Hello, I'm a bit concerned.
I've had mild back acne for a couple of years, never too serious. I've been wanting to treat it lately because it had gotten a bit worse and the Clean and Clear body wash or some anti acne soaps weren't doing anything at all. It got not super bad but had around 3-4 active pimples on each shoulder blade, and also down the spine a couple too. The dermatologist prescribed me with:
BP 10% cream
Hibiclens
Doxycycline Hyclate 100mg (for 1 month, 1 a day)
I followed the treatment and after 1 month it had maybe gotten worse, with some pimples forming on the triceps and no sign of stopping on the back and shoulder blades.
I did a refill for doxy and then went on to complete the second month of treatment with (maybe) the idea that it had finally gotten less worse. I called the doctor and did another refill for 20 days (pills), but he wanted to see me as he said this is not a drug to take for long periods of time.
He looked at the back, asked me about the whole thing, and explained him that it may have been improving, although I was still getting new pimples forming almost every day.
He prescribed me with an extra 30 days of doxy (which I would take after the 20 day refill I'm on right now) and also prescribed me with 14 days of Lamisil (Terbinafine 250mg). He said he wanted to see me again in about a month.
What concerned me the most was that he said that if the situation does not improve, he wants to do a biopsy. That really, really concerned me because I remember back acne being a mild problem for a couple of years. Now I look at my body and get freaked out about my moles (not on the back) and don't remember if they've been there forever or not.
Should I be concerned about this? Please help.
Thanks.
The biopsy is a wise move. That is the best way to determine if the issue is fungal or bacterial. You must know that to select the proper treatment. Using antibacterial meds on a fungal issue may very well cause the condition to worsen. I have personally been through this situation and it took 2-3 years to get it sorted out and cleared up.
It took that long because the first derm only did a visual assessment and prescribed antibacterial treatments (doxycline, clindamycin, etc) when in reality my problem was fungal. My condition actually worsened because bacteria was wiped out, allowing fungas to thrive (the two compete for real estate on your body). After 1.5 years of this I went to a different derm for a second opinion. He did a biopsy and determined my issue was fungal. From that point it took about a year to get me cleared up. Sometimes I still have minor flare ups that occur, particularly in hot weather.
I don't feel qualified to answer the question about taking doxycyline and terbinafine at the same time. You need to do a bit of investigation on that one....