Adult Acne

[simon3737]

Hi,
I've suffered acne, since I was 11 and am now 37 and still have acne. I've tried numerous treatments over the years and still have problems with acne. I did find however by chance that when I got an infection and was on amoxicillin that my skin cleared. My doctor did for awhile prescribe a low dose of amoxicillin that gave me a clear skin. However she was reluctant to keep prescribing it so told me to stop it and my acne came back. I asked to be referred to a dermatologist which I paid for privately. He said I should try isotretinoin, which sounded good, but as I suffer from panic attacks, anxiety and Cronic Fatigue Syndrome I think I wouldn't cope with the side effects and my GP agrees with me, which leaves me with what to try next as the dermatologist said that would really be the only thing that would clear my skin! I do have acne scarring too which is a constant worry for me, along with quite a few spider veins especially on my nose, can I get any help with this on the NHS as this worries me a great deal and really gives me low self confidence as I feel that everyone is looking at me all the time or is acne scarring only treated privately? Its almost that my skin has gone really uneven in places, almost sucken in if I can discribe it, I'm assuming thats the result of constant acne?
I would just like some advice at what I could do to improve my skin and give me some sort of reason to actually want to get on with my life without this constant worry and stress this acne causes me

Thanks in advance
Simon

[Dr Stephen Kownacki]

Simon
Acne certainly is a four letter word we could well do without!
First Amoxicillin is not used for acne since the bacterium involved (Propionibacterium acne) is not sensitive to this group of antibiotics. Your improvement may have been due to a secondary infection or part of the waxing and waning of the condition. Tetracyclines in adequate dosage often Lymecycline or Doxycycline are the common choices.
Isotretinoin is considered a dermatological wonder drug by those dermatologists who see the magical improvement it can produce, sometimes actually turning the condition off permanently. Unfortunately nothing comes free and there are side effects; some a nuisance such as dry lips and eyes and rarely the worsening or development of a depression which understandably but exaggeratedly gets dramatic press.
For you the first need may be help to cope with the psychological difficulties at the same time as aggressive anti acne treatment under close supervision. Perhaps a second dermatological opinion would be helpful to help you decide.
Laser treatment for scarring is rarely available on the NHS but if severe and affecting life so badly, application can be made for special dispensation although it is extremely difficult in these days of NHS cost savings coming first !
Always remember to look out at the world rather than spend too much time with a mirror which will magnify reality.
Good luck