Accutane alternative
May 21, 2012 6:40 AM   Subscribe

What's the next best option after Accutane? I have Crohn's disease so that's not an option, but doxycycline and topical treatments haven't worked. Are there any other options?

I've had acne on my face for many years and haven't been able to keep it under control. Crohn's Disease prevents me from going on Accutane. I've taken doxyclcine and used all types of topical treatments. Are there any other options out there? Surgeries, other treatments, etc.? Money isn't an issue here, so let me know anything. Thanks.
posted by anonymous to Health & Fitness (12 answers total) 3 users marked this as a favorite
I assume you're working with a dermatologist, not just a GP? Every face is different, and what works for one person may not work for another, but doxycylcline, harsh sulfer-based topical treatments and many other prescriptions failed for me. A combination of prescription Differin gel and hormones (i.e. birth control) have worked wonders. Folks who've known me since before I found this magic formula often comment on how much better my skin looks.

Significantly cutting back on the harsh over-the-counter products I used to use have also helped. I no longer use astringents, soaps, or anything with benzoyl peroxide on my face, instead only washing with a very mild cleanser (Cetaphil) and occasionally using lotion of my face is super dry. Harsh over-the-counter products did not seem to prevent acne -- just to declare war on it and turn it angry red and super visible when it appeared. With Differin and hormones, I get less acne. With a gentler home routine, the acne that I do get is less visible and then fades away without getting angry red.
posted by croutonsupafreak at 6:51 AM on May 21, 2012 [1 favorite]

My dermatologist put me on Spironolactone, which regulates the androgen hormone, and I am thrilled with the results. It's not for everyone but it's worth looking into.
posted by jschu at 7:10 AM on May 21, 2012 [4 favorites]

My doctor also recc'ed Spironolactone, but what's really helped me is a change in diet, drinking more water, and using the Arcona line of facial products. I don't know if you're male or female, but Arcona has products for both and they are seriously incredible. Unlike ProActiv, which apparently just pushes acne down into your dermis for another day, Arcona actively dispels acne and completely regenerates your skin. I get compliments from random strangers all the time now, and when I do get acne, it's because I've overindulged in sugar.

If you wear makeup, here's the regime that I've worked out to help my skin stay nice now.
posted by These Birds of a Feather at 7:36 AM on May 21, 2012

You might look into laser or light treatments.

Have you tried the heat treatment devices? Like Zeno? You can buy it at Target.

Also, have you tried all the topical treatments? Topical antibiotics (eg, Clindamycin) to old-school Retin A? There are a ton of directions you can go, but you have to find a derm who knows about treating acne (some just don't seem to care about it; I suspect they do a lot of Botox and fillers) and is willing to try new things every 8 weeks. It's a slog, I know.

Oh, and the one thing that's improved my skin the most -- aside from Accutane -- is frequently changing my pillowcase. Twice a week is best; once a week is good. At least it's cheap.
posted by purpleclover at 8:44 AM on May 21, 2012

I realize that everyone's experiences are different, ymmv and all that, but if you're willing to try an alternative medicine approach...I have had incredible success with vitamin B5. I admit that I was very skeptical at first, but after 35 years of acne and having taken so very many prescription treatments and OTC treatments (and getting only moderate, if any, relief) I was willing to give it a shot. For me, 500mg/day has cleared up the acne everywhere on my body. I have also been able to get rid of the little facial oil blotting papers that I used to by the carton. Maybe something to ask your dermatologist about?
posted by skye.dancer at 8:54 AM on May 21, 2012

There are a few, newer topical retinoids that have worked beautifully for me and are worth a try: One is Ziana (a combination of .025% Retin-A and an antibiotic) and Tazorac ... basically described as Accutane in topical form because it's a strong retinoid.

I'm currently using the Tazorac .05% cream. It's drying so be sure to use moisturizing products with it but it's keeping the skin clear and as a bonus, battles the wrinkles. Sunscreen is a must with both products. I like the Olay sensitive line.
posted by nubianinthedesert at 9:50 AM on May 21, 2012

I've struggled with cystic acne a long time, and I feel like I've finally partially conquered it. A few months ago, my dermatologist put me on Differin (a retinoid). That, paired with a few months of being on an antibiotic helped control my acne. I think a lot of getting rid of acne has to do with finding the right skin care routine. The dermatologist prescribed creams reduced my acne, but didn't get rid of it, and fiddling with my skin care routine helped get me to a point where I only get the occasional pimple every few weeks.

I have oily skin, and the thing that helped most with my skin care routine was getting the Clarisonic Mia, and using it with a BHA face wash and a chemical exfoliant (Dermalogica's Microfoliant) daily. This routine might not work for you, but if you're interested in trying out new products, I've found Makeupalley to be a great resource. You can go through products based on reviews given by people with your skin type, and see what suits people with your skin type.
posted by MFZ at 10:14 AM on May 21, 2012

A few suggestions, because everyone is different.

Vitamin B5, like someone else mentioned, helped me (I think). Not sure if it was just a placebo effect though.

Have you tried the "natural" route? I use this stuff with a lot of success having tried tons of over-the-counter stuff, tetracycline, etc. Never did Accutane because I was scared to do so.

I'm also on primadophilus optima. My cousin had Crohn's, and I have always had IBS issues. I don't have Crohn's though. And I'm not sure if this stuff affects my acne, but I know the "natural" combos have really worked out well for my issues.

And, it's worth mentioning—my cousin went gluten-free, and it cleared up a lot of his acne.

Hope you find something.
posted by uncannyslacks at 11:12 AM on May 21, 2012

After I thought I had exhausted all of the topical treatments (and developed an extremely painful sensitivity to benzoyl peroxide) I tried Sulfacetamide which has had a hugely positive effect on my skin with no discernible side effects.
posted by telegraph at 1:31 PM on May 21, 2012

I wanted to recommend the benzoyl peroxide regimen by Dan Kern, who is seriously my skin guru. I would follow him off a cliff. The catch is that his 3-step regimen (which does NOT require you to buy his products--he gives drugstore alternatives) must be followed perfectly to a T, even down to the technique you use to apply it. I find that if I slack off at ALL, I break out again and it might take weeks or months to get back on track.

It's a fairly time-consuming process: three steps with 5-15 mins between each, twice a day 12 hours apart, plus two other optional steps, and you have to work up to the full dose of benzoyl peroxide over the course of a few weeks. But for some people, including me (I am also someone who really needs Accutane but can't take it), it's worth it because it works, when NOTHING else has. So you should definitely check out the website, at least. It has a lot of good information.

I would also recommend the book The Clear Skin Diet. Truly life-changing for me. It got me taking daily turmeric, zinc, vitamin C, evening primrose oil, and omega-3 supplements, which you should also look into, in addition to a vegan, gluten-free diet.
posted by désoeuvrée at 5:28 PM on May 21, 2012 [1 favorite]

I know you said topical treatments haven't worked, but in case you didn't try this particular one, I have found Duac extremely effective. It's a combination of benzoyl peroxide and clindamycin, an antibiotic.

I had previously tried just BP using the regime, but I found the regime far too time consuming (see above) and I didn't have great results (probably because I wasn't doing it perfectly).
posted by reshet at 10:55 PM on May 21, 2012

Seconding the regimen at After months of following it, my skin changed and now I don't have to use it anymore (except for the occasional pimple).
posted by getawaysticks at 5:33 AM on May 24, 2012

« Older Why Offshore Banking?   |   Getting a master's degree when disillusioned with... Newer »
This thread is closed to new comments.