Males with Acne, Teenage and into my Thirties.

Acne started on my face around 14 and remained so until about 17 when it spread to my entire back. Hair formed in a spiral pattern on my shoulder and the skin pigmentation under the hair discolored. I'm now 31, have gone through 9 months of accutane at the age of 26 and still have copious amounts of acne on the face and back. Topicals, soaps, creams, medications, scrubs and month after month of derm surgery have yet to work. It's destroyed my self confidence and outward appearance. What now?

Doctor Answers 4

Diet Worth A Try for Acne

Some of the latest trends in acne treatment don't even involve medications. You are on the right track to think that diet may play a role in the developement of acne. Diet change is worth a try and would probably help to a degree with acne. Acne in the minds of many nutritionalists is in large part a food-borne illness–that is, it is preventable by changing what you eat. Acne is non-existent in non-Westernized populations (such as the Inuit, Okinawa islanders, Ache hunter-gatherers, and Kitavan islanders, all of whom do not consume dairy products), suggesting that acne is largely, if not completely, caused by diet. A study in 2011 in Korea, which followed a total of 1285 participants (783 with acne and 502 as control), supports this idea, concluding that “a high glycemic load diet, dairy food intake, high fat diet, and iodine in Korean foods appear to play a role in acne exacerbation.”

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Take a Look at Your Diet for Acne

Aside from treating your acne,  I recommend looking at your diet for any possible trigger of acne.  I suggest cutting out as much sugar as possible, and completely discontinuing sodas and diet sodas and artificial sweeteners.  Even sugary drinks, such as fruit juices and sports drinks, should be avoided.  Dairy can trigger acne and I recommend doind a trial off dairy completely and seeing how you do after about a month. Stick to home made meals, not from packages, as much as possible, and make sure you eat plenty of fresh vegetables.  Try supplementing with omega 3 fish oils, get a good quality one from the health food store or online.  Go for about 2000 mg of EPA + DHA per day (they should be able to guide you at the health food store).  All this can be done in conjunction with any acne treatment you choose.

Lisa Benest, MD
Burbank Dermatologist
4.7 out of 5 stars 4 reviews

Agressive photodynamic therapy works very well for acne

Agressive photodynamic therapy with RED light, not blue light can work very well.  I worked int he lab that helped develop this protocol and it works.  Aggressive refers to a few specifics.  Three hours with the medication on your face.  Severe discomfort during the light exposure (bright red light, not laser).  Swelling, discomfort, sensitive skin, and even an acne-like eruption after, which are all expected following the treatment.  If you can physically endure once a month therapy for several months, then there is a chance you can receive near cure results.  

Must tell you that this is a challenging thing to go through, but you would be one of the candidates that this is made for because of your frustration and resistance to Accutane.

Good luck.

Daniel I. Wasserman, MD
Naples Dermatologic Surgeon
4.0 out of 5 stars 2 reviews

Vigorous Photodynamic Therapy

There is a strong possibility looming that the lawyers, with their thousands of court cases filed and pending, will be able to do what some in government failed to do, delegate Accutane to the trash bin of once useful drugs. Dermatologists, being a resourceful breed, are searching for another solution for severe, cystic acne. It may come in the form of a "me too"  Accutane. Trials are pending for a new Accutane drug which reputedly has less of the GI drawbacks.

Another area of promise, which I would recommend to you is in the area of photodynamic therapy. Using high dose and intensity blue and red light, with prior activation by Levulan, we are able to achieve results comparable to Accutane. Dr. Rox Anderson, the dermatologist who is probably the leading figure in laser research, recently pronounced this treatment virtually as effective as Accutane in providing a sustained acne remission. It does so, by destroying the sebaceous glands.

However, you have to be prepared for a few days of absolute facial disfigurement. Your face will be red, blistering and look a mess. We have tried this treatment on  two patients in our office, one intentionally,  and I can attest to that. However, afterwards their acne was gone, their face was clear, and their acne has yet to return. 

The parameters have yet to be solidified and of course, this is an off-label treatment. It is also not paid for by insurance companies.

However, if you are willing to stay house bound for a few days, it might be worth it.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.