Discussion in 'The Watercooler' started by exhausted, Mar 3, 2012.

  1. exhausted

    exhausted Active Member

    So difficult child went to new dermatologist and she said we had to do something systemic. We have tried so much otherwise- from natural to antibiotics, birth control and so on. She even explained that difficult children IBS could be part of the acne. It has gotten so bad-big cysts on back and face is a constant battle.

    She recommended a 6 month course of accutane. She said she would go on it and even put her own kids on it. It scares me. difficult child had to sign a pledge-has to use 2 forms of birth control and promised to stay on her birth control and to use abstonance. She has a history of sexually acting out, so I am scared. Pretty sure she hasn't acted out in about 4 months. This drug causes severe birth defects before you even know your pregnant. She will have pregnancy tests every 30 days and blood tests for liver function. It has also in some cases caused psychosis and severe depression. difficult child has a history of depression. I told the dermatologist this. She told me that she though difficult child would do well and that it would help her self-esteem and in the end depression. She told me to read it all and scare myself. There is a 30 day waiting period before she can start.

    What do any of you know? Any experiences? difficult child Is determined.
  2. mom_to_3

    mom_to_3 Active Member

    I work for a dermatologist. She will not use accutane. Too many risks for everyone basically. There are many different medications or combinations of medications that can help your child. While acne is no fun, it is not the end of the world to have. That is the voice of experience speaking here. If I had to weigh which option had more harmful effects and more potential harmful and devastating effects, I know what I would chose. in my opinion, I would also be very careful about a difficult child signing and abiding by a contract requiring them to use two contraceptives or abstinence. Either alternative seems like it may be difficult for a teen to follow. Food for thought anyway.
  3. Signorina

    Signorina Guest

    My son did a course of accutane (5 months) his freshman year in HS. It was a godsend & his skin has been virtually perfect since. He too had cystic acne & the accutane prevented disfiguring lifelong scars. He exhausted all other options - spent almost 2 years being treated with rx topicals (retin A, Differin, Epiduo, you name it) and various antibiotics (monocycline, doxy etc) with no relief. We tried ProActive, peels, etc. His whole demeanor changed when the acne was gone. He stopped hiding his face, and stopped looking down all the time, he finally stopped wearing hats all the time -pulled low to cover his zits (whuch aggravated his acne) and his locker room/swimming anxiety was gone(due to body acne).

    It is a huge committment -we went for blood tests every 4 weeks and then a separate derm appointment. It's a bigger committment for females as far as needing to commit to birth sons bloodwork was always ok. I had the bloodwork done at his regular doctors office & sent to his derm so that both the derm & reg dr monitored it.

    Has your daughter tried birth control pills on their own? A few friends with- daughters started with bcp for 3-4 months reasoning that their daus would need to be on bcp AND accutane, so they may as well start w bcp. Many of the girls saw noticeable improvement w bcp alone.

    Just my own $.02
  4. bby31288

    bby31288 Active Member

    A friends daughter did a course and it too was a godsend. Her skin is beautiful now. Clear and smooth! She did the blood work birth control etc
  5. exhausted

    exhausted Active Member

    Thanks for your replies. difficult child has done birth control for 18 months (we would have done it anyway for other reasons). She has had retin-A, doxy, duac, Azelec, a sulfa medication and every kind of OTC and even a few natural treatments. She had yeast infections almost constantly on both antibiotics we tried. It has progressed to cycts. Any improvements were very short lived.We even did microdermabrasion. I know she is desperate. She had such beautiful skin and noone else on either side has had this. We had hormones tested because she has so many symptoms of Polycyctic Ovarian Disease-nothing showed up.

    Tough decision. I think I'm going to call her pediatrician and chat with her as well.
  6. HaoZi

    HaoZi Guest

    I hope she can stick with the program and it works for her, doesn't sound like many options are left.
  7. susiestar

    susiestar Roll With It

    It is difficult to make such a choice. we DO judge people on appearances and bad acne can cause problems for years. The people who say it is "just" acne haven't lived wth really bad acne. We had a male neighborhood teen with super-bad cystic acne when I was a toddler and accutane made a HUGE difference in his life. I have memories of him pre and post accutane, and in the pre accutane memories he was NEVER smiling or happy seeming. I was about 11 when I got my first zits and I freaked thinking I was going to end up looking like him.

    Most people don't know that the type of acne that is treated with accutane is also incredibly PAINFUL. Cystic acne is NOT like normal black or whiteheads, it goes WAY deeper and can cause very real chronic pain. I know people who did not want to kiss a boyfriend or girlfriend at times because their acne was so bad that the pain over-rode teenage hormones at times.

    If you can set into place a way to have her check for preg more often, like maybe buying a test and doing it each week, that might be helpful for your and her peace of mind, but PLEASE, don't underestimate the impact that this severe acne has on every facet of her life.

    in my opinion if difficult child is willing to be compliant AND if the doctor will stop the rx ASAP if difficult child is showing signs of non-compliance, then I would totally support it. Just please have her doctor tell her how many months after accutane is ended that she should not get pregnant. If memory is right, the dermatologists in our area want you to be free of the medication for 12-24 mos before even thinking about becoming pregnant.

    I really hope this helps. she has had so many self esteem problems, and this is a real medical problem - NOT a cosmetic one the way those not blessed iwth it may think it is. I do realize that some docs won't rx it, but many are starting to go back to it after they have started to see their own kids struggling with acne that they could not help. At least that is what I have been told about the medication.

    Your difficult child is close to being a legal adult, and given her past history, there are a lot of risks. Do YOU think she is capable of sticking to this plan? Would the birth control implant be an optoon she would consider? Or an IUD? Both are far safer now than they were in years past, and these could help take some of the risk to the "not immediate" basket. Still an important thng to consider, but she would have to see a doctor to stop using the bc method, which would give some time for her to think.

    I don't know if this would help or not, but one of J's friend's mom made her daughter go and look at pics and descriptions of babies born with damage from accutane. Seeing pictures of those poor babies made a big impact and the visual stuck with her even when she was out with friends. It owuldn't work for all kids, and might or might not be a way to get difficult child to really see how important sticking to the rules is, but I wanted to throw it out there for you to think about.
  8. exhausted

    exhausted Active Member

    Thanks so much. She is a pretty girl and so smart but this acne and her weight are issues that I think are key. Self-esteem is everything, it is the compass for our futures.

    I do think she will stay on it only because she wants it so bad and I would stay on her as I have to about BC and other medications. She hasn't run for a long time and so I don't have to worry about that. It's the health risks and the pregnancy. While I dont think she has been active sexually in some time, I think if there was a chance, she may be. It is a miracle she hasn't gotten pregnant before now-which to me is an even bigger indication of polycyctic ovarian disease. When she runs off she doesn't take her pills and she has sex (I'm sure). She believes she can't have kids (this tells me she is lucky to not be pregnant before now) .

    I think we will go to the gyn and check out some other options for BC as well. Also have the other tests that can diagnose PCOD-apparently blood work doesn't often catch it. This dermatologist was the 4th professional to tell me they think she has it.
  9. busywend

    busywend Well-Known Member Staff Member

    Here is my take. I took accutane when I was 16 or 17. I was not aware of the pregnancy issues at the time. Maybe my mom just thought it was not of concern for me since I was a easy child. I did have a stillborn, but have no idea if it was related to this or not - it was about 4 years later.

    I will say if you have not tried Proactiv do so first. I swear by the stuff. While I did finish the accutane (and there is currently some sort of lawsuit I keep getting invited to be a part of, not sure what for) I still get acne. The best my skin ever looked was when I was using Proactiv. It worked for my nephew perfectly. Still has great skin. I would love to have had my difficult child on it, but she was not consistent in washing her face so it would not work if she was not using it. I stopped using the Proactiv due to cost (I was a single mother and other things had to take priority). But, I am thinking of starting it up again. My face literally glowed when using it.
  10. Signorina

    Signorina Guest

    Exhausted-if you think she has PCOS- she needs to see a Reproductive Endocrinologist-not a GYN. They will also test her thyroid function. Unfortunately, PCOS can often be a diagnosis in absence of other diagnoses- based on symptoms as I believe there are no definitive tests AFAIK. The good news is that it can be managed w bcps and some types work better than others. Hth
  11. exhausted

    exhausted Active Member

    Thank you Signora. The pediatrician sent us to get blood work and said it should show up with hormonal abnormalities or with a bad A1C. No such luck. She did say that they could do an ultra sound and recommended the GYN. We saw an endocrinologist with my son-I have never heard of a reproductive endo. I'll see what I can find. She has almost no thyroid action-she has taken thyroid medications since she was barely 13. They found this on her first psychiatric hospital. admit. Thought it was the root problem. But her weight gain, worsening acne, fatigue, depression, heavy and irregular periods (until BCP)-sounds like I better go there first. Her thyroid is tested every 3 months and has leveled out over the last year-took about 2 years to get that right.

    P.S. I just found one that is on our plan and is a female (difficult child request). I will call tomorrow-thank you, thank you (I would never have known)
    Last edited: Mar 4, 2012
  12. susiestar

    susiestar Roll With It

    I think that PCOS is probably a reasonable thing to be suspicious of. I had HORRIBLE ovaries and didn't even know it until my hysterectomy. I also had thyroid problems, but from autoimmune issues. The pill didn't help me, mostly because it gave just enough hormones to get me pregnant. 3 mos on the pill and I got pregnant - twice. Both times using 2 other forms of bc with the pill! (This is why my husband walked around like he was 10ft tall and bulletproof for a month after we found out I was preg - esp since i was told at age 19 or so that I could not get pregnant ever. He really he thought he was superman, lol.)

    They did all the tests for PCOS, even did a non-pregnant glucose tolerance test and got NO abnormal results. But when the gyn went in to take them out, he was totally shocked at how bad they were. He expected some degree of PCOS, but not nearly what I had. He told us that no one in the hospital had ever seen ovaries that bad, esp in a woman who had no trouble ever getting pregnant.

    Why does she think she cannot get pregnant? If it is because PCOS, lots of women have that and have lots of kids. My two high school bffs each had 3-4 kids and we ALL had PCOS and problems long before we had kids. So I hoep the gyn can get through and change that thought pattern. The docs gave me six reasons why I could not get preg and also could nto carry a child to term. God laughed and I have 3 kids all full term. Well, thank you could have been called a premie but only by around 30 hours.

    She really NEEDS to be truly committed to birth control no matter what or she should NOT have the accutane.

    proactive can be very helpful. Walmart sells a version taht is very close but I don't know the name. It has the same 3 steps and Jess did a science project using proactive on one side of her face and the walmart version on the ohter and saw no difference. Obviously different people get different results, but it is what her results were.

    A regular gyn should be able to help get the initial diagnosis of PCOS. Reproductive endocrinologists can be hard to find outside of fertility centers, and around here the gyn treats the problem of PCOS unless the case is very complex. You should contact her regular endocrinologist and see if they will help with the PCOS issues with her gyn.
  13. Lothlorien

    Lothlorien Active Member Staff Member

    I have not read the other responses. I will tell you that my neice was on Accutane for a while and she had a drastic personality change from it. She is not the same kid. She is now an adult with a very twisted sense of reality. Her mother will swear the change started after the Accutane. Years later, supposedly, there were reports of similar issues. Personally, if it were my kid, I would steer clear of that stuff.
  14. SearchingForRainbows

    SearchingForRainbows Active Member

    A dermatologist recommended Accutane for difficult child 1. At the time, we needed to remind difficult child 1 to brush his teeth, trim his nails, etc... His hygiene was beyond horrible. He was non-compliant as far as treating his acne with antibiotics, topical preparations, etc. He was extremely fearful of needles and it would have been almost impossible, if not impossible, to get him to agree to regular blood tests. We were very fearful of the psychiatric issues associated with the drug. We decided against it for all of these reasons. SFR