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This month I broke out worse than I have in a while. I've been using topical retinoids and duac gel for 6 months, and I can only be clear for a few weeks at a time. Then... BAM... I get like 3 or four small annoying pustules on my face and like 5 on my chest once a month. Every other month I still get a cyst or two, and they take about 6 weeks to fully resolve, unless I get them injected. I've resolved to dealing with these monthly annoyences and when it's possible I try to schedule anything important (that I have to be pretty for) in the first two weeks of the month to insured a good skin day....

This month I switched up my regimen a bit because the flakiness and dryness was becoming unbearable, so I switched from my Aveeno Ultra Calming Cleanser back to Cetaphil gentle Clenser and started using Complex 15 (a not so non-comedogenic moisturizer, even though shering-plough claims it's non-comedogenic) at night. At first my skin was way less dry and my perception of oiliness was diminished. I was pretty happy. When my monthly scheduled breakout occured it was like 10 pustules instad of three (most of them small, but 4 were big) and a bunch of little whiteheads all over. It's healing up now, but they are leaving scars, not just redmarks but indented hypotrophic scars....

I had a spot on my back that's kinda sore, and I felt it earlier....it's swollen and hard inside....and about 0.5cm in diameter...then I felt a a sore spot on my cheek....sore, hard swollen and deep as hell...another one....great....

I'm soooo pissed.

I want to call my derm, but all he'll do it try to throw some antibiotics at me. I'm allergic to cyclins, sulfonamides (like Bactrim and Klaron), and cephlosporins (like Keflex), and possibly fluoroquinolones (like Cipro). The only thing I can take is macrolides like erythromycin and clindamycin, and penicillin type antibiotics. But even if I could take them with out a horrible allergic reaction, I don't want to. I know that they kill other benificial microflora all over the body and are linked to birth control pill failure. The last thing I want is to end up with a six month long yeast infection (they could put me on weekly diflucan, I'm allergic to that too....yay)...or pregnant....besided antibiotics are just a temporary solution...all they do is kill the bacteria and reduce some of the inflammation...I can't take them forever and wouldn't want to.....

besides they won't to anything for this oil slick I have every day.....

I think I want Accutane. I'm aware of the side effects, and know better than to get pregnant on it (I take enough precaution now, and I'm only on a topical retinoid). I'd take headaches, achey joints, dry lips and dry eyes, and a little hair loss (I could actually spare some hair) over a six month long yeast infection (sorry if that's TMI) any day.

I just think that no derm would perscribe it to me when I can be totally clear for a few weeks at a time. If a derm saw me on a clear day...they just laugh and tell me I don't have even acne (except for the faint scars and redmarks), but I do and it's scarring...they're not so bad now, but I can see them. My derm can see them too and says there's always peels, lazer resurfacing, and dermabrasion to fix the scars...

I only have mild acne now (with the occasional monster cyst). So am I even a candidate for accutane or should I just accept this scheduled monthly breakout cycle and schedule my life around it?...

My derm has brought it up before, and said I can't have it without trying a few antibiotics first (which I won't). Should I let him prescribe some and fake a reaction? Or just pretend to take them and say their not working? Should I quit using my duac so my acne goes nuts and then go see him?

I don't want to lie and be manipulative but he's so hard pressed to prescribe me these antibiotics. I know they will work for a little while, but my acne is a life sentence (I'm not a teenager)....so I can't use them forever. I'm pretty sure accutane will clear me up for a few years since I don't have very severe acne and my onset was a little later (19), and I don't have a family history of acne....these are all signs that a relapse is not as likely to occur, at least for a few years anyway....

I though about switching derms, but I'm worried if I see a different derm, that they won't even understand my history and say my acne isn't bad enough, and try to throw more antibiotics at me.....My friend's son goes to my derm group, and he got accutane after using only differin and duac, no antibiotics....so maybe still there is hope for my derm and he's just being a dimwit.....

I don't know what to do. Help....

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I think if you have tried all the bullshit, and are aware of the side effects, you should be given it. Doctors may dick your around more because you're female, pregnancy and what not. However, I totally understand the dislike/allergy for antibiotics and frequent topicals. I see no point in them delaying you accutane.

I wish you luck, and it never hurts to get a second opinion.

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labgirl, i think you should go for accutane b/c...... b/c..... you are nice.

my brain is not working, but normally i would offer some encouragement and sound reasoning. i'll pm you later.

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What type of birth control are you on, have you tried Diane 35, it seems to be the best for acne. I understand why you don't want to go on antibiotics, reactions aside, it is just not an option for those of us who have acne for the long haul. You should go to another derm, you don't have to switch outright, you are always entitled to a second opinion. If you like what they say, stay with them, otherwise go back to your old derm. Good luck, and let us know what you decide to do.

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see my derm asked me if I wanted accutane he told me if I keep giving u anitiobiotics and creams thye are not gogin to work so he wants me to try accutane

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I just think that no derm would perscribe it to me when I can be totally clear for a few weeks at a time. If a derm saw me on a clear day...they just laugh and tell me I don't have even acne (except for the faint scars and redmarks), but I do and it's scarring...they're not so bad now, but I can see them. My derm can see them too and says there's always peels, lazer resurfacing, and dermabrasion to fix the scars...

I only have mild acne now (with the occasional monster cyst). So am I even a candidate for accutane or should I just accept this scheduled monthly breakout cycle and schedule my life around it?...

My derm has brought it up before, and said I can't have it without trying a few antibiotics first (which I won't). Should I let him prescribe some and fake a reaction? Or just pretend to take them and say their not working? Should I quit using my duac so my acne goes nuts and then go see him?

I don't know what to do. Help....

Maybe the thing you need to schedule around your monthly breakout cycle is your next derm appointment. C'mon, LabGirl, get tough with the guy. (I already know you swing a mean baseball bat.) And if he won't give you Accutane and you won't do antibiotics, maybe it's time to switch loyalties. With an outbreak like the one you just described, there MUST be a derm out there who's willing to play ball ... so to speak ...

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What type of birth control are you on, have you tried Diane 35, it seems to be the best for acne. I understand why you don't want to go on antibiotics, reactions aside, it is just not an option for those of us who have acne for the long haul. You should go to another derm, you don't have to switch outright, you are always entitled to a second opinion. If you like what they say, stay with them, otherwise go back to your old derm. Good luck, and let us know what you decide to do.

I'm on tri-nessa (generic ortho-tricyclen). I was thinking of switching to ortho-cyclen (same progestin, but monophasic) and taking it continuously, without having pretend periods at all. That way I could eliminate the cyclical breakout. I have heard of Diane-35. My sister was on it and had some nasty side effects (physical and mental), I'm more scared of the side effects of that than I am of Accutane (my sister was on both).

I eventually want to have a kid though, so I can't take the pill forever either. I'd like to kick my acne in the ass a few years before I want to try to get pregnant. This is why I want Accutane now, not 2 years from now....

I just think that no derm would perscribe it to me when I can be totally clear for a few weeks at a time. If a derm saw me on a clear day...they just laugh and tell me I don't have even acne (except for the faint scars and redmarks), but I do and it's scarring...they're not so bad now, but I can see them. My derm can see them too and says there's always peels, lazer resurfacing, and dermabrasion to fix the scars...

I only have mild acne now (with the occasional monster cyst). So am I even a candidate for accutane or should I just accept this scheduled monthly breakout cycle and schedule my life around it?...

My derm has brought it up before, and said I can't have it without trying a few antibiotics first (which I won't). Should I let him prescribe some and fake a reaction? Or just pretend to take them and say their not working? Should I quit using my duac so my acne goes nuts and then go see him?

I don't know what to do. Help....

Maybe the thing you need to schedule around your monthly breakout cycle is your next derm appointment. C'mon, LabGirl, get tough with the guy. (I already know you swing a mean baseball bat.) And if he won't give you Accutane and you won't do antibiotics, maybe it's time to switch loyalties. With an outbreak like the one you just described, there MUST be a derm out there who's willing to play ball ... so to speak ...

He's got one more shot. I'm gonna try to schedule an appointment during one of my monthly breakouts, and I'm gonna stop using the duac that whole month before I go...(or maybe I'll come off the pill entirely so I break out like crazy) I'm going to tell him to stop dicking me around with the antibiotic nonsense and just ask him to give me Accutane. If he says no, I'll go somewhere else.......

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I say, do you what you feel is best for you labgirl! I was on Diane35 for about 3 years actually.... during this time my skin was virtually almost completely clear.... it was great... but then I started getting these pains in my calves and I thought it might be associated, then the chest pains came... and I got slightly terrified, although my doctor diagnosed them as stress related. Anyway, I ended taking that pill and needless to say it was just a quickfix, a lot of my acne is hormonal... I am now on ortho tricyclen lo w hich seems to be working great with my exfoliation routine.. I am about 97% clear.

backtrack lol

End of Aug. 2005 I broke out in cysts, as I was experimenting with different bcps it was terrible, I gave in to a short term treatment of tetracycline... it really cleared me up, I took it for about 4-5 months (some ppl stay on it yrs?!!?) anyway, I ended it about 7-8 weeks ago, and my skin is really going strong.. im taking a the low dose bcp ortho tricyclen lo and if you read my routine below there isn't much to it. I'm just left with quite a few red marks.. I actually believe that if I were to end this bcp my skin wouldn't change too much..

good luck

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You sound like you have an incredibly stubborn derm. Your reasons for not wanting to go through antibiotics are very valid, not to mention that you're allergic to many of them! I can't believe a derm would refuse to listen to that.

Like someone else said, try making an appointment around the time you get your bad breakouts OR take a few close up pictures of yourself, maybe outside or in good lighting and take the pictures to show him. That way he can see that it gets bad and can't argue with you. Just state your case and if he still refuses (he really shouldn't), try elsewhere.

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If you do get cysts and pustules, you don't have mild acne. Make sure you bring that up when you talk to your derm.

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If you do get cysts and pustules, you don't have mild acne. Make sure you bring that up when you talk to your derm.

Yeah he knows that . He saw me back in August, two weeks after I gave up on the regimen. My face was 80% clearer than it was earlier that summer (because of globbing copious amounts of BP on for the past 6 weeks). I called my acne mild, and actually I had went there for a suspicious mole on my foot, and not really acne (although I was mildly interested in using a topical retinoid for my acne). He said that's not mild acne...."it's moderate to severe, and you are scarring.....we'll some you some tetracycline..." I responded "I'm allergic"...so he said..."how bout minocycline"....if I'm allergic to tetracyclin, then I'm most likely allergic to all cyclins....duh....(and I didn't even go to medical school)........

He's totally aware that I get pustules and cysts....He's just being a jerk....

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Two words: NEW DOCTOR.

I suggest taking the shotgun approach and making appointments all over the place. Somewhere there has to be a reasonable derm.

It's the FDA approval that's getting in his way, right? It's only approved for acne cases that resist antibiotics or something like that? SURELY there is a loophole for people with allergies ...

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I had a feeling you'd be thinking about taking 'tane soon.

When I was on Retin-A Micro, I was never totally clear, and eventually started getting acne similar to what you're describing. The RAM, in my opinion, seems to make things worse in the long run if you're still getting cysts, because (and this is just from my experience) the RAM makes your skin more delicate, leading to more scarring than you might have had otherwise.

When I went into see my doc, I told her about everything I had taken and she immediately suggested 'tane. So far, it's probably been the best thing I've ever done for my skin. I just wish I would have been prescribed this years ago!

I've been off of it for about two weeks now, so I can't say yet if my results will be long-term. However, if nothing else, I at least had about five and a half months of almost perfect skin with zero oil. That was a gift enough in itself!

Go for it, LabGirl. Tell that jerk dermo to give it to you, or you're walking!

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I understand that bcp isn't a long-term solution if you want to have kids soon. But i was on Diane twice, and both times i didn't have any side-effects except clearer skin. It made a really big difference, if I'm not happy with the retin-a micro in a month I'm going back on it (I'm at 16 weeks).

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UPDATE:

Okay so it's been about 10 days since I've quit using any and all acne treatment products (Retin-A, Duac) and I've taken my last birth control pill. The weather was starting to get warm, which usually reaks havoc on my oily sensitive skin. I was expecting my skin to go nuts. I developed a few very angry looking pustules witing about 48 hours and I had a tiny smattering of whiteheads on my forehead that I can't see but I can feel. My skin was incredebly oily the first few days when the weather was warm.

Well it got really cold the other night and stayed that way for a few days. My oily skin calmed down, and those three angry pustules resolved quickly and I'm left with three small redmarks.....My skin is totally clear today......WTF??? My skin looks healthy and hydrated. Any wrinkles I had disappeared. My skin looks like it did before I ever had acne (aside from the rolling scars).

This makes no sense. I should be right smack in the middle of my pill induced breakout. Maybe my skin cell cycle has slowed down because I stopped the retin-a, so my breakout is delayed this month.

I definately noticed that BP irritates my skin, now that I'm not using it. I have sensitive fair skin and I'm prone to flushing. I am not red at all now. My face matches my neck. I did quit BP last summer for about 6 weeks but my face was covered with acne and inflammation that I didn't notice a difference. Did I out grow my acne and the products I was using were just aggervating my sensitive skin?? It's possible, but unlikely...

My skin is still very oily and my pores are pretty big, but overall my skin looks amazing. This is probably the calm before the storm, but with two weddings in the next month I'm looking forward to being clear for at least about two months (the time it will take for the effects of the retin-a and OTC to wear off and for the weather to become hot and humid).

I'm looking forward to being able to treat my skin like I did before I ever had acne. I can use self tanner. I can wear makeup without flaking. I'm also looking forward to being off the pill for a few months. My boobs might shrink and I might drop 5lbs of extra estrogen induced curves. Oh and maybe I'll get my sex drive back......the pill turned me into an ice queen over the last few years....

This should be an interesting summer........

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UPDATE:

Okay so it's been about 10 days since I've quit using any and all acne treatment products (Retin-A, Duac) and I've taken my last birth control pill. The weather was starting to get warm, which usually reaks havoc on my oily sensitive skin. I was expecting my skin to go nuts. I developed a few very angry looking pustules witing about 48 hours and I had a tiny smattering of whiteheads on my forehead that I can't see but I can feel. My skin was incredebly oily the first few days when the weather was warm.

Well it got really cold the other night and stayed that way for a few days. My oily skin calmed down, and those three angry pustules resolved quickly and I'm left with three small redmarks.....My skin is totally clear today......WTF??? My skin looks healthy and hydrated. Any wrinkles I had disappeared. My skin looks like it did before I ever had acne (aside from the rolling scars).

This makes no sense. I should be right smack in the middle of my pill induced breakout. Maybe my skin cell cycle has slowed down because I stopped the retin-a, so my breakout is delayed this month.

I definately noticed that BP irritates my skin, now that I'm not using it. I have sensitive fair skin and I'm prone to flushing. I am not red at all now. My face matches covered with acne and inflammation that I didn't notice a difference. Did I out grow my acne and the products I was using were just aggervating my sensitive skin?? It's possible, but unlikely...

My skin is still very oily and my pores are pretty big, but overall my skin looks amazing. This is probably the calm before the storm, but with two weddings in the next month I'm looking forward to being clear for at least about two months (the time it will take for the effects of the retin-a and OTC to wear off and for the weather to become hot and humid).

I'm looking forward to being able to treat my skin like I did before I ever had acne. I can use self tanner. I can wear makeup without flaking. I'm also looking forward to being off the pill for a few months. My boobs might shrink and I might drop 5lbs of extra estrogen induced curves. Oh and maybe I'll get my sex drive back......the pill turned me into an ice queen over the last few years....

This should be an interesting summer........

I hope you stay clear! :pray:

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So do I, but I doubt I will be clear for more than a few months.....This will be the first time in 6 years that won't be treating my acne at all for months.....

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So do I, but I doubt I will be clear for more than a few months.....This will be the first time in 6 years that won't be treating my acne at all for months.....

It's begun.....all hell is breaking loose, and I haven't even been off my pill for a week.....

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