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Is there a skincare cure for acne in case of post-isotretinoin relapse?

Acne & Scars

Hello, I have had acne for years since I was in secondary school and have since been on isotretinoin on and off. Each time I stop taking isotretinoin the acne gradually comes back and then I go back to my doctor (GP) and the cycle goes on. I was wondering if it could be possible to cure acne without the medication? I am a female and am pretty concerned about possible side effects of isotretinoin in the long run, especially on pregnancy. My GP also did not take any blood tests.

I have done much research and would like to ask if a skin care routine as such could possibly work:

Gentle, low pH cleanser

BHAs, AHAs and vitamin C serums to prevent breakouts, increase skin turnover rate and lessen acne scaring (smooth but dark marks)

Light moisturizer

Please advise!

DOCTOR’S ANSWER (2)

 

Good on you for doing your own background reading.

I was wondering if it could be possible to cure acne without the medication?

Taken in isolation, the answer to your question is yes. There are different severities of acne, each responding to different sorts of treatments.

If it is acne of a severity level that warranted Accutane in the first place (usually reserved for moderate to severe, failed other types of treatment), then there’s a chance a topical regime may not be good enough.

Having said that, hard for me to comment without knowing how severe your acne really is.

Personally, I’d just bite the bullet like what you are intending to do, and try a different treatment since it appears that you’ve completed a few course of Accutane already.

I am a female and am pretty concerned about possible side effects of isotretinoin in the long run, especially on pregnancy. My GP also did not take any blood tests.

Yes you should absolutely NOT get pregnant while on Accutane, or even if you are intending to get pregnant. You MUST have some sort of reliable birth control/abstain from sex if you are taking Accutane (it is not known to cause infertility too as a side effect, if that’s what your question was driving at).

Studies report no long term side effects of Accutane. It’s a safe drug to take – with proper doctor monitoring, and appropriate blood tests conducted periodically.

I have done much research and would like to ask if a skin care routine as such could possibly work:

Gentle, low pH cleanser

BHAs, AHAs and vitamin C serums to prevent breakouts, increase skin turnover rate and lessen acne scaring (smooth but dark marks)

Light moisturizer

This sounds like a reasonable regime to me. I’d add in a retinoic cream at night to that mix as it’s absolutely the best single cream to use for preventing new acne/reducing PIH after acne.

You can use your AHAs and BHAs in the morning.

 

758 views 25 Jan 2018

Thank you for your question. In order to comprehend treatment of any disease, it is absolutely important to understand the underlying disease process first.

Acne is fundamentally caused by 4main processes:

1. Increased keratinization (or skin thickening) and hypercornification (where skin shedding is slowed). This results in built up of skin debris leading to obstruction of oil flow

2. Increased oil (sebum) production

3. Inflammation

4. Infection with P. Acnes bacteria

Therefore, effective treatment of acne often requires a combination of different modalities to combat the various pathways leading to acne.

For acne, doctors may turn to the use of various prescription medications, depending on the severity of the condition.

These include:

  1. Antibiotics which can be taken orally or applied onto acne areas
  2. Agents containing benzoyl peroxide which keratolytic and anti-microbial properties
  3. Topical retinoids such as adapelene which act by inhibiting keratinisation
  4. Oral tretinoin such as roaccutane which reduce the size of oil glands and reduce skin oil production

The underlying disease pathways of acne would mean that it might be difficult to treat acne with skincare alone, especially in cases of moderate to severe acne.

However, for milder cases of acne, a good skincare regimen would definitely help in controlling acne. This would include:

  1. Cleansing. It is not true that the more you cleanse, the better it is for oil production. Overzealous cleansing strips your skin of essential fatty acids, and may trigger your oil glands to produce more oil instead. Cleansing twice a day is reasonable.
  2. Exfoliants containing AHA/ BHA to remove plugs and increase skin shedding
  3. Agents that contain calming/ anti-inflammatory properties. I personally like Skinceuticals’ Phytocorrective serum.
  4. Lightweight moisturiser to prevent the skin from drying out. Aknicare cream and lotion are excellent products that you may want to consider adding to your skincare regime.

Hope this helps!

754 views 25 Jan 2018
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