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Dermatologist treatment from Day 1

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Update January 2013

Just a quick update, sorry I haven't been updating for so long!

I stopped using Epiduo around 4 months ago, that may not be exact but it's been a while. I changed over to using bp and saw a lot more improvement. Most of my acne cleared up apart from 2 - 3 actives. I've continued to take Lymecycline antibiotics which I have been told to take for a further 6 months.

I saw my derm on 3 January and she prescribed me Retin A 0.01% gel which she said would fade my pigmentation scars. I've been using this every second night for 2 1/2 weeks and then started using it every night 3 nights ago - so far I haven't experienced any purging/breakout or dryness or peeling, just 2 tiny red bumpy zits and some minor flakiness around my chin and nostrils. My red acne scars are fading nicely and my skin feels soft and smooth. It's even cleared my blackheads on my nose so soon! So far so good. Also, I've gone back to cetaphil gentle cleanser and I do my cleanse an hour before I put on the Retin A. I much prefer Retin A to Epiduo.

Other things I'm taking daily:

1000mg Evening Primrose Oil x 1

1000mg effervescent vitamin C x 1

Mega Potency Acidophilus probiotic capsule x 1


Dermatology Update - Week 8

Just a quick update on how it's going with my treatment and dermatology appointments.

I've been on the same treatment as I mentioned in past posts for 8 weeks now. The improvement in my skin in this short space of time has been brilliant compared to how it was before treatment. If you remember, I was referred to the hospital for a Roaccutane consultation...now Roaccutane was always going to be my 'last resort' option as I am fully aware of all of the possible side affects that goes with this drug. The truth is, I'm not willing to chance it at the moment, especially as my skin is responding well with antibiotics and a topical. So I cancelled the consultation.

The other option my Dermatologist told me to think about was Dianette which is a birth control pill prescribed for acne but not birth control, although it's a very effective birth control pill. Confusing huh?! I was told this would work wonders for my skin but what they failed to mention was that should I come off Dianette in the future, my acne would return with a vengeance. I'd be back at square one. It was coming off another form of b.c that caused my acne in the first place. I'm not prepared to end up in a vicious cycle - I'd rather tackle it in other ways.

I've heard people talk about Spiro, but this is something my dermatologist and Dr's have never talked about. I'm still uneducated about Spiro at present.

So getting to the point, I had an appointment with a different dermatologist yesterday. Although I'm happy with my progress I am still concerned about the scarring i'm getting (the deep hole like scars and red marks) and the enlarged pores and oily skin. The Dermatologist was just trying to push Roaccutane and Dianette on me again, she mocked my concerns and told me I should go on Dianette. She also told me to increase my antibiotics to one in the morning and one in the evening. I left her office feeling a little angry. My gut instinct tells me to steer clear of Dianette. I'll see how increasing my intake of antibiotics goes, until my next dermatology appointment in 2 months from now.


So I think I totally jinxed myself in the last post by saying how great my skin was doing!

I'm not sure if I'm just experiencing the IB I was told to expect, but I have developed a new giant beast of a cyst on my cheek right next to the one I already had prior to starting treatment. And also a small yet annoying red zit on my forehead - I never get acne on my forehead so I can only guess that the Epiduo gel has brought it out, so I'm not using the Epiduo on my forehead now, only on the zit.

I'm scared of saying this for fear of jinxing myself again, but my chin area is improving a lot - it's much flatter, less painful and seems to be drying out although there's still some nodules that won't shift.

The areas of acne at the sides of my nose are practically clear, they are totally flat but I've still got the red scars and some 'ice pick' type scars left over. If it wasn't for the red scars left over from a lot of the acne which has cleared thus far, my skin would look much better, but when the time is right I can cover the scars with makeup.

Another thing I've noticed is that the pores all over my face have become very enlarged - my skin looks like orange peel!! I don't know if this is due to the Epiduo or the tetralysal but I hope it doesn't stay that way forever!

Today is the last day i'm on Tetralysal twice daily - starting tomorrow I reduce the dosage to once daily.

Here's the rant/vent part...

I was told by my dermatologist on the 12th July that I need to see my GP about prescribing me the Dianette pill that we both agreed should help my skin and as I have a consultation for starting Roaccutane in a few weeks, I need to be on it asap. However I've tried 3 times to get an appointment with my GP, I even went down in person with a letter from my dermatologist stating I need to see my GP about this but I've still no appointment - the receptionist fobbed me off saying the Dr is fully booked up but will ring me with a phone consultation but he never did. I think it's disgraceful that I can't even get an appointment so I'm in the process of registering with a different Dr at a different practice. If my Doctor had referred me to a dermatologist when all this started instead of telling me 'don't put anything on your skin' for weeks on end, I think it wouldn't have got this out of control. Also I have to wait over 3 weeks to get a blood test at my clinic that my dermatologist requested. It's pathetic.

Ok so that's my little rant over! I'm not at all happy with the treatment (or lack of it more like) from my Dr but I think my dermatologist is wonderful. I still need to try and get an appointment with a Dr for Dianette asap though!


Week 1 Review

What a difference a week makes!!

My first visit to the dermatologist last week resulted in the following diagnosis:

Grade 5/6 inflammatory acne with comedonal papules, pustules, and some deep nodular, pustular lesions.

The treatment plan for the time being:

Epiduo gel 45g to be used once at night time - build up tolerance to reduce risk of irritancy.

Lymecycline 408mg capsules - 1 to be taken twice a day for 3 weeks, therefore reducing to once daily.

Cetaphil cleanser - to be used twice daily.

I have stuck to the strict instructions by my dermatologist and all I can say is wow!

I really don't want to jinx myself by saying this but my skin has improved so much in one week, no new pimples or cysts, the cysts I had have reduced a LOT, and the infection is gone! And much less pain :)

I am pleased I was told how to use the Epiduo gel correctly - I have managed to build tolerance without irritating my skin and no major IB - it drew a lot of crap out from the lesions I already had but didn't bring out any new pimples...yet!

The Cetaphil gentle cleanser is really good for me - why haven't I used this before?! It's the best I've ever used and I will continue to use this from now on. I'm not allowed to put any moisturiser of any kind on my skin right now but i don't feel I need any as the cleanser balances my skin wonderfully.

Hopefully the progress is further boosted when I get to start Dianette, which i'm still waiting for.

I feel a lot better in myself as well - I have been out every day for the last few days without wearing the bandage on my chin and I don't feel as self-concious about my skin as I first did. Sure, I have a long way to go and my face still looks bad but it's nothing like it was before treatment.

My dermatologist is a God send, I am so happy right now!


So day 2 and it's not a good day. I woke up feeling great, then my pms decided to come and torment me again. Feeling wretched, ugly and in a bad place...so bad I went out for the first time without my 'bandage' (a piece of sterile gauze held over my chin area with sterile surgical tape).

I haven't been out much in the last couple of months but when I have no choice I go out with the safety net of my bandage. I had to go out today so going out without it today was a very big deal for me. I just thought 'you know what, sod what people think'. I took my daughter out with me in her pushchair and kept my eyes down avoiding eye contact with anyone even when I was being served at the PO and in the supermarket. I began to regret my decision and felt a mini panic attack coming on but I took deep breaths and carried on.

As for the treatment i'm on at the minute, the epiduo cream I applied last night felt very strange! I know it's supposed to cause irritation at first so i'm not worried about it, i'm following orders and building up slowly.

I also washed my hair in the shampoo I was prescribed and it dried my hair out, I couldn't even drag a brush through it!

So that's how it's going today, i'll update when I next see my dermatologist on Thursday.


Day 1: First ever appointment with a Dermatologist

For the last three months I have been suffering with a bad outbreak of acne. What started as a huge hard lump which covered my entire chin has rapidly regrouped, spread and formed into the acne you see in the picture of me today. I suspected it to be hormonal due to the removal of the contraceptive implant Nexplanon.

I have tried several methods of clearing the acne including:

-Changing my skincare from medicated products (Quinoderm wash and cream, Nixoderm, Differin, Clinique anti-blemish Step 2) to organic natural products (organic tea tree wash, Dr Bronner's baby mild liquid soap, organic tea tree oil, organic lavender oil, Green People OY cover & clear spot it treatment concealer, natural/mineral makeup).

None of which improved my skin. I know that a skincare regimen can take months to show any improvement but anything I tried made matters worse not better.

-Changing my diet to an organic (where possible) non-dairy, meat-free, no alcohol, no refined sugar, low fat, no junk diet.

-Introducing herbal teas and remedies, vitamins and supplements (high strength Evening Primrose oil, Vitamin B complex, Omega 3)

On top of this my acne became infected.

Several visits to my GP has resulted in a one month course of Erythromicin and a two week course of Flucloxicillin which I finished today (to treat the infection). For the last few weeks on the advice of my GP, I have used NOTHING on my face except water. I was referred to a Dermatologist who I saw this morning.

After a lengthy chat with the Dermatologist she agreed the acne appears to be hormonal and that it was grade 5/6 severe. She mentioned I have seborrhoea of the face and scalp and took a swab of one of the pus filled lesions to test for a yeast infection. We talked about the effects of Roaccutane and Dianette, one of which I will be taking as treatment. We then discussed treatment and a new skincare regimen for the next 3 weeks which is:

A.m: cleanse with Cetaphil cleanser

take one Lymecycline 408 mg capsule

P.m: As above

introduce Epiduo 0.1%/2.5% gel starting with 4 hrs before washing off, then building up slowly from there.

3 times weekly: washing my hair with Nizoral Ketoconazole 2% shampoo - a medicated shampoo to treat the seborrhoea of the scalp.

All of the above was prescribed to me today to start immediately to avoid further lesions and scarring...I was told to expect scarring but the nodules and cysts should go in around 3 months+. I have another appointment on Thursday with the Dermatologist and another specialist who will advise me on whether Dianette or Roaccutane will be the best treatment for me but it's looking like Dianette will be the more appropriate option at this time.

I'd also like to mention that the dermatologist told me that the change in diet has NO effect at all on acne! A healthy, well-balanced Mediterranean style diet is the best way to go.

I am feeling very optimistic after seeing my Dermatologist for the first time today. I'm glad I can finally get the treatment I should have been given months ago before it got this bad.

I will keep this blog updated with how my treatment goes...who's with me? smile.png