<p>S2, 17 yrs old this week, has had a moderate bout of acne for about a year now. It didn’t particularly bother him; its not like he’s a shy, retiring kid who spends all his time in his room playing WOW (well, the last part is sometimes true). He’s on a varsity team, is VP of the Student Council, holds a state-wide stuco position and has plenty of other activities. But his father (whom the acne does bother) finally persuaded him to see a derm and the dermatologist prescribed the following regimen:</p>
<p>Wash three times a day with Cetaphil
Duac CS (clindamycin/benzoyl peroxide) topically in the morning
Tazorac 0.1% cream (tazarotene) topically in the evening
and Solodyn 135 mg (minocycline) once per day</p>
<p>Anyone’s kid have experience with this combo of drugs? I’ve done a little research on the internet and have a general idea of the possible side effects and have also read that his skin will likely look worse (for about two weeks) before it gets better. The derm projected a 12 week total schedule for this treatment. Just wondering if anyone has any insight.</p>
<p>In my experience, no topical medications had any affect on my acne over a period of 15+ years.</p>
<p>If you don’t see the improvement you want, tell them you want your son to get accutane. Alot of dermatologists will make you trying everything else before giving you this medicine. I had acne for 15+ years before I could convince them to give me this (it can have negative affects on pregnant women, which obviously won’t be a concern for your S</p>
<p>I think it’s a good start. It is roughly the treatment that my daughter used though she didn’t stay on the Solodyne for long. Her acne was never cystic however.</p>
<p>I would encourage him to stick with it for a couple of months. If his acne is cystic or unresponsive there are other treatments - including accutane. Accutane comes with it’s own set of problems, though.</p>
<p>It is true that his skin could look “worse”. It may turn red a peel - that is actually good.
Have him be very careful out in the sun. These medications can make the skin more prone to burning and he could get a severe sun burn this time of year. Hopefully, the dermatologist covered this.</p>
<p>Both of my girls have (had) very bad case of acne, especially the older one. What your son’s doctor has prescribed is the first step treatment. My D2 is in the similar regiment now. She was using Practiv, but it really wasn’t working. She went to see the derm a few weeks ago, and it’s showing a great improvement on her face. My D1 started with face wash and cream, it became ineffective after a while. The doctor started to “cut” her acne in office, which work really well, then she also took some antibiotics for a while. Luckily her face started to clear up about 2 years ago. I am hoping D2 will only need this face wash stuff, and not have to go to the next step.</p>
<p>That regimen worked very well for DD. She no longer takes an oral antibiotic…and is now using Tazorac and Clindamycin only. DS didn’t have the same luck and did the Accutane route the summer between his junior and senior years of high school. He uses Clindamycin topical now and his skin is terrific.</p>
<p>Accutane was also discussed, as the next step. But wow…from reading about side effects, that’s a route I’d like to avoid. Just the cautions about depression and increased suicide are enough to make one think twice.</p>
<p>Hopefully this combination of treatments shows results. He’s only three days into it, so we have time. The doctor originally prescribed aczone in place of the duac. The aczone had a cost of $150 for a thirty day supply, so I asked for an alternative. Can’t believe the cost of these drugs; none covered by our insurance.</p>
<p>S did the antibiotics, the topicals…no use. He did a course of accutane, and his skin cleared up. Eventually it came back. He did another course of accutane, starting at a fairly low dose because his skin immediately became VERY dry and his lips were painful, despite using something on them. He stopped using it shortly after he went to college, before finishing the course, because he said he thought it affected his mood. His acne has come back again, but not as bad. But if he won’t take it, there’s nothing I can do to force him. :(</p>
<p>It will take a few weeks and likely will get worse before it gets better. Try the regimen perscribed first. If it’s mild/moderate acne, the treatment should help…but if on it for an extended period, it loses effectiveness.</p>
<p>I went on 3 cycles of Accutane (had cystic acne freshman year of high school)…after about 15 years being off it, my lips still chap and my scalp gets very dry.</p>
<p>Another big Accutane fan here. We went straight for the elephant gun. Two courses and now just regular, manageable, mild flare-ups. For her it was a wonder drug.</p>
<p>My S also had acne, but the prescription creams alone helped. I didn’t want him on a regular regimen of antibiotics. You might consider suggesting to your son that he try just the topical stuff first. Two good reasons for this: acne isn’t terminal, and it doesn’t seem to be bothering your son!</p>
<p>My S was on some prescriptions med and then decided to try Proactiv products. They worked better than the meds, so he switched full time to Proactiv.</p>
<p>Regarding your son’s perscribed regimen, I don’t think I would wash the face 3 times/day…unless he’s working out and sweating mid-day. 2 times a day max. 3 times can irritate the skin and make the situation worse.</p>
<p>If it is important for you to clear up the acne, Accutane, from all that I have heard and experienced, is the only real cure.</p>
<p>As you try all these other treatments that probably won’t work, scarring begins – the longer you wait for Accutane, the more scarring is likely to take place.</p>
<p>He’s got time…see how he responds to the initial perscription. If it flares up strongly after initial treatment, go for a round of Accutane. Monthly blood tests aren’t fun. Lips that feel like they’re going to fall off and severe nosebleeds aren’t fun either. But, I do agree that it does work.</p>
<p>UCBChem: Right now he has a Lifeguard class (as PE) at school and also daily lax practice. The 3X wash probably is a good idea at this point and the Cetaphil is mild enough. I’m guessing that hygiene (or lack of it…come on, he’s a 16 yr old) is at least part of the problem. And I do want to avoid the Accutane process if at all possible, so we will definitely see this regimen through.</p>
<p>^ Regarding lifeguarding, I was on the swimming and water polo team during high school. Accutane and strong sunlight don’t mix. I had to be careful while on Accutane especially during outdoor club swim practices during the summer.</p>
<p>The basic concept of acne treatment is that you MUST try the topical-stuff-plus-antibiotic route first. If that fails, then they can prescribe Accutane for you. There’s some reason that I don’t understand why they can’t just start with Accutane.</p>
<p>I think your son should go through with the treatment and see how things go. Then, if it doesn’t work, Accutane may be worth a try. Taking Accutane requires monthly visits to the doctor, prescriptions with elaborate restrictions on them (because if a woman is taking this drug and becomes pregnant, there’s a high risk that the drug will cause serious birth defects), and regular blood tests. It is MUCH easier to do this when you’re living at home than when you’re away at college. Fortunately, most people only take Accutane for a few months, but the benefits (if it works) may last much longer.</p>
<p>My son took Accutane for three or four months and had excellent results in terms of his acne – which was really bad. But he did experience a well-known Accutane side effect: severe chapped lips, which continued long after the medication period was over. He says it was worth it. However, his sister, who has also had some acne, would never be willing to take Accutane no matter how bad her acne got because she plays a wind instrument, and the lip problem would interfere with that. Different people have different priorities.</p>
<p>I am very concerned about the advice that somebody gave earlier in this thread about taking vitamin A.</p>
<p>Vitamin A, in high doses, is toxic. Accutane is indeed a form of vitamin A, but it’s not the same form that’s available in vitamin supplements. The form in the vitamin supplements is actually MORE toxic in high doses than Accutane is. Please do not suggest to your son that he should take vitamin A supplements in doses greater than 100% of the Daily Value.</p>
<p>Accutane works to shut down the oil producing glands. I have always had oily skin. Even as a mid-lifer, my skin is never dry. The dry lips were a pain, but easier to deal with in summer than winter (when lips are naturally drier)</p>