Troublesome Acne!

[mommysboy]

I'm 48 and in generally very good shape.

Since the age of 15 I've had mild to moderate acne. It is now just confined to specific small areas and comes and goes.

But for the past couple of years I've had a cluster of spots come and go just on the bony spot above and behind my left ear. I've just dismissed them as you do. But now I find myself in genuine pain at times, and they are quite protracted bloody affairs. Just lately I've also had a mild ringing in the same ear and I'm getting a bit worried. The area has been cheked out and there aren't any fistulas or anything sinister.

I could kill the game by taking doxycycline (or a tetracycline). At times I've taken this and the spots go away. Is it ok to go on this drug for a couple of months? and at what dose?

I went to a specialist in UK who said it was not severe enough for Accutane, and have dismissed this as an option. Would that be right? What's the criteria?

[Ruperts]

Accutane is controversial because of it's alledged side effects, most notably depression. Some kids have apparently commited suicide due to depression caused by accutane. I took it four years ago and couldn't have been happier, since it cleared up my acne like nothing else. I did get a few side effects such as extremely dry skin and chapped lips, as well as an awful initial breakout, but overall it was brilliant... for about six months, and then it all came back. Regardless, the side effects issue is why your derm would have said no. It's harsh on the liver, too, so it's only prescribed to people who have tried all other anti-biotics with no results, and are suffering mentally or physically due to the acne. I got it after telling my derm that it was stopping me from being social, which was true. You could probably push the pain angle with success if you really wanted to go on it.

As for the tetracyclines. I've been on them almost constantly for over ten years. During this time I've drank alcohol and taken recreational drugs, as well as consuming excess protein during several bodybuilding phases that i've been through, and my blood test results have always came back fine. I've told my Doctor about this and he says it is not something to worry about... although in any case, I should stop with the drugs and alcohol. Of course you should talk to your own Doctor about this but for me personally there doesn't seem to be any problem. I'm taking doxy at the moment and it works very well, which leads me onto a question of my own, if anybody knows...

When in Thailand for a long time, what changes occur in the skin that make us westerners less tasty to mosquitoes? When I first arrive, they kill me. After a while, they start to leave me alone. Could this change be the reason why I don't seem to suffer from acne in Thailand anywhere near as much as I do at home? For example, here in Thailand I take doxycycline and will go months with minimal acne, yet if I take the exact same medication home and take it there, the acne reappears. I thought it was probably the weather - the UV rays, but even when living through a hot Australian summer, taking the same meds, I suffered far more than I do here. Maybe it's the diet, the spicy food perhaps. Or maybe it's the alcohol, lowering testostorone levels. It might also be down to stress and the lack thereof. Whatever it is, I'd really like to know. And if anyone can find out there is a pretty large market in acne prevention to be tapped into there.

[Sheryl]

tetracyclines can safely be be taken for long periods provided the person is not allergic and does not have any serious chronic diseases and has normal liver & kidney function. For acne suppression usual dosage is 25-500 mg tetracycline twice a day or 100mg doxycycline twice a day.

Accutane is reserved fro severe cases unresponsive to the tetracyclines because of its many side effects. Most serious of these is that it causes birth defects if taken by a pregnant women; it can also have toxic effects on the liver, causes depression in some people and causes dry, cracked lips in most people.

An alternative is to use the same thing in topical form, i.e. Retin-A cream. This avoids the systemic effects and usually is effective although it takes at least 3 months of use to see the effect. Can be bought over the counter in Thailand. the area treated needs to be protected from sunlight as it will become very sensitive to sun exposure.

Be sure to keep your hair very clean and also when washing your face top get the area all around the ears cleaned well. The far sides of the face and around the ears are often afflicted due to oil deposits clogging the pores which easily happens from hair or from not being cleaned as thoroughly as the main face.

[mommysboy]

tetracyclines can safely be be taken for long periods provided the person is not allergic and does not have any serious chronic diseases and has normal liver & kidney function. For acne suppression usual dosage is 25-500 mg tetracycline twice a day or 100mg doxycycline twice a day.

Accutane is reserved fro severe cases unresponsive to the tetracyclines because of its many side effects. Most serious of these is that it causes birth defects if taken by a pregnant women; it can also have toxic effects on the liver, causes depression in some people and causes dry, cracked lips in most people.

An alternative is to use the same thing in topical form, i.e. Retin-A cream. This avoids the systemic effects and usually is effective although it takes at least 3 months of use to see the effect. Can be bought over the counter in Thailand. the area treated needs to be protected from sunlight as it will become very sensitive to sun exposure.

Be sure to keep your hair very clean and also when washing your face top get the area all around the ears cleaned well. The far sides of the face and around the ears are often afflicted due to oil deposits clogging the pores which easily happens from hair or from not being cleaned as thoroughly as the main face.

Thanks for the 2 very good postings.

I'm back on doxy as it's obviously safe for me to use and it has instant/dramatic effects for me- within hours my skin looks much better. Interestingly my ear stopped ringing within a few hours, is that possible with doxy too? And I'll pay special attention to cleansing the area. It's the side I sleep on and I think this is an aggravating factor so I'll change the pillow casing every night and maybe apply a plaster of some sort.

It's an interesting point as to what causes acne, and I think poster 1's affliction sounds like a composite of stress, hard exercise, and change in sunlight, and possibly diet although one has to be very careful with this last point, ie, it's nothing to do with eating too much chocolate I'm sure.

Certainly, doctor's in UK used to advise some sunbathing in moderation. I think basically anything that changes hormones also causes acne as sebum production is linked to hormonal activity.

Again thanks for the great input.

[FBN]

The effect of Tetracycline on acne is not just an antibiotic effect but it also inhibits the formation of sebaceous secretions the oily/fatty secretions, by the skin which in turn, reduces acne.

Try and go with the lowest dose tetracycline that will have an effect. Doxy is fine in an acute phase to treat the local infection as well but for the longer term, try the ordinary Tetracycline in the dose as suggested by Sheryl above. The intestinal flora quickly develops resistance to the antibiotic effect so no ill effects there.

Don't take it with milk...

[Alter2]

When I get a few spots I take a zink supplement for a few days, and they clear right up! Seriously, google it as there is lots info on this valuable mineral.

[mommysboy]

The effect of Tetracycline on acne is not just an antibiotic effect but it also inhibits the formation of sebaceous secretions the oily/fatty secretions, by the skin which in turn, reduces acne.

Try and go with the lowest dose tetracycline that will have an effect. Doxy is fine in an acute phase to treat the local infection as well but for the longer term, try the ordinary Tetracycline in the dose as suggested by Sheryl above. The intestinal flora quickly develops resistance to the antibiotic effect so no ill effects there.

Don't take it with milk...

Thanks also, I'll drop down to a low dose after a few weeks. Yes it was the possible effect on the stomach that frightened me, but it seems a tried and tested drug and I have taken mino. for long periods before (incidentally this works even better than doxy. for me but is not available in thailand).

[mommysboy]

When I get a few spots I take a zink supplement for a few days, and they clear right up! Seriously, google it as there is lots info on this valuable mineral.

Maybe, it's just a case of differences in intensity I reckon. Mild acne can be treated in any number of ways, but moderate or stubborn acne really is something different.

But I may give it a whirl anyway!