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Cystic Acne And Accutane - Need Advice

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I'm 18, male and I'm on my first cream product now. I got "noticable" acne about 6 or 7 months ago. I eat healthy and have been for 8 months. I've cut out all of those acne foods. My derm says I might need accutane if the cream doesn't work. I have 80% superficial acne and some cysts.

I am really hopeful about accutane but:

1. I heard it won't fix cysts, and once you stop it all comes back and you're stuck with it. Can accutane fix acne problems and cysts long term?

2. Are cysts hormonal? I'm only 18 could my acne just be due to my age?

3. Is it common for acne to not come back long term with bad/cystic acne? Or will it come back after.

4. Can acne.org regimen get rid of cysts + someone said 10% of patients on accutane have died?

Please help, I want accutane to be a real last resort, but also a long term relief from acne.

And I feel as if I might be stuck with it if accutane can't get rid of cysts afterwards as well.

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Hello hello (:

First off I think you heard a couple things quite wrong... especially the one about accutane and 10% mortality.. but ill go through each of your questions individually!

1. Accutane is the best prescription treatment for cysts! It's actually recommenced to people whom deal with difficult cystic acne the most. It is often a long term solution to the user.. and if it re-occurs it's often MUCH more mild... but studies have shown if you go on a topic retinoid after accutane treatment, your prognosis will be very bright ( I believe the number is 75% of people who follow up with a retinoid remain clean ) but many if not all will have reduced acne at the end of the treatment.. its very effective!

2. I believe thoroughly that most all teenage acne has hormones to blame~ So I would assume it would be hormone related.. but as some others suggest it can be from other causes!

3. I believe I answered this well enough in the first question.. it's not always going to come back.. in many cases it does not.. but if it does it's usually less severe.

4. The acne.org regimen can absolutely get rid of cystic acne! While I believe it is more effective against other forms of acne.. there have been PLENTY of users that have received wonderful results from the regimen for their cystic acne.. Nicmic's results are wonderful proof of this! Also the claim that accutane kills 10% of people is absolutely NUTS.. the rare side effects from the medication are listed at 1 in 10,000 .. and it would NEVER be approved if it even killed 1% of people.. don't listen to this nonsense at all!

I would personally try the regimen for 4 months following it VERY strictly.. and I believe you will be surprised with the results! Accutane is a very harsh drug, and should only be used as a last resort..

But remember, you have plenty of options! and a whole community for support~ Keep at it, and you will have clear skin before you know it (:

PS Check out Nicmics Regimen log.. in the first post it shows her before pictures.. and a link to her after pictures.. and you can see for yourself how powerful the regimen can be for cystic acne~

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I'm 18, male and I'm on my first cream product now. I got "noticable" acne about 6 or 7 months ago. I eat healthy and have been for 8 months. I've cut out all of those acne foods. My derm says I might need accutane if the cream doesn't work. I have 80% superficial acne and some cysts.

I am really hopeful about accutane but:

1. I heard it won't fix cysts, and once you stop it all comes back and you're stuck with it. Can accutane fix acne problems and cysts long term?

2. Are cysts hormonal? I'm only 18 could my acne just be due to my age?

3. Is it common for acne to not come back long term with bad/cystic acne? Or will it come back after.

4. Can acne.org regimen get rid of cysts + someone said 10% of patients on accutane have died?

Please help, I want accutane to be a real last resort, but also a long term relief from acne.

And I feel as if I might be stuck with it if accutane can't get rid of cysts afterwards as well.

Good response Garrett.

Accutane can/will fix cysts, and it's one of the only acne treatments that can. In fact, >90% of people are COMPLETELY cleared by Accutane.

Absolutely untrue that 10% of Accutane patients die. Everyone will eventually die, but <1% of people get a significant side effect from Accutane (see this table).

Almost everyone (>90%) is cleared or virtually cleared by Accutane while they're on the drug; the real question is whether you'll relapse post-treatment. That depends mainly on:

  • Your age (younger = more likely to relapse),
  • Your pre-treatment acne severity (more severe = more likely to relapse), and
  • The cumulative dose of Accutane you receive during treatment (higher = less chance of relapse, arguably up to a point).

You can't alter the first two factors, but you can change the last. Statistically, a cumulative dose of 120-150 mg/kg gives you the best chance of permanent remission.

Overall, after 1 course of Accutane (reaching ideal cumulative dose):

  • ~40% of people are "cured",
  • 40% have less severe acne manageable by topicals or antibiotics, and
  • ~20% eventually require more Accutane (whether 1 or more additional courses).

(If relapse happens, it usually occurs within 3 years.)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/pdf/de0103_0162.pdf

http://www.karger.com/Article/Pdf/90646

Good luck

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Great responses from the others- and good to try other things first before Accutane.

So give the regimine a go first- and when you say you've cut out the acne foods, what do you mean? I would suggest you cut out dairy for a month and see how that goes- that is a big trigger for many.

Unfortunately Accutane didn't work for me, but I'm a rare one, it works for most with minimal side effects. I got clear after dropping dairy and gluten- hard to do but those two diet changes eliminated my cystic acne.

But try the regimine first, and drop dairy.

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Thank you all for the great information. I will take note of all of that. From what you're saying, Accutane is a good way to long term keep serious acne(cystic) away, long term. Am I right?.

When you say 40% are cured, could that include people that had cystic acne and then after accutane don't get cystic acne anymore?

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Thank you all for the great information. I will take note of all of that. From what you're saying, Accutane is a good way to long term keep serious acne(cystic) away, long term. Am I right?.

When you say 40% are cured, could that include people that had cystic acne and then after accutane don't get cystic acne anymore?

"40% are cured" means that these people never experience significant acne again (including cystic acne).

"40% have less severe acne manageable by topicals or antibiotics" means that acne comes back for these people, but less severe than it was originally.

"20% eventually require more Accutane" means that acne returns for these people severe enough to require more Accutane.

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Okay thanks, got it! My derm is saying I HAVE to trial antibiotics first before I can go on Accutane, I'm currently trying a cream, but I don't want to take antibiotics, is it a must to trial antibiotics to go onto accutane?

He never mentioned having to take it to go on accutane, he prescribed it only to help redness.

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For patients with very severe acne that is psychologically and/or physically scarring, Derms sometimes prescribe Accutane without trying antibiotics first.

Otherwise, especially if you are young, Derms usually don't prescribe Accutane unless/until everything else has been tested and failed, including oral antibiotics.

Antibiotics may work, particularly if combined with a topical retinoid cream. It is worth trying this combination for at least 3 or 4 months before trying Accutane.

post-145613-1307356507_thumb.jpg

(Click graph)

http://pediatrics.aappublications.org/content/118/3/1188.full.pdf+html

http://pediatrics.aappublications.org/content/131/Supplement_3/S163.full.pdf

Good luck

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Thank you again for the information. I have to take antibiotics anyway now due to a infection.

To be fair, my acne is ruining my life, it makes me cry, depressed and my self esteem is to rock bottom.

I've heard accutane has no proven link to depression, I have depression so should it be a issue? My psychologist is recommending me I take it and has a plan to keep my mental health monitored ready. Lastly, would it help to post a picture of my acne as it is now?

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Thank you again for the information. I have to take antibiotics anyway now due to a infection.

To be fair, my acne is ruining my life, it makes me cry, depressed and my self esteem is to rock bottom.

I've heard accutane has no proven link to depression, I have depression so should it be a issue? My psychologist is recommending me I take it and has a plan to keep my mental health monitored ready. Lastly, would it help to post a picture of my acne as it is now?

No harm in posting a pic.

If your depression is related mainly to your acne, a Dermatologist would be more likely to prescribe Accutane.

See my recent post here on Accutane/depression and also this page and

by Dan (maker of acne.org).

Of course, you should monitor your moods very closely on Accutane if you decide to take it.

Good luck

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Thanks again. I just posted pictures of my acne as it is now. A lot of it is redness from previous acne. I've been using a tretinoin cream or Retri or something for about a month. My neck has painfull, itchy big pimples. Never happened before. My back and chest are clear although I use to have acne their a few years ago.

Honestly although the cream has cleared it up a bit. I am still incredibly depressed and have no self confidence left. Is my acne bad enough for accutane?

I feel as if I need something stronger that has a way more drastic improvement results then this. It's about 2 months until I see my derm and it's going to be a battle to wait that. The ones on my forehead are really painful and feel big and thick. Cheeks are the areas it has improved.

post-189057-0-33629100-1376012241_thumb.

post-189057-0-71055600-1376012247_thumb.

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post-189057-0-33629100-1376012241_thumb.

post-189057-0-71055600-1376012247_thumb.

post-189057-0-59689800-1376012255_thumb.

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Bump. I know they're bad pictures, but would you say this is bad enough for accutane in your opinion?

Looks like moderate inflammatory acne, definitely suitable for Accutane.

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I'm 18, male and I'm on my first cream product now. I got "noticable" acne about 6 or 7 months ago. I eat healthy and have been for 8 months. I've cut out all of those acne foods. My derm says I might need accutane if the cream doesn't work. I have 80% superficial acne and some cysts.

I am really hopeful about accutane but:

1. I heard it won't fix cysts, and once you stop it all comes back and you're stuck with it. Can accutane fix acne problems and cysts long term?

2. Are cysts hormonal? I'm only 18 could my acne just be due to my age?

3. Is it common for acne to not come back long term with bad/cystic acne? Or will it come back after.

4. Can acne.org regimen get rid of cysts + someone said 10% of patients on accutane have died?

Please help, I want accutane to be a real last resort, but also a long term relief from acne.

And I feel as if I might be stuck with it if accutane can't get rid of cysts afterwards as well.

LOOOOOOOOOOOOOL

You need to stop believing everything you hear my friend, it won't do you any favours.

At your age the chances are it's hormonal.

Topicals may or may not clear you up but one thing is for sure, if you stop using them it will return.

Best thing to do is speak to a dermatologist. If I were you I would push for accutane as it will prevent scarring from long-term cystic damage.

All my opinion of course smile.png

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your acne doesn't look cystic to me, probably due to your age and hormones. it looks moderate but its inflamed and red. If its ruining your life, take action now and dont delay. you have the support if people on here, family and your psych to help you as well as a doctor who will monitor. if you feel anything bad or any worsening depression just stop taking it.

cystic acne btw usually starts under the skin, its the painful ones that they call nodules and cysts which you can 'feel' starting under your skin. sometimes they dont come out. They are so painful, you feel like crying when you have them. i'm a female, and hormones can deifnately cause those nasty cysts and its genetic. they are the type of spots that really respond well to accutane but your type of acne would really benefit as well if you choose to take it. BTW. doxycyline, REALLY cleared my skin up when i took it, within 2 weeks my acne had reduced as well as the redness. BUT as i have a hormonal issue, it came back.

my doc said 2++ months on doxy gives good results.

i did have an increase of anxiety on the drug though, and its listed as a side effect.

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I was on accutane when I was 18/19. I'm 22 now and my Abe hasn't came back. I had sever cystic nodular acne. It was awful. I didn't grow out of it. As I got older it got worse. No creams helped, proactive made my skin angry, scrubs didnt help. And it definitely was not diet. My skin has been clear since the treatment was over. I did get 2 cysts on my face though. However they were where my cysts started on my jaw line and there were not bad. They went away really fast too. My derm said it may have been scar tissue inflammation ad not cysts. But other wise. Everything is better. Even the hyper pigmentation.

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