I need some advice...I'm going to be 30 in February and have had a long history dealing with acne. As a teenager I tried a host of OTC and perscription treatments (Differin, Retin-A, etc.) and finally ended up on a course of Accutane which was the only thing that cleared me up. Through my late teens and 20's my skin hasn't been totally clear but has been manageable.
Fast-forward to the last year and a half or so and my face has become an absolute mess, the last 6 months especially. I understand much of it is probably hormonal but I'm breaking out in places I never had acne before, especially my cheeks (which has always been the 1 place I have nice skin and that is no longer).
I visited a dermatologist 5 weeks ago and started on 100mg of ampicillin twice a day along with .01% tretinoin cream. I'm in the middle of the dreaded IB and I know it's been a short time but it's very frustating (literally crying myself to sleep at night...my husband is a saint for dealing with me!)
My question is this...I would like to start a family and I know I won't be able to keep using the tretinoin throughout pregnancy. At this point I'm not even sure it's going to work. I'm leaning toward pushing my derm to send me to someone who will perscribe accutane just to get it done with (he doesn't even deal with it given the iPledge program). What should I do? I'm not excited about the possible side effects but I'm concerned that given my history it is the only thing that will work. Even if I contact my derm tomorrow I'm probably looking at at least 8 months until I'm finished with my course of accutane and I want to start trying for kids sooner rather than later.
HELP!
Beth--first, a hug.
I'm really leery of newbie posters like above ^^ who immediately make a referral to a website. Yet this person might be onto something (minus the sales pitch, of course). There is an answer--many in our medical and scientific community already know it! but unfortunately, it is ignored in our society, and doctors believe their patients want an easy fix, a.k.a. a prescription drug.
I had terrible, horrible cystic acne starting about age 12. I lived behind a thick mask of make-up because nothing else worked. Through my 20's I learned to ignore it and go on with my life. But I knew there was something wrong with my skin and I couldn't figure out why I had this problem but other women didn't (of course, I only saw the ones with great skin). It has taken me years and years to figure my skin out--and to accept that I have to make changes in my life-- but I have finally done so, and now I am encouraging my daughter, 20, who has skin issues, to do the same.
Starting in 1925 there has been a known correlation between what is called the gut-brain-skin triangle. Research continued through the 1930s, and then waned, to be started again in the 1960s, with some great results. However, during that same time the big pharmaceutical companies came into being--it was the advent of the birth control pill--and the average person began to want more "modern" things, like TV dinners and dishwashers and remote control TVs and such. So, research in the area of gut-brain-skin was forgotten, eclipsed by major pharmaceutical and commercial interest in promoting "drugs". It is only just in the past 10-15 years that we are once again looking more closely at the gut-brain-skin triangle, and the intricate balance in our bodies.
To establish credibility, I'm going to send you to this bonafide scientific abstract, not some infommercial site http://www.gutpathogens.com/content/3/1/1 If you read it, and then continue to do more research on the internet, the answers will start to come to you. Then you will have to decide if you want to make the lifestyle changes necessary to change your health and consequently, your skin.
The dysbiosis in your gut will have to be corrected. You may have to take a prescription drug (oral nystatin or flucanazole) to begin to make a dent in the harmful pathogen overgrowth in your gut. (Thank gosh for a young and progressive dermatologist who prescribed my daughter flucanazole for 1 month, with a continued dose of 1x a week. I, myself, used an OTC oral antifungal/anticandida product.) Simultaneously, you will have to change what you eat--you'll find hundred of links to anticandida sites which outline the various diet/food options which cut down on gut overgrowth. You will have to supplement with super high-quality probiotics like VSL3 (used for cancer patients and those who have had colonoscopies) and you will probably have to take some kind of fiber supplement to kickstart your excretory system. You will have to put up with a purge of toxins while the pathogens exit your body--and your skin is the largest excretory organ! You may have to seek moral support from others who are undergoing the same as you; on a site like thecandidadiet.com (take the extremists with a grain of salt; they're everywhere). You will have to continue to be on top of your food quality, because at this time there are no permanent cures for gut dysbiosis. However, there are medical tests (you can get one from your physician, of all places) http://www.rxlist.com/candin-drug.htm to determine if you have a candida sensitivity. And there is continued hope, as currently more research being done for widespread anticandida vaccines http://www.ncbi.nlm.nih.gov/pubmed/15378749 .
Best of luck.
Kimanjo, thank you for the thoughtful reply! I have indeed had many of the symptoms outlined. I'm already taking a high quality probiotic, which I started at the same time as the antibiotic to ward off yeast overgrowth (I've had problems in the past). I don't really know how effective it will be, though, given the daily ampicillin. I already eat a pretty healthy diet with minimal sugar/processed foods/simple carbohydrates so with some minor tweaks (coffee...argh!) I might already be on my way to giving this a shot. Before my wedding I went on a low carb diet to try and lose some extra pounds and come to think of it, my skin was pretty good at that time! I'll definitely look into this further. Thanks!