and yet nothing they did could fully cure her acne. Even now, with it under control, it is still a very sensitive subject.
It is easy to say looks don't matter when you aren't the one who feels that their body has turned against them. Further, acne causes people to feel like they are losing their identity, which is less about vanity, than the reality that your body is self-mutilating.
I appreciate this article as it confirms what I learned first hand: that in addition to physical scars, the emotional scars left by acne linger on.
50
I had mildish acne as a teen. It's continued my whole life (I'm 69). In my late 30s, my work required being on TV regularly so I went to a dermatoligist. He prescribed Tetracycline for me for a year; as it didn't work, he finally prescribed Accutane (isotretinoin) for 4 months. It worked well. I had no acne for 10 years. I had to have bloodwork each month to check my liver function, and had no problems. My worst side effect was having dry lips. I learned to love my lip balms. I have occasionally spoke to adults or parents of teens who clearly have severe acne, to recommend they talk with a doc about isotretinoin. No one, esp. a teenager or young adult, should have to suffer the pain & embarrassment of bad acne.
28
@Susan
My elder son used Accutane without incident, unfortunately, it triggered mild depression in my younger son - he was a very happy active teen before and after, but he asked to discontinue it after about 6 weeks because the depression was getting worse. You have to be very careful and watchful when your teens are using this medication.
17
@nvguy I'm very sorry to hear about your younger son and hope he's feeling better. Your advice to parents is solid. Just as we are each unique, individual reactions to any drug, incuding supplements & caffeine, will vary.
10
@Susan - thank you, yes the depression symptoms went away after the Accutane use was stopped and it was out of his system. Depression is a known side effect of the medication and definitely something to watch for, especially in otherwise healthy and happy patients.
3
I am in my middle sixties and have never, ever gotten past the shame of my acne, and the facial scars that I still bear. No prom, no family or yearbook pictures for high school or college, no auditions for the plays that I longed to participate in, no pursuing drama or dance as a career. All because of the shame and embarrassment of bad skin. A teacher had to explain to my parents what a dermatologist was, because they were certain that "I would outgrow it." When the antibiotic resistance kicked in, and the derm suggested birth control pills, their feigned moral outrage terminated any further treatments.
It began around sixth grade, age 12 yet I can barely a time when I did not have to worry and fret over my skin. At 66, my skin still breaks out. The upside ? I monitored my children rigorously and sought levels of help at the first sign of teen skin troubles, and all six have been spared. My heart rejoices when I read how resourceful parents are investigating techniques and treatments that can help their child- trust my small words, it can truly make the difference of a lifetime.
64
I had really bad acne in high school. Since adulthood my acne went away but I have noticed I’ll immediately break out if I have mainstream chocolate candy like Snickers or M&Ms. I have no problem with high quality dark chocolate and eats tons of that. I also have no problem with dairy but avoid it anyway for health reasons.
Anyway, everybody is different but I offer my experience in case it helps others.
6
My heart goes out to anyone suffering from acne. I recall in sixth grade, a group of about 5 girls gathered around me curiously examining my puss filled zit on my nose. I wanted to disappear into the floor. I have had mild acne since age 10 (a few cysts per month, otherwise fine). Just that was embarrassing enough for me as a teen, and my face looked pretty clear most of the time. With my sons, I am going to make a dermatologist appointment at the first sign of acne.
7
My cystic acne appeared in 8th grade, with lesions on my back which stained my blouses. I always wore a shirt over my swimsuit, and high-backed prom dresses, to hide the acne. 65 years later, the scars remain. Diet made no difference. Despite the acne, I was a beauty queen in high school and college, and also a fashion model, since my face was unaffected. I have great empathy with people who have acne and post-acne scarring.
14
Luckily, I only had fairly moderate acne when I was in high school, but I remember eating lots of hamburgers, french fries, pizzas, sodas, and sugary and processed carbohydrate foods.
It seems like a central point in this article is that "acne is virtually unheard of in populations that traditionally consume" a diet rich in whole grains and legumes, with few sugary or processed carbohydrate foods.
I also, recommend the following -
Article -
"Acne: John A. McDougall, M.D./ McDougall's Health ... -includes recommendation to eat a low fat diet -
See additional nutritional recommendations by Dr. McDougall - mostly vegetarian
- Dr. Fuhrman's Nutritarian food pyramid -
mostly minimally processed plant foods, but also some meats and dairy
6
I started going to the dermatologist for acne when I was 12. This was the 1970s, and he prescribed the then-revolutionary tretinoin ("Retin-A") along with benzoyl peroxide and oral tetracycline. He then added topical clindamycin, which had to be compounded at the pharmacy. Topical antibiotics were a brand new idea, and weren't yet commercially available. It probably helped, but I still had cystic acne that turned into keloids. (Isotretinoin wasn't yet available.) I refused his suggestion to try estrogen.
While I was in high school, my parents decided I should try a new dermatologist who offered a radically different treatment. He used a lancet to open and clean out the "lesions," one at a time. I doubt it was any more effective, but it was painful! I suspected the doctor was a sadist.
During the summer after my freshman year of college, I read an article about the lack of an animal model hampering research on acne. Lab rats don't get acne, possibly because they're covered with fur. So I decided to grow a beard. After a month, not only were the scars covered, but I completely stopped getting new "lesions" on my face. But the acne on my back and then-hairless chest continued in full force for several more years. Doctors always ask if I've had heart surgery because of the keloids from acne on my chest.
I've kept the beard ever since. Especially now that beards are ubiquitous, that's a "treatment" older teenage guys might try.
3
My horrible acne started at age 10 and lasted to age 23.
From 10 on I was taken to a dermatologist every couple of months till age 23. They froze my face with dry ice, put chemicals on it, put me on a variety of diets, etc. I felt like I was going to a witch doctor with no results at all. In the summer of age 23, I went home to get married. The birth control pill had just been invented and my family doctor put me on it readily. In less than two weeks my face cleared completely. People stopped me on the streets of my home town to comment. I stayed on the pill up to age 55 or 60 except for one pregnancy.
9
My adult acne cleared up when I stopped eating products made with conventional flour (breads, pasta, pizza, hamburger buns). Organic flour products are fine. It was amazing.
3
@Sue Greer My son had acne into his sophomore year of college, when he found out he had gluten intolerance. He stopped eating bread and not only did his stomach stop hurting but the acne cleared up. I would advise anyone with skin problems, not just acne, to stop eating flour products for a few weeks and see what happens.
5
@Sue Greer This might work for some but I'm a 30 something year old who has suffered from acne since my early teens and have tried literally everything, including significant diet changes over prolonged periods. None of those changes made any difference. What helped me, was the same as the young woman in the article, a prescription for Spironolactone, birth control pills, and tretinoin cream. I have finally found a winning combination. Not to diminish the diet relationship that might help some people's acne, I just want to point out that it may not help everyone.
11
I had never heard of this medication before reading this column. My 18 yr old daughter suffers from acne and tried Accutane for a few months, with some improvement, but she experienced debilitating joint pain from it and the dr advised her to stop taking it. Her skin looked pretty good for several months, but it is now right back to where it was pre-accutane. I'm definitely going to ask about this. We live in Boston area as well and would love the name of a good dermatologist. Not sure if that's ok to ask here.
1
Accutane (isotretinoin) can be highly effective, but the government regulations around it are onerous and can be traumatic for young teenage girls.
Because it can cause severe birth defects, women are required to take birth control with regular pregnancy tests, or go in to the doctor each month to take a pregnancy test and sign an abstinence pledge. This can feel humiliating for young women, especially those who aren’t sexually active. Additionally, the monthly required pregnancy tests require a blood draw, imposing additional costs on the patient and demands on their time.
The government should back off. Doctors should be trusted to know their patients, and trusted to safely prescribe medication. A 13 year old girl should not have government mandated required blood draws to prove her abstinence.
46
I agree! The whole experience was off-putting and expensive.
1
@MH
As someone who also has acne (at 31, with a hormonal disorder) and I happen to be a family doctor here in Hungary, I have to disagree with you partly. I unfortunately know a dermatologist who ran into this terrible situation : she presribed isotretinoin to a patient here, and well, the lady got pregnant. The regulations regarding isotretionin are not so strict in this country, but the consequences of taking the drug are the same.
5
@MH
It can be onerous. I had trouble getting Accutane in my late 40s because I was in perimenopause and so wasn't on birth control pills. But the problem remains that too many women didn't take the warnings seriously and got pregnant. Doctors don't want to be sued for malpractice. Babies with severe birth defects should not be conceived if there's something we can do about it.
3
No other treatment worked for me, but Accutane changed my life at the age of 31. I had horrible cystic acne from age 13 and left the house every day with pancake makeup that didn't fool anyone. I became a bookworm and something of a recluse because I was so embarrassed by my face.
I went to many dermatologists, but the last one I went to about a different issue, told me I should take Accutane. No other dermatologist had ever recommended it and I fought it because I had heard and read that Accutane has a lot of side effects. But she was right - for me it was the beginning of a whole new world where I could start to look people in the eyes.
80
@LibertyNY At 35, six months of Accutane also changed my life. Had I been on it 10 or 15 years earlier, I wouldn't have the scarring I do now. The government needs to ease up in all the restrictions - women shouldn't be forced to take birth control pills if they don't want to. I had pregnancy tests each time my prescription was filled and that was that. it truly changed my life for the better.
21
My daughter was required to be on the pill, though she was not sexually active, and she also had to have a blood test each month. She did this for several months and ended up having to stop accutane because of horrible joint pain. Still trying to find a treatment that works
4
@LibertyNY
It was the 1980s. I was 28 and had suffered from acne for 14 years, tried every OTC and standard treatment, seen numerous doctors who weren't able to treat my then not-ghastly but still very visible acne. Finally, one doctor said, "Have you considered Accutane?" In the past, other doctors said my acne wasn't severe enough for me to qualify.
I took it and it worked. Even with the side effects and specter of birth defects, it was a miracle drug. I only wish it had been available during my adolescence.
In "The Singing Detective," which is about a writer with disfiguring psoriasis, a character says "[T]he skin is very personal."
1
Anecdotal, but recommended by her doctor and makes all the difference for my daughter: omega 3-6-9 capsules. Eat with every meal. In addition to being anecdotal, this is for acne that is moderate, not severe.
3
It is, I’ve gathered, for anyone who has not suffered through severe acne very hard to understand the full impact and all too easy to dismiss. For 5 years, starting at age 13, I suffered through deep scarring cystic acne while the dermatologist I originally saw continued to prescribe antibiotics, topical lotions, gels, and administered cortisone injections, all while my acne didn’t improve and the deep scarring continued covered larger areas of my face. It wasn’t until I begged for a different doctor that things improved, and absolutely due to a course of Accutane (isotretinoin). The benefit far outweighs the risk for someone suffering with acne as long as there is 100% compliance. I only wish it was prescribed much sooner. As an adult now, acne is still a problem, though not as severe as it had been as a teen. Hormones must be to blame, as the only treatment that seems to fully work is spironolactone. Yes, there are risks to using medications that target hormones, but the risks are minimal compared to the agony of never ending acne and the psychological impact of it.
38
I am 61years old & suffered with adolescent acne, starting at age 13. There was no Accutane available & the treatments scarred me emotionally & physically. From dry ice treatments to chemical peels to sulfur soaks to antibiotic usage for years. Nothing actually got rid of the lesions which caused me to retreat from social situations growing up & followed me into adulthood. My wedding pictures had to be touched up, as the blemishes were so obvious.
It's true that acne doesn't define the person, but, it certainly affects the psyche. I would have tried Accutane in order to avoid the physical pain from my treatments. Stress, however, cannot disappear by taking a pill. I am convinced that that is one of the biggest contributors to acne breakouts.
36
@Lj My Dr. told me that once I graduated from college and was under less stress, my acne would clear up. He was right.
1
Are Acne and Rosacea related? Are they both related to high-inflammatory diet with too many omega-6 fatty acids (corn, corn oil, corn syrup, and corn-fed meats) and not enough omega 3 fatty acids (fish, flax seed, walnuts)?
I believe that sugary diets are a huge factor in acne, as well as a lack of omega 6 anti-inflammatory foods. My rosacea ended with a change in diet to drastically lower sugar intake and increase omega 6 intake. A low-glycemic diet which is also high in omega 6 fatty acids is a proven strategy for good health in general and better skin in particular.
1
Meant to encourage increase in Omega 3 fatty acids - fish, flax seed, walnuts (not Omega 6 fatty acids - corn, corn oil, corn syrup, corn-fed meats) which are inflammatory), of course. Low-glycemic diet high in Omega 3s = better health and skin.
2
@Deborah Christie Yes—I would love to see more research into this connection. Rosacea has never gotten the attention it deserves— it’s the time bomb of skin diseases, lying in wait for younger adults, with no long term effective therapy.
4
@Deborah Christie
Acne is the result of androgens gone wild. Sugar has nothing to do with causing it. It's a gene pool bad draw.
Rosacea might be affected by a change in diet -- I have eczema, and no matter what I include or eliminate, a flare is a flare. I cannot control it. Again, gene pool bad draw.
Before we blame our diets we should look to our DNA. THAT more than anything is the cause of most of our ills.
3
I was plagued with cystic acne from age 14 on. I'm now 73. Daily application of benzoic peroxide helped but it wasn't until I tried the spice turmeric as a supplement that I achieved good control. It is available in capsules but far less expensive as a bulk spice. I take a slightly rounded teaspoon knocked back quickly with water. The taste is a bit rough as one would expect from a spicy root, tastes like the soil somewhat but there are far worse tasting things. Do not inhale the powder, get it wet and swallowed quickly. Turmeric worked for me. Eventually I ended the benzoic peroxide. Good luck cystic acne is a nasty business.
11
I had acne in high school and college and it was a source of deep embarrassment. My parents were supportive and I went to a dermatologist who worked with me to try various treatments. Antibiotics helped but only moderately. Finally toward the end of college I inquired with a doctor information about Accutane (referred to in this article by its non-brand name Isotretnoin). I had a friend in high school who had cystic acne and was treated with it, and it was very effective for him.
Over the course of two years, I went through two rounds of Accutane. I don’t know if this is common or not. It is not an easy medicine to take, but it is manageable. It was a total game changer for me. It both completely cleared up my acne and also totally altered the nature of my skin (I also don’t know if this is common or not). My skin leans more dry-normal now, rather than oily.
Twenty years out, this was one of the best medical decisions I made. It gave me my skin back, and as a result literally and figurately gave me the opportunity to feel more comfortable in my skin.
For those who are experiencing acne or those who have loved one who are experiencing acne, I wanted to share my story. I know Accutane has risks, but it worked for me and I am grateful for it.
56
Me too! My skin was VERY oily when I had acne, but I tell people now I don't have a single oil producing pore anywhere on my body. That was o.k. for 20 yrs after I finished my Accutane treatment, but now, my skin gets SO dry, ALL OVER that I feel like my skin is tightening all over, and the tops of my hands look like a dried up lake bed. I have to put lotion on ALL the time, and I live in hot humid Florida! I would STILL do it all over again though.
Accutane ( Isotretinoin) as mentioned positively in the article, saved my son's life.
Yes, of course it has side effects, what drug doesn't? (Dry mouth and eyes, etc being the most common.)
But in severe case, especially cystic acne, it is a true life saver when all else has been tried.
62
Ivory soap and a good clean heavy washcloth. Your skin should feel dry after washing. Washing removes the oil in the pores which carries away the dirt. Your skin will produce oil to replenish it within an hour or so, you do not have to put anything on and that is a bad idea when dealing with acne anyway.
That said your appearance is not who you are and should not take up so much time in your mind, even though it does when you are a teen. If you can push forth and do the projects and other things you avoid because of being self conscious about acne you will find that value in yourself. It is a lot more difficult today by my estimation than it was in the 70's but the truth is still the same, your looks are not who you are. Be yourself and work on not letting yourself be so distracted by immature feelings about your appearance and it will come to you.
1
@magicisnotreal
Yep. Ivory soap, a washcloth, and no extras did it for me. I was on the verge of deep scarring, but keeping hands off my face and good old Ivory saved my looks.
A beneficial side effect: A lifetime fear of makeup. My face was able to breathe. Today I look decades younger than peers who wore heavy makeup.
4
I think your information about cleansing the skin is misleading and likely inappropriate for many people. Posting this kind of anecdotal advice in a public forum is not helpful at best and harmful at worst.
Similarly, your dismissal of teenagers’ feelings about their appearance as “immature” is unnecessary. That these feelings are worthy of consideration is what the first part of the article is about.
118
@magicisnotreal
I had to reply to this comment to say that the recommended routine is not an appropriate suggestion for acne sufferers. Your skin should not "feel dry" after washing, as that is a sign that the cleanser is actually stripping the natural oils from your skin and damaging the skin's natural water barrier that keeps it hydrated and able to repair itself. The skin producing "oil to replenish it within an hour or so" is actually the skin overcompensating for the dryness caused by the cleanser and can worsen acne due to the increased amount of sebum. And stating that putting anything on the face "is a bad idea when dealing with acne anyway" is directly contradictory to the article and a way of thinking that can delay treatment for acne and exacerbate its problems. While acne can be caused by irritation from facial products (i.e. allergic irritation, damaging skin structure, etc), avoiding the use of all products is too simplistic a recommendation for the complexities of acne.
Secondly, regarding the psychological effects of acne as being "distracted by immature feelings about your appearance" is insulting. The article specifically talks about acne's relationship with depression and social isolation; one dermatologist even called it one of the most debilitating diseases in dermatology; and the American Academy of Dermatology's website for acne has the number for the suicide hotline listed.
98
As someone who quickly and successfully cured my teenage acne forever with Accutane, I think it really deserves a mention here. I can’t imagine why any dermatologist would recommend antibiotics over Accutane for permanently curing acne. Readers would surely benefit from hearing how Accutane fits into the array of treatments for acne in 2018.
49
@Daniel Krieger Accutane = Isotretinoin. Agreed, it is miraculous for cystic acne and probably shouldn’t be reserved as second line for severe acne. Deforming scarring lasts a lifetime.
24
This is a fairly comprehensive and accurate piece- thank you. As a physician, its extremely difficult to see teens struggle with a potentially devastating condition while parents hold out for them to “outgrow” it, or turn to non-evidenced based homeopathy. Agreed, there is always some degree of physical risk with any medical intervention, but the mental and physical fallout from inaction can be lifelong and severe as well. And, while prudent dietary and cleansing habits do play an important role, don’t let your child struggle too long with these alone if proving insufficient! Have a conversation with their doctor, at least....
69
I would just like to point out that men can suffer from adult acne as well as women. I'm in my 60's and have been dealing with acne since the 6th grade. All through my teens I was told it would clear up when I hit my 20's. It was awfully disappointing when that didn't happen. Now don't get me wrong. I don't have the kind of chronic breakouts I had as a teen, but the health of my skin is something that I have to be constantly vigilant about.
One thing that isn't mentioned in this article that is worth trying would be alpha hydroxy lotions. They don't help everyone and some people find them too irritating, but they've helped me tremendously.
21
@jim There are so many gentle and amazing products now. Look into Korean skincare. It really calmed my skin down. I wish it would have been available in my younger years!
3
It is extremly irresponsible to recommend that a teenage girl ingest birth control pills to control acne when there are better ways to treat the condition. The side effects of birth control pills are extremely dangerous and should not be an option for a girl at this age. I am reluctant to suggest that my adult girlfriends go on birth control because of the side effects. I have a teen daughter who has acne and while she does take topical prescription medication for it, I would NEVER allow her physician to prescribe birth control pills.
10
@Angela it’s this type of thinking that prevents doctors from tailoring medicine to their patients. Some patients respond exceptionally well to birth control in order to regulate hormonal levels. Of course, not all, and some do get moderate side effects. All the doctor does in that case is either discontinue it or find a suitable alternative. There’s no reason to say never, because it just might change a young teens like if they did.
81
Let me guess, you’re conservative? I get being a concerned parent but if something was medically approved and safe for a condition and could help her, why deny any possibility that might help?
Consider endometriosis. One of my sisters had severe symptoms as a young teen and the doctor recommended birth control pills. It was the mid 90’s (pills are even better today and free!) and my strict father was not having it but her suffering was unyielding so he finally relented. She now has three beautiful children.
Whether it’s moral or scientific, I kind of don’t get denying something that has been shown to be overwhelmingly safe and beneficial. There comes a point when one must reassess beliefs if logic dictates they don’t hold up to current reasoning.
Faith is faith, love is love none of these things are less true because one decides to accept common sense and wisdom. We do not come to wisdom and understanding without faith and love and of course, forgiveness asking/receiving, which as I understand it, is always available when sought.
Even for medicine. Embrace it.
74
@Colleen There are so many other side effects of birth control pills that are dangerous for ALL females. Please believe me, I went through it after 10 years of being on BC pills. I am not speaking politically or religiously, but from experience. BC pills are not the answer.
4
I had severe acne throughout high school, and I think it had profound psychological effects that lasted many years. Not only did it crush my confidence, but it got so bad that I would avoid social events because the thought of having others see my face was unbearable. I was depressed and always anxious which lingered throughout my college years. After trying dozens of prescribed topical creams and ointments, Accutane ended up being the final solution. 5 years now out of college, I'm still working on my confidence and anxiety that I believe all stemmed from 4 years of torturous acne.
103
@Brian
Accutane helped one of my sons. At the time, 20 years ago, it was almost a last resort for whatever reason, but it worked.
8
@Brian I am glad that it worked for you. Best wishes on regaining your self confidence.
I had severe acne as well, and felt as you describe. I am much older now and have found that doing things well and not being afraid of what other people think, and a lot of time made me feel better.
Best wishes.
6
I, too had terrible, cystic acne starting in 5th grade, lasting through college. My sister's was just as bad. Our school pictures from those years are STILL painful to look at, and I am 55 yrs old now. My parents never even suggested seeing a doctor or dermatologist, our pediatrician never said anything about it. Both my parents had bad acne as teens and I think just thought that acne was just something you had to deal with, a part of growing up. It wasn't until I graduated from college, got my first job and my own health coverage that I too finally went to see a dermatologist and was prescribed Accutane. I got a terrible sunburn while taking it - 2nd degree blister burns on my back, so now I worry about skin cancer! I live in Florida and can get sunburn on my arm just driving for 30 minutes in the car! So the sun sensitivity has lasted my entire life. I would STILL take it again in a second if I had to do it all again. It was a true miracle drug for me.
4
Probiotics alone or in combination with a homeopathic remedy has helped at least a dozen teenagers in my world. Just a lot of case studies, but worth considering I think.
4
My 15 year old has acne. It’s very painful. We went to a dermatologist. She’s on antibiotics. Oral and topical. Only mild benefits. We are very concerned about oral contraceptives and Acutane. There are potential side effects for both that seem alarming. So what’s the next step? Would have liked to read more about the variety of ‘cutting edge ‘ treatments.
11
@NA:
Accutane ( Isotretinoin) as mentioned positively in the article, saved my son's life.
19
@NA My heart goes out to your teen. I suffered from intractable acne from the age of 13 to my late 20s. My mother took the 'time will heal all wounds approach,' but the resulting anxiety and rock bottom self esteem outlasted even the physical scars. When I took control of my healthcare at 18, I started on oral contraceptives, which helped somewhat, but two courses of Accutane and all the topicals and anti-biotics a doctor could think of were no match for my skin. The stress of grad school in my mid-twenties caused such eruptions on my face that random ladies in shops would approach me and whisper their home remedies in my ear. Luckily I found a dermatologist who allied with me, and a combo of AHA and BHA peels, 8 weeks of light therapy and the introduction of a high concentration (15%) of glycolic acid (AHA) into my oil-free daily skincare routine finally managed to tame my skin. At 27 I had fractional laser resurfacing that removed 80% of the textured scarring from my face, and 10 years later another round removed the last 20%. I will name my firstborn after my derm. I will be hard-pressed to ever forgive my mother her laxity. I encourage you to find a doctor who is willing to think outside the box.
73
The concerns about Accutane are real but pale in comparison to the benefits. It is
, literally, a life changing drug. Don’t dismiss it out of hand; it gets a bad rap.
34
It's a very frustrating condition - and really can be seriously damaging to self esteem, not at all insignificant to those who suffers severe forms.
I wish more had been included here on the side effects of spirolactone and isoretinoin. Also on what happens if the user stops use of the heavy hitters. Is there a rebound?
I also suspect if there an environmental effect affecting our hormones from the massive use of pesticides and herbicides, directly or indirectly from foods.
7
@cheryl spirolactone might have rebound. But isotretnoin, also known as accutane, is the end all be all. Once you’re finished with 6-12 month course, it’s virtually impossible for the acne to come back worse. 85% of patients even have no more acne after that. Of course, this assumes the patient responds to the drug.
18
@Homer When my son was prescribed Accutane in the mid-90s, there was included a dire warning against women who were pregnant or might become pregnant taking it. The impression I got was that it had a long-term negative effect on fetuses. Has this changed?
@KySgt64, Accutane can cause birth defects if you take it while you're pregnant, but there's no long-term risk for any future pregnancies.
3
Acne is caused by dairy. Get rid of the dairy from your diet--all of it--get rid of your acne.
3
@Greg Gerner
Dairy might be a cause for some people and it's certainly worth giving up to see if that helps, but acne can be caused by a great many things. To say that all acne is caused by one cause, whether it's dairy or something else, is just flat out wrong.
66
Please explain the presence of cystic acne in Asian populations where there is no dairy. Inquiring minds want to know.
27
@Greg Gerner
This has been true for me, especially with cheese and milk. But if I eat high quality cheese from a cheese shop and avoid the supermarket stuff, then I don't break out. Also, when I visited Ireland recently I ate lots of dairy and had no ill effects. So there must be something in our dairy in the U.S.
10