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First, let me just say that I have been truly inspired and moved by the many courageous people here. I am also extremely impressed with the number of obviously good-hearted souls that are on this board.

I have been fighting nodules and cystic acne for 20 years now (I'm 30). I have gone to numerous dermatologists and been on all manner of topical creams (EG: BenzaClin and Retin-A) and antibiotics. Nothing has worked. However, over time, things got less bad. I recently went to my former derm's office over a rather serious rolling scar I got in recent weeks. Instead of getting the derm, I got his assistant. She basically blew off the scar I wanted to discuss, refused to discuss miscellaneous methods of treatment, alternative creams or drugs (I was on BenzaClin and a prescription vitamin I can't remember right now) and spent the entire visit pimping SmoothBeam. She wouldn't discuss anything else and was painfully vague about how SmoothBeam would work. She also insisted on payment ($2,250) up front.

So I went to a 2nd derm. The doctor immediately prescribes Accutane 40 mg x 1. I weigh 210 lbs, so this is a rather trivial amount proportionately speaking. Now I know the derm is full of it to some extent because he tells my fiancee (who was with me) and me that I will "never get another pimple again" after taking the first Accutane pill. I know better, initial breakouts are inevitable, but I figure, "eh".

I take the drug for 17 days when all hell breaks loose (yesterday). All of a sudden I am dealing with 1) major ulcerating acne, which I have never had in my life. We're talking about multiple holes in my skin the diameter of a U.S. quarter or bigger...and...2) even more frighteningly dark lines are forming connecting one rolling scar to another or just on their own. I'm pretty much being turned into a human jigsaw puzzle. This is happening on both my left and right cheek. Mind you, neither of these things have happened before. I have followed the "don't"s to a "T" on this product.

When I called derm #2 yesterday he blew me off (after I explained the symptoms at length to his receptionist/nurse) and had his receptionist call me to tell me to just keep taking the Accutane and he'll see me in a few weeks. (Edit: I was also told there was no need to see me or put me on any additional drugs)

Is this something that can be cured with steroids? Or am I stuck with these new scars for life? There's no pus, swelling, or any of that. Just new massive craters and dark lines zig-zagging across my face.

Any information would be appreciated greatly. I'm going to try and find another derm to go to tomorrow. Thank you to everyone who responds!

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This does not sound like a normal reaction to Accutane AT ALL especially given the fact that you are taking such a low dose (to be honest I wouldn't even expect you to get an IB). Don't take any nonsense from these guys. Go to the derm's office and insist to be seen. One very rare possible side effect of Accutane is an extreme form of acne. If that is what you have you need specialist help asap.

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i've never heard of an IB that bad.............^ i'd follow his advice and go see a derm again or your family doctor

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That sounds scarily like Acne Fulimans. Google it... if that looks like what you're getting then you need to get off the tane stat and go back to that derm and figure out what to do about it before it gets any worse.

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Shmelis that is *exactly* what I was thinking. Either acne fulminans or acne conglobata. My symptoms are a spot-on match. I'm scared to death. My fiancee is a pharmacy tech, so she got me a far lengthier version of the Amnesteem info pamphlet. The first "Adverse Reaction" listed under "Skin and Appendages" was acne fulminans. My fiancee thinks I'm being dramatic, but I've been fighting acne for 20 years and I've never been scared of acne; I am trembling and sick to my stomach right now (sorry, not trying to be dramatic, just providing perspective). I am watching as my skin is getting carved up. What's especially frightening is that in the 48 hours since my last pill the symptoms and scarring is getting worse.

There's no pimple, no heads, no pus, nothing. Just enormous ulcerative scars and zig-zagging dark lines carving my skin up (about 1/16th of an inch wide, may not seem like much, but hold a ruler against your face for perspective).

I guess I'm calling off work tomorrow. I'm leery about going to this derm after he blew me off so thoroughly over the phone but I don't have another doctor I trust. If anyone knows of a good derm in the Chicagoland area, I'd appreciate it.

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Im from Chicago and every derm here is crap!...every single one!!!..

If i were you, I would screw the derm and get myself over to an emergency room asap!

Patients with acne fulminans should consult a dermatologist urgently. Management can prove difficult, and several medications are usually required. These may include:

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It sounds like acne fulminans to me as well but I didn't want to scare you because it is extremely rare. Even if it isn't you need medical advice. BTW - if derm #2 just tells you to keep taking the Accutane get a second (and hopefully better) opinion. Best of luck to you - wish you the best.

P.S. - Fuman I am a she!

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It sounds like acne fulminans to me as well but I didn't want to scare you because it is extremely rare. Even if it isn't you need medical advice. BTW - if derm #2 just tells you to keep taking the Accutane get a second (and hopefully better) opinion. Best of luck to you - wish you the best.

P.S. - Fuman I am a she!

JBHK, I thought that was what you were referencing in your response, but I didn't want to put words in your mouth.

I haven't gone to an ER yet because the care in ERs (from what I have been told) is notoriously slow and abysmal. This is also something relatively rare, so I think a specialist should look at it.

At this point, I'm going to be at derm #2's office before they open, waiting at the entry door. There isn't a doubt in my mind it is acne fulminans (although I am certainly open to suggestions that are less scary!), I just didn't want to prejudice any of you in my original post.

I certainly don't have to worry about sleeping in; I doubt I'll get much sleep. If I don't get anywhere with derm #2, I will go the ER route or try or find someone in the city. Regardless of what the derm says, I do believe I have taken my last isotretinoin, regardless of what is suggested. I'm just glad I recognized it as a major problem within hours of it showing up and stopped taking the drug. Hopefully that'll minimize the damage.

Does anyone have any idea if the length of the acne fulminans will last as long as the time I was on accutane or have I opened the proverbial Pandora's Box right onto my face? Is there anyone else on this board who has had this condition? As indicated earlier, any information is appreciated.

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It is characterised by:

* Abrupt onset

* Inflammatory and ulcerated nodular acne on chest and back

* Severe acne scarring

* Fluctuating fever

* Painful joints

* Malaise (ie. the patient feels unwell)

* Loss of appetite and weight loss

* Raised white blood cell count.

Although it mostly just happens, it may be precipitated by:

* Testosterone (legally prescribed or illegally taken to enhance muscle growth)

* Isotretinoin

Do you feel physically ill? If not, then there is a good chance it may just be a bad break out. I would still go to the hospital and get checked out. They will be able to do a white blood cell count on you at the least.

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It is characterised by:

* Abrupt onset

* Inflammatory and ulcerated nodular acne on chest and back

* Severe acne scarring

* Fluctuating fever

* Painful joints

* Malaise (ie. the patient feels unwell)

* Loss of appetite and weight loss

* Raised white blood cell count.

Although it mostly just happens, it may be precipitated by:

* Testosterone (legally prescribed or illegally taken to enhance muscle growth)

* Isotretinoin

Do you feel physically ill? If not, then there is a good chance it may just be a bad break out. I would still go to the hospital and get checked out. They will be able to do a white blood cell count on you at the least.

I assumed it was a cold or flu brought on by air conditioning but I have the following regarding your list...

Abrupt onset, inflammatory and ulcerated acne (on face), SEVERE scarring, feeling sick, loss of appetite. Now granted, the loss of appetite, I'm sure, is stress related to some extent.

I just got off the phone with the doctor who was incredibly rude. Growled at me that it wasn't a problem at all, that these symptoms are perfectly normal (I kid you not) and said "do you wanna' see me or not?" and told me to be at his office at 7:40 a.m. Meanwhile, there was a freakin' dinner party in the background, so I know I wasn't waking him up or anything.

I don't know if I even want to see him at this point. In spite of my insurance, I might end up making that trip to the ER after all.

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I have spent some time in the diet / holistic forum defending doctors but yours sounds like an ar$e. Please make sure you stand up for yourself and ensure that he takes your (legitimate) concerns seriously. You know, it is possible that he may not have heard of acne fulminans so you might want to take some information on the subject in with you. There was a thread, maybe about a month back, of someone who had a similar reaction. I couldn't find it but you may have better luck. Ask your derm straight out whether or not he thinks you have it and if he says no ask him to explain why he has that view. Grrr - thinking about it is making me angry. Make sure you update us and good luck!!

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Hello. What a night. At about 2 am my breathing got all screwy (sometimes fast, sometimes slow, at times shallow, at times deep, try as I might I couldn't control it). Even then it took me two hours of irregular breathing (I had asthma as a kid, it wasn't asthma) to go to the hospital. That was at my fiancee's prompting (and, God bless her, driving). Per her there were a couple of times where I stopped breathing. I recall her shaking the %$&* out of me in bed once, but I don't recall things beforehand. Anyway, so I go to the ER, tests, etc. All my heart vitals were fine (blood pressure, pulse, actually those were lower than they've been in a while). The doctor isn't really familiar with Accutane and acne fulminans and is decent enough to admit so. She does a little research, finds nothing on acne fulminans, and I think called a derm (I heard an orderly ask the doctor which other doctor he should call at home) Her first piece of advice is "STOP TAKING THE ACCUTANE!" ;) They regulate the breathing after a couple of hours, regulate my oxygen, etc. ER doc says it'll take a week to flush the Accutane from my system.

So I go home at about 6 am and I'm going to the derm at 7:40 to give him a piece of my mind. I see him, he immediately tells me it's (the scarring) nothing. I actually stayed polite (I suck) but flatly told him that although he's the professional I thought he was out of his mind. We go back and forth for a while. Derm tries to pimp the Accutane. I politely tell him in no uncertain terms that I will NOT take Accutane again. Period. He writes me a scrip for an antibiotic. He says he isn't comfortable giving me an anti-inflammatory first (I dropped the scrip off at the pharmacy, I'll edit with the name of it later). He pimps the 'tane again and I shrug it off. Before that I firmly point out that I wouldn't have called him if it wasn't an emergency and that, like him, my job involves my getting called by people regarding work at all hours of the night, so I realize how frustrating that can be. In short, I'm off the Accutane, on an antibiotic, and if things don't start turning around in the next couple of days it'll be off the derm #3 for a steroid &/or anti-inflammatory. The doctor equivocated royally on whether it was inflammation or scarring, which I can't say exactly builds up confidence.

Oh, I went through the symptoms and asked him why he thought it wasn't acne fulminans. Derm says that if it was acne fulminans I would be crying in agony and in the hospital from the pain and chaos. Derm says that in 23 years he has seen one episode of acne fulminans.

I am going to try and keep an eye on things and make sure they don't get worse. That's going to suck because I hate mirrors as it is and, right now, I really don't feel like being in front of them. I'll keep people posted for informational purposes.

Let me just say this because I know a lot of people, like me, lurk before they post. If your acne is anything but life destroying (I'm talking chin to crown and ear to ear nodule and cystic acne) please avoid Accutane. I come here with no agenda, no ax to grind. However, I don't have it in my heart to wish the last 72 hours on my worst enemy. Please don't repeat my mistake. Nobody deserves this.

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Sounds like you could have the rare severe reaction to accutane, acne hypochondria. You spent the night in hospital almost dying (apparently), then as soon as you can, you get to the computer to warn all the poor vulnerable souls of this world to avoid accutane? Very charitable. Sorry, sounds like a whole lot of scare-mongering bullshit :liar:

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Sounds like you could have the rare severe reaction to accutane, acne hypochondria. You spent the night in hospital almost dying (apparently), then as soon as you can, you get to the computer to warn all the poor vulnerable souls of this world to avoid accutane? Very charitable. Sorry, sounds like a whole lot of scare-mongering bullshit :liar:

Wow. That's not very nice. There are rare but serious side effects to Accutane, and he's right, it is a dangerous drug for that reason. He came here for help and advice, not to scare everyone in the world away from Accutane. Just because you can't accept that his symptoms are legitimate doesn't mean you have a right to accuse him of lying to strike fear in the hearts of would-be Accutane users.

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Sounds like you handled him well. I hope the antibios help the symptoms short term. I am really sorry you have had this reaction to Accutane. I have found my experience with it only positive. Keep us posted!

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Let me just say this because I know a lot of people, like me, lurk before they post. If your acne is anything but life destroying (I'm talking chin to crown and ear to ear nodule and cystic acne) please avoid Accutane. I come here with no agenda, no ax to grind. However, I don't have it in my heart to wish the last 72 hours on my worst enemy. Please don't repeat my mistake. Nobody deserves this.

Well, most people have doctors that aren't pieces of sh$t, and these doctors monitor them closely to ensure that everything is going alright. Accutane is a powerful drug, yes, but there are other drugs that are equally as powerful and are prescribed much more readily, without as many restrictions, and with even less monitoring (think oxycontin--My aunt has 2 friends that became addicted to it and had to go into rehab. It was prescribed long-term for their severe arthritis pain with no regard for its addictive qualities!).

Acne is a TERRIBLE problem; it ruins self-esteem and people's LIVES. It prevents them from living how they would like to live. It makes them feel ugly. I think that ANYONE with persistent acne (be it mild, moderate, or severe) is completely justified in wanting Accutane.. and they shouldn't have to be afraid of it.

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Sounds like you could have the rare severe reaction to accutane, acne hypochondria. You spent the night in hospital almost dying (apparently), then as soon as you can, you get to the computer to warn all the poor vulnerable souls of this world to avoid accutane? Very charitable. Sorry, sounds like a whole lot of scare-mongering bullshit :liar:

Wow. That's not very nice. There are rare but serious side effects to Accutane, and he's right, it is a dangerous drug for that reason. He came here for help and advice, not to scare everyone in the world away from Accutane. Just because you can't accept that his symptoms are legitimate doesn't mean you have a right to accuse him of lying to strike fear in the hearts of would-be Accutane users.

Hypochondria (as per Wikipedia):

"irrational fears of being diseased/dying" check

"doubt and disbelief in doctors' diagnosis" check

"constant self-examination and self-diagnosis and preoccupation with one's body" check

"Hypochondriacs often require constant reassurance, sometimes from multiple doctors, family and friends." check.

All I'm saying is, some people are destined always to have horrific, rare symptoms which, if only doctors weren't so stupid, would surely be recognized as the grave illnesses they truly are :rolleyes:.

As for the idea he "came here for help and advice" idea, I can think of better people with whom to discuss apparent near-death experiences. Like a doctor. Although apparently he knows better than his dermatologist. I feel sorry for the doctor frankly having to deal with such crap.

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aboulton, you are on an acne message board trying to start flame wars? acne hypochondria? Classy. Whatever. Please troll somewhere else.

As for my being on a message board, I'm preoccupied with my current condition. Straight up, it is every thought I have at this point. I just got back from the hospital and doctors what else am I going to do? I can't sleep. Standing in front of the mirror isn't going to help. Right now I can't concentrate on something long enough to watch a DVD (preoccupied). I'm certainly not in the mood to go bouncing around town. Yeah, as my face is getting carved up, let's go to the mall!?! WTF? I am looking for a place to vent and share information. I benefit in no way from trying to scare people off of Accutane. I'm scared, I don't know what is going on and (yourself excluded) there are a lot of really knowledgeable and decent people here. Based on some messages I've gotten there are also really cool people who care; I want to keep them posted. Again, please troll somewhere else.

The antibiotic is Minocycline, 100mg x 2. I may get another opinion because these scars can't be normal. They are primarily horseshoe in shape and darken and widen as time progresses. They also connect to one another. Those are on the right cheek and they are still accelerating even though I've been off Accutane since Tuesday at 7 p.m. CDT. My left cheek is primarily ulcerative acne with a "horseshoe" thrown in here and there (not many relatively speaking). I'm not sure how the anti-biotic is going to help though. I thought anti-inflammatory medicines and steroids were the route to go. We will see.

I'll keep updating as appropriate to provide my perspective and experience.

Sounds like you could have the rare severe reaction to accutane, acne hypochondria. You spent the night in hospital almost dying (apparently), then as soon as you can, you get to the computer to warn all the poor vulnerable souls of this world to avoid accutane? Very charitable. Sorry, sounds like a whole lot of scare-mongering bullshit :liar:

Wow. That's not very nice. There are rare but serious side effects to Accutane, and he's right, it is a dangerous drug for that reason. He came here for help and advice, not to scare everyone in the world away from Accutane. Just because you can't accept that his symptoms are legitimate doesn't mean you have a right to accuse him of lying to strike fear in the hearts of would-be Accutane users.

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Just Michael, if you could bring yourself to take some pictures of the affected areas (please don't think you have to, though) and post them, that might help a lot for people who know more about it or have personal experience and can help you figure out what to do next. I'm having a little trouble picturing exactly what you're describing, though it certainly sounds very unpleasant and painful.

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Just Michael, if you could bring yourself to take some pictures of the affected areas (please don't think you have to, though) and post them, that might help a lot for people who know more about it or have personal experience and can help you figure out what to do next. I'm having a little trouble picturing exactly what you're describing, though it certainly sounds very unpleasant and painful.

I might have the lady help me out with that tonight or this weekend (she'll think it's strange but she has the skin of a porcelain doll). It's emotionally painful and frightening because of how aggressive it has been (this only started 48 hours ago). Physically there's nothing at all in the way of pain and that's the strange part. I'm used to nodules and cystic acne that are hyper-sensitive to the touch. There's no pain at all with these. Just friggin' Dig Dug being played on my right cheek...and I'm losing.

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I have an appointment to get a 2nd look at it on Tuesday in downtown Chicago. I'm really spooked by how aggressively this is moving. Is there anybody else on this board who has had acne fulminans?

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I have an appointment to get a 2nd look at it on Tuesday in downtown Chicago. I'm really spooked by how aggressively this is moving. Is there anybody else on this board who has had acne fulminans?

hi. i have not shared in an experience of this severity, but i am just posting to let you know that i feel for you. please keep us updated often. good luck, and you can and will get through this.

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Take pictures of your face and post them. This will give us some indication as to whether or not your dermatologist is a liar.

btw, I also experienced decreased sensation on the effected area of my skin when I was on Accutane. I'm not sure what causes this effect.

##

-Roaccutane Science: http://max001.proboards42.com

-Retinoid signaling, etc.

-FDA Advisory Committee on Accutane (2000)

-Accutane package label (2005)

-Package label history

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All I'm saying is, some people are destined always to have horrific, rare symptoms which, if only doctors weren't so stupid, would surely be recognized as the grave illnesses they truly are

Acne Fulminans is a recognised but rare side effect of Accutane. Since you are good with dictionaries, look up the word "rare". It means that whilst something is uncommon it can still happen. Why you have chosen to disbelieve this poster I don't know but, you have made your point now please go away. :rolleyes:

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