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_Andy_

The answers I got from my doctor about hair loss

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I'm really curious but does anyone on this forum with accutane hairloss have the same symptoms as me?What I mean is everyone is shedding hair while im not shedding at all....What seems to happen is that my hair just keeps getting thinner everywhere and then I guess eventually just kinda falls out and never grows back .Also I can only grow my hair out 4-7 inches before it stops growing considering its already growing really slowly.

lamaar-How many months did it take you before you were able to get proper treatment?

I think I have this also, but I still shed slightly. The topical steroids are starting to help I think......

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Jp, combine minox with the topical steroids.

It makes me sick the way dermatologists never admit to the diffuse aa which accutane can cause. Sure it may appear to be male pattern baldness because of the recession you naturally get with diffuse AA. But if they look hard enough all the signs are there.

The topical steroids are fine man, give them and the minox combined atleast 6 months. Add in lasers and essential oils if you want. I plan on using minox again at some stage as it does help to a certain extent!

I use 100ml of clobetasol every 2 months and 100ml of betnovate every month.... I haven't seen any negative side effects in over a year of use. I will cut back on this when the agressiveness hopefully dies down a bit...

Also your derm probably had cream and solution mixed up. Maximum dose they say for clobetasol per week is 50ml, now i use 1/4 of this but i know i am using it long term so i shouldn't be near the maxium!!

Thanks lamarr,

6 months is exactly what I was thinking. I am planning on continuing the minox twice a day for the first 3 months, and then add in xandrox 15 at night for months 3-6, and of course do shed counts and shaved photos at each transition. I may decide to wait for the xandrox until month 6, so as to single out the efficacy of the steroids as much as possible. I started the essential oil mix last night, so I will continue this as well. I have a question about the lasers though. I am sure they have been discussed here thoroughly, but I was wondering what the consensus on most economical setup is? My dad has a single laser that he uses to stimulate acupuncture points, wavelength 635-670, <5mW. It spreads out to about an inch square at six inches, could I use this? I am guessing no, as covering my head would be very tedious. Anyway, if you could let me know what the most convenient system is, and how I can order one, I would greatly appreciate it.

Also, are you using both clobetasol and betnovate together, or alternating them in some way?

MoreGano,

How long have you been using the steroids? In what ways is it starting to help? Have you noticed any regrowth or has it just slowed down the shedding? Are you gaining density back?

Thanks, JP

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Everything you need to know is on this website, regarding the use of lasers (LLLT therapy).

http://www.overmachogrande.com/

Thanks Lamarr,

Wow, that is my kind of project. I will be constructing my own as soon as this term ends and I have some spare time. How many diodes do you currently use? And does this cover your entire scalp or must you reposition every couple minutes? I can see the advantages in convenience from a helmet type that covers the entire scalp, but from a cost perspective I can imagine easily constructing a dense panel, and moving it around a couple times. What is your take on this? I know overmachogrande recommends simultaneous stimulation, but is it really that important?

So I have been doing hair shed counts very precisely the last few days, and astonishingly I am still shedding over 400 hairs per day on average. This is just shocking to me. I knew I was still shedding abnormally, but I had no idea it had been that bad this whole time. I have been shedding like this for almost ten years!!! What is really amazing is that I still have a pretty decent head of hair. It just keeps growing in and falling out, which completely explains why I can't achieve any length, and the longer I keep it the thinner it looks.

I will be starting clobetasol scalp solution tomorrow, but my mom has made it clear that she is only prescribing this to me on a trial basis. She says if I do see results, she would like me to again seek the supervision of a derm to assess long term management, and will not continue to prescribe me steroids as it is not her area of medicine. I'm really worried that finding a derm that will believe me is going to be hard and also costly. I hope that the results are drastic enough that they cannot be ignored, and I plan on documenting them very thoroughly.

My mom has agreed to a six month trial, and will prescribe me enough solution to apply 1 ml/day. I am wondering how to best utilize this amount. I have the feeling that because of the long standing nature of my case, results may take longer to appear. I guess I generally feel that the follicles will need more time to readjust, since they have been trapped in a state of flux for so long, and I believe have all experienced some degree of miniaturization. For this to reverse, wouldn’t I need at least a couple hair cycles to see noticeable change? Is this reasonable?

I was thinking I might just use 1 ml every other day for a year, or perhaps every day and every other day on alternating weeks, for a total of 9 months. If this type of schedule would be effective, I would think it would also limit the chances of sides, and not give my mom anything to worry about. I am personally not scared of a little folliculitis in the name of science, but I know my mom would freak, and I can’t say it would be much fun either. What do you guys think? What’s my best option?

Thanks, JP

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Jp i can tell from your posts that your a smart dude. You will win this battle....I use 165 lasers at the moment in a hood style, i am soon to get a helmet and upgrade to 225 diodes. Using say 100 and moving them across the entire scalp in three sections, each exposed for 20 minutes would be good.

As for the steroids.... If you are using only clobetasol, i would be more inclined to apply more EVERY other day. e.g. 2ml every other day verses 1ml very day. Do this at night aswell.

1ml isnt much imo, so i would apply it to the top of the scalp if this is your main area of concern....

Definenetly go with the every other day if you are only using clobetasol.... I say this because you WILL get folliculitus if you use clobetasol every day. I do but i put up with it only on a small section of my hairline. This is partly why i don't use clobetasol across the entire scalp. Like i said though every other day should limit the folliculitus.

And yes you are spot on with the other things, the good thing is you probably aren't going to receed any more than you have already (hairline i mean). The rest of your hair should regenerate pretty well once your relieve the inflammation and stimulate some growth.

Hopfully your mum will see (especially when using the lasers aswell) that you will have no side effects from the steroids. The lasers ensure no skin thinning will occur to any degree.

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Jp i can tell from your posts that your a smart dude. You will win this battle....I use 165 lasers at the moment in a hood style, i am soon to get a helmet and upgrade to 225 diodes. Using say 100 and moving them across the entire scalp in three sections, each exposed for 20 minutes would be good.

As for the steroids.... If you are using only clobetasol, i would be more inclined to apply more EVERY other day. e.g. 2ml every other day verses 1ml very day. Do this at night aswell.

1ml isnt much imo, so i would apply it to the top of the scalp if this is your main area of concern....

Definenetly go with the every other day if you are only using clobetasol.... I say this because you WILL get folliculitus if you use clobetasol every day. I do but i put up with it only on a small section of my hairline. This is partly why i don't use clobetasol across the entire scalp. Like i said though every other day should limit the folliculitus.

And yes you are spot on with the other things, the good thing is you probably aren't going to receed any more than you have already (hairline i mean). The rest of your hair should regenerate pretty well once your relieve the inflammation and stimulate some growth.

Hopfully your mum will see (especially when using the lasers aswell) that you will have no side effects from the steroids. The lasers ensure no skin thinning will occur to any degree.

Thanks lamarr,

It is clear to me that you are also a highly intelligent dude, and that you have done all your homework. I will take your advice and go with the every other day routine. I'm gonna see what kind of coverage I get with the solution, and decide on mL/day from there. Probably 1.5-2mL, we'll see. Also, I'll go ahead and start with a 100 diode setup for the lasers and build up from there. I will definitely keep everyone informed as to my progress. Btw, has anyone heard from Julius? Looking back his hair looked quite similar to mine, and he seems to have disappeared shortly after starting the topical steroids. Did he just recover and move on?

JP

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I believe Julius still sheds, he was only applying the steroids to bald temples. You won't get much regrowth on slick bald areas with just topical steroids.

He has used minoxidil for 5 years ish, which has helped him keep hold of most of his hairline. He also takes propecia but imo, it is rarely helpfull for us. There is some logic behind it working for certain reasons (other than the ones helpfull in MPB). E.g. upregulation in insulin growth factors.

But you have to be very lucky to have these benefits to a significant level. So in short, no i don't think he has recovered, he doesn't like visitng the message boards to much.

I think the general consensus with accutane hairloss is that you have the most significant loss within the first 18 months, then it stays the same for many many years, or progresses ultra slowly.

I personally will carry on with what im doing, and if one day i need it i will get a FUE transplant with one of the top docs to fill in the hairline. Fortunately alopecia areata is non scarring and i believe if you find the right treatment you can regenerate pretty much all of your hair....

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Thanks for the info Lamarr. I agree with that. The first two years were really bad and then it just kind of stabilized. I clearly still shed, but am continuously re-growing hair, and only over time has this led to thinning. I have basically given up hope on any temple re-growth, but if I can thwart the shedding I am sure I will regain considerable density, and hopefully be able to grow my hair out longer. btw, how far in front of the hair line do you apply the steroids? I have about a 1/4"-1/2" area of very fine vellus hairs at the front and temples, and still have some hope they will grow into terminal hairs. Should I treat them and stop there, or is it worth coming out a bit more? Where is the fine line between scalp and face skin? I am going to start the steroids tonight, and am anxious to see how my scalp feels over the next couple weeks. I still have the occasional itch session, and I imagine that will be the first to go. I am also going to be aware of how the rest of my body hair reacts. I know with my regimen I won’t have very much systemic absorption, but my arm and leg hair are pretty much always itchy, so if that starts to go away, I will be very pleased. Wish me luck.

JP

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Hey Lamaar,

I'm currently in the process of creating a laser helmet/hood. I'm going to be starting off with 100 diodes but I have no idea where and to find an adapter to power this bad boy because from my understanding I'll need an adapter with about 3000 mA. Any tips?

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Hey Lamaar,

I'm currently in the process of creating a laser helmet/hood. I'm going to be starting off with 100 diodes but I have no idea where and to find an adapter to power this bad boy because from my understanding I'll need an adapter with about 3000 mA. Any tips?

Hey bro,

I used this one http://www.aixiz.com/shop/product_info.php?products_id=74

Which is up to 5000mA. They didn't have the 15amp one available when i purchased mine but i may get one in the future, because i will be running 225diodes of two transformers.

Thanks for the info Lamarr. I agree with that. The first two years were really bad and then it just kind of stabilized. I clearly still shed, but am continuously re-growing hair, and only over time has this led to thinning. I have basically given up hope on any temple re-growth, but if I can thwart the shedding I am sure I will regain considerable density, and hopefully be able to grow my hair out longer. btw, how far in front of the hair line do you apply the steroids? I have about a 1/4"-1/2" area of very fine vellus hairs at the front and temples, and still have some hope they will grow into terminal hairs. Should I treat them and stop there, or is it worth coming out a bit more? Where is the fine line between scalp and face skin? I am going to start the steroids tonight, and am anxious to see how my scalp feels over the next couple weeks. I still have the occasional itch session, and I imagine that will be the first to go. I am also going to be aware of how the rest of my body hair reacts. I know with my regimen I won’t have very much systemic absorption, but my arm and leg hair are pretty much always itchy, so if that starts to go away, I will be very pleased. Wish me luck.

JP

Apply the steroids anywhere there is signs of hairs, or has recently had any amount of hair growth. Be it velous or otherwise.

The steroids will have no effect on the rest of your body. If you want to stop the itching an oral anti histamine will work.

The itch should be gone within 5 days.....

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Apply the steroids anywhere there is signs of hairs, or has recently had any amount of hair growth. Be it velous or otherwise.

The steroids will have no effect on the rest of your body. If you want to stop the itching an oral anti histamine will work.

The itch should be gone within 5 days.....

Hey Lamarr,

Yeah, i was just dreaming about any systemic effects helping with my body hair itching, LOL. Anyway, anti histamines are a great idea as they also help me sleep. I was already considering using them again. I have another question though. I have been applying the essential oil mix at night. My night regime is now: minox - 1 hour - Clobetasol - 1 hour - essential oils --> sleep. In the morning, first thing, I apply minox and do my morning routine- breakfast, read paper, workout, etc... then I shower. The reason is that the minox is really messy, and makes my hair look like crap, so I try to get a good application in before I shower for the day. Anyway, here is the deal. Every time I apply minox I get a tingling sensation that makes me feel the minox is absorbing and working. Since starting the oils at night, my hair is still very oily in the morning, and when I apply the minox I get none of the tingling. Is it possible that the oils are preventing absorption? It is markedly different from my night application, where I still get the tingling. Could it be that there is still absorption, but the oils prevent me from feeling it? Any ideas?

JP

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whatsup guys heres my deal

I'm 17 and finished my accutane about 2 months ago, maybe a little more. I've really noticed my hair has been sooo bad. My hairline has definitely receded about an inch and its just getting to the point where i want to do something about it. My hair used to be so thick and course icouldnt run my hand through it, now its just thin and weak looking and thinning by the day. I've been reading through this thread and noticed some interesting things. First of all I've never had an itchy scalp on accutane, so i guess that's a plus. But what do you guys suggest? a topical sterioid? will that hopefully gain taht inch back on my hairline or just stop the shedding? thanks guys.

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Apply the steroids anywhere there is signs of hairs, or has recently had any amount of hair growth. Be it velous or otherwise.

The steroids will have no effect on the rest of your body. If you want to stop the itching an oral anti histamine will work.

The itch should be gone within 5 days.....

Hey Lamarr,

Yeah, i was just dreaming about any systemic effects helping with my body hair itching, LOL. Anyway, anti histamines are a great idea as they also help me sleep. I was already considering using them again. I have another question though. I have been applying the essential oil mix at night. My night regime is now: minox - 1 hour - Clobetasol - 1 hour - essential oils --> sleep. In the morning, first thing, I apply minox and do my morning routine- breakfast, read paper, workout, etc... then I shower. The reason is that the minox is really messy, and makes my hair look like crap, so I try to get a good application in before I shower for the day. Anyway, here is the deal. Every time I apply minox I get a tingling sensation that makes me feel the minox is absorbing and working. Since starting the oils at night, my hair is still very oily in the morning, and when I apply the minox I get none of the tingling. Is it possible that the oils are preventing absorption? It is markedly different from my night application, where I still get the tingling. Could it be that there is still absorption, but the oils prevent me from feeling it? Any ideas?

JP

Hey JP,

Two thoughts come to mind when considering this issue your having. Firstly we need to remember that topical steroids are vasoconstrictors, i am sure you know what this means. Minoxidil is the complete oposite in that it was originally used to lower blood pressure and thus causes vasodialation.

Now here is one of the possible reasons for the change in tingling you decribe.... When you apply your nightly application of minox, you will still get the vasodialative properties because you are yet to apply the steroid. Now from experience i know the vasoconstrictive properties of clobetasol lasts a good 20 hours. So when you apply the morning application of minox you may not get the usual vasodialation from the minoxidil, thus no 'tingling'. I just want to say now, that the topical steroids actually ENHANCE the performance of minoxidil because the vasoconstriction from them means the minoxdil stays in the local tissue for longer....

Now the other reason could be as you propose, but we can easily avoid a nightly application of the essential oils to find out which one of these is the culprit. If you find that the tingling returns when you cease use of the essential oils then we made need to review your regime.

Hope this helps.

whatsup guys heres my deal

I'm 17 and finished my accutane about 2 months ago, maybe a little more. I've really noticed my hair has been sooo bad. My hairline has definitely receded about an inch and its just getting to the point where i want to do something about it. My hair used to be so thick and course icouldnt run my hand through it, now its just thin and weak looking and thinning by the day. I've been reading through this thread and noticed some interesting things. First of all I've never had an itchy scalp on accutane, so i guess that's a plus. But what do you guys suggest? a topical sterioid? will that hopefully gain taht inch back on my hairline or just stop the shedding? thanks guys.

Don't do anything for a while, you may only have telogen effluvium. Give it a good 6-10 months before taking action.

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Hey JP,

Two thoughts come to mind when considering this issue your having. Firstly we need to remember that topical steroids are vasoconstrictors, i am sure you know what this means. Minoxidil is the complete oposite in that it was originally used to lower blood pressure and thus causes vasodialation.

Now here is one of the possible reasons for the change in tingling you decribe.... When you apply your nightly application of minox, you will still get the vasodialative properties because you are yet to apply the steroid. Now from experience i know the vasoconstrictive properties of clobetasol lasts a good 20 hours. So when you apply the morning application of minox you may not get the usual vasodialation from the minoxidil, thus no 'tingling'. I just want to say now, that the topical steroids actually ENHANCE the performance of minoxidil because the vasoconstriction from them means the minoxdil stays in the local tissue for longer....

Now the other reason could be as you propose, but we can easily avoid a nightly application of the essential oils to find out which one of these is the culprit. If you find that the tingling returns when you cease use of the essential oils then we made need to review your regime.

Hope this helps.

Thanks Lamarr,

I will do a little experimenting and let you know what I find. Worst case scenario, I may just need to rinse my hair in the morning before minox though. Otherwise, I think I've got a good thing going. Thanks for all the support.

JP

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I apologize if this has already been stated, but i noticed the thread was 119 pages long - so i hope you can understand why i didn't continue reading it after the 1st post.

But i'm a male (23) and i'm on my last month of accutane. My hair doesn't seem less thick or anything like that, but the one thing that i recently noticed was that my hairline has receded big time. Like probably an inch. I know that hairloss is a possible side effect but i always read that it was more along the lines with thinning hair. When i feel my forehead/scalp where the hairline has receded, it almost feels like a baby's butt - very soft and smooth.

Is this normal? Can i expect my hairline to grow back to normal? If so, how long after treatment? What type of treatments would be needed for this?

Anything would be greatly appreciated.

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Hey guys,

Just another update. It's now been about a month and a half since I took my last Accutane pill...

First, the good news -- my shedding has slowed quite a bit. I still see around 5 hairs on my pillow every morning, but only see a few on my hands when I apply the emu/grapeseed/rogaine to my scalp in the morning and at night. The best indication of my scalp health has been the lessening of the tingling/itching feeling. I never had intense itching or anything of the sort, but it was enough to know that something wasn't right, you know? I can confidently say now that my scalp feels almost 100% back to how it did pre-'tane.

Now, the bad news. I went to my derm and he took a scalp biopsy from the top of my head, where I seemed to be shedding the most. This is the result from the lab:

"MICROSCOPIC EXAMINATION: Sections show a normal total of follicles with a marked increase in the percentage of vellus and indeterminate hairs. There are fibrous "streamers" indicating miniaturized hairs. There is no significant inflammation or scarring. Multiple horizontal step sections are exained giving a total of thirty-five follicles (anagen - 31, telogen/catagen - 2, miniaturized - 2). A PAS stain does not demonstrate present of pathologic fungal hyphae.

COMMENT: These findings are most consistent with androgenic alopecia."

When my derm explained that it was basically MPB that was brought out by the Accutane, obviously my mood soured. He told me I was a very rare case and told me my options were rogaine (which I'm already doing) and propecia (but we're holding off on that for now). It's just so frustrating to know that I took Accutane at a relatively low dose for only a month, and I still this happen to me.

Mark/Lamarr, can you shed any light on this biopsy? I know I've read that they're always not very reliable, and TE/MPB often have overlapping characteristics. I'm trying to stay positive, and that means I'm holding out hope that some (if not most) of my hair will grow back by doing the things I'm currently doing.

Thanks all...

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When was the biopsy taken? This shit often presents itself as MPB to the average derm. Even biopsys can present the same findings.

My only thought on the biopsy is this....IF there is no inflammation present, which i find hard to believe because there is always inflammation in MPB or Alopecia Areata. Maybe your hairloss had actually stopped before the biopsy was taken and you were simply shedding due to slightly miniturized hairs being forced out by new anagen hair growth.

Tane induced hairloss is unique in some ways, so the fibrosis isn't a certain indicator of MPB.

I presume you shed hairs across your entire scalp and not just the hairline/top of your head? If that is the case you do not have MPB.

My feeling is that if your shedding has decreased that much, you will eventually recover completely. Keep using the rogain etc. Don't touch propecia because chances are it won't do shit. You don't have MPB as such, that i can be certain of (if indeed you shed outside of MPB regions).

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The biopsy was taken 2/18, which was a little over a week ago. I just got the results back today.

Yeah, the report stated there was no significant inflammation present whatsoever. The report shows most of my hair was in the anagen phase. I will say though that my condition had continually gotten better over the past few weeks, which could make the case that it was the new anagen hair growth like you mentioned.

I have been shedding all over, but it was hit the worst on the whole top portion of my scalp. Oddly enough, my hairline doesn't seem to have budged one bit; it's just the thinning that has caused such bad cosmetic changes (at least to me).

I'll keep up what I'm doing and report back again. I've also added milk thistle, as I hear it's good for you following a round of Accutane.

Thanks again Mark -- I think I speak for all of us when I saw we really appreciate all you do for the peeps on this thread!

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The biopsy was taken 2/18, which was a little over a week ago. I just got the results back today.

Yeah, the report stated there was no significant inflammation present whatsoever. The report shows most of my hair was in the anagen phase. I will say though that my condition had continually gotten better over the past few weeks, which could make the case that it was the new anagen hair growth like you mentioned.

I have been shedding all over, but it was hit the worst on the whole top portion of my scalp. Oddly enough, my hairline doesn't seem to have budged one bit; it's just the thinning that has caused such bad cosmetic changes (at least to me).

I'll keep up what I'm doing and report back again. I've also added milk thistle, as I hear it's good for you following a round of Accutane.

Thanks again Mark -- I think I speak for all of us when I saw we really appreciate all you do for the peeps on this thread!

No problem man,

Sounds like my guess was fairly accurate. I don't believe you have anything to worry about now. You don't have MPB. Milk thistle is good, it's the only thing ive taken consistently ever since i finished accutane.

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Hi, just read your post and was curious if your dermatologist has attributed your receding hairline to accutane? If so, has he suggested any type of treatment?

I apologize if this has already been stated, but i noticed the thread was 119 pages long - so i hope you can understand why i didn't continue reading it after the 1st post.

But i'm a male (23) and i'm on my last month of accutane. My hair doesn't seem less thick or anything like that, but the one thing that i recently noticed was that my hairline has receded big time. Like probably an inch. I know that hairloss is a possible side effect but i always read that it was more along the lines with thinning hair. When i feel my forehead/scalp where the hairline has receded, it almost feels like a baby's butt - very soft and smooth.

Is this normal? Can i expect my hairline to grow back to normal? If so, how long after treatment? What type of treatments would be needed for this?

Anything would be greatly appreciated.

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Hello, thanks for sharing your experience with accutane.........just need to clarify something ........are you saying that after taking Accutane at a relatively low dose FOR ONLY A MONTH, you experienced hairloss? HOW MANY MG/PER DAY WAS THE REALTIVELY LOW DOSE???

When my derm explained that it was basically MPB that was brought out by the Accutane, obviously my mood soured. He told me I was a very rare case and told me my options were rogaine (which I'm already doing) and propecia (but we're holding off on that for now). It's just so frustrating to know that I took Accutane at a relatively low dose for only a month, and I still this happen to me.

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Hello, thanks for sharing your experience with accutane.........just need to clarify something ........are you saying that after taking Accutane at a relatively low dose FOR ONLY A MONTH, you experienced hairloss? HOW MANY MG/PER DAY WAS THE REALTIVELY LOW DOSE???

When my derm explained that it was basically MPB that was brought out by the Accutane, obviously my mood soured. He told me I was a very rare case and told me my options were rogaine (which I'm already doing) and propecia (but we're holding off on that for now). It's just so frustrating to know that I took Accutane at a relatively low dose for only a month, and I still this happen to me.

Hey there,

I took 40 mg/day for the first 2.5 weeks, then 40 mg/every other day for a little over a week, and then two days of 20 mg/day and experienced rapid hair thinning.

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I'm in a similar situation, I took only 18 doses of accutane at 40mg/day and stopped when I noticed my hair falling out en masse. My last dose was almost 5 months ago to the day - the shedding still hasn't stopped, I have some temple recession and a drastic reduction in volume, although I still have full coverage. Nothing really seems like it's getting better and from talking to other people with hair loss after short stints with the drug I don't think this is really ever going to resolve on its own. Now my acne is coming back, this blows

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Don't worry cmerski. I have never read of anyone who took accutane for less than two months and failed to recover from accutane hair loss. just give it 12 months and see how it goes.

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