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ughhhhh

Do I Really Need Accutane?

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So I gave birth a month ago and my face exploded. It wasn't great during pregnancy, but I had really limited options for treatments while pregnant (doc said no otc so I wasn't even using BP). But I had a long stressful labor, ended up with a horrible rash called PUPPPS that covered my entire body and so obviously my skin was stressed out which led to cysts and nodules. I just went to the derm to get some cortisone shots and see about some topicals.

But she walked in the room and said "your choices are accutane or doxy. Neither can be used while breastfeeding but I can't really help you. Nothing else will work." I was floored, my baby is only a month old, she needs me and I don't want to stop breastfeeding for my vanity. I didn't think it was accutane bad? A lot of this redness is previous blemishes, but now that I take pictures of it I see it is pretty bad.... but is there no hope? She said if I don't get on antibiotics fast, I will have thousands of dollars of treatments down the road to repair my face. I figured if this was hormonal, I should be on spiro (ok for breastfeeding at least), or at least wait and see when I'm back on birth control (though estrogen will also deplete my milk supply) but her threats left me terrified.

I have started the Regimen, taking zinc and B complex, as well as an overhaul on my diet, no sugar or dairy. I have eaten like shit for a few months because we just didn't have the energy to cook. But I guess I'm posting this because I need an unbiased opinion. Is there no hope? Do I need to go on this horrible drug? It scares the crap out of me, I have a lot anxiety and a history of depression, not to mention the physical symptoms. My husband is so against it. Should I seek a second opinion? Are those really my only options? Doxy seems stupid too because it doesn't seem that antibiotics ever work - and she just said I'd need a two week treatment which I highly doubt because everyone ends up on them forever. Help?

Edited by ughhhhh

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You don't need to do anything you don't want to do. Since you haven't tried diet changes, give it a try. Try dropping:

Dairy

Soy

Gluten

and see how that works out for a few months. As for skin care, why not try a retinoid and see how your skin reacts?

Accutane and Doxy should never be the first things you go on. Accutane for me was a last resort type of thing

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Thanks for responding - I'm definitely doing the diet changes, I don't eat that much Soy (had edamame last week with no noticeable effect but I'm going to keep a diary) but already working on cutting out dairy and gluten/sugar. So should I find another derm? She prescribed topical erthythro to make me feel better but told me I shouldn't bother with it because it wouldn't work so I don't think she'll be much help in getting a retinoid. Is there an OTC I can try or is that prescription only?

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If thats her attitude, definitely! Start at the lowest retinoid tretinoin .25% and see how your skin does. Some people also add in an antimicrobial such as bp for day time use. You could also try holistic skin care - which personally never worked for me but seems to work well for others.

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So you're saying you have acne plus a different rash thing? Because the purple rash on your face is definitely not acne.

Also I thought spiro wasn't okay for breastfeeding, but then after your post, it appears that they did studies with breastfeeding mothers and declared it safe. But the manufacturer recommends against it (probably 'cause they don't want to get sued if something goes wrong).

http://www.drugs.com/breastfeeding/spironolactone.html

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I have had acne look purplish before.

Definitely see a different dermatologist and get a second opinion. Her attitude is B.S. I went to a derm who did THE SAME exact thing to me. She didn't even LISTEN. She saw my face and the first thing she said was, "ACCUTANE." I was devastated. There is no way you can gain the trust of a patient if you won't even listen to their story and work with them on their level. No one can force you to take any medication that you don't want. Breast feeding is amazing, and I hope you stand up for that, and find a way to help your acne while still helping your baby.

I second the use of prescription topicals and an anti-inflammatory diet. Do you know about Dr. Perricone? He has helped a lot of people reduce their acne with a fairly strict anti-inflammatory diet. If you're serious about helping the situation, it's always worth a shot, and it won't hurt you or your baby, unlike an oral medicine.

Here is an example of his clear skin diet, and he's also written a book on clear skin: http://www.perriconemd.com/display.do?ruleID=101122&itemID=5&itemType=LANDING

I say all this even being on accutane, because this is one of the only diets I tried where I saw some pretty good results. I even try to eat like this as often as I can to lessen inflammation since I get a lot of facial redness sometimes. I highly recommend you take fish oil to increase the effectiveness, too. A high quality high-dose probiotic can also help.

Yes, it is hard, but it's worth a shot. If you get tired of salmon, you can eat beans and turkey.

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Green gables- the rash I mentioned is gone and doesn't affect the face. But I tried a new regimen while the rash was happening and I reacted very negatively ( dermalogica) and its been like this ever since, about two weeks. You don't think it's acne? The purplish spots seem to be a large cyst and module cluster- its possible it looks purpler just because of the lighting, I've always thought it was mostly red.

Thanks for the link to the diet- in already taking ish oil as part of my prenatals but I have always hated fish. Perhaps I need to try harder to incorporate it into my diet. I love berries and kiwi though so no issues eating more of that! I am trying to remain confident that I can do this naturally and give my daughter what she needs without completely shattering my self esteem :)

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Green gables- the rash I mentioned is gone and doesn't affect the face. But I tried a new regimen while the rash was happening and I reacted very negatively ( dermalogica) and its been like this ever since, about two weeks. You don't think it's acne? The purplish spots seem to be a large cyst and module cluster- its possible it looks purpler just because of the lighting, I've always thought it was mostly red.

Thanks for the link to the diet- in already taking ish oil as part of my prenatals but I have always hated fish. Perhaps I need to try harder to incorporate it into my diet. I love berries and kiwi though so no issues eating more of that! I am trying to remain confident that I can do this naturally and give my daughter what she needs without completely shattering my self esteem smile.png

Well if it looks red to you, then I'd trust that rather than what's coming off the camera. But if it's as purple as I'm seeing it, I mean, it almost looks like a bruise color in the shape of rash :P

If you can get on spiro, I would...pregnancy gives you an awesome estrogen surge which can clear your skin some (obviously not 100% in your case), but after pregnancy that goes away. So if it is acne my guess would be that the best thing for you is hormonal treatment.

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I feel your pain. I had to quit retin a before allowing it to work because I became pregnant and my skin became the worst it has ever been. Once I gave birth, things also got worse for me. I am now done breastfeeding and back on retin a and things are looking up, so maybe you should give it a try. Just keep in mind that if you do decide to go on a retinoid, it is not safe for breasteeding. I wish you the best of luck!

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Hey there - I defnitely sympathize. I had horrible acne while pregnant, although for some reason I became completely clear in my third trimester. I thought I was done, but gradually the hormonal changes post-partum took over and now two and a half months after birth I am breaking out again. I recently had a derm visit where she also said accutane and I was quite surprised. I only had two active pimples at the time but I"m sure the old red spots didn't help.Regardless, I do not think that is the answer for my hormonal acne. I am going to another derm next week and asking for Spiro. The American Academy of Pediatrics oks it for breastfeeding. Really, it just mutes hormones not adds them to your system so I have decided I feel comfortable with that. Also, I do think that retinoids are okay for breastfeeding - check out Thomas Hale - he is the expert on medications while breastfedding and oks them. Let's keep each other posted!

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