# ACNE



## mikeoxlong (Jul 28, 2009)

hello ppl i am having problems with acne all over my back shoulders and chest from this test enathate cycle and i have had lots of good advice from all you ppl posting back to me what medication to use and to stay away from.

well i just been to doctors and he has priscribed me some meds called tetralysal and it is a 2 month course and i hope that it clears up, if it doesnt he will transfer me to see a dermatologist and try and solve the problem.

also my doctor gave me some info leaflets so i have posted this info hope its some use to ppl who have acne problems for what ever reasons 

Acne is the common cause of 'spots'. Most people with acne are aged between 12 and 25, but some older and younger people are affected. Acne usually affects the face but may also affect the back, neck, and chest. The severity can range from mild to severe. About 9 in 10 teenagers develop some degree of acne. Often it is mild. However, it is estimated that about 3 in 10 teenagers have acne bad enough to need treatment to prevent scarring. Untreated acne usually lasts about 4-5 years before settling. However, it can last for many years in some cases.

*Understanding normal skin*

Small sebaceous glands lie just under the skin surface. These glands make the 'oil' (sebum) that keeps the skin supple and smooth. Tiny pores (holes) on the skin allow the sebum to come onto the skin surface. Hairs also grow through these pores. During the teenage years, you make much more sebum than when you were a child. This is due to the hormone changes of puberty which stimulate the sebaceous glands. As a rule, the more sebum that you make, the more greasy your skin feels, and the worse acne is likely to be. Some people make more sebum than others.

*Mild to moderate acne - blackheads, whiteheads, and small pimples*

Some pores become blocked ('plugged'). This is due to the skin at the top of the pores becoming thicker, combined with dead skin cells that are shed into the pores. You can see the 'plugs' that block the top of the pores as tiny spots known as comedones (blackheads and whiteheads). Note: the black of the blackheads is due to skin pigment, and is not dirt as some people think. In many cases, acne does not progress beyond this mild stage.

Some sebum may collect under blocked pores. You can see this as small spots called pimples or papules. In some cases, acne does not progress beyond this mild-to-moderate stage when you can see a number of small pimples, blackheads, and whiteheads.

*Moderate to severe acne - larger spots and inflammation*

Trapped sebum is ideal for a bacterium (germ) called P.acnes to live and multiply. Small numbers of this bacterium normally live on the skin, and do no harm. However, if a large number develop in the trapped sebum, the immune system may react and cause inflammation. If inflammation develops, it causes the surrounding skin to become red, and the spots become larger and filled with pus (pustules). In some cases the pustules become even larger and form into small 'nodules' and cysts.

Each inflamed spot will heal eventually. In some cases the area of skin that was inflamed remains discoloured for several months after the inflammation has gone (post-inflammatory hyperpigmentation). This is often more noticeable in darker skinned people. Also, a small pitted scar is commonly left on the skin where there was an inflamed spot. These small scars often do not fade fully and are a marker in older people that they once had inflamed acne spots.

*Rare causes of acne*

The description above is the cause of almost all cases of acne. Rarely, certain diseases in girls and women may cause acne, or make acne worse. For example, polycystic ovary syndrome, and conditions that cause excess male hormone to be made in the ovary or adrenal gland. These conditions cause other symptoms in addition to acne such as thinning of scalp hair, excess growth of facial or body hair (hirsutes), and other problems. Another rare cause of acne is exposure to halogenated hydrocarbons (chemicals that occur in some work places).

*What makes acne worse?*


 The progestogen-only contraceptive pill may make acne worse.

 In women, the hormone changes around the monthly period may cause a flare-up of spots.

 Thick or greasy make-up may, possibly, make acne worse. However, most make-up does not affect acne. You can use make-up to cover some mild spots. Non-comedogenic or oil-free products are most helpful for acne-prone skin types.

 Picking and squeezing the spots may cause further inflammation and scarring.

 Sweating heavily or humid conditions may make acne worse. For example, doing regular hot work in kitchens. The extra sweat possibly contributes to blocking pores.

 Spots may develop under tight clothes. For example, under headbands, tight bra straps, tight collars, etc. This may be due to increased sweating and friction under tight clothing.

 Some drugs can make acne worse. For example, phenytoin which some people take for epilepsy, and steroid creams and ointments that are used for eczema. Do not stop a prescribed drug if you suspect it is making your acne worse, but tell your doctor. An alternative may be an option.

 Anabolic steroids (which some body-builders take illegally) can make acne worse.


*Some myths and wrongly held beliefs about acne*


Acne is not caused by poor hygiene. In fact, excessive washing may make it worse.

Diet has little or no effect on acne. For example, there is no evidence that chocolate, sweets, or fatty foods cause acne or make acne worse.

Stress does not cause acne.

Acne is not just a simple skin infection. The cause is a complex interaction of changing hormones, sebum, overgrowth of a normally harmless bacteria, inflammation, etc, (described above). You cannot 'catch' acne - it is not contagious.

Acne cannot be cured by drinking lots of water.

There is no evidence to say that sunbathing or sunbeds will help to clear acne.

Some people believe that acne cannot be helped by medical treatment. This is not true. Treatments usually work well if used correctly.


*Skin care for people with acne*


Do not wash more than normal. Twice a day is normal for most people. Use a mild soap and lukewarm water. (Very hot or cold water may worsen acne.) Do not scrub hard when washing acne-affected skin. Do not use abrasive soaps, cleansing granules, astringents, or exfoliating agents. Use a soft wash-cloth and fingers instead. Excess washing and scrubbing may cause more inflammation, and possibly make acne worse.

Antiseptic washes are heavily advertised, but are unlikely to make any difference.

You cannot clean off blackheads. The black tip of a blackhead is actually melanin (skin pigment) and cannot be removed by cleaning or scrubbing.

Some topical acne treatments (described below) may dry the skin. If this occurs, use a fragrance-free, water-based moisturiser cream. Do not use ointments or oil-rich creams as these may clog pores.


*What are the treatment aims and options for acne?*

The aim of treatment is to clear spots as much as possible, and to prevent scarring. There are different types of treatment that work in different ways. A doctor or pharmacist will advise, and the treatment they advise will often depend on the severity and type of your acne. Treatments can be 'topical' (treatment that you apply to the skin), and/or tablets.

You may prefer not to treat mild acne which is not inflamed. That is, if you just have blackheads, whiteheads and mild pimples. Mild acne is common, and usually goes in time without scarring. However, inflamed acne can scar. If you develop inflammation (redness, red spots, pustules, etc) then it is best to treat early to prevent scarring. Treatment will usually clear most spots if you use it properly. However, no treatment will clear your skin perfectly.

*Topical preparations for acne*

Various gels, lotions, and creams are used to treat acne. Different preparations work in different ways. The following briefly describes the different types. However, always read the leaflet in the packet, because such things as 'how to apply it', and 'precautions' vary between different preparations. One general point is that you should apply topical treatments to all the affected area of skin, and not just to each spot.

*Benzoyl peroxide*

This is a common topical treatment. It has three actions - it kills bacteria, reduces inflammation, and helps to unplug blocked pores. Therefore, it often works well to clear inflamed spots and helps to clear blackheads and whiteheads. You can buy benzoyl peroxide at pharmacies without a prescription. It comes in different brand names and strengths - there is a 2.5%, 4%, 5%, and 10% strength. Benzoyl peroxide:


Works best if you wash the skin 20-30 minutes before using.

May bleach hair, bed-linen, or clothes that come into contact with it.

Commonly causes mild skin irritation. If your skin does become irritated then stop using it until the irritation goes. Then try again with a lower strength, or reduce the time it is left on your skin before washing off. To prevent skin irritation, the following may help:

Use the lowest strength at first. In many cases the 2.5% preparation works just as well as the 10% preparation, but causes the least irritation. If you wish to increase the strength, do it gradually.

Use a water based preparation (rather than an alcohol based one).

Apply once daily at first, and wash off after several hours.

Gradually increase the length of time left on the skin.

Aim to put on twice-daily when you get used to it.



*Retinoids*

These are good at unplugging blocked pores. They include adapalene, tretinoin, and isotretinoin which come in various brand names. They also have some effect on reducing inflammation. Therefore, one is often used early on in acne to help to unblock pores and to treat blackheads or whiteheads (comedones) and mildly inflamed spots. You need a prescription for all retinoid preparations. When you use a topical retinoid:


You may develop some skin redness and skin peeling. This tends to settle over time.

The spots sometimes get a little worse before improving.

Your skin may be more sensitive to sunlight. Therefore, it is best to apply at night and wash off in the morning. A sun protection cream may also help if you are out in the sun.

The most common side-effects are burning, irritation, and dryness. Therefore, you may be advised at first to use a low strength, less frequent application, and for a shorter duration.

You should not be pregnant, or intend to become pregnant, as there is a slight risk of harm to unborn babies. Discuss contraception with your doctor if necessary.


*Topical antibiotics*

There are various topical antibiotic preparations. They reduce the number of bacteria and reduce inflammation. However, they have little effect on unplugging blocked pores. So, they are usually good at treating inflamed acne, but blackheads and whiteheads may remain. You need a prescription to get a topical antibiotic. They may cause mild irritation, but generally cause less side-effects than the other topical preparations.

*Azelaic acid*

This is an alternative that mainly works by unplugging blocked pores. So, like retinoids, it is good at clearing blackheads and whiteheads. It has some effect on reducing inflamed acne too, but probably not as much as antibiotics or benzoyl peroxide. However, it may cause less skin irritation than benzoyl peroxide.

*Combinations*

Some preparations contain a mixture of ingredients. For example, benzoyl peroxide plus an antibiotic, or a retinoid plus an antibiotic. These may work better than either ingredient alone.

*Tablets that can treat acne*

*Antibiotic tablets*

Antibiotics work by killing bacteria that contribute to the cause of acne. They also have a direct effect of reducing inflammation. Antibiotics usually work well to clear inflamed acne spots, and any surrounding skin inflammation. However, they have little effect on unplugging blocked pores (which you can see as blackheads and whiteheads). So, if you only have mild acne with just blackheads and whiteheads, you are better off using a topical treatment that unblocks pores. If you have a lot of blackheads and whiteheads as well as inflamed acne spots, you may be advised to use a topical treatment such as benzoyl peroxide in addition to taking an antibiotic tablet.

Always read the leaflet that is in the packet of antibiotics. Things such as precautions and possible side-effects vary between different antibiotics. The following are some general points.

Tetracycline based antibiotics are the most commonly used antibiotics to treat acne. These include: oxytetracycline, tetracycline, doxycycline, lymecycline and minocycline.


Children under 12 years should not take tetracycline based antibiotics.

Do not take tetracycline based antibiotics if you are pregnant, breastfeeding, or intend to become pregnant. Discuss contraception with your doctor if necessary.

Food and milk affects the absorption of oxytetracycline or tetracycline. Therefore, take these tablets on an 'empty stomach', between meals, with a glass of water, (not milk). Doxycycline, lymecycline and minocycline can be taken with food.

Women taking 'the pill' should use additional contraceptive precautions (such as condoms) during the first three weeks of taking antibiotics.


Other antibiotics that are sometimes used include erythromycin and trimethoprim. You may be advised to take one of these if one of the above has not worked well, or is unsuitable.

*The pill (a hormone treatment)*

The combined oral contraceptive pill ('the pill') may help some women if their acne seems to be partly related to their hormone changes. For example, acne that began or became worse in adulthood, or if acne seems to flare up around the time of a period. It is the oestrogen part of the pill that is thought to help. A variant of the combined pill called co-cyprindiol (brand name of Dianette®) may be especially useful where a sensitivity to androgen hormone is thought to be making acne worse. For example, for women with excess facial hair growth in addition to acne. Co-cyprindiol contains a combination of an oestrogen plus cyproterone (an anti-androgen).

*Isotretinoin tablets*

Isotretinoin greatly reduces the amount of sebum that you make by the sebaceous glands. It works very well, and usually clears spots even in severe cases. However, it is normally used only on the advice of a specialist after other treatments have been tried first. This is because there is a risk of serious side-effects with isotretinoin tablets.

*How long is treatment needed?*

Whatever treatment is used, it is normal to take up to four weeks for there to be any noticeable improvement in the skin. There is often a good response to treatment by six weeks. However, it can take up to four months (sometimes longer) for maximum response to a treatment, and for the skin to be generally free of spots. The most common reason for a treatment failure is because some people think that treatment is not working after a couple of weeks or so, and give up.

Therefore, persevere with any treatment for at least six weeks before deciding if it is working or not. If there is no improvement after six weeks of taking a treatment regularly and correctly, do not despair. Adding in another treatment, or a change to a different or more powerful treatment will usually be advised, and is likely to work. Although treatment can usually clear most spots, there is no treatment that will make your skin perfect, and the odd spot may remain.

*Will acne return after treatment?*

Once the spots have cleared, acne commonly flares up again if you stop treatment. Therefore, after the spots have gone or are much reduced, it is common to carry on with a 'maintenance' treatment to prevent acne from flaring up again. It is common to need maintenance treatment for 4-5 years to keep acne away. This is typically until the late teens or early 20s. In a small number of cases, acne persists into the 30s, or even later. For these people it is possible to continue to treat the skin to keep it under control.

Maintenance treatment is usually with either benzoyl peroxide or a topical retinoid. These can both be used indefinitely. The dose used to prevent spots from returning is often lower than that used to treat acne. For example, one application to the skin every other day with a low strength preparation may be sufficient to keep spots from returning.

It is not usual to use topical antibiotics or antibiotic tablets as maintenance treatment once the spots have cleared. This is because long-term use of antibiotics can lead to resistance of germs to the antibiotics. Also, azelaic acid, another topical treatment, is only licensed for treatment periods of six months. Also, it is best not to take 'the pill' long term solely to prevent acne. Therefore, if at first you are treated with an antibiotic, azelaic acid or 'the pill', you may be advised to switch to benzoyl peroxide or a topical retinoid for maintenance treatment.


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## Darylbethyname (Dec 2, 2008)

tetralysal is crap if you have any proper acne at all. after the first 3 months they'll be like 'takes a year to start working' at which point you say you want to see a dermatologist. i was on tetralysal for a year, it doesn't work. it probably works for mild acne.


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## mikeoxlong (Jul 28, 2009)

well i thought so when she gave me these, she said she has doubled the dosage to 500mg due to my acne been bad to see if it works i dont think they will do anything, she seemed to not know alot anyway lol.

i had to make an emergency appointment to see some one about my acne problem i couldnt see my usual doctor otherwise he would of prob give me something much better since he is a good doctor so on monday i will make appointment to see him and get some good stuff hopefully lol.


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## Darylbethyname (Dec 2, 2008)

mikeoxlong said:


> well i thought so when she gave me these, she said she has doubled the dosage to 500mg due to my acne been bad to see if it works i dont think they will do anything, she seemed to not know alot anyway lol.
> 
> i had to make an emergency appointment to see some one about my acne problem i couldnt see my usual doctor otherwise he would of prob give me something much better since he is a good doctor so on monday i will make appointment to see him and get some good stuff hopefully lol.


good luck with the appointment mate. i'm on roaccutane at the moment, if they suggest it don't be discouraged by the side effects. the sides everyone chats about are very rare, the most you'll experience is dryness, and occasional sore back. although it depends on the dose. its likely you'll get a cream or ointment, i was never offered any but try whatever and see how it works on you personally.


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## LittleChris (Jan 17, 2009)

I would get accutane if I were you. The longer you wait, the worse it will get, and you will have scarring from it.

Sides from accutane IME are over-played, dry lips, dry skin and an initial outbreak are all you need to worry about.


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## Zee Deveel (Nov 5, 2009)

I was kinda spotty when I was a teenager, wouldn't really call it acne though.

I used a Hydrogen Peroxide cream, seemed to work really well. Check it out.


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## mikeoxlong (Jul 28, 2009)

accutane will work i know it will but like ppl have said the sides what come with it are bad. i will try anything as long as it gets rid of these spots on my back.


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## Suprakill4 (Jul 11, 2008)

Hi dude, i would try something with Benzoyl Peroxide in (cream/gel)

I had terrible acne on my shoulders and chest to the extent they were extremely painful. I bought some Panoxyl 5 gel off ebay and i am completely shocked at how good this stuff is. Is cleared it up really well and to finish it i will be going onto the stronger panoxyl 10 now as you need to build a tolerance to it first.

Its really dried my skin out and it is like im sort of peeling but definately worked REALLY well.


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## Galtonator (Jul 21, 2004)

QUINODERM cream is cheap and very effective


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## Zee Deveel (Nov 5, 2009)

kieren1234 said:


> Hi dude, i would try something with Benzoyl Peroxide in (cream/gel)


Err yes! That's what I mean, not bloody Hydrogen Peroxide!

It's pretty evil stuff, burns when you put it on, probably gives you cancer but sorts out your acne!


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## Irish Beast (Jun 16, 2009)

Depending on the severity some creams may help. However for severe cystic acne accutane really is the only cure.

I tried Tetrcycline, lymocycline, minocycline and another med which is used for UTIs (Trimethoprim) and they were all a complete waste of time. Doctor had me on antibiotics for years before referring me to the dermatologist.


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## Virgo83 (Jul 19, 2009)

I never had a problem with acne but midway through test e 500mg pw cycle and got it pretty bad on back n shoulders. Got some panoxyl 10 cream from pharmacy2u and within 2 weeks its virtually cleared up. It says on the box that it wont work for 3 weeks so im well pleased. Id reccomend it as I didnt fancy accutane either


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## Irish Beast (Jun 16, 2009)

AIGW said:


> I never had a problem with acne but midway through test e 500mg pw cycle and got it pretty bad on back n shoulders. Got some panoxyl 10 cream from pharmacy2u and within 2 weeks its virtually cleared up. It says on the box that it wont work for 3 weeks so im well pleased. Id reccomend it as I didnt fancy accutane either


Do you realise you can buy it in any chemist OTC?


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## frowningbudda (Dec 16, 2008)

Irish Beast said:


> Do you realise you can buy it in any chemist OTC?


'Bout 3quid, there is a no-named one and Panoxl (sp).

Good stuff. :thumbup1:


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## mikeoxlong (Jul 28, 2009)

my spots are drying up which is a good thing im still taking tetralysal and i think its doin the job. i do go on sunbeds twice a week and my m8 said it sounds silly but use talc powder everyday apply twice and its working well.

i got to see a dermatologist in 3 weeks so that will be good but yeah im feeling a lot better than last week i thought these spots were on a right outbreak i was scared and the pain i was in were real bad was finding it hard to lay down on my bench to do workouts that was a pain lol.

so thanks ppl for all your advice just hope it keeps goin well.

cheers ppl


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## Virgo83 (Jul 19, 2009)

Irish Beast said:


> Do you realise you can buy it in any chemist OTC?


 No mate never really looked. Got it posted through my door anyway so easier for me:thumb:


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## dusher (Jul 8, 2008)

This thread has really helped me. Always had mild acne on my face but since my first course of AAS they have got much worse and spread to my back, chest and shoulders. Tired going to doctors, told him I was on AAS (big mistake). Tried to give me some crappy tablets, so decided to buy some Accutane. They work. But when your on AAS they just seem to cancel each other out.

I started on 40mg a day and sides were just dry lips and slight joint pain. Went up to 60mg a day as I finished my course, sides were the same just slightly worse. Looking to get a cream aswell for my next course as Im guessing they are just going to come back. Going to get some benzoyl peroxide 10 and see how things go. Ive tried Duac which is a 5% and that worked very well.

Ill let you all know how I get on


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## kitt81 (Sep 4, 2009)

ive been using panoxyl aqua gel 10% from boots. works a treat!!


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## dusher (Jul 8, 2008)

kitt81 said:


> ive been using panoxyl aqua gel 10% from boots. works a treat!!


On your face or back etc? Any sides?


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## treb92 (Jun 10, 2008)

The food and stress doesnt give you acne myth is complete and utter bollocks. I can tell you now they play a big part in acne for many including myself.


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## frowningbudda (Dec 16, 2008)

dusher said:


> On your face or back etc? Any sides?


With the 10% strength you will probably get really dry skin,

but I agree stress does play a major factor.


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## Críostóir (Dec 12, 2009)

sounds to me like your explosion of spots is hormonal acne related to the panoxyl you were on. Generally speaking guys suffer with spots more than girls because spots are caused by androgens (sex hormones like testosterone) and the panoxyl caused you to have an outbreak.

Check this out for info acne info

more info


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## kitt81 (Sep 4, 2009)

dusher said:


> On your face or back etc? Any sides?


its mostly on my shoulders and jaw line. your skin might get a little dry so just back off the gel for a coupla days and use a really good moisturizer.


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## fitrut (Nov 20, 2007)

I had acne problems for nearly 10 years by now;it was messed up by drugs I used when I had serious head injury back 1997;

I used Retin A for 6 months; it has really good affect to me; I have clear face now. still some spots appear but now deep painful spots.

I was advised to use Roacuttane but those side affects was kind of scary so decided to try Retin A.

I'd think if you go for medicine, have to see doctor first and get proper info.

Also you can try to treat it using Glycolic acid creams (some contains 10% or 25% of acid); that one helped me too.


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