# Best medication/treatment for treatment restistant acne?



## Noca (Jun 24, 2005)

What is best medication/treatment for treatment resistant acne? Any ideas. List them all and tell me which you think is the best or has worked for you.


Heres a few I come up with, not sure how good they work tho as ive never tried them.

Accutane
Proactive
Murad
Neutrogena


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## korey (Apr 25, 2006)

I use clindamycin phosphate 1% gel (an antibiotic) on my face during the day and Retin A Micro 0.1% gel at night for my acne. Retin A Micro is topical Accutane, pretty much, so it works similarly. If you have _really_ bad acne, Accutane and/or tetracycline (another antibiotic) would probably be worth considering being as they're the go-to oral meds for severe/treatment-resistant acne, but Accutane comes with a series of unpleasant side effects (and I think your psych will have to write a note of your mental health standing to whichever dermatologist or doctor you might get an rx for Accutane from because Accutane has been linked to depression/suicide, or so I've read).

I've tried all sorts of prescription sulfur-based emollients plus antibiotic wipes/pledgets, not to mention just about every antibiotic there is for acne.

Oh, and I hope I don't have to mention that I exhausted all the over-the-counter acne treatments (Clearasil, Neutrogena, Clean and Clear, Biore.... AHHHHHHHHH :afr), even Proactiv. None of them worked. Some of them may have helped my face's oilyness or whatever for a short period of time, but nothing OTC works like the rx stuff I use now.


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## Noca (Jun 24, 2005)

Thanks korey :heart 

Is your current treatment working well? Do you get side effects with your topical accutane?


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## Speak Easy (Jun 27, 2006)

from personal experience:

RX: if you have mild/moderate acne and you're considering oral antibiotics i would recommend minocycline. if you want a cream i would say benzaclin. as for severe acne, retin-a, and all the other topical retinoids work well, as does accutane (or so most people claim, however i would be uneasy considering the risk for depression/suicidical thoughts). 

OTC: vitamins, vitamins, vitamins. Vitamin A will heal scars and fade red marks; vitamin C and E work in combination to promote healthy skin; zinc works as a natural antioxidant that fights off bacteria; omega-3 is an essential fatty acid; evening primrose oil relieves redness and is also an efa. Also, i have tried this in the past, but it is a hassle...vitamin b5. it works, but it is annoying to pop 10mg of b5 per day, when they come in .5mg (thats 20 pills a day of just b5). NOTE: be weary when using a multivitamin since it may contain iodine, which can easily cause inflammation of the skin and lead to even worst acne. 

MY REGIMEN: i have tried so many rx acne medications and only one thing has worked for me, and that is a combination of natural products with rx. for me it is as follows: wash face 2x daily with Basis Cleansing Bar for Sensitive Skin (Dove Bar for sensitive skin....both very good cleansers). Apply benzaclin at night to areas that are acne prone or use as on-the-spot if you want (depends how sensitive your skin is and how severe the acne is). then, make sure to take Vitamin A, E, C, Zinc, Evening Primrose Oil, and Omega-3 (if you want doses, etc...simply ask and i will post). this has worked wonders for me and this is coming from someone who has tried (i'll try to remember everything): proactiv, murad, acne.org regimen, minocycline, tazorac, differin, neutrogena on the spot, doxycycline, and probably many others. 

very long post, but acne ruined my life when i had it, and i am so happy to be clear so i had to share my success story in full detail.


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## Redefine (Jan 11, 2005)

If you have bad acne, then take accutane. I'm on it right now, its been 4 months and I'm almost completely free of lesions. However I still have all these annoying left over red marks, so it still looks bad. The only other things that helped for me was benzaclin and tazorac for a while, but not nearly as good as accutane. I don't see the point in wasting time using a million different remedies when accutane works every time. If the acne isn't that bad, then any kind of benzyol peroxide should work if you apply it twice a day.


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## Noca (Jun 24, 2005)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> from personal experience:
> 
> RX: if you have mild/moderate acne and you're considering oral antibiotics i would recommend minocycline. if you want a cream i would say benzaclin. as for severe acne, retin-a, and all the other topical retinoids work well, as does accutane (or so most people claim, however i would be uneasy considering the risk for depression/suicidical thoughts).
> 
> ...


your regimen sounds very promising, please post the dosages


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Noca said:


> your regimen sounds very promising, please post the dosages


Vitamin A = 10,000 IU (one at night)
E = Natural E 400 IU (one at night)
C = Ester-C 500mg (one at night) 
Zinc = 50mg (one at night)
Evening Primrose Oil = 1300mg (one in the morning, one at night)
Omega-3 = 400mg EPA + 200mg DHA (get the Premium Omega Mega Potency; it is more expensive, but very efficient. take one in the morning and one at night, or just one at night if you find it to be more economical)

All of these vitamins can be purchased at your local GNC.


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## korey (Apr 25, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Noca said:


> Thanks korey :heart
> 
> Is your current treatment working well? Do you get side effects with your topical accutane?


My current treatment is working well, although I've been wanting to bomb my entire body's skin with a cycle of Accutane ever since I read about it. Facial acne is one thing, but shoulder acne/"bacne" is another monster, one that can't be easily treated with topicals. Too bad Accutane would cost me between $300 and $500 a month (even as generic). Damn retinoids and their high cost.

Retinoids are derived from vitamin A (aka retinoic acid), which is probably why vitamin A has the skin treatment qualities that it does. In fact, there is some website that sells bottles of highly concentrated vitamin A for topical treatment of skin problems (mainly acne). When I say highly concentrated, I mean 25,000 IU per drop, which is pretty high for those who are familiar with the IU system in vitamin dosages/measurements.

I've tried supplements, but none of them ever worked that great for me. I remember that a vitamin A supplement I took made my facial skin less oily for a few days, but that was all. I take a sublingual vitamin B complex supplement occasionally because I've read that the B vitamins (particularly B12) can help metabolism => increase medication absorption, and give energy to boot :b.

I didn't have much of a life to ruin, but acne definitely tested that fact when I started breaking out badly back in high school. My mom finally let me see a dermatologist near the end of my junior year of high school, but I didn't come across RAM until the summer before my senior year.

As for side effects, think "sunburn." Retinoids like RAM, Tazorac, and Differin all work by increasing the rate at which your skin sheds its cells, which stops your pores from clogging, which really does stop zit formation at the source. But like I said, there is a sunburn that you get on your face for a couple of weeks once you first start treatment. Your skin peels and gets red and shiny for a while. It's a little painful, but that's because it's bringing all the crap at the base of your skin to the surface and then getting rid of it. It also speeds up healing (perk of being a vitamin A derivative), so when a zit does form, it can be gone within a day or so rather than a week to a month as mine used to last.

Since the point of retinoid treatment is to keep your pores unclogged, it's best to use cleansing and moisturizing products that specifically say "noncomedogenic" on the label. I used to use Purpose Gentle Daily Cleanser and its corresponding daily moisturizer/sunblock, but then I found this Eucerin Redness Relief skin calming system that actually worked a lot better (but is a lot more expensive). It's tinted light green, so it actually neutralizes the red color from acne/hyperpigmentation. I love that stuff. I need to go get some more from Walgreens.

Oh, and while antibiotics can be useful, they shouldn't be used long-term. I was on minocycline for almost a year and found that it was starting to kill the good bacteria in my digestive system, so I had to stop taking it. Doxycycline gave me terrible stomach cramps. I was never brave enough to try tetracycline being as it was the "strongest" of that type of antibiotic. I'm also apparently allergic to sulfa-based antibiotics because I tried Bactrim DS for my acne once, and it was during Hurricane Katrina. I had a rash all over the place (and I mean _all_ over the place) and no A/C or running water. That was an unpleasant experience...


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## Caedmon (Dec 14, 2003)

Accutane (isotretinoin), period.

I have been on them all. Wrt antibiotics, I've tried all the anti-acne types: -myacin, tetracycline, and bactrim/sulfa classes, as well as intranasal and high-potency antibiotics. I have tried all topical retinoids; the strongest topical retinoid is Tazorac. No topical is as effective as Accutane, however. I've tried anti-inflammatories, azelaic acid, so on and so forth... I can't even remember them all.

I was recently on Tazorac, Benzaclin, _and _high-dose minocycline (as well as intermittent cephalaxin Rx's). And fish oil and specific doses of vitamin E and B and C and zinc and other stuff. This was the most effective combination I'd been on, yet it was crap. I continued to have nodulocystic acne. I tried every OTC remedy as well... in fact, continue to take several OTC remedies (for other purposes), but for acne they do nothing.

I started Accutane therapy last Saturday. There was *literally* nothing left to try.


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## Speak Easy (Jun 27, 2006)

everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.


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## archaic (Jan 16, 2006)

*Re: re: Best medication/treatment for treatment restistant a*

I've been on Accutane twice and still have crummy skin. After the second round failed to show lasting improvements, I just stopped seeing my dermatologist because at that point I'd already been with her for 6 years.


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## Redefine (Jan 11, 2005)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.


I understand where you are coming from. For those with mild to moderate acne, many of the other treatments can work (though usually half-assed). But if you are looking for the BEST treatment for acne, accutane easily wins. Accutane is really looked upon as this super serious and dangerous drug. But, its side effects are not really any different from other acne medications. Basically what you get is dry skin, specifically dry lips. Other acne treatments like benzoyl peroxide and topical retinoids dry out and irritate your skin a lot worse than accutane will. Unless you plan on getting pregnant, accutane isn't any more dangerous than an ssri.

I tried going through a regimen of different cremes, washes, vitamins and moisturizers, and it was ok, but it was way too much of a hassle without any strong results. People like me who are resistant to these treatments, I recommend accutane to because it works for me and everyone else I know.


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## Speak Easy (Jun 27, 2006)

"best medication/treatment for _treatment resistant acne_"?

if this is the case, then accutane. but make sure your acne really is "treatment resistant" and that you haven't just tried a couple of otc's.

has anyone here actually tried accutane? what was your skin like before the tane? after? side effects?


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## lilly (Mar 22, 2006)

I took my daughter to the doctor yesterday and for acne she has put her on Duac . Firstly she must wash her face with fragrance-free cleanser such as Neutrogena or Cetaphil then put on this gel.
This stuff has Clindamycin/Benzoyl peroxide in it - it's on prescription here.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



lilly said:


> I took my daughter to the doctor yesterday and for acne she has put her on Duac . Firstly she must wash her face with fragrance-free cleanser such as Neutrogena or Cetaphil then put on this gel.
> This stuff has Clindamycin/Benzoyl peroxide in it - it's on prescription here.


Duac never worked that well for me as benzaclyn (same basic ingredients)


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## archaic (Jan 16, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



drive-to-the-hoop said:


> [quote="LDG 124":8e5b2]everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.


I understand where you are coming from. For those with mild to moderate acne, many of the other treatments can work (though usually half-assed). But if you are looking for the BEST treatment for acne, accutane easily wins. Accutane is really looked upon as this super serious and dangerous drug. But, its side effects are not really any different from other acne medications. Basically what you get is dry skin, specifically dry lips. Other acne treatments like benzoyl peroxide and topical retinoids dry out and irritate your skin a lot worse than accutane will. Unless you plan on getting pregnant, accutane isn't any more dangerous than an ssri. 
[/quote:8e5b2]

That's incorrect. They consider it serious because it _is_ serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are _much_ different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body).

Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



archaic said:


> That's incorrect. They consider it serious because it _is_ serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
> Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are _much_ different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body). Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.


 :agree

and although many people are skeptical about the suicide rate factor, it is not made up information. there are many stats proving this.


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## Zephyr (Nov 8, 2003)

Accutane is the heavy duty artillery in the acne-fighting arsenal. I was on it for five months and it basically cured the moderately severe acne I had, though the side effects were bad. Now that's all over but I'm left with those annoying red marks and icepick acne scars that don't seem to be getting any better. I don't know if there's any way to get rid of them.


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## Redefine (Jan 11, 2005)

*Re: re: Best medication/treatment for treatment restistant a*



archaic said:


> That's incorrect. They consider it serious because it _is_ serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
> Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are _much_ different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body).
> 
> Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.


Wow. Sounds like you had a really tough time. I've never known anyone to get brain swelling from accutane. Your right that I shouldn't have compared it to an ssri, which is a totally different drug. However, from what I've heard from my doctors, the side effects are mostly dose dependent. I've worked very slowly up from 10-40mg over a course of 4 months, and never had worse side-effects than dry lips or headaches. Although it worked much slower than starting at a high dose, its still as effective in the slighter-longer run. Perhaps moving slowly up the dosage chain is the key to minimizing side effects?

The worse side-effect I've ever heard from someone I knew was a raise in blood-cholesterol levels. Yes, this is why blood-tests are important. He cut down on his cholesterol intake and fatty foods, and he was fine. For most of those with severe acne, there really isn't any medication that is going to work better for you than accutane. I'm sorry if I'm biased, but this drug saved my life and many other lives I know.


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## Zephyr (Nov 8, 2003)

> The worse side-effect I've ever heard from someone I knew was a raise in blood-cholesterol levels. Yes, this is why blood-tests are important.


Yep. In fact, at the conclusion of my Accutane course the dermatologist wanted me to take another blood test because my cholesterol levels (the 'bad' cholesterol, or LDL) were too high. I never did end up doing that though. That was almost five years ago though so I assume I'm fine now :lol


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## Caedmon (Dec 14, 2003)

*Re: re: Best medication/treatment for treatment restistant a*



archaic said:


> We can't forget the mental effects that Accutane has, which are common and significant.


Which mental effects?

Some studies note reduced anxiety and depression in individuals who have taken Accutane. That's the only effect I'm aware of. There are case reports of increases in depression, or coincidental suicide, but there is no significant trend towards either depression or suicide within the overall population taking Accutane.


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## Zephyr (Nov 8, 2003)

*Re: re: Best medication/treatment for treatment restistant a*



Caedmon said:


> archaic said:
> 
> 
> > We can't forget the mental effects that Accutane has, which are common and significant.
> ...


I think the Accutane = suicide link was forged from one particular case. There was a guy several years ago who suicided while on Accutane and his parents tried to sue the manufacturer of the drug (Roche I think). Since then it seems that everyone has become paranoid about it, but as you pointed out studies have not shown a causative effect.


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## jakejohnson007 (Jul 27, 2006)

ACCUTANE cures acne, for almost everyone. There is nothing else, in my experience, that has come close to the effectiveness of this incredible medication. It works. Your skin will become pimple-free in 1/2 a year... and if you have bad acne, you're used to patience.



Accutane should not be taken for mild acne. Accutane is probably not necessary for moderate acne. For moderate/severe and worse, go Accutane and don't use a single topical ever again.

I was on the drug in 2004-5 and it took me from severe acne to perfect skin (except for mild scarring, not noticeable in most lighting). Acne came back about six months later, and I gave topicals another shot to no available. It kept getting worse. I went back on the drug in September 2006 and I haven't had a whitehead in 3 months. This time I am hoping I have taken enough of the drug for permanent remission.

Accutane + SA drugs have given me a great social life where there was none previously.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Zephyr said:


> I think the Accutane = suicide link was forged from one particular case. There was a guy several years ago who suicided while on Accutane and his parents tried to sue the manufacturer of the drug (Roche I think). Since then it seems that everyone has become paranoid about it, but as you pointed out studies have not shown a causative effect.


Since 1982, the U.S. Food and Drug Administration has documented 173 cases of suicide among Accutane patients. Since such cases are self-reported, there is a good chance that the numbers are even higher.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Caedmon said:


> Some studies note reduced anxiety and depression in individuals who have taken Accutane. That's the only effect I'm aware of.


not from simply taking accutane. the studies were based on the results that accutane would bring:

clear skin = decreased hyposensitivity = increased confidence = possible decrease in depression/anxiety


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## Speak Easy (Jun 27, 2006)

by the way, even Roche agrees that their miracle drug may have some extremely grave and negative side effects (below is a publicly released letter from roche).


Dear Doctor:

Please be advised of important changes to the prescribing information for Accutane (isotretinoin).

The information pertaining to Adverse Experience reports of depression, which has appeared in the ADVERSE REACTIONS section of the prescribing information, will now also appear in the WARNINGS section. The following revisions will be made:


the WARNINGS section will now begin with the following paragraph in bold type:
"Psychiatric disorders: Accutane may cause depression, psychosis and, rarely, suicidal ideation, suicide attempts and suicide. Discontinuation of Accutane therapy may be insufficient; further evaluation may be necessary. No mechanism of action has been established for these events."


the paragraph on depression in the ADVERSE REACTIONS section will become paragraph 5 of that section and will be revised as follows:
"In the post-marketing period, a number of patients treated with Accutane have reported depression, psychosis and, rarely, suicide ideation, suicide attempts and suicide. Of the patients reporting depression, some reported that the depression subsided with discontinuation of therapy and recurred with reinstitution of therapy." 

It is important to note that reports of these Adverse Experiences are uncommon but, because of their potential consequences, clinicians should be attentive to any new behavioral signs and symptoms.

Please consult the revised complete product information for Accutane, which is enclosed. If you have any questions about Accutane, we encourage you to call the the toll-free number for Roche Medical Services at 1-800-526-6367. Also, if you are aware of any serious Adverse Experiences potentially associated with the use of Accutane, please report such information to Roche at the above number or to the Food and Drug Administration MedWatch program at 1-800-FDA-1088.

Sincerely,

Russell H. Ellison, M.D.
Vice President
Medical Affairs


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## archaic (Jan 16, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Caedmon said:


> archaic said:
> 
> 
> > We can't forget the mental effects that Accutane has, which are common and significant.
> ...


From the FDA site on Accutane side effects:
"2. Mental problems and suicide. Some patients, while taking Accutane or soon after stopping Accutane, have become depressed or developed other serious mental problems. Symptoms of these problems include sad, "anxious" or empty mood, irritability, anger, loss of pleasure or interest in social or sports activities, sleeping too much or too little, changes in weight or appetite, school or work performance going down, or trouble concentrating. Some patients taking Accutane have had thoughts about hurting themselves or putting an end to their own lives (suicidal thoughts). Some people tried to end their own lives. And some people have ended their own lives. There were reports that some of these people did not appear depressed. No one knows if Accutane caused these behaviors or if they would have happened even if the person did not take Accutane."


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## Zephyr (Nov 8, 2003)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> Zephyr said:
> 
> 
> > I think the Accutane = suicide link was forged from one particular case. There was a guy several years ago who suicided while on Accutane and his parents tried to sue the manufacturer of the drug (Roche I think). Since then it seems that everyone has become paranoid about it, but as you pointed out studies have not shown a causative effect.
> ...


But so what? Thousands and thousands of people take Accutane every year. Suicide is actually a fairly common cause of death among young people. Certainly in the 25 or so years Accutane has been in use, there would've been people, many, many people, who kill themselves while on the drug. What I'd find weird is if there were no suicides reported.


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## jakejohnson007 (Jul 27, 2006)

Remember that the clientele of those on Accutane have severe acne and are predisposed to poor social lives, leading to depression and suicidal thoughts.

However, I have noticed that Accutane increases my irritability, depression, and suicidal thoughts MILDLY. Therefore, i think it should be co-perscribed with an antidepressant when there is possibility of depression or suicidal tendency existing in the patient before starting treatment.


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## NeverEverEnds (Mar 16, 2007)

korey said:


> I use clindamycin phosphate 1% gel (an antibiotic) on my face during the day and Retin A Micro 0.1% gel at night for my acne. Retin A Micro is topical Accutane, pretty much, so it works similarly. If you have _really_ bad acne, Accutane and/or tetracycline (another antibiotic) would probably be worth considering being as they're the go-to oral meds for severe/treatment-resistant acne, but Accutane comes with a series of unpleasant side effects (and I think your psych will have to write a note of your mental health standing to whichever dermatologist or doctor you might get an rx for Accutane from because Accutane has been linked to depression/suicide, or so I've read).
> 
> I've tried all sorts of prescription sulfur-based emollients plus antibiotic wipes/pledgets, not to mention just about every antibiotic there is for acne.
> 
> Oh, and I hope I don't have to mention that I exhausted all the over-the-counter acne treatments (Clearasil, Neutrogena, Clean and Clear, Biore.... AHHHHHHHHH :afr), even Proactiv. None of them worked. Some of them may have helped my face's oilyness or whatever for a short period of time, but nothing OTC works like the rx stuff I use now.


I'd look deeply into accutane. I have a condition called Exfoliative Cheilitis. It is a skin problem of the lips, there is no cure for it, the only thing that can cure it is time. I delevoped this from picking at my lips. Through searching the internet endless hours looking for a cure i have come across a select few who have developed Exfoliative Cheilitis because of accutane. I'm sure there are many who have used it without this side effect, but i can gurentee you that you dont want this problem.

I have had it for three years and although its not even as close to as bad as it used to be its still no picnic. Infact its the reason i shut myself up in my house for so long, which is the reason my SA has developed to the severity it is now. Please listen to me on this one. Google "curezone peeling lips" and try to find the forum page. You might want to read some of the posts, and click on the "image" link at the top middle which has some of the worst cases of E.C. I've ever seen. Once you got it, you got it. It never really goes away, but makes minor improvments every 6 months to a year. I have found ways to make my lips feel/look just about as normal as anyone elses, but its become it life leaching chore, and if you miss just a couple days they scum up pretty bad.


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## NeverEverEnds (Mar 16, 2007)

http://www.healthy.net/scr/article.asp?Id=3401

http://curezone.com/ig/f.asp?f=657

The first link is about a person who used accutane and developed Exfoliative Cheilitis.

The second link is pictures of the condition. Prepare yourself before clicking.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> Zephyr said:
> 
> 
> > I think the Accutane = suicide link was forged from one particular case. There was a guy several years ago who suicided while on Accutane and his parents tried to sue the manufacturer of the drug (Roche I think). Since then it seems that everyone has become paranoid about it, but as you pointed out studies have not shown a causative effect.
> ...





Zephyr said:


> But so what?


lets ask that question to the family members of the individual who never suffered from any kind of depression until he started taking accutane and then developed suicial ideation, and eventually killed himself. or the other man who became a paranoid schizophrenic after taking accutane.



Zephyr said:


> Thousands and thousands of people take Accutane every year.


accutane is not that commonly prescribed. some derms are hesitant to rx it simply because of the fact that it is a serious drug that should not be given to everyone.



Zephyr said:


> Suicide is actually a fairly common cause of death among young people.


define young people. in teenagers suicide is the 2nd most common cause of death. in anyone 18+ it is not even listed as top 10 causes. is someone who is 18 years old not young? i am a senior in high school and the majority of people in my grade are 18. i'll be in 18 in september. so, i suppose we should promote this figure and give adolescents drugs that will make them even more prone to killing themselves?

...however, internal FDA documents suggested this was less than 1 percent of the total number of suicides by people on Accutane, indicating the real number could range from _2,000 to as high as 20,000_...

...with 11,000 to 13,000 Accutane-related abortions and 900 to 1,100 Accutane-related birth defects...



Zephyr said:


> Certainly in the 25 or so years Accutane has been in use, there would've been people, many, many people, who kill themselves while on the drug. What I'd find weird is if there were no suicides reported.


Not reporting a suicide is actually quite common. suicide, in our society, is looked down upon as an act of immorality, sin, and ultimate disgrace. families would much rather cover up the death as an "accidental overdose" or "natural death", than having "suicide" forever written all over their loved-ones' names.


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## Caedmon (Dec 14, 2003)

jakejohnson007 said:


> Remember that the clientele of those on Accutane have severe acne and are predisposed to poor social lives, leading to depression and suicidal thoughts.


Also, isotretinoin is most commonly prescribed in adolescents and young adults - the age at which most psychological disorders first become clearly manifest.

I know of people committing suicide, or becoming depressed, who did _not _take Accutane. Maybe a lack of Accutane causes depression - after all, post hoc ergo propter hoc.


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## Zephyr (Nov 8, 2003)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> [quote="LDG 124":9ea4a]
> 
> 
> Zephyr said:
> ...





Zephyr said:


> But so what?


lets ask that question to the family members of the individual who never suffered from any kind of depression until he started taking accutane and then developed suicial ideation, and eventually killed himself. or the other man who became a paranoid schizophrenic after taking accutane.[/quote:9ea4a]
I'm not saying 'so what' that people committed suicide. I said 'so what?' in response to your assertion that X number of people suicided while on Accutane shows that there's a link between Accutane and suicide. As I said, over a large amount of time there'll be lots of people who kill themselves, no matter what they're on. That doesn't mean a causal link necessarily exists.



> Zephyr said:
> 
> 
> > Thousands and thousands of people take Accutane every year.
> ...


Think again. All the data I've seen indicates that *several hundred thousand* people a year are prescribed it.



> Zephyr said:
> 
> 
> > Suicide is actually a fairly common cause of death among young people.
> ...


Ages 15-24 sounds pretty good to me as defining 'young'. It's also the age at which many people take Accutane (especially males). And guess what? Suicide is the third leading cause of death among people in this age bracket in the US.



> i'll be in 18 in september. so, i suppose we should promote this figure *and give adolescents drugs that will make them even more prone to killing themselves?*


But here you're a priori just assuming that it does do that. It hasn't been shown.



> ...however, internal FDA documents suggested this was less than 1 percent of the total number of suicides by people on Accutane, indicating the real number could range from _2,000 to as high as 20,000_...


Source?



> ...with 11,000 to 13,000 Accutane-related abortions and 900 to 1,100 Accutane-related birth defects...


We're not talking about this. Accutane is a serious drug and can strain the liver and potentially cause birth defects, so that's why it's dispensation has to be monitored carefully, via blood tests and birth control for females. This doesn't necessarily have anything to do with depression and suicide rates.



> Zephyr said:
> 
> 
> > Certainly in the 25 or so years Accutane has been in use, there would've been people, many, many people, who kill themselves while on the drug. What I'd find weird is if there were no suicides reported.
> ...


So? All this would mean is that suicide, _in general_, might be underreported. Actually, since there has to be an examination by a coroner to determine an official cause of death, I'm not sure how easily a suicide could be officially 'hidden'. But even if it could be, it would just imply that suicides are more common than is reflected in the data...but more common everywhere, not just among those on Accutane. Remember, the vast, vast majority of suicides were not on the 'tane at all.

Here's the abstract of a study done recently on the psychologic effects of Accutane as compared with more conservative treatment:



> OBJECTIVE: To determine whether patients with moderate to severe acne who were treated with isotretinoin experienced significant increases in depressive symptoms over a 3- to 4-month period compared with patients who received conservative acne therapy. DESIGN: Cohort study. SETTING: Hospital-affiliated and community-based clinics in St Louis, Mo. PARTICIPANTS: One hundred thirty-two subjects aged 12 to 19 years with moderate to severe acne. MAIN OUTCOME MEASURES: Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D), a standardized self-reported instrument. Mean CES-D scores were compared between treatment groups, as were the prevalence and incidence of scores suggestive of clinically significant depression (CES-D score >16). RESULTS: A total of 101 subjects completed the study. At follow-up, CES-D scores (adjusted for baseline CES-D score and sex of patient) suggestive of clinically significant depression were no more prevalent in the isotretinoin group than in the conservative therapy group. Similarly, the incidence (new onset) of depressive symptoms suggestive of clinical significance also was not significantly different between the treatment groups. *CONCLUSIONS: The use of isotretinoin in the treatment of moderate-severe acne in adolescents did not increase symptoms of depression. On the contrary, treatment of acne either with conservative therapy or with isotretinoin was associated with a decrease in depressive symptoms.*
> 
> PMID: 15897376


There are other studies showing similar results. The bottom line is that the link between Accutane and depression/suicide is still very controversial (as well as tenuous). It should absolutely *not*, by any stretch, be considered 'proved', because it isn't. It's still being studied. The FDA has them put the warning on just to cover their own asses just in case there might be something to it, but the overblown hysteria about this issue is kind of unfortunate, because it might make patients (and some doctors) hesitant to prescribe the only med that could help some people.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Zephyr said:


> There are other studies showing similar results. The bottom line is that the link between Accutane and depression/suicide is still very controversial (as well as tenuous). It should absolutely *not*, by any stretch, be considered 'proved', because it isn't. It's still being studied. The FDA has them put the warning on just to cover their own asses just in case there might be something to it, but the overblown hysteria about this issue is kind of unfortunate, because it might make patients (and some doctors) hesitant to prescribe the only med that could help some people.


so you believe that every reported suicide on accutane (with no prior history of clinical depression or suicidal ideation) is complete coincidence?


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## Noca (Jun 24, 2005)

guys whatever you do just dont get this thread locked, stay on topic thanks


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## Zephyr (Nov 8, 2003)

*Re: re: Best medication/treatment for treatment restistant a*



LDG 124 said:


> Zephyr said:
> 
> 
> > There are other studies showing similar results. The bottom line is that the link between Accutane and depression/suicide is still very controversial (as well as tenuous). It should absolutely *not*, by any stretch, be considered 'proved', because it isn't. It's still being studied. The FDA has them put the warning on just to cover their own asses just in case there might be something to it, but the overblown hysteria about this issue is kind of unfortunate, because it might make patients (and some doctors) hesitant to prescribe the only med that could help some people.
> ...


It could be coincidence. One thing I've found is that people often underestimate the effect of coincidence in life. Like Caedmon alluded to, if one thing happens and then another thing happens, people like to think the first thing caused the second. I'm sure that, among those who commit suicide who've never been on Accutane (which of course would constitute the majority of suicides), there'd also be a certain percentage who seemed well adjusted with no suicidal tendencies beforehand. Everything seems fine, and then they off themselves. Maybe something changes quickly, or they were just good at hiding their depression from others. What I don't know, and I don't know if anyone knows, is if there is data comparing this percentage of 'surprise' suicides for those who suicided on Accutane with those who suicided without any Accutane involvement. That'd be interesting to see. Without having some idea of that, we can't draw any links whatsoever.

Of course, there also could be a very few people for whom Accutane does induce suicidal depression. They'd be the unfortunate ones, but it'd be tough if that ruined it for everyone.


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Zephyr said:


> It could be coincidence. One thing I've found is that people often underestimate the effect of coincidence in life. Like Caedmon alluded to, if one thing happens and then another thing happens, people like to think the first thing caused the second. I'm sure that, among those who commit suicide who've never been on Accutane (which of course would constitute the majority of suicides), there'd also be a certain percentage who seemed well adjusted with no suicidal tendencies beforehand. Everything seems fine, and then they off themselves. Maybe something changes quickly, or they were just good at hiding their depression from others. What I don't know, and I don't know if anyone knows, is if there is data comparing this percentage of 'surprise' suicides for those who suicided on Accutane with those who suicided without any Accutane involvement. That'd be interesting to see. Without having some idea of that, we can't draw any links whatsoever. Of course, there also could be a very few people for whom Accutane does induce suicidal depression. They'd be the unfortunate ones, but it'd be tough if that ruined it for everyone.


in fact, i have never generally condemned the use of tane; i simply believe it is not fit for everyone. accutane can bring amazing results, and most of the time it does and they last. then, there is that like 2-5% of unfortunate people to whom the acne comes back, but apart from that most people remain clear; i find that to be quite amazing. 
however, seeing that there definitely have been problems in the past between depression and accutane, i think that accutane use should be investigated more thoroughly until a link can be established between the two, or until someone can scientifically prove that there is no link whatsoever, and it is, indeed, nothing but an utter phenomenon.
until then, i think accutane should be reserved as a secret weapon; it should be the last resort to treating acne, unless someone has such severe acne that not even a strong topical retinoid such as tazorac would do anything, or they have already tried everything else. also, i think someone suggested rx'ing an ssri in combo with accutane. although, i would not go to that extent, i think that if someone is taking accutane they should be required to see a therapist a couple times throughout treatment, who should report back to the dermatologist, simply to make sure the patient is mentally stable.

btw, these are interesting sites:

http://www.fda.gov/cder/drug/infopage/a ... efault.htm

http://www.acne.org/messageboard/index.php?showforum=46 (browse for depression topics; there are several)


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## Caedmon (Dec 14, 2003)

*Re: re: Best medication/treatment for treatment restistant a*

http://www.pubmedcentral.nih.gov/articl ... id=1463189

I very much recommend reading the above article. 
This pretty much says it all:

"Consideration of the limited data available would suggest that the incidence of depression and suicide during isotretinoin therapy may be no greater than the background incidence. A causal relationship has not been demonstrated. The occurrence of an idiosyncratic reaction to isotretinoin producing major depression and suicidal ideation, as suggested by case studies, remains a possibility - although, if so, this would seem to be a relatively rare occurrence. Given the evidence suggesting that isotretinoin treatment may attenuate psychiatric associations of acne, and given the evidence that acne is often not a trivial complaint, withholding therapy because of concerns regarding depression or potential for suicide is not justified. Nevertheless, there are grounds for carefully monitoring patients undergoing treatment with isotretinoin for the emergence of depressive and suicidal ideation. Ideally, the patient's GP, as well as their dermatologist, should be involved in this surveillance."


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## Speak Easy (Jun 27, 2006)

*Re: re: Best medication/treatment for treatment restistant a*



Caedmon said:


> "Nevertheless, there are grounds for carefully monitoring patients undergoing treatment with isotretinoin for the emergence of depressive and suicidal ideation. Ideally, the patient's GP, as well as their dermatologist, should be involved in this surveillance."


 :agree. interesting article.

by the way, to the original poster, Noca, have you come up with a plan for skin treatment yet? have you started taking anything or made an appt with a derm?


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## Noca (Jun 24, 2005)

This isnt for me, its for someone else.


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## Shauna (Jul 29, 2006)

Proactive helps my skin alot. It took like 3 weeks before i started seeing results though. It has cleared up my acne and has made my skin tone brighter. I've heard it works differently for everybody..so i'm not sure how it will work for you. I like Proactive because it really works good for me...and plus its not expensive. 

If you're a chick.....geting facials and drinking alot of water helps out too. I also take Prenatal Vitamins every now and then. I started taking them to help my hair grow faster, but i quickly noticed that they were helping my skin look better as well.


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## apealbista (Jun 9, 2013)

*best acne treatment*

Acne is a pain or disorder to any part of system. It is very painful to bear for long time so its treatment is to be done properly. best acne spot treatment http://www.relogynow.com/ If any part of the body is seen with such acnes then visiting doctor is foremost duty of a person. Advice should be taken and regular medicines should be taken with exercises.


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## gilmourr (Nov 17, 2011)

Acne.org DO IT.

I use spectrum gel to wash my face in the morning (water alone is awful, it leaves a lot of grease = pimples)

night I use

spectrum gel again + benzyl peroxide 2.5% (5-10% is way too strong and burns your face. You can't find 2.5% except this website. You can try 5-10% OTC, but it sucks. I've tried it).

**Accutane is good, but it can make you have mood swings/want to kill yourself.

My face is 95% clear using this mixture. There's a lot of bull**** out there, but this is really...not one of them. Check out all the different people from day 1-90. There are so many posts.


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## A Sense of Purpose (May 8, 2011)

Noca said:


> What is best medication/treatment for treatment resistant acne? Any ideas. List them all and tell me which you think is the best or has worked for you.
> 
> Heres a few I come up with, not sure how good they work tho as ive never tried them.
> 
> ...


Roaccuatane is by far the most intense and potent drug listed here.
It has a lot of benefits, but under any circumstance, dont underestimate how severe and traumatic the effects can be. Even after stopping treatment.


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## CD700 (Apr 22, 2010)

A Sense of Purpose said:


> Roaccuatane is by far the most intense and potent drug listed here.
> It has a lot of benefits, but under any circumstance, dont underestimate how severe and traumatic the effects can be. Even after stopping treatment.


They put me on it when I was 14 and I am not really sure if it contributed to my mental problems but it was around the same time I got SA.
It was a horrible horrible drug


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## GotAnxiety (Oct 14, 2011)

Nurition cures acne stay away from deep fried and sugary foods that causes imflammation, i had a pizza face when i was a kid soon as i cleaned up my diet and went off the stimulants my face cleared up.


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## mike20821 (Jul 1, 2013)

I suffered from moderate acne through my teenage years. I was on a variety of different acne medications and had regular blood tests to make sure they weren't doing more harm than good. I ended up just growing out of my acne. I get the occasional breakout but that's about it.


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## istayhome (Apr 4, 2012)

stop masturbating, eat healthy and get plenty of exercise. Also don't work in fast-food joints.


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## basuraeuropea (Jul 25, 2012)

^ stop masturbating, lol.


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## istayhome (Apr 4, 2012)

It's an urban legend but it can't hurt. I swear though, when I was in junior high and high school if I masturbated I would get some acne and other than that I never had acne <- which I attribute to good clean living.


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## basuraeuropea (Jul 25, 2012)

haha.


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## lorimeyers (Jul 1, 2013)

I struggled with severe acne for 8 years and tried various creams and medications which never seemed to work, until I started using Papulex soap free cleansing gel. Since using it I almost never break out and only ever have 1-2 pimples. I'd recommend it to anyone!


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## Lacking Serotonin (Nov 18, 2012)

No one mentioned to two I've had success with. Ampicillan and Solodyn. Doctors and dermatoligists only give me ampicillan for a short time though which sucks.


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## Asaad (Oct 4, 2013)

I have severe cystic acne, and I have been on everything lol. I am finally on Accutane and it's the only thing that's worked for me. But remember I have severe CYSTIC acne with severe scarring. If all you have is just a few pimples do not go on Accutane. Get some benzyl peroxide gel or some sulfur cleansers; a cream that helped a little bit was Tazorac, but it was greasy :<. I was actually prescribed a good sulfur cleanser but I don't remember the name; hardly did sh*t for my acne but it made some of the redness ease up. You didn't specify how bad your acne was so idk. But if it's really bad and OTC meds aren't working for you I'd go to a dermo (obv).


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## PaulaM (Nov 24, 2013)

Hey there,

I agree with the others, Acne.org's treatment did great for me. Be aware though that it will dry your skin and that it will be itchy in the first few weeks. Make sure you use and abuse heir moisturiser to help counter that but even then it's going to scratch a bit.

Hope that helps,

Paula


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## jimmythekid (Apr 26, 2010)

The only things that worked for me were things my GP prescribed, so I'd suggest seeing one if you haven't already. 

Differin was good, it's a cream. Topical clindamycin worked, too. I'd ask for Differin, since it is not only good for acne, but also good for your skin generally (anti-ageing, sun-damage etc.).


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## TeasaAlbee (Mar 1, 2017)

*Dermalmd Acne Treatment Works Great!*

I swear I have lots of pimples on my face and neck back. I applied dermalmd acne serum in morning and night. It works fast and it only takes 4-5 days, and my pimples are gone! Also they do not cause any redness or peeling/flakey skin.( :kiss: - this for dermalmd. lol)


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## Kevin001 (Jan 2, 2015)

I feel like I've tried everything.....keep going I guess. I'll give some these a look.


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## emmaclark07 (May 1, 2017)

Noca said:


> What is best medication/treatment for treatment resistant acne? Any ideas. List them all and tell me which you think is the best or has worked for you.
> 
> Heres a few I come up with, not sure how good they work tho as ive never tried them.
> 
> ...


Acne can be cured by using natural processes. But, many doctors suggest to use acne products. I use one of them. I use Cetaphil products for 2-3 months and I get better result. So, now i'm happy with cetaphil products for acne.If you want to know more about cetaphil products visit my blog: cerave vs cetaphil


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## Apexio (Jan 20, 2017)

I had great sucess with a treatment of pantothenic acid + l-carinitine. There is some research to back this up. It is basically a roaccutan-light, a similar mechanism without the horrible side effects. There is also a product on amazon with a pretty good rating. You can find some infos here.


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## Captainmycaptain (Sep 23, 2012)

Low dose Accutane.


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## littleghost (Oct 29, 2016)

I use a retinol from the dermatologist, tretinoin, but I've just seen they now have an over the counter retinol available called Differin. I may try that to see if I can save money. Even with the insurance, the tretinoin is about $100 a tube.


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## SplendidBob (May 28, 2014)

littleghost said:


> I use a retinol from the dermatologist, tretinoin, but I've just seen they now have an over the counter retinol available called Differin. I may try that to see if I can save money. Even with the insurance, the tretinoin is about $100 a tube.


Do you use it for acne or anti ageing? I use tretinoin for acne scarring, Differin is interesting esp as it seems buyable over the counter (though afaik there isn't the evidence there yet for its effects re wrinkle reduction?).


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## littleghost (Oct 29, 2016)

splendidbob said:


> Do you use it for acne or anti ageing? I use tretinoin for acne scarring, Differin is interesting esp as it seems buyable over the counter (though afaik there isn't the evidence there yet for its effects re wrinkle reduction?).


It's not acne like teens get, it's just bumps, not pustules.


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## SplendidBob (May 28, 2014)

littleghost said:


> It's not acne like teens get, it's just bumps, not pustules.


Ah ok 

Just wondering how it is for anti ageing really. That more or less equates to effectiveness for acne scars (basically softening them, improving general skin quality due to cell turnover and so forth). It's presumably going to be effective (being a retinoid) but doesn't have the evidence the older retinoids have.


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## adria (Jun 1, 2017)

One of the lovely product I got after a long time. It is really a nice product for acne & pimples. Especially for oily skin.it subsides pimples n acne to quite an extent. I feel it brightens the skin also..I use it along with the dermalmd treatment and pimple spot correcting cream...it has helped in lightening the spots visibly after only one week of application..


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