what to expect

[jadenshaden]

hi,
here's my story. i'm 18 years old and never had acne before until i started taking ortho-trycyclen lo to regulate my periods back in july. it made me break out in huge pimples all on my cheeks and chin and some on my forehead. i stopped the pill after two months and it left me with scars and i was still getting some pimples but not as bad. then to help the scars i started a microdermabrasion at home called epidermx 3 times a week for 2 months and my face was smooth and the scars were getting lighter. they warned about getting a few pimples from using it at first because it was getting out all the impurities but lately i've been getting alot of little one on my forehead and sides of my head(my mom has been doing this too and she's getting pimples where she never got many at all). so i went to go see a dermatologist a few days ago and he said that my acne wasn't horrible and he couldn't tell me why birth control would make me break out b/c ortho is specifically used to treat acne. but he put me on doryx twice a day 75mg(low dose b/c im a small person 5'2 102lbs) and retin-a-micro at night.  now i've heard it gets worse before it gets better and it takes awhile.  i'm wondering since i have never had an acne problem before birth control and that i since i was doing microdermabrasion for two months that maybe most of my impurities are out that if it won't be a big struggle for me. i've used these medications for two days now and when i put the retin on my face gets dry and had white flake areas. i also already see little bumps coming up on the tip of my nose.  is it already working???

thanks!!

[Alan Rockoff, MD]

Actually, it happens all the time for people to start breaking out--at 18, 25, even 35.  That's just the way things happen.  You should treat it, though, because you can.

Dr. Rockoff

[jadenshaden]

During my junior and senior year I went on a health kick and got into really good shape.  Totally changed my lifestyle.  My junior year though I kinda went too far for a couple months then realized that what I was doing(not throwing up just exercising and not getting enough calories)was gonna hurt me so I slowly made progress in getting healthy.  My senior year was te best; I felt great and I was doing the right things for my body and I was managing my weight but I still didn't get my periods.  My gyno. told me that it was b/c I prob. wasn't getting enough fat in my diet and that I prob. needed to gain about 3 pounds by adding a bit more calories; other than that she said I was fit and healthy.  So I did and it was the good fats and I worked out while doing it and I have gained muscle mass and I am up to my ideal weight.  I added more protien to my diet(chicken, fish everyday, whey, egg whites) along with good carbs. After she gave me this hormone to make me have my period and I had it, I started taking birth contol, had two periods in two months and also breakouts.  So I stopped the pill.  I didn't have my period the following month but I have but I had it this month so I think I'm getting regular( i didn't have to be on birth control to have it).  So do you think that my hormones are just out of control bacause I don't see how a person can go their whole life without having acne and then just suddenly break out in 6 months.

[Alan Rockoff, MD]

Although your birth control pill has been shown to help acne a bit, it isn't very effective.  On the other hand, it doesn't make it worse either.  Your breakout is a coincidence--people your age can break out for no special reason.  Microdermabrasion can be moderately helpful, but wouldn't prevent acne.

Acne treatment like the regimen your doctor put you on takes weeks or months, but it doesn't have to make you worse before you get better.  You need to be patient.  If the Retin-A continues to make your skin flake, please let your doctor know, since there are ways around that (other creams, less frequent applications).

Take care.

Dr. Rockoff