I also agree with you, jfiligree. Most of the research is pointing towards a "no" for isotretinoin causing depression, but it isn't entirely ruled out, and there is a biological plausibility, since it can cross the blood-brain barrier. The FDA stated that one should watch for depressive/anxiety symptoms and other side effects anyway and treat it when necessary.

Accutane is poison. Period. It is a CHEMOTHERAPY drug that PERMANENTLY alters gene expression. That's how it "works".

I obviously don't know enough about treatments to comment but I have always been a person that feels everyone has their right to an opinion and in this case I don't think that either sides of the argument should advocate that their way is the ONLY way .. I am sure that both paths work for many people.

When we started Roaccutane last year, his acne was not 1/2 as bad as it is at the moment and he was not affected emotionally by it at all¦ a very self confident boy who was 100% focussed on his fitness/football.

After the Dermo explained the possible side affects he was slightly concerned of the possible muscle fatigue & joint pain.

A few weeks into the treatment we were seeing improvement and not a lot was bothering him, he was experiencing slight muscle fatigue but just worked through it¦

then he suffered a shoulder injury that put him out of the game and gym for 6/8 weeks, during this time we decreased his dose and it was then that he began to become depressed/angry & withdrawn.

Now i am not saying that the Accutane caused him to become depressed/unstable. In fact i would guess that it could very well have been the fact that he was unable to participate in the one thing that he LOVED, lets put it this way.. he is not your average teen who would pass this time by watching movies and playing playstation.

He then stopped taking the medication all together on the advice of his team Dr. and in the sports Dr's opinion it was likely to be the accutane that increased the recovery time for that type of injury.

He now has a promising career in his sport and does NOT want to risk it again.. this is why he is so adamant that he will not take it.

So please argue all you like .. i just want to be clear that i am not against the drug.. it is simply not right for him in his circumstance.

Anyway as promised here is a photo update.. I actually thought it looked better than this when i looked at him this morning .. the photo seems to bring the red out more.

Obviously the dryness has gone since the moisturiser has been used daily and i think it is a little smoother¦ but still very bad, i know.

Thanks for clarifying, OneProudMumma. I wasn't sure if a doctor advised your son to stop taking it--it's common for people to stop taking their medication altogether without consulting or telling their doctor(s) first.

The best you can do for now is bring him back to the dermatologist and see if she can prescribe your son something else. Please share your/your son's questions and concerns to your dermatologist. I can't emphasize this enough. If you feel like you're getting ignored, then it'd be a good idea to get another derm.

I hate seeing people suffer, and even more so when they're desperate enough to try unproven or quack remedies. My greatest sympathies are with your son.

Based on his pictures, it appears to me that his inflammation is dying down considerably. The redness seems to be made up of quite a few post-acne marks (as opposed to active lesions), which do take a while to go away under normal circumstances. Keep doing whatever you are currently doing. I know you mentioned he has given up milk. I've seen a few cases in which that was the only change needed, while others require a much more drastic diet change. It all depends on genetics. Everyone has different sensitivities, but some sensitivities are so common that we usually mention them as a first defense.

What changes has he made for his acne so far? I agree it is looking much less inflamed!

I haven't read through all of the responses, but I'm glad you told everyone to stop pushing accutane. It may seem like it's the only cure for acne, but trust me it is not. I started getting acne when I was your son's age and my mom spent a lot of money on topicals, dermatologists, gynecologists, etc. As someone who has been through most conventional treatments for acne, I want to advice you to think about your son's health and not put him through anything that could potentially have long term side effects. I'm glad you reconsidered accutane. If there are good holistic or integrative doctors in your area, please take him to one. Holistic = taking into consideration the WHOLE body and causes, not just the symptom (acne). They can run hormonal panels, blood tests, histamine/ allergy tests to figure out what his issues are. Acne is a symptom, not a cause, so you need to figure out the cause of his acne so that he won't have to put up with it for the rest of his adult life.

Acupuncture can also help him if he is receptive to alternative methods. It helped me diagnose health issues my regular doctor didn't know I had, it's so useful if you find the right practitioner.

Here are a few other things I recommend based on the information you posted:

If he can't exercise less intensely, then make sure he washes his face afterwards to prevent getting clogged pores from sweating. Have him use makeup removing wipes to cleanse his face after sweating (I recommend ponds wipes with kaolin clay for drawing out impurities - not just for makeup removal and he can put them in his gym bag). He can do this up to twice a day. Nothing should be done excessively.

Ask your doctor about inositol...it's a B8 vitamin that reduces testosterone. It has helped me tremendously, but I don't know if it would work on males so ask someone who might know. A good multivitamin can help too...I recommend either herpanacine or solgar's earth source vitamins. His body needs the right nutrients to begin healing. Digestive enzymes might be useful too if he has food intolerances (I recommend enzymedica's digestive enzymes because they don't add fillers and other crap to the capsule). Ask him not to drink water WITH meals, only in between meals, to ease digestion. It's good that he likes to drink water, but if he drinks it with meals it can impair the digestion of food.

Lose the protein shake. If he needs protein, try a protein bar but again, I would try to avoid protein bars altogether. A good one I sometimes take is south beach bar with yogurt and honey, that one doesn't break me out at all and it has high fiber. I am mostly grain free, but when I need grains that's what I eat along with gluten-free & yeast-free pitas. Barbara's gluten free honey cereal is another grain that helps me because it contains prebiotics. So, if it's too hard for him to cut out all grains, then just cut the very processed ones to begin with. A paleo diet is ideal for acne, but it's definitely not for everyone especially a teenage boy.

One last thing. Try switching from tap water to filtered or distilled water when he washes his face. My area has really hard water with fluoride and chlorine, and adding a water filter in my shower and washing my face with distilled water has helped a lot with redness. He needs to balance his PH, and if he is using hard water he is ruining his acid mantle. Find a gentle, sulfate-free (no SLS) cleanser to help with that. No proactive, no harsh chemicals. I recommend Image Ormedic Cleanser, but really any cleanser that says "balancing" or "restoring' will do provided it doesn't contain sulfates or other chemicals.

Topically: honey, greek yogurt, and aloe vera (ALL pure, no additives, no sugar) can help but spot treat first to see how his skin reacts. Calamine lotion might also help (the walgreens kind with the fewest ingredients, I don't remember exactly what it's called) can help with inflammation as well.

Sorry for the long post. Your concern reminded me of how concerned my mom was for me when I was your son's age and I wish someone could have given her the same advice I had to research by myself to find all these years. There's no magic pill unfortunately. I'm glad you didn't let accutane get in the way of his love for sports....if he keeps doing what makes him happy and doesn't stress out about his skin, he's already won half the battle.

Great information wishclean.. thank you ..i will print this off and look at introducing some of your points.

Dscully, yes the red marks are pretty dominant but i am hoping they will fade.. i am also hoping that it is only the Milk that we need to remove.. it is just so hard when it comes to food and a 15yo appitite!

Paigems.. yes i agree it does look less inflamed, this is what he is doing:

We have removed Milk.. and eased up on Protein shakes [not 100% gone but only having 2 a week at this stage]

Introduced a probiotic

He is using the Regimen cleanser / moisturiser and jojoba with the Stieva A cream and applying all in the gentle method shown..

i'm also an athlete too, and have moderate acne similar to your son's(opposite of t-zones). i've used milk and protein shakes in the past as an easy source of calories and protein, and they definitely cause me to break out. if your son insists he must be getting enough protein every day, then add more meat into his diet.

I wouldn't dispute that there are things that can keep acne at bay - "the regimen" worked very well for me for several years. My dermatologist said accutane is the only cure for severe acne which I personally believe to be the case until something new comes along but I understand now why your son doesn't see it as an option so good luck with the topicals. Some of them are very good.

Accutane is poison. Period. It is a CHEMOTHERAPY drug that PERMANENTLY alters gene expression. That's how it "works".

let's not hijack this post with arguments about pro or con accutane...a mother here has asked for help, if you want a personal conversation, please keep it to yourselves and don't hijack this post- enough

as far as the protein shakes go, use almond or coconut milk, ice cubes and add hemp, rice, or pea protein (I use a heaping tablespoon of each)...and you can add some frozen pineapple or other fruits....no need to do with out protein, just avoid whey and milk

Just want to add, maybe he could take a food intolerance/food sensitivity test? Its a bit pricey but then you'll know for sure what foods are causing his acne.. e.g. if you live in australia, syd http://www.imupro.com.au/ or if you just do a google search you could find some places to get him tested.

Large amounts of non-synthetic, food-based vitamin A have helped me and my friends considerably. That means a couple pints a day of carrot juice. I don't break out at all anymore unless I eat sweets or pizza (which contains all my food triggers at once). You can't OD on vitamin A from carrots, and your body can store this vitamin, as well. I've been dosing up on it for months. Haven't turned orange yet!

Carotenoids (from brightly colored vegetables like carrots and beets) help speed healing and reduce inflammation. They also help to detox the liver. They are an all-around miracle for acne. They also kill cancer cells and reduce the risk of cancer! Food can do amazing stuff!

I wanted to add that, by looking at your son's photos, it looks as though what started out with a few pimples led to inflection and spreading of the acne. It almost looks like a rash. Which means that you need to not only prevent new acne from forming internally (nutrition, supplements, etc), but also treat the infection before it spreads even more. By the looks of it, the updated photos you posted look a lot better, so keep doing what you are doing. It's going to take time, but if he is willing to try a new regimen then you'll gradually see results.

Even though I had a bad experience at a spa yesterday (skin exfoliation gone wrong!), I still recommend seeing a qualified esthetician who can do extractions and properly disinfect. Ask them not to use glycolic or salycylic peels on him, just gentle calming masks at this point. If you can add a high frequency and/or red pulsed light treatment (I use Light Touch, IPL is too much at this point) and maybe some blue LED treatments, you should see great results with the inflammation.

Tell your son not to touch his face without washing his hands with antibacterial soap, and try to improve the quality of water he washes his face with. Try for a week to use distilled/spring/filtered water and see how he reacts. I guarantee you his skin will feel softer and more manageable.

I agree. Keep it clean. Definitely use distilled water for a week and see what happens. Great idea.

Disturbing the acid mantle of the skin too much (with harsh cleansers and chlorinated water) can cause more irritation and acne. I've noticed that anything I wash my face with that causes it to feel tight is going to trigger more irritation. He could also try washing his face with organic grapeseed or jojoba oil and a warm/hot washcloth. A couple drops of oil spread all over the face will dissolve oil and other gunk. You spread the warm or hot (but not too hot) washcloth over the face and let it sit for a couple minutes then remove it. If he has very oily skin, a little castor oil is a gentle cleanser as well. I've found it's too drying for me to use everyday, though.

Washing your face with oil if you already have oily skin sounds ridiculous, but I've found that it greatly reduced the amount of irritation I was causing my skin, and irritation=more acne for most acne sufferers. When my skin feels comfortable and smooth after washing, it's a much better feeling than I had when I was scrubbing it into submission with a gritty, detergent-based cleanser. Oil dissolves oil, but never strips the skin, which lends that uncomfortable, tight feeling cleansers with SLS in them can give you.

It has worked for me, anyway. If you're scared of oil, a gentle non-soap cleanser like Cetaphil works great as well.

For your son's condition, I don't think it works if you look for usually treatment.

have you ever consider Chinese traditional medicine or herb treatment. I think there must be something wrong with your son's body system.

Suggesting Accutane is not "pushing" it. Everytime you have one of these posts, it gets taken over by people who "push" all the holistic healing home remedies. Also notice that these folks do not or have ever had severe cystic acne that is scarring. If your acne is NOT scarring, it is not that severe.

I know your son is against it, but his acne is quite severe. If the acne is starting to scar, then it has already passed the tipping point where less aggressive means will not stop it. I had one of the most severe cases of cystic acne in high school, at the same age. I really commend you for your concern. My parents did not understand and I have suffered a lot. First it was the cystic acne, and now it's dealing with the aftermath - severe scars.

I'm a smaller built guy, and at one point I was on 80mg/day of Accutane. After 5 months, my acne has gone into complete remission. I do break out anymore, and I could slather Crisco oil on my face and not break out.

I'm not exactly PRO-Accutane, I'm pro science based approaches when the acne is severe.

How is his skin doing now? Excited to see the outcome of the tips from this amazing community!

Sorry if i have not responded directly to each comment or suggestion but please know that i am taking it ALL on board and appreciate everyones input.

glee12, I did post an updated photo on the 14th [pg 3] and will do so again on the 21st.

I am just not sure today.. obviously you have your good & bad days and he is following his current routine strictly and suffering with "foul tasting milk" his words! He seems to now have pimples popping up on his forehead he has never had them there before

His jawline & cheeks are looking pretty bad at the moment but he hasn't had too many "new" pop ups.. his skin is just really bumpy and he has deep red marks where the pimples have dried out.

He often complains that his skin is very itchy.. i am hoping that is a sign of healing.

He has discussed the possibility of trying Accutane again after the current representative season [approx.12 weeks time] IF we see no impressive change with the other treatments / ideas we are trying .. so yes, he is considering it as a last resort.

Acne on forehead can be a sign of detoxing or liver issues. It might be a detox reaction from cutting out some foods from his diet.

Not sure if you tried some supplements that help men, but you could consider adding one at a time (provided it's good quality, gluten & dairy free, etc). Zinc and Vitamin D, and also Vitamin C for skin healing. Vitamin E can help with healing too. You can also try herbs that lower testosterone if he does have high test/DHT, like spearmint tea and saw palmetto, but I wouldn't try those unless you are sure his testosterone is the problem. Accutane will not fix hormonal acne, it will simply come back....check the forums to see how many people do a 2nd, 3rd, and even 4th course...those people suffer with hormonal or other type of acne that can't be treated by accutane. It's best to find the root of the problem and treat it rather than treat the symptom with something that has the potential to cause other problems. They don't ask you to sign a waiver and take the i-pledge every month for nothing. My mom put me on every pill imaginable (accutane wasn't even an option in my country back then because of the risks) when I was a teenager and now I"m paying for it with liver issues, digestive problems, hormonal imbalances and who knows what else. I would blame my mom for it if she knew better, but she was trying to help me clear my skin without imagining of the side effects that came with that. You are responsible for your child's health, and I'm sure you'll weigh the pros and cons carefully and do what you think is best for him. Of course, a natural and holistic approach takes more work....that's why most people would rather pop a pill and be done with it. But wouldn't it be great if you could find the cause of his acne so that it doesn't come back in the future?

Also keep in mind that if his skin is infected, new pimples will keep popping up until you get the infection under control. You have to find a qualified dermatologist/ esthetician to perform extractions and keep the inflammation from spreading, otherwise the infection will just keep spreading. This is a skin-deep issue, but you have to approach acne from a topical and an internal perspective, since in the first photos you posted it looked as though his skin was infected. It could be fungal (in that case, anti-fungals like tea tree and even nizoral, which many on this forum recommend, can get it under control) or bacterial (witch hazel might work for this).

Wishclean,

1. Could you cite where forehead acne is linked to detoxing/liver issues? To me, that sounds like pseudo-science. I believe only jawline/chin acne in women is the only type of acne linked to any location (with that being related to fluctuating hormone levels i.e. during menstruation).

2. Please be very wary of messing with androgen levels during male puberty. I would suggest against it.

3. Supplements may help a bit, but more than likely the effect isn't going to be huge (especially for severe acne). I would be happy to link to some studies if it would help (but the link button seems to be broken). There is little evidence to support vitamin D helping acne and "modest at best" for zinc. Vitamin C and E are, I believe, helpful in healing, but won't do anything for acne.

4. Hormonal acne can certainly be treated by Accutane. All acne is technically hormonal/genetic, which is why children don't get acne. Androgens can trigger an overproduction of sebum which can cause acne. Accutane shrinks the sebaceous glands.

5. You shouldn't scare someone off Accutane just because a few people have had, say, 4 rounds of it. A lot of people have to look around at different treatments/routines to treat their acne - that doesn't mean the products don't work, it just means it didn't work for them. One study found only a 39% remission rate after a 3 year Accutane follow-up with 19% doing another course. That's amazing considering that the acne usually comes back much milder and treatable topically.

6. Accutane really isn't a big deal - you read and sign the iPledge once (not monthly) as a male and get blood tests every month just to make sure that your liver is doing ok. Your dermatologist checks up on your progress and you talk to him/her about side effects you're experiencing. Major side effects are very rare (and usually not permanent).

7. I would suggest against an extraction. This can certainly induce more inflammation which is the opposite of what you want. Sometimes a bentonite clay mask can help heal pimples in a similar, safer fashion though.

I'm sorry if that sounds defensive or like I'm trying to bring up Accutane again, but I do feel it's important for people not to be immediately scared of such an amazing, powerful medication. As always, research and inform yourself before you make such big decisions...but for me, I know that Accutane was the only thing that would work (and it did).

OneProudMumma,

I think it's wonderful that you are being so involved with helping your son! You're a great parent - I know that the support of my mom helped me so much when my acne was really bad. Itchiness is usually a sign of either inflammation or dehydrated/dry skin - I'd load up on moisturizer to be safe.

Hello OneProudMumma,

There's one thing that my homeopath told me while I went to visit her. I was put on antibiotics for a while too, because of resistant bumps and acne. What she told me, was to make sure to take probiotics during the whole course of the antibiotics. It helps to keep the good bacteria in the digestive system, and this can contribute to faster healing and a stronger immune system too!

It's really simple, just make sure he gets Vitagen/Yakult or some form of natural yogurt in his diet everyday! It should help to boost the number of good bacteria in his body! =)

Your son has really beautiful blue eyes too!

God bless~

Have you considered food sensitivity testing?

These tests are unproven, and thus must be ordered through a naturopath; however, based on my experience with these tests, they have been very helpful in identifying the problem. They are about $100, and test many, many foods as well as common allergens. You can also get a vitamin/mineral test, which I would also recommend. The tests I did were the IgG Food Antibody Assessment by Genova Diagnostics, and the NutrEval test also by Genova Diagnostics. When I first took these tests about 2 years ago, my acne looked similar to your son's, though a little less inflamed, and more on the forehead. Serum levels of a large number of vitamins and minerals were low; I had high sensitivities to wheat, soy, peanuts, and a few other things; my gut flora was out of whack (I did a stool test as well). The naturopath I was seeing put me on a restricted diet and gave me some herbs and probiotics to help with gut flora.

ow at the time, I thought the whole process was silly; there was really no evidence for any of her 'treatments' in scientific literature, and, being a scientist, I had more faith in the literature than in a quack naturopath. I didn't think acne had anything to do with diet. In fact, I dismissed the naturopath's claims outright at first, and while I took the herbs and probiotics, I didn't really change my diet.

Anyway, here I am two years later. The transition to a paleo-esque diet has been hard, and it took a long time to get used to. It's really only been the last few months that I've been very serious about avoiding the foods I tested to be sensitive to. Last week I took the food sensitivity and vitamin tests again. Everything has improved drastically. I have almost no reaction to wheat, peanuts, and soy; my serum vitamins are within the norm. Most importantly, though, my acne is about 90% better. Not gone - but much, much better. It doesn't look like I have acne any more, unless you get up close.

I've tried a lot of things. I've probably tried just about everything short of accutane. Some things helped, other things didn't. What I can say for sure is that my acne did not improve because of topicals. In fact, my topical regimen is extremely limited - I only wash my skin once a day with a salicylic acid scrub (this I have found to help, which is why I am continuing it) and I do not apply any medications or moisturizers (I occasionally moisturize, but maybe only once a week).

The real turning point came just a few weeks ago. Up until then, I would get spots on my chest after eating something that I was sensitive to. I went to Minnesota last weekend, and was unable to adhere to my diet; I ate soy, I ate wheat, I ate everything and anything, muffins, donuts, pasta, ice cream etc. Not a single spot. It seems as though my gut has healed enough to prevent some larger food antigens from entering my blood. I began consuming bone broths via soup about a month ago, and I think this is how I healed.

Of course, this was in combination with a safe diet. And it took me two years (though I didn't have all the tools at my disposal that I do now for the majority of that time).

I would really recommend getting testing done. It's easier to solve a problem if you know what needs to be fixed. And you'll probably save money in the long run. Until then, though, paleo diet (rice is okay though) with a strong emphasis on bone broths (use hamhocks and beef bones with some vegetables and spices, get the joints and tendons too, add 2 tablespoons of apple cider vinegar, let it simmer for 18-24 hours) will probably be immensely helpful. Vegetable juice would also be good (carrots, kale, celery, cucumber, a little green apple, broccoli, etc). A perfect meal would be a chicken, vegetable (cherry tomato, onion, celery, cauliflower, carrot, spinach), and rice soup in bone broth with a glass of vegetable juice.

I think it's important to note that probiotics could make the situation worse if your son has a compromised gut barrier. Gut microbes are often behind forehead acne, so it might be good to stop those for now. If you want to cover all the bases, order a stool test from the naturopath as well. If there's an overgrowth of a particular bacteria, removing it could drastically improve your son's acne.

Now that I've written all that, I noticed that you mentioned itchy skin. This can be two things. The first is an IgE reaction to food antigens - so, leaky gut. In this case I would recommend testing for food sensitivities, and all the other stuff I mentioned above to heal a leaky gut.

The second is fungal folliculitis. It's possible that this is a topical infection - NOT acne. You can test this by washing with an anti-dandruff shampoo; I would use head and shoulders with zinc pyrithione; apply in a layer in the shower, leave it on for ~3 minutes, wash off - make sure it all comes off, otherwise you could get lots of irritation. If it's fungal, it will respond within a couple days, and be drastically improved within a week or two. Note that zinc pyrithione is also antibacterial, so it will improve normal acne as well - just not as much, and not as quickly, and not as completely. Using a shampoo on the face can be quite irritating, so it would be good to moisturize afterward. Like I said, I tried everything

My bet is still that it's the first option, though, so if you want to test the head and shoulders shampoo, I would do it in combination with bone broth/restrictive paleo+rice diet in addition to getting the three tests mentioned - food antibody and vitamins (which are both blood tests), and stool.

Yeah, folliculitis can be a possibility too, that might explain the rash-like appearance. Whatever it is, it's also a topical problem now because it spread. So the infection needs to be treated along with the internal reasons.

But hey, I feel like we holistic advocates are wasting out time sometimes giving advice because we know where this is gonna end...

Ok, I will be bluntly honest.. a paleo diet is not an option for him at this time. He is a 15yo who is more interested in gaining mass to follow a sporting dream & anything that stands in the way of that will be a "no go". I feel keeping it as simple as possible is our best option.

Although in saying that i am interested in having some of these tests done to see what results they produce.

I 100% believe that diet is a contributing factor here.

The removal of milk, combined with the continued used of the Stieva A topical, his antibiotic & the addition of a pro biotic & gentle cleansing & moisturising routine seems to be producing steady results right now.

this was taken this morning..

Yeah, folliculitis can be a possibility too, that might explain the rash-like appearance. Whatever it is, it's also a topical problem now because it spread. So the infection needs to be treated along with the internal reasons.

But hey, I feel like we holistic advocates are wasting out time sometimes giving advice because we know where this is gonna end...