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nocluewhattodo

Failed Actuate Twice What To Do?

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Ill try to keep this concise its a long story! Im a 21 year old male.

Been battling acne for 4 years tried topical (retinoids, BP etc) antibiotics, nothing cleared me. It got super bad cystic and horrible about 2 years ago I had tried natural methods like gluten free diet, no diary, low GI etc, B5, zinc, and a heap of others nothing helped.

The first 3 images show me in this state

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I started Accutane about 2 years ago 6months at 40mg and then 4 months at 20mg three times a week, worked amazing! When I stopped I relapsed I started again in March this year with 40mg and then up to 60mg for about 10 weeks, worked really fast skin was even better than last time so happy, but the side effects got really bad I got dry eye so severe I was in really bad pain and I can't wear contacts anymore, even drops and warm compresses couldn't touch it so I had to stop the tane.

The acne came back only very minor (I haven't taken take in about 5 months) I was put on doxy for a couple of months to help with my eyes which helped quite a bit, but had to stop that coz of headaches all the time!!! worst luck I know. Anyway its been about 3 weeks since I stopped doxy and things have gone nuts!!! broke out so bad in scalp and now face (I had a scalp swab and they said they could not grow an culture, it said on my results I had gram + cocci.... waiting to see my derm, this test was done by a GP)

Picture of the pustals coming into my side burn from scalp (I though it was staph)

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This was my face at the time 14 days days ago, def some small acne and blackheads etc, but nothing like now...

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It seems any cleansers makes thing worse! e.g cetepahil, benzac (caused a big breakout like I have now, so I went to just wash with water, helped a bit but still was getting some minor spots), I just used dermalogica 3 nights ago think this contributed tot he breakout in the last pictures. Tonight.

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It seems to be better when I just wash with water ( I have just used distilled water

I am so confused don't know what to do!!!! Derms keep throwing take at me. It has flared up so quick!

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It definitely does not seem like typical acne so getting the results of the culture sample may be helpful. In terms of failing accutane, i should point out that you were under dosed based on what you have written. With underdosing relapsing is very common. It may help for you to see a naturopath to help you internally as you seem to have tried some very good things on your own with little results. I feel for you man as Ihave done 4 courses of accutane and i'm still struggling.

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It definitely does not seem like typical acne so getting the results of the culture sample may be helpful. In terms of failing accutane, i should point out that you were under dosed based on what you have written. With underdosing relapsing is very common. It may help for you to see a naturopath to help you internally as you seem to have tried some very good things on your own with little results. I feel for you man as Ihave done 4 courses of accutane and i'm still struggling.

Yeh the culture that I had done last week, pretty much did not show a specific pathogen The GP said it could be because I had only stopped doxy a week or so prior, so I may need to try and do it again. Yeh the dosing concerns me, terms in Australia seem to be quite conservative on the whole over the 6 month peered I did meet the target dose of 120mg/kg and after the maintenance course and half second course it is around the 200mg/kg mark, maybe its the daily dose??? I seen a naturopath before taking tane for a couple of months but didn't see much improvement, and had assorts of crazy herbal tonics and stuff hahaha

did you stick with a healthy diet ? just because you take accutane , it doesnt mean you can eat sweets and all that bad food

just wondering

Yeah I did prior to Accutane, although at the moment I haven't been to strict, I do avoid eating junk food in general (in fact at one point I was so paranoid about everything I put in my mouth, and lost weight its insane) at the moment I still don't eat dairy products.

I guess my big thing is why does it come back so quickly, and rapidly like all over my face and scalp?

Thanks for the support guys I will keep you posted seeing my derm tomorrow.

Edited by nocluewhattodo

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Today wasn't great broke out heaps and they are getting deeper now forehead, neck hairline, and a fair few pustules on face. Do you think it is really acne or maybe fungus or something? skin feels like sandpaper and look really bumpy in person and itchy sometimes. sorry that the pics keep ending upside down when I upload them. post-440531-0-58759700-1418650267.jpgpost-440531-0-49765300-1418650295.jpgpost-440531-0-54883900-1418650341.jpg

Edited by nocluewhattodo

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are you using clindamycin and doxycycline atm ? im using them for about 3 days now and no acne has come up and if they do clindamycin dries them out in a day

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are you using clindamycin and doxycycline atm ? im using them for about 3 days now and no acne has come up and if they do clindamycin dries them out in a day

not using doxy atm, i quit about 2 weeks ago as i had headaches for about 10 straight weeks from it. Funny about the clindamycin, I used this for 7 days after having my wisdom teeth out about 10 weeks ago, and just before that my acne had started to flare up again, it the clinda cleared it up, at least I think it did, I then went back to doxy after that.... May see if I can take clinda again for a bit longer. How long are you taking it for?

Edited by nocluewhattodo

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What about extreme dryness? I know this might sound nuts, but maybe try sleeping with vaseline at night (after you have washed your face as it locks in moisture) and see what happens. It might calm things down a bit. It did for me anyways, I think I was really dry.

I have been to a couple of nuts too (Naturopaths). Know that some are not really qualified or even know what they're doing. But some do. I guess doing some research on your own, trying to find a pattern to your problems. Certain hormones, testosterone (hormone test)? Gut problems (try food intolerance test IGg, not like these fake ones you actually want a lab to test your blood)? Try to increase antioxidants (NAC for glutathione, or glisodin to increase SOD, lots of green tea)? Have you tried paleo-organic-grassfed meat diet? Try lowering oxidative stress factors (bad diet, abundance of heated omega 6 oils, stress, lack of exercise, depression)? Is it liver, or colon? Try some colon cleanse (I have no idea about this though, but this girl did a colon cleanse with psyllium and bentonite clay and was successful so there you go). If liver maybe try milk thistle or dandelion or burdock.

As for skin stuff, try witch hazel or neem oil? You can also try non-comedogenic oils as you said that most things break you out. You might be too sensitive for conventional products, even 'natural' ones. Try with just one ingredient. Non-comedogenic oil high in linolenic acid (there is a lack of this in people with acne).

Just some tips. I feel for you. I hope everything works out.

Edited by il90

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Thanks for the tips! Got a couple of those tests done, and looking at the paleo diet. Turns out I have erupted in some painful cysts on my cheek, haven't had anything like this for 2 years. Absolutely shattered. My skin was pretty good a couple of weeks ago now its regressing so fast its not funny

Edited by nocluewhattodo

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Maybe it is something else... what about some fungus? Try neem oil, or head&shoulders, or witch hazel? The problem is with the cysts right now... How do you feel otherwise? Maybe it is some other health issue? Can you go to a doctor and tell them to run some other tests on you? Thyroid? Do you have any gut problems (IBS symptoms, bloating)? Is there a functional medicin doctor you can see or a homeopathic doctor (cured my eczema as a kid)?

Until then, start exercising (jog out in the open, or take long walks). Keep active, eat a lot of healthy food and try to relax as much as you can. Anxiety and stress will do nothing for you (that's how mine got really bad). Know that you're having a hard time right now, and try to just focus on you and what you need.

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Thanks for the advice, I am working on some new diet plans swell I am being tested for some allergies basic ones from bloods (waiting to get skin prick test), thyroid (although this has always been normal in the past, testosterone and diabetes. The docs/derms don't seem to think its fungus, and said it would have shown up in pus swab. I did try nizoral on my scalp the other week and it burnt and itched like crazy for a couple of days after so haven't tried it again. I feel like it still could be fungal though seems odd to me and it is itching like crazy and then the pus things show up and it just gets worse does acne itch?..... Or maybe allergy, but will take some time trying to nut that out. I did have a nasal swab today just to double check for staph, but I have no nasal sores, and my pus swab didn't show it so I doubt it is this.... The cyst in the red circle seems more acne though don't think fungus or even staph would do this...I shouldn't have done this but i scratched a lot of the whitehead things off, some where to deep to do this....(I'm thinking its more folliculitis than acne) but they too gross to just leave there. They seem to just refill tho and ooze clear liquid after and then foam a crust.

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Edited by nocluewhattodo

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Yeah I'm sorry, I have no idea... Make sure you keep hydrated, and use lots of vaseline so it won't get more dry... At least you're doing lost of things so something will probably pan out... You're doctors will figure it out, it is their job. I got cysts because of allergies... I used anti-histamines for it which oddly worked.

I really hope everything works out soon, because it will work out eventually!!

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Update: started using a SA and sulphur lotion, has helped the whitehead a bit but is making my very flakey and I am getting some larger pimples, nodules. The ones all over my forehand hairline, and scalp and super painful. I am thinking I will just take yet another antibiotic.... I can't get more scars an be in pain again it sucks. Im not sure its heat rash... the pimples are looking like proper zits now, and I am getting some cyst like things in my scalp as well, total mess. Using head and shoulders but that just seems to make it worse, and I have heaps of dandruff I had the allergy skin prick test done showed nothing.

Also the nasal swab came back negative, no pathogenic bacteria isolated.

Thinking long term low dose tane.

Edited by nocluewhattodo

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Have you seen a homeopath or a naturopath? I know there are some bad ones out there, but they might have some tips for you. They'll go through your history and try to put it together.

You should go on low dose tane until you find what is actually causing this. Try to get in touch with some functional medicine practitioner that can help you.

I am on low dose (I had moderate-mild acne when I started) but I know that tane will probably not be the answer and it is either internal stress (I'm seeing a psychologist) or some bacterial gut imbalance (a symptom of psychological trauma) that I have to try to fix. You're mind is everything, so it can create havoc on your system when you are depressed or anxious (which is very common with acne). I had it really tough, psychologically, before my acne got really bad which created stomach problems along with acne so I think this is my problem.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038963/ (you should check this out)

Go on tane for now if acne is too stressful for you, but try to find an alternative while on it so you can eventually go off it. Some homeopaths will work with your doctor to ween you off the med.

I hope everything works out for you.

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Unfortunately I relapse rapidly after stopping a standard course, and I had to stop my second course 2 months in due to severe e dry eye, thats still not fully recovered and has gotten worse again since stoppig doxy. Given a choice I dont want to take the accutane again, but I will low dose for a couple of months and introduce a tooical retinoid and slowleycome of the accutane hopefully in 6 months and see how I go. Also make positve diet changes, I have cut out gluten again, probiotics, exercise etc in the meantime. Pretty much due to meibomian gland dysfunction ( which is very painful and means I cant wear contacts) I cant take a regular course of accutane again, and considering how quick I relapse I dont see the point in going through regular dosing.

I have been on 10mg a day for 5 days and a probiotics and my skin and scalp has calmed down dramatically. I expect the major culprit behind the breakout was that I had to stop the doxy so suddenly, and the oils coming except for my eyes!!!. I plan to drop the dose to 5mg day and then use a retinoid. Like I said I would rather not take it, I resisted tane for a long time and got lots of scars asa result, I need to by myself time till I hopefully outgrow this I am still young, and acne greatly diminishes my quality of life.

Edited by nocluewhattodo

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So after dry eye got really and and headaches 10 days into low dose, skin was looking good, but I decided to stop the accutane, I'm over it. I then had a breakout within days again, and almost started antibiotics :( so annoyed I wasn't put on a retinoid after my first course anyway... I have been on a Zantac regiment for the last week, and things have been looking better fewer breakouts, still get some but it actually seems to be helping, so I am going to look into this. I used to take Zantac when I had bad allergies when I was younger when ai would get bad flare ups, I have had bad seasonal allergies dust dog dander etc.

I know it's not a long term solution but it my help me discover my cause I hope.

I defiant fit the histedlia and fast metabolism catagory, in fact just before all my skin problems started I lost a bit of weight, and allot of the other things fit me as well....

Anyway I'll keep you posted if I find anything major.

Edited by nocluewhattodo

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Hi!

Im sorry to hear about your struggle with acne. Im

Also struggling with it but it Getting better now,

I just started using acne.org regimen and it helps to clear My pores and reduce acne.

Anyway,

In september i had very bad breakout and i started drinking green smoothies Once a day and i still do it.

Have you tried it?

In addition i drink a Lot of water during the day.

My recepie for the green smoothie varies but the basic ingredience stay the same.

Here it is:

Spinach about 100g

1-2 bananas

Coconut oil(fat, or olive oil 1 spoon)

Sometimes i add 50-100g of carrot

Frozen strawberries 1 cup

Wallnuts sometimes

Honey 1 spoon

Sometimes small piece of fresh ginger

This is My breakfast and i see big differences in My skin.

Of course i need to use BP but i think that this smoothie is vital as it is packed with vitamins that are essential for skin.

I noticed My skin improving a Lot when i ate soup for the whole week( must be Homemade soup!) i had some chicken soup with thai spices etc.

Hope it help and i hope you can clear up your skin and stay clear

Best wishes :-)

Edited by EleFC

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Might want to check this out.

Looks like you have some sort of folliculitis. Could be gram-negative due to all the antibiotics or staph colonization in your ears or other moist regions (since you said you don't have nasal colonization of staph)

Just look this up too - Eosinophilic folliculitis

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Might want to check this out.

Looks like you have some sort of folliculitis. Could be gram-negative due to all the antibiotics or staph colonization in your ears or other moist regions (since you said you don't have nasal colonization of staph)

Just look this up too - Eosinophilic folliculitis

Thatnsk for the info. I was swayed tested on the lesions as well couldn't find gram negative. I have looked into Eosinophilic, it seems to be more red bumps cyst looking things (terms don't think I have it,but who knows )... I know I def have folliculitis in scalp, although the swabs showed no fungus or bacteria. It hasn't been too bad now I have been off doxy for a bit, I think it really caused it to go nuts when I came off it.

I also found some blood tests from during my first round of accutane my eosinophils where 0.1 range is 0.0-0.5. I know this is 18months ago but I had bloods since and nothing had changed... The only thing I remember having out of whack in my blood count was a low level of lymphocytes, which increased during accutane.

I do breakout after shaving though..... I really still wonder about staph, but the docs said if its not in nose I don't have it.... arrrhhh frustrating

The thing that seems to have helped most it the Zantac which is interesting...

Edited by nocluewhattodo

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Might want to check this out.

Looks like you have some sort of folliculitis. Could be gram-negative due to all the antibiotics or staph colonization in your ears or other moist regions (since you said you don't have nasal colonization of staph)

Just look this up too - Eosinophilic folliculitis

Thatnsk for the info. I was swayed tested on the lesions as well couldn't find gram negative. I have looked into Eosinophilic, it seems to be more red bumps cyst looking things (terms don't think I have it,but who knows )... I know I def have folliculitis in scalp, although the swabs showed no fungus or bacteria. It hasn't been too bad now I have been off doxy for a bit, I think it really caused it to go nuts when I came off it.

I also found some blood tests from during my first round of accutane my eosinophils where 0.1 range is 0.0-0.5. I know this is 18months ago but I had bloods since and nothing had changed... The only thing I remember having out of whack in my blood count was a low level of lymphocytes, which increased during accutane.

I do breakout after shaving though..... I really still wonder about staph, but the docs said if its not in nose I don't have it.... arrrhhh frustrating

The thing that seems to have helped most it the Zantac which is interesting...

The S. aureus may be in your ears. It was in my nose, but a few people who had cystic acne were negative for Staph in the nose but positive in the ear. One guy who was positive in both ears had SIGNIFICANT improvement with his acne after putting neosporin in his ears for about a month.

Furthermore, I teach microbiology and I have tested 19 students. I will put the data together soon, but it looks like there are just as many people with nasal Staph as ear Staph. Most of those people suffer from acne as well. Bleh445 linked my post; please take a look and consider trying it. I truly believe it will make a difference.

Edited by healthyalmonds

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No worries, I will try an convince my doc to ear swab as well. Hopefully they do it, was a push to get the nasalnone done. If it was staph is there any reason why the pus swab from the pimples came back negative of anything? I do 100% agree that before I took the tane in my first pic looks like staph. At this stage I dont have all those horrible whiteheads on my face which is good.

I do agree about ears that where I had that gross breakout and my cheekd

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