Andy Jacobs said:
Don,t know if any one can give me some advice,not a med student.Had acne over 20 years not bad, but enough to have an impact on my life.It mainly affects my back.Tried low dose antibiotics and then Roaccutane some years ago which suppressed it,but hasn,t cured it.It,s flared up recently and i,ve been on Oxytetracyclene for the last month.Can,t help feeling I,m wasting my time on this, but a little worried about the pontential side effects of Roaccutane,if I end up going that route.Also any suggestions for reducing scarring a sun tan would help is that such a big no no.
Hello Andy,
Were you put on some kind of maintenance regimen after the Roaccutane (or Accutane, as it's known in the US)? There is no cure for acne, and what Accutane does is only temporary. The processes that give you your acne don't go away, and that is why you should have been on some kind of maintenance therapy. If you weren't on maintenance therapy, it would be no surprise that you flared again.
It is possible that you are wasting your time with the oxyTCN. If you've been on it a while and aren't seeing results, then you should ask your provider to consider changing to a different class of oral antibiotic. There are indeed several other very good choices that you could change to.
If your acne is bad enough to need Accutane, then I think you should talk it over w/ your provider. Many thousands of former Accutane patients have needed additional courses in order to achieve a long-term remission, so your case would not be out of the ordinary. As for your worry about long-term effects -- again, talk it over with your derm provider. They can tell you about the ways to monitor for the onset of these effects, and you can always stop treatment if it looks like effects might be appearing. And also consider that if you are reasonably young and healthy, that the odds of long-term side effects is actually quite low.
As for scarring... if your scarring is minor, then you can look into microdermabrasion or mild chemical peels. I personally don't recommend these, but there are lots of derm providers who do so. I find that once a person's acne is well controlled and the deep inflammation that brings out the scarring is gone, that people tend to look at their minor scarring with much less criticism. I do believe, along with many other derm providers, that long-term retinoid therapy for acne can also help with minor scarring, but it certainly won't make drastic changes.
On the other hand, heavy scarring can be treated quite effectively with the deep chemical peels, dermabrasion, or laser ablation. All of these work by stripping off your outer layer of skin (and the scarring along with it), forcing you to grow new, unscarred skin. Please keep in mind however that these procedures can produce great unwanted side effects, and that you must decide if the risk is worth the potential benefits. If you do ever decide to do one of these procedures, make sure you find someone that has done a lot of them.
Lastly -- you didn't mention if you were seeing a derm provider, or someone else. If you have been seeing a non-derm provider for your presumed back acne, then you should definitely consider seeing someone trained in derm. This is because there are other things that your problem could be, instead of acne. I've seen cases where things like dermoid cysts or pityrosprorum folliculitis were treated as acne, with the expected poor results.
hth,
Phil R.
anywho, i know that diet has never been proven to be a cofactor in development of acne, but it seems to me that everytime i have a seafood meal, i get breakouts...am i just nuts? i wish there was a cure for this damn thing..haven't yet tried accutane though. 
