Duac Rash

I, and the rest of my family for that matter, have a bad history of severe acne. When I was in High School, I was prescribed a generic brand of acutane (I can't recall the name.) It seemed to work, clearing up most, if not all, of my acne in the months I was on the program. I was lucky enough to not suffer from any of the side effects other than the dry skin. It cleared up my face and not I will occasionaly get a zit once in awhile on my face... usually on my chin, under my chin and on my cheek where my facial hair grows, but I figure that is normal from the dirt and oils in your hair and it doesn't concern me because they aren't ever bad. The generic acutane, however, did not help my frequent break outs of "backne and neckne." I always have really bad acne on my chest and neck.

I went to my dermatologist and she prescribed me two topical gels (duac and differin .3%) The differing is a real winner and seems to help somewhat however, I seemed to have problems with the duac. I used it for the the first few weeks as she described me to, but it didn't seem to work... it seemed like i as breaking out more and it concerned me, so I stopped using it (for those first month or so, I didn't suffer from any side effects). I continued to use only the differin, which only seemed to help prevent my current pimples from becoming more inflammed.

I went back to her for a 2mo check up and told her i stopped using it. She said that it might be that it needs to work for a little longer before I see any results so I went back to the original treatment. Within a couple of days of restarting treatment, I developed a severe rash on all the areas where I would apply the duac (in the center of my chest and along my collar bones and base of my neck.) It burns initially whenever i apply an lotion or pain relief onto it to relieve itching and pain. It itches constantly and it really concerns me. I compare it to a severe sunburn whenever I describe it to people... its really red, burns, and itches.

I've had it for a week now and it doesn't seem to be getting much better. It is more blotchy and less red than before. I can't get in to see my dermatologist because I recently moved (for school) a couple hours away from her office since seeing her last and she is backed up with appointments for weeks. I was just wondering that for this very rare side effect from the use of duac, will it go away eventually or do I need to go on some other form of treatment to heal it. I'm just afraid of scarring. I'm already semi-self conscious of my body as is (thats why i went on the duac/differin treatment in the first place) and don't need this to be the icing on the cake, and I don't want to continue using the combo in fear it will only make matters worse.... what do i do?

[loiloi]

It is not uncommon to get a rash from Duac, espeically when used in conjunction with a topical retinoid. Differin is effective and generally better tolerated so I would recommend continuing with that alone.
Use a bland cleanser such as one by La Roche-Posay or Eucerin until your rash is better. It would also be advisable to not recommence the Differin until the skin is no longer sensitized.
Take an anti-histamine such as Piriton to relieve the itching. Hydrocortizone cream will help clear the rash but should not be used for a prolonged period as it causes the skin to become thinner. You should also be aware that whilst it will clear the rash, cortizone creams are not helpful for acne.
Eloise x