I am a 47 year old male. I have had oily skin and acne since I was a teenager although it has been a lot less severe in the past twenty years or so. Except for the the last several years 3-5 years I have been breaking out on and off quite frequently around my mouth, chin and corners of the nose. Usually it starts as a white tipped pimple and then another sometimes right next to the first one, maybe thre or four to maybe six spots total around the mentioned areas. When I was younger my doctor used dry Ice to clear it up and an antibiotic and I would use retin a cream at night. and the results were fairly good.
My new dermatologist who is aa PA has been prescribing an antibiotic and sevral topical treatments such as Retina and Brevoxyl wash for the past several years but it barely seems to help. I also recently had a cyst or wart - a ***** pimple/growth on the back of my ear which he removed but keeps getting red, sore and sometimes itchy. Now he wants me to switch to Sulfamethoxazole twice a day. After one month he said if it's still not going away we should do a biopsy to see if it is a fungal infection from over doing the antibiotics for several years. I would much rather prefer just a topical treatment- as opposed to pills of any klind- like the old dry ice treatment but he says they don't use that anymore.
Do any dermatologists still use dry ice? Also, any guess as to what this could be? Adult acne, fungal infection, cancerous, not cancerous?
Hi. What antibiotic and topical lotion are you currently being prescribed?
I would recommend oral oxytetracycline because this is good for acne and peri-oral dermatitis (spots around the mouth). Dermatologists have found that Differin is the most effective topical gel especially when used in conjunction with oral oxytetracycline. Eucerin make a good cleanser for impure skin which is compatible with acne medication and is available instores or online at Pharmamundi.com
As this has been a long-term problem, ask your dermatologist about oral isotretinoin which is statistically most likely to result in long term remission from acne. What contra-indications cause your reluctance to take pills?
If you want an alternative to tablets have you looked into laser surgery? Advances in technology mean they can treat acne and other skin problems. Ask for a consultation and analysis in a reputable clinic. There are different types of laser treatments which work in different way to either shrink the oil glands or remove the bacteria from your skin.
I was using Minocycline for the past four to six years and also retin a cream which seems to work in spurts and then it seems to stop working for a while. He recently prescribed Sulfamoethoxazole and I have also been using Brevoxyl wash for about six months which seems to help a little but I really don't want to start using any new drugs I don't need.
He told me that laser treatment doesn't last long term and recommended accutane but that's another drug known to have a lot of side effects that I don't want to get involved with. If laser does work, I wouldn't mind trying that. Can you give me any more info on laser treatmetns? Also, do they use dry ice treatments anymore?
Hi. I live in Bristol England and have not heard of anyone who performs dry ice treatments.
Your dermatologist may promote accutane over laser treatments if he is an accutane prescriber but does not conduct laser treatments. There are merits and potential side effects of both.
Accutane is given for 16 to 24 weeks and most patients only need one course. Due to your age you are unlikely to relapse from accutane. If you took it as a teenager it is possible you would need further courses later in life. The most common side effects are dry lips and skin. More serious side effects are rare and include muscle and joint pain, changes to the hair or nails and depression. The statistical chances of each side effect occuring are listed inside the accutane leaflet eg 1 in 100 patients or 1 in 1000 patients.
I have taken accutane twice if you want to talk about it.
If you are considering laser treatment go to a reputable clinic. The most widely used treatments are N-Lite, White Light and Blue light. You will be given a consultation and skin analysis prior to treatment. Advances in technology mean nearly every skin type and color can now be treated. Make sure they carry out a test patch on a small area 48 hours before you have the complete treatment. Most clinics claim there will be no side effects or "down-time" afterwards. Objectively speaking, a histamine response is possible.
Several treatments may be needed to achieve a long-term remission and some clinics will offer finance or a discount when you book multiple appointments. Do not use any products on the area to be treated for 48 hours prior to laser therapy. The clinic will advise you on aftercare and may recommend products to compliment the treatment.
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