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Suggest Treatment For Severe Unresolved Acne
My daughter is 18 and has been having severe acne. She went through the regular course of antibiotics and creams and then finally the doctor prescribed Isotroin 20mg. I did not want to put her through that course given its side effects. She is a fun-loving, active college going girl but gets bogged down with her face. I am planning to take her to another reputed dermatologist now. What do you suggest?
posted on
Sat, 9 Aug 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 30 Dec 2014
Answered on
Tue, 10 Feb 2015
Last reviewed on
Hi,
As you said your daughter suffers from acne vulgaris.You may be knowing that acne is a recurring skin disease and caused by multiple factors. Genetic influence may be also there.
Stress,anxiety,sun exposure,oily skin,oily food, dandruff,sleeplessness, hormonal imbalance,drugs like steroids,pills,iodine..etc factors might exacerbate the disease.
She should continue treatment for long time even after control of disease.
Antibiotics like minocycline or azithromycine in proper doses may be safe. And that can be continued for long time. If needed, isotretinoin in low dose of 5 mg may be given under observation of dermatologist.
Local application of clindamycine with adapalene gel at night with cleansing the face by antiseptic face wash like cetaphil may be considered.
Tell her to avoid anxiety related to acne and to keep patience for the good result.I hope you got my answer.
Dr. Ilyas Patel MD
As you said your daughter suffers from acne vulgaris.You may be knowing that acne is a recurring skin disease and caused by multiple factors. Genetic influence may be also there.
Stress,anxiety,sun exposure,oily skin,oily food, dandruff,sleeplessness, hormonal imbalance,drugs like steroids,pills,iodine..etc factors might exacerbate the disease.
She should continue treatment for long time even after control of disease.
Antibiotics like minocycline or azithromycine in proper doses may be safe. And that can be continued for long time. If needed, isotretinoin in low dose of 5 mg may be given under observation of dermatologist.
Local application of clindamycine with adapalene gel at night with cleansing the face by antiseptic face wash like cetaphil may be considered.
Tell her to avoid anxiety related to acne and to keep patience for the good result.I hope you got my answer.
Dr. Ilyas Patel MD
I find this answer helpful
Hello. Thank you for writing to us at healthcaremagic
The total dose of isotretinoin that is considered to be adequate/ curative in acne is 120-140 mg/kg.
If it was not given in adequate doses that might be one reason for the recurrence.
I want to assure you that Isotretinoin is an excellent antiacne product and the only product that offers any chance of cure in acne.
Many patients may require repeat courses of Isotretinoin even after adequate treatment, specially those who have had severe acne.
Side effects are mainly cutaneous i.e dryness of lips/ cheilitis and dryness of skin.
Apart from these, Isotretinoin is considered to be relatively safe, though, it should be monitored for side effects like raised blood lipids.
The only major precaution with Isotretinoin is that it should be avoided in females who are pregnant or intend to become pregnant as it can have serious side effects on fetus.
In past there have been a few isolated reports of suicides in patients on Isotretinoin but that is because these patients had severe acne and were already depressed.
Isotretinoin in fact improves the quality of life in acne patients.
In my view, she can be re-started on isotretinoin if her acne severity warrants it.
Regards
The total dose of isotretinoin that is considered to be adequate/ curative in acne is 120-140 mg/kg.
If it was not given in adequate doses that might be one reason for the recurrence.
I want to assure you that Isotretinoin is an excellent antiacne product and the only product that offers any chance of cure in acne.
Many patients may require repeat courses of Isotretinoin even after adequate treatment, specially those who have had severe acne.
Side effects are mainly cutaneous i.e dryness of lips/ cheilitis and dryness of skin.
Apart from these, Isotretinoin is considered to be relatively safe, though, it should be monitored for side effects like raised blood lipids.
The only major precaution with Isotretinoin is that it should be avoided in females who are pregnant or intend to become pregnant as it can have serious side effects on fetus.
In past there have been a few isolated reports of suicides in patients on Isotretinoin but that is because these patients had severe acne and were already depressed.
Isotretinoin in fact improves the quality of life in acne patients.
In my view, she can be re-started on isotretinoin if her acne severity warrants it.
Regards
I find this answer helpful
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