Accutane and BCP's . . .

  1. My daughter, aged 17, is appalled at her "mild" acne. She has been on two antibiotics and both worked well for awhile. Two days ago at a sports physical she talked to the NP about her "mild" acne (even the NP agrees with me that it is mild). Anyway, the NP suggested Accutane.

    I've been trying to avoid this for many reasons. One, she doesn't have the type of acne usually reserved for this last resort med. Of course I remember being a teen and remember the humiliation of pimples and completely understand her feelings.

    BUT . . . you have to sign a contract promising to use two types of birth control. Pills and a barrier method. She is not sexually active.

    Also, I'm not crazy about her putting chemicals into her body. I don't like the effects of BCP's . . . . long term.

    I don't like the idea of being on BCP's when you aren't even sexually active. She has NO problems with her period that need to be corrected by BCP's.

    The only reason for taking them is the risk of birth defects while using Accutane. But that assumes you are sexually active.

    So, I'm wondering about the ethics of just not taking the pills. Supposedly the Accutane works in about 4-6 months.

    What do you think?

    steph
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  2. 25 Comments

  3. by   muffie
    isn't accutane for the deep cystic acne ?

    wish i was on the pill as a teen

    periods are just so much better [have a happy period !]

    she's 17 ?

    she can/will do what she wants in a matter of months

    but this conversation is from someone who had her daughter sterilized surgically

    good luck with [your] decisions
  4. by   Cherish
    I took accutane and I had cystic acne. It was A LOT of big swollen hurtful acne pimples. I had a lot of it and tried MANY things. I think you should take her to a dermatologist. Accutane is some heavy stuff and only used as a last resort after trying other options. You get blood-tested every month because if you get pregnant while on it, it is harmful to the baby.

    I did it when I was 16-17 for 6 months. It worked but I would only have done it if other options like Retin-A, Tetracylcine, other acne creams, and pills havent worked. I even had needle shots into my Acne that didn't work that is when my Dermatologist suggested Accutane because he had seen me for 9 mths and nothing else was working.

    Talk to a dermatologist and try other things. It should be the last resort and is NOT for mild acne.

    It also has a potential for raising blood pressure and I was anemic while taking it.
  5. by   Jolie
    Steph,

    I would strongly urge you to see a dermatologist to seek out other options for treatment of your daughter's mild acne. Even if there were no birth control issues involved, Accutane is a nasty drug that should be reserved for the most severe, unresponsive cases of acne. The side effects can include severe dry mouth, to the point of ulceration, among others. I would be hesitant to give it a try, even if my child HAD a severe case of acne.

    Just off the top of my head, I can think of 2 milder, topical medications, Differin, and Retin-A. And what about teaching proper skin care. So much of what teens do to their skin actually aggravates acne, such as over-zealous cleansing and toning that strips their skin of all oils, making breakouts worse.

    If birth control must be used (and it must be with Accutane), why not try Ortho-Tri-Cyclen or Demulen first? These are 2 formulations of the pill that are known to improve acne.

    Lastly, PLEASE don't allow your daughter to use Accutane without complying with the birth control requirements set forth by your NP. The danger to a developing baby should your daughter have unprotected sex is just too horrible to think about. And I never think it is fair to mislead our healthcare providers. If there is an aspect of treatment that we disagree with and don't intend to carry out, I believe we owe it to our care-givers to be honest about it. After all, we would (rightfully) lose trust in our providers if they subjected us to a treatment without our knowledge or consent. I think we owe them the same courtesy.

    Best of luck to you both.
  6. by   GooeyRN
    I would have her see a dermatologist. I too had mild acne. I used a combo of benzoil peroxide 5% wash, Benzamycin cream, and Retin-A. As long as I used the stuff as I was supposed to, I had GREAT results. Perfect skin. I just had to use the stuff as I was supposed to. It would have been much easier to pop a pill, but I didn't really want to take the Accutane.
  7. by   compassion1
    Has your Dd tried ProActiv? That is quite good at getting rid of acne. If she uses cosmetics, maybe she should try something like Bare Minerals. Covers better and is better for your skin than liquids.
    Last edit by compassion1 on Feb 22, '07
  8. by   donsterRN
    Hi Steph-

    I swear by ProActiv. My acne came in my 30's; I tried everything and nothing worked until I found ProActiv several years ago. Clear skin forever after...
  9. by   bethin
    Can she try some topical tx? Maybe ProActive, Retin A? My friends swear by ProActive. It has helped their acne immensely.
  10. by   Spidey's mom
    I'm reading your responses to my daughter . .

    We did try ProActive . . . for 6 months - it did nothing.

    She has been on erythromycin and tetracycline, both worked for a time.

    She was using my topical antibiotic, Cleocin T.

    She says she tried Retin A from a friend . . not sure she did the whole treatment regimen.

    She tried Differin that she got from a friend. But I'm sure it was the same as the Retin A . . she didn't use it correctly.

    A couple of days ago she bought out the local drug store with their OTC stuff.

    I notice it is hormonal . . .she just had a period and her face broke out prior.

    I appreciate your input. She really really wants Accutane and told me she would do anything to get rid of her acne. She says 6 or 7 of her friends at school have been on Accutane and the only side effects have been chapped lips and dry skin. But they also have perfect porcelain skin now, after using Accutane.

    She doesn't care about blood tests or anything else "I don't care what it takes - I'm sick of my face".

    Ok - she finally walked away . . .. sheesh.

    I did have an appt with a dermatologist about a year ago but the antibiotic started to work and so all was well. She really doesn't have that bad of acne. I kind of resent the NP giving her this info - although the NP is a friend of mine.

    Ah - such fun with teenagers.

    Thank you all so much for this info . . .

    steph
    Last edit by Spidey's mom on Feb 22, '07
  11. by   SmilingBluEyes
    If she is gonna do Retin-A she needs to do more than "try it" from a friend. This is not a regimen that you just do a few days and give up. I was on Retin-A in my early 20s for horrible cystic and disgusting facial and back acne. It took a few weeks--- but results did come, slowly. If this were MY daughter, I would MUCH rather see her using Retin-A or other similar regimen and really, really avoid the Accutane, for the very reasons you fear.

    Retin-A worked for me, and WELL. I used that, Plus upped my water intake, took vitamins and did NOT overclean my face. It required a whole change in lifestyle and thinking for me, but it worked. I would urge her to try anything before the Accutane, first, were it my kid.

    Good luck Steph. I feel your pain and hers. Having been there, with the horrible cystic acne on my face, I hated to be in public most of the time. But even then, knowing I was in prime fertility and not wanting to risk it, I did not go to Accutane. The regimen I was on worked and well.

    Do understand, however, any Retin-A or similar such regimens still really necessitate the use of reliable birth control because while not as teratogenic as Accutane, Retin-A is NOT recommended in pregnancy.

    I hope things get better for her. I feel for her.
    Last edit by SmilingBluEyes on Feb 23, '07
  12. by   Spidey's mom
    Thanks Deb.

    Jolie - I'm really not going to lie to the doc about NOT using BCP's. I've since found out there is an opt-out provision.

    The truth is her acne is mild. In her mind it is gargantuan.

    I think we will try something other than Accutane for now. Let's give Retin-A a chance and not just a one time thing when she stayed the night at a friend's house.

    The stuff she bought at the drug store is making her poor face really red and dry. She uses 5 different products - all with salicylic acid.

    Again, thanks for listening to me rant . . .

    steph
  13. by   SmilingBluEyes
    ANY time, Steph. I am just sorry she (and you) are going through this. I hope help comes quickly and is complete.
  14. by   kitty29
    Quote from stevielynn
    My daughter, aged 17, is appalled at her "mild" acne. She has been on two antibiotics and both worked well for awhile. Two days ago at a sports physical she talked to the NP about her "mild" acne (even the NP agrees with me that it is mild). Anyway, the NP suggested Accutane.

    I've been trying to avoid this for many reasons. One, she doesn't have the type of acne usually reserved for this last resort med. Of course I remember being a teen and remember the humiliation of pimples and completely understand her feelings.

    BUT . . . you have to sign a contract promising to use two types of birth control. Pills and a barrier method. She is not sexually active.

    Also, I'm not crazy about her putting chemicals into her body. I don't like the effects of BCP's . . . . long term.

    I don't like the idea of being on BCP's when you aren't even sexually active. She has NO problems with her period that need to be corrected by BCP's.

    The only reason for taking them is the risk of birth defects while using Accutane. But that assumes you are sexually active.

    So, I'm wondering about the ethics of just not taking the pills. Supposedly the Accutane works in about 4-6 months.

    What do you think?

    steph
    Steph I was put on Accutane Finally after having years of cystic acne...in your daughter's case I would also suggest derm (pref. a female doctor - just personally I've had better understanding from female docs).

    For me now differin works...they have things that are not as harsh as retin A. I think just finding a good derm doctor that will listen and follow your daughter will make the difference.

    I never had that until in my 30's. Good luck.

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