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Too Old For Accutane?


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#1 DawgDaze64

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Posted 31 May 2013 - 09:56 AM

Hello all,

 

I've been a member of this forum for years, although I only post occasionally.

 

Long story short, after a round of Accutane at age 25 sent my problem skin into complete remission for 15 years, the acne started creeping back at age 40 and now, at 49, my skin is breaking out terribly since I had to stop taking Oracea, a drug that kept things mostly at bay for the last 5 years. I switched insurers and they refuse to cover it, even though they DO cover doxycycline (which is what Oracea is, only a much lower dose, so go figure that one out). I was willing to pay out of pocket, but it's $500 a month (where do these drug companies get OFF?)

 

Only three weeks off Oracea and my skin is a MESS! I see my doc in a couple weeks to discuss where I go from here. Spiro is likely out— I tried it once, but two days after taking it, got so incredibly nauseous and dizzy on a morning run (something that never happened before or since), that my doc immediately told me to stop.

 

My question to those of you in your forties and fifties: what other treatment options are available that have worked for you? Should I give Spiro another go? Full-on doxycycline? How about Accutane? I'm considering just cutting to the chase and asking for it again. I tolerated it very well the first time, although I realize 25 is very different from 49 and I'd sure hate to lose joint mobility OR my hair.

 

I'd appreciate any of your thoughts/advice.


Thanks!

 




My regimen:

Mornings:
CeraVe Foaming Cleanser Normal to Oily Skin
Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)

Paula's Choice Skin Balancing Super Antioxidant Serum

CeraVe AM Facial Moisturizing Lotion 30 SPF for Normal to Dry Skin

Amnesteem 40mg daily, 6-month course started June 30, 2014

Evenings:
CeraVe Foaming Cleanser Normal to Oily Skin
Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)
CeraVe PM Facial Moisturizing Lotion for Normal to Dry Skin

Make-Up (on the days I have to wear it for business, etc.):
Estee Lauder Double Wear or Almay TLC 16 hour foundation


#2 Tim714

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Posted 31 May 2013 - 04:01 PM

I've read about people taking it in their forties with success so it's most likely a viable option. You just gotta see what the Dr says. Good luck.

#3 Hiddy Cheeks

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Posted 01 June 2013 - 01:49 AM

I'm 40 years old and just started on accutane 2 days ago. I first went on it in my early  thirties, it worked well for about 4 years, the acne came back , I then did a short course, the acne went away for a few more years and now it's back  again. Frustration. My derm didn't say anything about my age being a problem this time around.  His main concern was that I take enough of the stuff to hopefully kill the acne once and for all. He says I need to take 100 mg for each kg of body weight. So as I weigh 85kg, I will need to take 8,500 mg of accutane over about a 6 month period.  That said, next time I see him I'm going to ask him to prescribe me 10,000 mg just to be sure. To be honest I hadn't thought my age might be a problem until i read your post. 



#4 shadylee

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Posted 01 June 2013 - 06:27 AM

hi ya dawg daze...i was on accutane last year for a month when i was 45..unfortunately i had to stop due to dry eyes.  my derm told me she has prescribed accutane to ppl in their 50s.  she said us elders (heehe) just need to be a little more careful bc our bodies arent that of 20 year olds...so i think if you talk to your derm and you feel strongly about using it again, its your decision.  just be aware of how your body is reacting to it.  

 

when i had started my course there was a woman on here who was 48 taking it, and besides some bad back pain she did quite well...since i havent seen her on here anymore i'm thinking it was a success with her.

 

good luck with whatever decision u make!!



#5 DawgDaze64

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Posted 04 June 2013 - 07:28 PM

Thanks, folks, for your responses! I see my dermo July 1st, so we'll see what she thinks. In the meantime, she prescribed regular doxycycline, two 20mg pills a day, to tide me over. Although at this point, it will take months I'm sure before I'm relatively clear. (On a puzzling side note: my insurance still won't cover this. It's too low a dose—they only cover 100mg—but at least it's only $80 a month instead of $500. Not only am I shaking my head at the vagaries of my skin, I'm at a total loss as to why there is such a discrepancy in cost between the same dosage of the same drug.)

 

At any rate, I responded so well to Accutane the first time around—dry lips, a little achy, but that was it—that I'm hopeful my body is still tolerant and my skin still responsive. If I can get the same 15 years of remission, maybe that will knock it out for good. But I'm also under no illusions that my body and skin may have a totally different reaction now. I'm especially fearful of joint pain, and the possibility of it being permanent. I'm very active (runner, swimmer, bicylist, etc.) and I'd hate to have the drug effect my ability to perform my sports.

 

Shadylee, since you had to stop Accutane, what is your current treatment?

 

Hiddy Cheeks, best of luck with your treatment—I hope the third time is the charm!




My regimen:

Mornings:
CeraVe Foaming Cleanser Normal to Oily Skin
Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)

Paula's Choice Skin Balancing Super Antioxidant Serum

CeraVe AM Facial Moisturizing Lotion 30 SPF for Normal to Dry Skin

Amnesteem 40mg daily, 6-month course started June 30, 2014

Evenings:
CeraVe Foaming Cleanser Normal to Oily Skin
Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)
CeraVe PM Facial Moisturizing Lotion for Normal to Dry Skin

Make-Up (on the days I have to wear it for business, etc.):
Estee Lauder Double Wear or Almay TLC 16 hour foundation


#6 shadylee

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Posted 11 June 2013 - 08:07 PM

hi dawgdaze...i'm currently wash my face with aveeno ultracalming foaming wash in the morn, and apply acanya...at night i wash again and use .5% tazorac cream..had a few glitches with this regimen but i seem to be back on track, havent had a breakout in weeks..keeping fingers crossed!  i dont breakout tons, i tend to get gigantic cysts 1 or 2 at a time, then i'll be clear for awhile, and a lovely cyst will appear...have been doing good now tho...and there was 3 months where i didnt get any cysts..so i'm sticking with this regimen!  best of luck to you and pls keep updates!



#7 kimmers

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Posted 28 June 2013 - 08:54 AM

Hi, I just joined this community/forum today because i am at my wits end too. I am 43 years old and have fought cyctic acne since i was a teen.  I have been on Accutane 3 times, the most recent was when i was 32.  It works; i am confident that it saved my life. 

 

But, 10 years later, my new adult acne is so bad - the cysts are deep and never fully go away or come to a head. I'm at the dermatologist getting a cortisone injection every month.

 

I've considered going back on accutane but I'm scared because of the dryness, the muscle aches around my ribs that lasted for months afterwards, and frankly, just the HASSLE. BUT, it's in the back of my head as a last resort.

 

I had good luck until recently with a birth control pill (sorry guys, that wont help you, i know) called Lo Loesterine Fe - which cleared my skin so well, i couldnt believe it. Unfortunately, it stopped working and the cysts are back with a VENGEANCE!  (As i write this, I have a huge deep and painful cyst on my forehead that has been recurring for months - this month is was so bad, the gland under my jaw was swollen and painful.  I had FOUR cortisone injections on Monday and started on a round of doxycycline (sp?) last Friday but it makes me so tired, i can hardly function. I had to lower it to 1 pill/day because i had a big business trip this week. But the cyst is still there a week later so I've upped my dose back to 2/day, drowsiness be damned.). I am hoping the doxycyline breaks this cycle i am in the middle of.

 

I have been reading a lot about topical Aczone/Dapzone and i have always pooh-poohed anything topical.  I think, "Topical wont help, this is deep and systemic!"  But I have read online people reporting that if they are FAITHFUL - 2 x day for three weeks+ -- they see results, so I am banking on that for the moment. Anyone else try/have luck with faithful application of Aczone/Dapzone?

 

God speed to all of you fellow adult acne sufferers. I appreciate just knowing that i am not alone. I dont know anyone else who suffers this curse like i do (appreciating, of course, that there are worse things in life!!!) and they all try to offer well-meaning support and advice but it doesnt make me feel better.  Thanks for letting me vent to someone who understands.  - Kimmers 



#8 Cali04

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Posted 28 June 2013 - 02:20 PM

Kimmers, I am just as frustrated. I think about it constantly. Have you asked your doctor about Spironolactone? I am currently trying it now.

Edited by Cali04, 28 June 2013 - 02:22 PM.


#9 Hiddy Cheeks

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Posted 28 June 2013 - 04:40 PM

Hi, I just joined this community/forum today because i am at my wits end too. I am 43 years old and have fought cyctic acne since i was a teen.  I have been on Accutane 3 times, the most recent was when i was 32.  It works; i am confident that it saved my life. 

 

But, 10 years later, my new adult acne is so bad - the cysts are deep and never fully go away or come to a head. I'm at the dermatologist getting a cortisone injection every month.

 

I've considered going back on accutane but I'm scared because of the dryness, the muscle aches around my ribs that lasted for months afterwards, and frankly, just the HASSLE. BUT, it's in the back of my head as a last resort.

 

I had good luck until recently with a birth control pill (sorry guys, that wont help you, i know) called Lo Loesterine Fe - which cleared my skin so well, i couldnt believe it. Unfortunately, it stopped working and the cysts are back with a VENGEANCE!  (As i write this, I have a huge deep and painful cyst on my forehead that has been recurring for months - this month is was so bad, the gland under my jaw was swollen and painful.  I had FOUR cortisone injections on Monday and started on a round of doxycycline (sp?) last Friday but it makes me so tired, i can hardly function. I had to lower it to 1 pill/day because i had a big business trip this week. But the cyst is still there a week later so I've upped my dose back to 2/day, drowsiness be damned.). I am hoping the doxycyline breaks this cycle i am in the middle of.

 

I have been reading a lot about topical Aczone/Dapzone and i have always pooh-poohed anything topical.  I think, "Topical wont help, this is deep and systemic!"  But I have read online people reporting that if they are FAITHFUL - 2 x day for three weeks+ -- they see results, so I am banking on that for the moment. Anyone else try/have luck with faithful application of Aczone/Dapzone?

 

God speed to all of you fellow adult acne sufferers. I appreciate just knowing that i am not alone. I dont know anyone else who suffers this curse like i do (appreciating, of course, that there are worse things in life!!!) and they all try to offer well-meaning support and advice but it doesnt make me feel better.  Thanks for letting me vent to someone who understands.  - Kimmers 

Do you scar? For me it's about the scarring. If I get a big cyst on my cheeks it will leave a scar. Small cysts tend to be ok and the rest of my face is fairly resistant to scarring but my cheeks are another story. So, even though I hate accutane if I don't go on it I will inevitably develop more scars. Like you, I put it off because of the dryness and the general hassle. Now I'm back on I feel happy that I have taken a positive step in my battle. And tbh things are much the same as before, my lips are dry and cracking, the skin on my face is dry and prone to flaking but that's about it. And if anything, things are somewhat better as I am managing the dry lips alot better than I did last time by regularly applying a gel that my chemist sold me.

 

I haven't read much about accutane but as I understand it some people have real problems with it. Like you, I know it works for me and I am thankful for that. Anyway, good luck. And oh yeah, what's going on with us, acne in our forties? It seems insane, I don't know a single person in my age group who has acne, but like you say there's worse problems. 



#10 kimmers

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Posted 28 June 2013 - 08:45 PM

Hi, Hiddy Cheeks and Cali04! Oh my gosh, I've never joined a forum before and I'm so glad to "talk" to people who understand this hell, I am sitting here crying. (My poor husband must think I'm insane.) 

 

NO, I cant FRIGGING BELIEVE I am still suffering from cystic acne in my 40s. I mean, if you told me I was going to still be fighting this curse 20+ years later, I might have killed myself. Instead of thinking I'll grow out of it when I'm 40, now i cant wait for menopause, hoping THAT will help, as clearly for me, it is related to my hormones! Granted, for many years its truly been manageable. But I have had several bouts over the years that were SO BAD my entire face was disfigured --  I would have people stop me on the street and say, "What happened to your face?"

 

When I was in my late 20s, over the course of a week, my whole face swelled up and I had a chronic fever from the infection. This went on for weeks/months. I had to be on steroids before they would dare start me on Accutane because they were afraid it would get WORSE before it got better. Some of my doctors were afraid to treat me; I went to see an Accutane specialist several states away who said, "I've seen worse", which made me feel better. Anyway, now when I have a flare up that's particularly bad, I panic thinking its going to accelerate....

 

Anyway, I'm sorry to babble.

 

Hiddy Cheeks - Regarding scarring, fortunately my skin is AMAZINGLY resilient. Sure, I have scarring - lower cheeks, forehead -- but its' NOTHING to complain about.  Also, fortunately, as a woman, I can wear makeup and I have some great stuff, cover-ups and powders, so you'd never know I've had cystic acne for years. So, I am sorry to hear about your scarring - that would make it 100x worse than it already is.

 

Recently, I tried laser treatments to lessen the scars - Fraxel. Have you heard of it? I tried other things that didn't help at all.  With Fraxel, they do a more "shallow" treatment first which was fantastic for removing the hyper-pigmentation (I also have melasma) but that did not last. The second treatment was deep/more intense and the subsequent swelling of my face (for about a week) scared the CRAP out of me.  Yes, it DID lessen some of the pitting, so I recommend you look it for scarring! But I was too afraid to do a third treatment. Also, it's expensive, so shop around. I found that a medical spa was $1000 cheaper than my dermatologist for a package of several treatments.

 

I am glad to hear that you are doing Accutane again. Good for you! I should make a promise to myself that if I am not under control with some of these other things, I will try Accutane again.

 

Cali04 - I have not tried spironolactone. Or if I have, it was when I was in high school or college. Has it been around that long? It sounds familiar. Are you noticing any relief with it?  I have been reading what other people have recommended and made a list of things to try/ask my dermo about. Someone also mentioned Oracea which is just a stronger doxycycline? And using an intensive alpha hydrox? Has anyone had luck with Retin A? I haven't.

 

Again, I'm so sorry to babble. I cant help myself. THANK YOU THANK YOU THANK YOU for being on this forum. Best of luck and please keep me posted on your successes. 



#11 Cali04

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Posted 29 June 2013 - 06:48 AM

Cali04 - I have not tried spironolactone. Or if I have, it was when I was in high school or college. Has it been around that long? It sounds familiar. Are you noticing any relief with it?  I have been reading what other people have recommended and made a list of things to try/ask my dermo about. Someone also mentioned Oracea which is just a stronger doxycycline? And using an intensive alpha hydrox? Has anyone had luck with Retin A? I haven't.

 

Again, I'm so sorry to babble. I cant help myself. THANK YOU THANK YOU THANK YOU for being on this forum. Best of luck and please keep me posted on your successes. 

If you look under the Hormonal Acne forum, I have a Spiro log that I update every week.  Also, other people give a lot of information about this medication.  This medication is to help hormonal acne.  Some doctors won't prescribe this medication because it's use is not directly related to treating acne.  But my doctor had no problem prescribing it.  Spiro blocks androgen receptors in the body, preventing you from absorbing hormones. Spiro lessens hormonal fluctuations that can cause acne breakouts.  You do have to get blood tests every couple months to check your potassium.  Google it to find reviews.  Make sure you type "Spironolactone Acne Reviews."  Talk to your derm to see if it is right for you.

 

I def think the Spiro is working for me.  I have been on it for 7 weeks.  My breakouts have become smaller, and I am not getting new ones everyday.  But I am not clear yet.  This medication takes time.  People say they get side effects, but I don't have any from this medication.  I am also take Bactrim once a day (an antibiotic).  Check out my log.

 

I have never tried Oracea.  I was on doxycycline for about 2 months, and my skin was never so bad, so I got off of that.  I am using the get Atralin because Retin A was way too harsh for me.  Atralin is a form of Retin A.  I like it, but I can only use a pea size.  If I use more than that, my face gets really dry.  But a small amount doesn't really cause too my dryness.