Acne

WHY DO YOU HAVE ACNE?

It's not your fault! Blame your parents- it's all in the genes! Some girls have a mild hormonal imbalance called "Polycystic Ovary Syndrome" that can make acne worse.

IS THERE SOMETHING 'NATURAL' YOU COULD TAKE TO FIX IT?

Unfortunately, there are many 'natural' / herbal diets and treatments such as lactose-free or gluten-free diets, blue-light laser, microdermabrasion etc which do not usually help acne.

HOW CAN ACNE BE TREATED?

Usually, treatment starts with: topical antiseptics/ antibiotics and topical retinoids. If this doesn't clear acne, we would generally suggest adding in a tablet antibiotic such as Akamin (Minocycline) or Doryx (Doxycycline) or Erythromycin. In girls, the newer contraceptive pills such as Diane, Brenda, Yaz, Estelle etc can also help but these are not advisable in very young girls.

WHAT IF YOU HAVE DONE ALL THIS ALREADY AND NOTHING WORKED?

If the above treatments don't clear acne, we often need to move on to the best acne treatment: ISOTRETINOIN (Oratane, Isotrex, Roaccutane).

ISOTRETINOIN

The benefits of Isotretinoin are:

· It is MUCH more effective than any other acne treatment.

· Once you finish a full course (usually 8-10 months) there is a 90-95% chance your acne will be cured forever.

· When you start Isotretinoin, you usually can stop all other lotions, potions, creams, antibiotics etc.

· It is a tried and tested treatment. It has been given to more than 14 million people, over the last 30 years.

THERE ARE 3 DERMATOLOGISTS AT LOFTUS ST DERMATOLOGY AND TOGETHER WE HAVE OVER 35 YEARS PRESCRIBING EXPERIENCE. WE HAVE PRESCRIBED ISOTRETINOIN TO OVER 7,500 PATIENTS.

WHAT IS ISOTRETINOIN?

Isotretinoin is not an antibiotic. It is related to vitamin A. It works by drying the facial oil glands, reducing the blockage of pores and getting rid of bacteria.

WHAT SIDE EFFECTS DO PEOPLE GET ON ISOTRETINOIN?

· When you start Isotretinoin, your acne will flare up a little. This usually happens 1-2 weeks after starting and settles after 1-2 weeks. The flare-up is usually mild.

· Everyone who takes Isotretinoin will get very dry lips. You will need to apply lip balm 5-10 times a day.

· Almost everyone who takes Isotretinoin will be more easily sunburned. You will need to wear sunscreen and a hat when outdoors.

· The skin becomes sensitive to friction- so girls should not wax.

· Healing may not be as good as normal so it is advisable not to get any new piercings or tattoos.

· Rarer side effects include dry itchy skin (eczema) and dry eyes.

· Very rare side effects include headaches, ingrown nails, muscle aches and pains.

WHAT IS THE MOST IMPORTANT SIDE EFFECT OF ISOTRETINOIN?

· The most serious side effect of the medication in females is that it causes abnormalities to a developing baby. One only needs to stop the medication 1 month prior to getting pregnant.

· Older girls may need to commence the contraceptive pill if there is any chance they could get pregnant.

· The medication does not affect hormone levels, ovaries, or future fertility.

· For males, there is no effect on sperm count, testosterone levels, or future fertility.

· All patients need to sign a consent form to show they understand they should not share the medication with anyone else- e.g. sisters, brothers, friends at school etc.

DOES ISOTRETINOIN CAUSE DEPRESSION?

· This issue is the MAIN reason why parents are worried about the medication. Sometimes, they are so worried that they refuse to let their children consider starting Isotretinoin.

· Unfortunately we know depression is a very common problem amongst all teenagers. This is a time in your life where you are often under stress from school, university exams, your parents and teachers telling you what to do, relationships, peer pressure etc.

. "Normal life" has a 5-10% per annum risk of depression. That means that in the next 12 months somewhere between 1 in 10 and 1 in 20 people will get depression requiring treatment.

· All good scientific studies looking into this issue have shown that Isotretinoin is NO MORE LIKELY TO CAUSE DEPRESSION THAN ANTIBIOTICS, AND NO MORE DEPRESSING THAN NORMAL LIFE.

· We also know from large scientific studies that teenagers with moderate-severe acne are more likely to suffer from depression BECAUSE OF THEIR ACNE.

· This makes sense as having acne can obviously affect your self-confidence, self-esteem, relationships etc.

· Fixing your acne will probably make you happier!

Dr Grant Masel MBBS FACD FACD Dermatologist

Dr Bernadette Ricciardo MBBS dipCH FACD Dermatologist

Dr Gary Moloney BEng (Hons)/ BComm MBBS FACD Dermatologist

LOFTUS STREET DERMATOLOGY