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lafasta

Hormonal Acne and Accutane

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I have hormonal acne and i've tried almost every regimine on this website and nothing seems to work. I'll be almost completely clear for a little while and then...BAM...I get a horrible break out.

Does anyone know if Accutane will work for hormonal acne? I read somewhere on here that it doesn't, but if anyone could give me some advice I'd be soooo greatful!!! Please help!

Thanx

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Yeah, i've used 3 different birth control pills, including Diane 35 which is supposed to be for hormonal acne. I haven't tried spiro yet, but is there anyone out there who has had success on accutane with hormonal acne?

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or you should try spiro (if you're female). There's a spiro thread on this board for more info. Good luck!

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Hey!

The best thing to do is to go to your doctor and get blood tests carried out if it is hormonal coz then they or a dermatologist can put you on Hormonal tablets (treatment) to balance your hormones..thats what i might be doing..

Hope that helped!

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my doc said that if he acne comes back after accutane, it is more than likely to be hormonal. And then we would treat it from there. But wiping it out completely with accutane first, makes treating it as hormonal afterwards alot easier.

Good luck.

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I agree accutane will wipe out any acne. I've been on birth control (Diane 35 to Orthro Tri Cylcen to now Yasmin) for 8 years and they never fixed my acne, though I believe it is mostly hormonal, because 90% of it used to be on my chin. I have been on 20mg of accutane for 3 weeks and now 30mg/day, total of 26 days now and it has helped my skin so much already!!! I can only recommend it. Side effects aren't bad, just dry lips and scalp but manageable with the right products.

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Thanks for the info. I'm scared to try accutane, but i feel like i don't really have any other choices. Just a quick question about spiro tho. Will i have to keep taking it for the rest of my life in order for the acne to stay away?

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Thanks for the info. I'm scared to try accutane, but i feel like i don't really have any other choices. Just a quick question about spiro tho. Will i have to keep taking it for the rest of my life in order for the acne to stay away?

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I'm in my early 40's...mine's been hormonal, and I FINALLY just got put on Accutane! It's worked better than anything ever has. Go for it.

Cashmira biggrin.gif

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It will make work but there is a chance it will come back a year later. I've been on it 2xs, 3 years apart. I went to the derm yesterday and I'm on another round of Bactrim, when I get my period. He said if this doesn't work we'll try accutane again. Honesty, I think it's worth it. It has saved my face from serious scars.

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I'm not sure what "hormonal acne" means, exactly - since most is - but if you're an adult woman, and you have "hormonal acne," Accutane will work, but temporarily. Unless and until you treat the underlying hormonal problem, the acne will return.

A previous poster said Spiro would help - and they're right - in some cases, it can treat the underlying hormonal disturbance and lead to reduction/resolution of acne. You should see a doctor first, of course.

Other medications used to treat PCOS - not just acne - (which is often the real reason for "hormonal acne" in women):

Metformin

Spironolactone (Aldactone)

Finasteride

Flutamide

BCPs (oral contraceptives)

I mentioned this in another post, but it's worth repeating: adult females with acne may have PCOS or an unrelated metabolic disorder, that if untreated, can affect one heck of a lot more than your face. Get treatment!!!! See a doctor; ask about a full hormonal work-up. It could be PCOS. Do a google search.

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Thanks for all ur posts. I think i might try accutane. Is there anyone who actually has hormonal acne and has been on accutane that can give me any advise before i start?

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GAG ME, I am soo annoyed! I was just at the dr's today and she suggested Accutane for me too, even though I am positive my acne is hormonal as well. She told me that taking spiro would be much more extreme, in her opinion, than using Accutane to take care of it and that the side effects of spiro in the long-term could be worse than the side effects of Accutane.

I don't know, I just feel in my heart that if this Accutane stuff doesn't nip it in the bud, I'll be very POed. Plus, this chick is of the opinion that if the acne does come back after your round of treatment it's the patient's fault. But, the upside of going to her is that I'll get the meds for free, so what can you do?

I guess, lafasta, we both should just go for it and hope for the best.

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Carys: I have to tell you, your doctor is a complete idiot. I can't possibly overstate that enough, because that moron actually said Spiro was more extreme than Accutane. Total BS. Where did she get her MD - K-mart? Accutane has a far worse side-effect AND safety profile than Spiro. Spiro's also been in use for decades longer than 'tane, with far less adverse-incident reporting.

I'm not saying it'll work for you - but it's the best place to start. It's safer, and addresses the hormone issue, if it's hormonal (along with other drugs like Metformin and finasteride). Accutane doesn't. If the Spiro doesn't work, maybe the Accutane's worth it. You could determine if it's truly 'hormonal' by getting the appropriate blood tests (not JUST testosterone, either), and then (a good) doctor would have a better idea what your best treatment option really is.

Please, if you suspect it's hormonal - LISTEN TO YOUR BODY, not all doctors will - and go see an endocrinologist (one that will listen, anyway - hopefully UNlike the one you're seeing now. They know the right tests to do, and will do all of them, not just one or two that won't give a complete picture.

You stand a much better chance of getting to the bottom of your acne if you do. I promise.

And? OMFG. She would BLAME the patient if the 'tane didn't work? Acne comes back post-tane very frequently (almost always) in cases where it's PCOS or PCOS-like acne. Some docs see it as diagnostic of hormonal disturbance, in fact, if adult females take Accutane and it comes back.

Anyway. What a shit your doctor is. Run - don't walk - away!!! Find another. She sucks.

:o)

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Karmagirl: I am totally agreeing w/you 150% that my doc is probably an idiot, but she's and Air Force dr, so you can't expect the best and the brightest when you're dealing w/the military.

That being said, I can't go to another doctor and have the insurance pay for it unless a military doc refers me to one. Isn't it ironic?

Anyway, what I meant by her being one to blame the patient if the treatment isn't successful is because of what she said to me when I asked her what would happen if I needed another round. She basically stated that the only reasons anyone would ever need another round would be if they didn't use a topical retinoid after treatment and if they wore makeup. I immediately felt she was wrong (especially on the makeup tip, since during times of very clear skin, like when I was preggo, I wore makeup all the time and didn't get one blackhead, much less a pimple) and was somewhat concerned, but every time I tried to voice my concern or add any input, she was quick to shut me down.

I guess I could go back and talk to her and see what her answer would be if I asked her if I could go on another round of Accutane, providing I needed it after completing the first, if I did all that she asked and it still wasn't effective.

AF doctors usually are shit. That's why they aren't practicing in the real world.

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Well, there's some good ones out there, Carys. It's getting better all the time. I work for the Navy and am not a flight surgeon or clinic doc, but I do consult on certain aviation medicine cases. I just feel that some docs should stick to doing flight surgeon stuff, and give referrals more often when they're out of ideas instead of acting like they know it all, because docs - like everyone else - are people. They can't know everything.

So you're AF, then, right? TriCare usually lets dependents go to civvie docs, so I'm guessing you're not one. Correct me if I'm wrong, since the AF might not work the same as Navy.

I would suggest you keep asking her for a referral until she gives you one. The only person who can best take care of you is you, so...keep asking.

Good luck, and PM me if you have questions.

:o)

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I have hormonal acne. I took tane. 4 months later, i'm about 90 percent clear. I get about 4 a month but well worth it, at least for me.

I have hormonal acne and i've tried almost every regimine on this website and nothing seems to work. I'll be almost completely clear for a little while and then...BAM...I get a horrible break out.

Does anyone know if Accutane will work for hormonal acne?  I read somewhere on here that it doesn't, but if anyone could give me some advice I'd be soooo greatful!!!  Please help!

Thanx

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I too suffer from hormonal acne. I've been on the pill Diane 35 and I finally have clear skin but every pms week, I so break out. IT'S SCARY!! I get so many pimples big and small and then they scar so I'm left with ugly marks for at least 2 months. I went to the dr and she said that once my body truly adjusts to the pill I should see less and less breakouts. Unfortunately this is the end of the month for me so next week, who knows what disgusting breakout awaits. Good luck everyone.

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This is from noted acne researcher JJ Leyden:

"Oral isotretinoin. How can we treat difficult acne patients?

Leyden JJ.

Department of Dermatology, University of Pennsylvania, Philadelphia 19104, USA.

Isotretinoin (Roaccutane/Accutane) therapy (120 mg/kg) normally results in complete clearing of nodulocystic acne followed by prolonged remission, and many patients remain free of disease. Four groups of patients respond poorly or have a high rate of relapse. Preteens and young teenagers show a high rate of relapse and several courses of treatment are usually needed; 14 of 20 under the age of 12 years, 21 of 47 aged 12-14 and 23 of 66 aged 14-16 relapsed within 1 year. Individuals with linear lesions consisting of undermining tracks of follicular epithelium often show only a partial response. These individuals typically have a history of other 'sinus track' disease such as pilonidial sinus and hidradenitis, either themselves or other family members. Hemorrhagic or crusted lesions can be exacerbated by full doses of isotretinoin and patients develop pyrogenic-granuloma-type lesions and even acne-fulminans-like eruptions. Women with adrenal or ovarian syndrome associated with elevated androgens commonly relapse with 6-12 months after isotretinoin therapy. "

http://www.ncbi.nlm.nih.gov/entrez/query.f...st_uids=9310743

Here are more opinions from dermatologists:

Is the Cause of Adult Acne the Same in All Women?

Dr. Baldwin: The precise cause of acne is unknown, but it is often associated with at least one hormonal abnormality in healthy women. At some point, many women will have slightly abnormal androgen levels.

The first consideration should be to distinguish between acne that is related to an underlying medical condition and acne vulgaris. Acne that occurs in adult women as part of a medical problem may result from polycystic ovarian syndrome (PCOS), a tumor, hyperplasia (ovary or adrenal gland overproduction), or a testosteronesecreting tumor, which is likely in the ovaries.

Dr. Bergfeld: An adult woman with acne without a teenage history of acne should be looked at closely for hormonal irregularities. That said, I often look at hormones, particularly for cases of inflammatory acne, because there are likely to be increased circulating androgens. We have learned that older women can have elevated androgens episodically released by the ovaries, a fact that was not appreciated in the past. As a screening tool, there are three hormones to measure, dehydroepiandrosterone (DHEA), free testosterone, and total testosterone. These values might fall within a normal range, but levels may have to be checked a few times during the month to find the androgen excess, as older women often experience episodic androgen levels. The other problem is that currently acceptable laboratory ranges are too high. Therefore, it is best to have the screening done by an endocrinology laboratory that has a normal range for these values. In addition, the ranges are not adjusted for the older population, and, thus, care must be taken in the interpretation to gain proper perspective.

It takes more than just a blood test, however, to properly diagnose the cause(s) of the acne. Clinical suspicion is required. Frequently, acne is not the only symptom. The patient may have facial hair, an oily scalp or face, or increased body hair, all of which are signs of androgen excess. This can be treated.

In women with hormonal abnormalities, the resulting acne frequently is difficult to treat. A failure to respond to isotretinoin (Accutane, Hoff-mann-LaRoche, Nutley, NJ) is sometimes a signal of hormonal imbalance. Women who have not yet tried to get pregnant would not have been worked up for PCOS, which is a likely diagnosis in women who are in their 20s and early 30s.

I.e. it's pretty important to know if your "hormonal acne" is caused by a (form of) PCOS.

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This is from noted acne researcher JJ Leyden: 

"Oral isotretinoin. How can we treat difficult acne patients?

Leyden JJ.

Department of Dermatology, University of Pennsylvania, Philadelphia 19104, USA.

Isotretinoin (Roaccutane/Accutane) therapy (120 mg/kg) normally results in complete clearing of nodulocystic acne followed by prolonged remission, and many patients remain free of disease. Four groups of patients respond poorly or have a high rate of relapse. Preteens and young teenagers show a high rate of relapse and several courses of treatment are usually needed; 14 of 20 under the age of 12 years, 21 of 47 aged 12-14 and 23 of 66 aged 14-16 relapsed within 1 year. Individuals with linear lesions consisting of undermining tracks of follicular epithelium often show only a partial response. These individuals typically have a history of other 'sinus track' disease such as pilonidial sinus and hidradenitis, either themselves or other family members. Hemorrhagic or crusted lesions can be exacerbated by full doses of isotretinoin and patients develop pyrogenic-granuloma-type lesions and even acne-fulminans-like eruptions. Women with adrenal or ovarian syndrome associated with elevated androgens commonly relapse with 6-12 months after isotretinoin therapy. "

http://www.ncbi.nlm.nih.gov/entrez/query.f...st_uids=9310743

Here are more opinions from dermatologists:

Is the Cause of Adult Acne the Same in All Women?

Dr. Baldwin: The precise cause of acne is unknown, but it is often associated with at least one hormonal abnormality in healthy women. At some point, many women will have slightly abnormal androgen levels.

The first consideration should be to distinguish between acne that is related to an underlying medical condition and acne vulgaris. Acne that occurs in adult women as part of a medical problem may result from polycystic ovarian syndrome (PCOS), a tumor, hyperplasia (ovary or adrenal gland overproduction), or a testosteronesecreting tumor, which is likely in the ovaries.

Dr. Bergfeld: An adult woman with acne without a teenage history of acne should be looked at closely for hormonal irregularities. That said, I often look at hormones, particularly for cases of inflammatory acne, because there are likely to be increased circulating androgens. We have learned that older women can have elevated androgens episodically released by the ovaries, a fact that was not appreciated in the past. As a screening tool, there are three hormones to measure, dehydroepiandrosterone (DHEA), free testosterone, and total testosterone. These values might fall within a normal range, but levels may have to be checked a few times during the month to find the androgen excess, as older women often experience episodic androgen levels. The other problem is that currently acceptable laboratory ranges are too high. Therefore, it is best to have the screening done by an endocrinology laboratory that has a normal range for these values. In addition, the ranges are not adjusted for the older population, and, thus, care must be taken in the interpretation to gain proper perspective.

It takes more than just a blood test, however, to properly diagnose the cause(s) of the acne. Clinical suspicion is required. Frequently, acne is not the only symptom. The patient may have facial hair, an oily scalp or face, or increased body hair, all of which are signs of androgen excess. This can be treated.

In women with hormonal abnormalities, the resulting acne frequently is difficult to treat. A failure to respond to isotretinoin (Accutane, Hoff-mann-LaRoche, Nutley, NJ) is sometimes a signal of hormonal imbalance. Women who have not yet tried to get pregnant would not have been worked up for PCOS, which is a likely diagnosis in women who are in their 20s and early 30s.

I.e. it's pretty important to know if your "hormonal acne" is caused by a (form of) PCOS.

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I too suffer from hormonal acne.  I've been on the pill Diane 35 and I finally have clear skin but every pms week, I so break out. IT'S SCARY!! I get so many pimples big and small and then they scar so I'm left with ugly marks for at least 2 months. I went to the dr and she said that once my body truly adjusts to the pill I should see less and less breakouts.  Unfortunately this is the end of the month for me so next week, who knows what disgusting breakout awaits.  Good luck everyone.

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Yup. I have this. I actually have to have surgery to take care of it soon, but I am an extreme case, so don't worry.

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