Acne medication was so new when I was younger. I didn't have bad acne, but most kids did. I think a lot of treatments became popular when I was in college. Now, acne medication is well researched and developed. And, from what I understand, not all that expensive.

Anonymous wrote:

Anonymous wrote:They may all be taking accutane. Personally, I wouldn't touch it. My brothers both used retin a when they were teenagers, but the only thing that really worked was time, outgrowing it.

Disagree.

Do you mean you disagree that accutane should be a drug of last resort (rather than first resort)? Or that my brothers used retin a? Or that they grew out of acne?

Anonymous wrote:They may all be taking accutane. Personally, I wouldn't touch it. My brothers both used retin a when they were teenagers, but the only thing that really worked was time, outgrowing it.

Disagree.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:To the poster who said her daughter's acne was attributed to a higher level of testosterone--I never heard of this. an you offer more details/info?

My dermatologist said the same thing--it's why the pill can help reduce hormonal acne. Spironolactone, which is actually a blood pressure medication, also reduces testosterone levels and is used for women with hormonal acne. (Men are not prescribed spironolactone for acne because of the feminization side effects, and women shouldn't get pregnant while taking it because it can negatively affect male fetuses.) If you google spironolactone, you can fine more information.

If your daughter has this condition, pay attention to PCOS -- polycystic ovarian syndrome. Acne can be part of this syndrome, which they believe is related to testosterone levels, and it can cause infertility, as well as unpleasant effects like difficulty regulting weight gain and facial hair.

It can be controlled but if you don't know you have it, you could (as an adult) experience years of infertility and frustration.

PP here. Se my longish post above about my daughter's high testosterone. PCOS is the diagnosis commonly given to those with some combination of acne, weight gain, hirsutism, irregular periods, and polycystic ovaries. PCOS is quite common; it produces symptoms in 5% to 10% of women of reproductive age. The prevalence may be as high as 20% with some experiencing no symptoms until they find they are having trouble conceiving.

Because this is so prevalent, a hormonal panel definitely should be done on any women contemplating Accutane. It may not work (or work just temporarily as in my daughter's case) because it does not address the underlying hormonal imbalance. Just not worth it for such a potent medication without checking out other possibilities first.

Testosterone is typically elevated, but not high, in PCOS. Other causes of high testosterone (all of which can result in acne and/or hirsutism) include testosterone secreting tumors (usually benign and almost always found on either the ovaries or adrenals) and nonclassic congenital adrenal hyperplasia. While both PCOS and NCAH can cause infertility, but there are a number of ways to address that if one wishes to become pregnant.

Anonymous wrote:

Anonymous wrote:To the poster who said her daughter's acne was attributed to a higher level of testosterone--I never heard of this. an you offer more details/info?

My dermatologist said the same thing--it's why the pill can help reduce hormonal acne. Spironolactone, which is actually a blood pressure medication, also reduces testosterone levels and is used for women with hormonal acne. (Men are not prescribed spironolactone for acne because of the feminization side effects, and women shouldn't get pregnant while taking it because it can negatively affect male fetuses.) If you google spironolactone, you can fine more information.

If your daughter has this condition, pay attention to PCOS -- polycystic ovarian syndrome. Acne can be part of this syndrome, which they believe is related to testosterone levels, and it can cause infertility, as well as unpleasant effects like difficulty regulting weight gain and facial hair.

It can be controlled but if you don't know you have it, you could (as an adult) experience years of infertility and frustration.

My 11 year old DD is beginning to experience acne. I asked her pediatrician if it was time for a referral to a dermatologist and she advised that I try over the counter medications first like medicated face washes, wipes and topical ointments with benzoyl peroxide (10%) and see how that does. So far, so good. She is already on ADHD medication and I would like to avoid other prescription drugs. But, we have good health insurance which affords access to treatments that "poor kids" (not my term) likely do not have.

I agree that I have seen clearer face is in much higher income areas.
My young cousin and most his male friends (wealthy area) all had creams and medication to manage. I worry wonder about side effects.

be very cautious about using accutane if you have a family history of IBS.

Anonymous wrote:To the poster who said her daughter's acne was attributed to a higher level of testosterone--I never heard of this. an you offer more details/info?

PP here. Daughter had few periods and acne. When we finally got to the gynecologist, she dx'ed her with polycystic ovary syndrome (PCOS) on the spot before running a hormonal panel. PCOS can be something of a garbage diagnosis. Initially, it was given to women who had numerous small cysts on their ovaries, which show up on an ultrasound. Often, though, they will skip the ultrasound if you have several of the following symptoms: infrequesnt periods, treatment resistant acne, hirsutuism, overweight, or dark patches on the skin. Typically, but not always, when the hormone panel is done testosterone is elevated. Not everyone with PCOS is overweight, but it is typically a pre-diabetic form of insulin resistance and some are treated with Metformin.

My daughter had only few periods and acne. Her testosterone came back high, not just elevated, and she had to have an ultrasound to see if she had a testosterone producing ovarian tumor (negative). A tumor on the adrenals can have similar effects. The PCOS dx in her case seemed to be a rather dubious--really just a shorthand for high testosterone. In any case her skin cleared up nicely with birth control and spironalactone.

She recently underwent another round of tests with a reproductive endocrinologist to see if she has another cause of high testosterone--nonclassic congenital adrenal hyperplasia, a genetic disorder involving a missing enzyme. We don't have the results back. NCAH is more common in Ashkenazi Jews, Italians, and Hispanics, among other ethnic groups. Treatment can involve steroids, but I don't know much about this as we haven't gotten there yet.

Having gone through three failed rounds of Accutane, a very potent drug, I would advise any female reaching the point of considering it to first see a gynecologist to have a hormonal panel done to check if hormones are the cause.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:01:12 pp: it is absolutely not true that good skin is "all about good hygiene" and you're insulting lots of people by saying that. My DD washed her face religiously but still needed accutane. It worked beautifully, by the way.

+1. All about good hygiene? Please. I could have scrubbed off layers of my skin and I still would have had acne.

+2. Clearly someone who has never had to deal with severe hormonal acne. Hygiene has very little to do with it. And OP, "cream of the crop genes"? Do you actually believe that? I would guess better nutrition and access to medical care, plus parents who have the time and money to help their children address skin issues.

Another kid who was obsessive about cleaning her face, to no avail. My acne is totally hormonal, and no amount of cleaning makes a difference.

I think the difference is that wealthier parents have the time, money, and inclination to pursue prescription treatments for acne. If you have less disposable income and paid leave, trips to the dermatologist to address a cosmetic issue are probably lower on your list of priorities.

Anonymous wrote:To the poster who said her daughter's acne was attributed to a higher level of testosterone--I never heard of this. an you offer more details/info?

My dermatologist said the same thing--it's why the pill can help reduce hormonal acne. Spironolactone, which is actually a blood pressure medication, also reduces testosterone levels and is used for women with hormonal acne. (Men are not prescribed spironolactone for acne because of the feminization side effects, and women shouldn't get pregnant while taking it because it can negatively affect male fetuses.) If you google spironolactone, you can fine more information.

Anonymous wrote:My brother became severely depressed from taking Accutane. Once he came off it, the depression lifted. He has had depression ever since (now in his 30s). I don't think the Accutane single handed caused his depression but it certainly precipitated it and increased the severity.

If you have a history of depression in your family I would be very cautious.

I recently went to the derm to discuss treatment for my (adult, hormonal) acne, and I read the book that comes with Accutane--depression and suicidal thoughts/attempts are listed as possible side effects. Since I have a history of depression, I decided against Accutane. Plus, if you're a girl, you have to be on two forms of BC and pledge not to get pregnant while on it. You have to have two clear pregnancy tests before you can get a prescription, and a monthly test to get a refill. It might work really well, but it's got some serious side effects and its not for everyone.

If you want to do something absolutely risk free and completely natural, try acupuncture. Many insurances actually cover it, but even if not, a treatment is between $50-$75 and it only needs 3-6 treatments for most teens to get rid of acne

Anonymous wrote:

Anonymous wrote:I choose not to put my son on anything like that. He will grow out of it. I don't think it is a big deal to him as he does not even commit to washing his face daily.

terrible idea…in the meantime he will suffer from self-conciousness and likely will end up with permanent scars. You don't have to use systemic drugs to get good resolution of acne, but at least take him to see a derm and get effective topical treatment.

Ha Ha. My son has acne on his forehead. He hardly suffers from self-consciousness issues. He thinks he is the most handsome kid on earth. Truth be told, he really is, he just has acne.

As an affluent parent of a son in private school with acne on his forehead, it has NEVER occurred to me to do anything, but make him wash his face more.