What will help bad acne, but not ruin my eyes?

[tiff]

I've tried everything topical under the sun, nothing is working. The doc prescribed me spironoactpne, but I read its terrible for dry eye. What on earth can I use? The acne is depressing me. Thanks.

[jenny2008]

i need help too.. i went to the derm today and he again just gave me dif types of retinoids.... he says because they are topical they will not harm the meibomian gland.. but according to some posts on here it will... he basically told me to try the retnoids and if not just live with the acne!

can someone hlep???

[sunshinelover]

What about tetracyclines? Thats what helped my acne in my 20s. Don't know if they affect the eyes, havnt heard that.

[jenny2008]

i am on doxy for my eyes but i think my face has grown resistant toward them-bacterial resistance.
are alpha hydroxy acids safe since retinoids are not?

[spmcc]

What about tetracyclines? Thats what helped my acne in my 20s. Don't know if they affect the eyes, havnt heard that.

Tetracyclines (doxycycline, minocycline) are used for both acne AND for meibomian gland dysfunction. I've also been on erythromycin and biaxin (clarithromycin) for my facial rosacea and ocular rosacea. But I do not have acne.

[MeibomianGlandman]

I am not a doctor, but I have read some dermatology books and they have all stated that Acne is caused by these few things
Excess hormone's, The hormone testosterone is responsible for producting sebum which is the oil that comes out of the pores on your face. Excess levels of androgens in the bloodstream are absorbed by the Sebum producing cells in the sebaceous glands of your face, they then break down the androgens and produce oil, if its too much, the glands can become infected, causing Acne. From what the Dermatology book stated, acne can only be caused by certain types of micro organisms that are oil feeding, these germs as we call them could be anything from s. aureus, to staphylococcus, to streptococcus, oil feeding yeast such as Malassezia fur fur, to even micro insects such as demodex folliculorum. The Treatment for each of these is completely different, you see acne is an infection and the bacteria part should be treated with tetracyclines, the yeast can only be treated with topical antifungal cream and the mites only can be treated with oil. However I have discovered that 90 percent of skin problems are due to a diet problem, I am not a doctor however but, check with your dermatologist to determine the best treatment.

[jenny2008]

90% are due to diet? where can we get that info?? my doc of course says diet has nothing to do with that.. they always do.

[spmcc]

I've tried everything topical under the sun, nothing is working. The doc prescribed me spironoactpne, but I read its terrible for dry eye. What on earth can I use? The acne is depressing me. Thanks.

Tiff - what else have you tried? Did other treatments affect your eyes? Is the prescription for spironolactone solely for your acne or did your doctor mention hormone problems too? Have you tried oral antibiotics? Do you have a good dermatologist who is helpful?

(here's a 2005 study about antibiotics and inflammatory diseases: http://www.ncbi.nlm.nih.gov/pubmed/15562139)

I seem to remember a past post of Littlemermaid's where she mentioned acne can be considered "diabetes of the skin". Have you noticed any relationship between your acne and eating sugar? Could you try a sugar-elimination diet to test that connection? I'm just grasping at straws to help you - I'm not a doctor.

Good luck.

[tiff]

The derm seems to know nothing about dry eyes. None of the derms I've tried know anything about dry eye.

Here is what I've tried:
finacea, oracea, metrogel, retin-a micro, differin, tetracycline, doxycycline, benzoyl peroxide, clindagel, duac, gylcolic acid peels, salicylic acid, lactic acid peels, sulphur treatment products, and probably others i can't remember.

i barely eat any sugar or processed food, don't drink alcohol, never smoked, though i do have stress and sometimes don't get enough sleep.

my acne has gotten progressively worse over the past 2 years and it's to the point that it's really depressing for me. i wear absolutely no makeup so i know i'm not exacerbating it.

as a 20-something i used retin-a for years and potentially that, or the birth control i was on, have caused my dry eyes.

i just don't know what to do, but am fed up and afraid to fill the spironolactone prescription even though i read rave reviews online.

[littlemermaid]

Tiff, Is it more rosacea than acne?

I'm with MGman on treating the dermatophytes feasting on the excess sebum - we've got much better control using gentle tea tree oil products as well as chronic-use topical antibacterials (in rotation, like Spmcc - currently we are using erythromycin) so there must have been overgrowth of demodex as well as bacteria. Malassezia furfur, if you see it, can be shifted with TTO but needs a gentle scrub with a loofah because mycellial strands go a little sub-cutaneous and it didn't go with TTO products (we had Tinea versicolor patches on the back and hairline during early puberty). If anyone uses an antifungal topical for Tinea, make sure there's no steroid in it because there's no need for it. Eg we're doing well with a very dilute TTO (1:50) shampoo eye clean for blepharitis although I'm wondering about taking this up a step to Dr Tseng's recipes. We're using TTO bath and shower soap, and rotating shampoo with anti-dandruff. The problem with rosacea is not to set red reaction off with some of these ingredients.

Derm advice recently was not just to rotate the gentler antibacs, but to consider building up tolerance for stronger ones, eg azelaic acid or metronidazole, by using less frequently eg 2 or 3 /wk and then increasing. We haven't done this because it's a microbiologist nightmare, but if the acne rosacea was more severe, we might.

However, none of this treats the cause. Certainly we have correlated diet triggers - gluten, sugar, dairy - but also stress and post-virus and pre-menstrual. ATM I'm thinking about gut dysbiosis and wondering about SIBO and digestive enzymes. Acne rosacea sufferers are deficient in hydrochloric acid in the stomach (they've known this since post mortems in the 1920s) but I can't get LM to drink apple cider vinegar although she likes lemon in water. This would be to alter the stomach pH to more acidic to assist normal digestive bacteria v protagonists.

Acne and rosacea are very different pathways. Rosacea seems to be a type IV hypersensitivity inflammatory disorder. Many people have success if they can identify their various triggers and I have actually met these people (http://rosaceagroup.org/new/); sometimes it's something we've consumed through childhood from habit like fruit juice or white bread. Bizarre, isn't it.

We are using a multivitamin on/off but one with trace minerals in case of deficiency, maybe through inability to process (see a well-qualified Pharmacist, some of them are really good on this type of thing). I have to say this is the first thing a vet would give after doing a swab or biopsy, after that they're thinking about systemic disorder and building the immune system.

There's a good chance some of these chronic acne/rosacea overactive immune responses were triggered by dealing with invaders or new residents - virus, bacteria, helminth (maybe don't google that...) - and an over-reaction to identifiable 'allergens' was set up (even sunlight in the case of rosacea).

All this clogs the MGs and damages the eyes with keratitis (search 'blepharoconjunctivitis or 'blepharokeratoconjunctivitis''), unfortunately. But there's a lot of work underway currently to look at various inflammatory pathways for this and other autoinflammatory disorders, thank God (see PubMed 'acne rosacea' 'acne blepharitis' etc) and some of the endocrinology journals are way ahead of derms and ophth but too detailed and specific to be useful yet, but interesting eg Journal of Hormone, Steroid and Lipid Metabolism. Therein, I feel, lies the key.

Jenny, In MGD and acne, what we're doing is trying to improve the lipids and the sebum and diet is one of the ways to do this (poor LM has what she's eaten written all over face and coming out of the MGs some days, so I know a good clean nutritious diet helps). We are listening to EyeAllergyKids on diet, esp not eating processed foods, esp not with the enemy, glucose-fructose corn syrup, (but without the enemas, lol). But you've got a lot more going on than MGD, haven't you, so health-wise you'd be building your strength, esp immune system <hug>

Despite all this trailing around the best available derms in UK, I've just finally given in and booked a naturopath to see if they have a clue what's happening, lol. I'm expecting them to say it's the thyroid-adrenal-pancreas axis (and a few more bits not working), and there's food intolerance and hypersensitivity. Yeah, but what do we do about it.

I still think using various steroids for immunosuppression, eg for acne, can trigger acne rosacea (search PubMed 'steroid acne') and in some people it hasn't rectified (this is proven for children, search PubMed 'child steroid rosacea').

Jenny, didn't your acne start after you started N Acetyl Cysteine? I'm wondering what the heck that is doing to you (mucolytic).

If it is rosacea more than acne, Tiff, you'd be looking at helping the skin maintain a good barrier with compatible moisturisers (pH neutral, perfume and paraben free etc).

Again, not a doc, not a derm. Just trying different things too, trying to work out what's gone wrong

[tiff]

I think the Rosacea is not to blame for the blackheads and large pimples. I don't get any flushing or other facial Rosacea symptoms, but I
Do have a very slight pink tone to my skin.
I know nothing of the microbial and diet issues you commented on, little mermaid, and don't know where to look to learn more. The docs I've seen for my eye issues chalk this all up to bad luck, and have not
Made connections with my acne or my eye problems to diet, digestion, medication, or microbial issues. I feel lost and desperate with both my eyes and my skin.
I'll continue to search this board for more info. Thanks for the very helpful feedback!

Tiff, Is it more rosacea than acne?

I'm with MGman on treating the dermatophytes feasting on the excess sebum - we've got much better control using gentle tea tree oil products as well as chronic-use topical antibacterials (in rotation, like Spmcc - currently we are using erythromycin) so there must have been overgrowth of demodex as well as bacteria. Malassezia furfur, if you see it, can be shifted with TTO but needs a gentle scrub with a loofah because mycellial strands go a little sub-cutaneous and it didn't go with TTO products (we had Tinea versicolor patches on the back and hairline during early puberty). If anyone uses an antifungal topical for Tinea, make sure there's no steroid in it because there's no need for it. Eg we're doing well with a very dilute TTO (1:50) shampoo eye clean for blepharitis although I'm wondering about taking this up a step to Dr Tseng's recipes. We're using TTO bath and shower soap, and rotating shampoo with anti-dandruff. The problem with rosacea is not to set red reaction off with some of these ingredients.

Derm advice recently was not just to rotate the gentler antibacs, but to consider building up tolerance for stronger ones, eg azelaic acid or metronidazole, by using less frequently eg 2 or 3 /wk and then increasing. We haven't done this because it's a microbiologist nightmare, but if the acne rosacea was more severe, we might.

However, none of this treats the cause. Certainly we have correlated diet triggers - gluten, sugar, dairy - but also stress and post-virus and pre-menstrual. ATM I'm thinking about gut dysbiosis and wondering about SIBO and digestive enzymes. Acne rosacea sufferers are deficient in hydrochloric acid in the stomach (they've known this since post mortems in the 1920s) but I can't get LM to drink apple cider vinegar although she likes lemon in water. This would be to alter the stomach pH to more acidic to assist normal digestive bacteria v protagonists.

Acne and rosacea are very different pathways. Rosacea seems to be a type IV hypersensitivity inflammatory disorder. Many people have success if they can identify their various triggers and I have actually met these people (http://rosaceagroup.org/new/); sometimes it's something we've consumed through childhood from habit like fruit juice or white bread. Bizarre, isn't it.

We are using a multivitamin on/off but one with trace minerals in case of deficiency, maybe through inability to process (see a well-qualified Pharmacist, some of them are really good on this type of thing). I have to say this is the first thing a vet would give after doing a swab or biopsy, after that they're thinking about systemic disorder and building the immune system.

There's a good chance some of these chronic acne/rosacea overactive immune responses were triggered by dealing with invaders or new residents - virus, bacteria, helminth (maybe don't google that...) - and an over-reaction to identifiable 'allergens' was set up (even sunlight in the case of rosacea).

All this clogs the MGs and damages the eyes with keratitis (search 'blepharoconjunctivitis or 'blepharokeratoconjunctivitis''), unfortunately. But there's a lot of work underway currently to look at various inflammatory pathways for this and other autoinflammatory disorders, thank God (see PubMed 'acne rosacea' 'acne blepharitis' etc) and some of the endocrinology journals are way ahead of derms and ophth but too detailed and specific to be useful yet, but interesting eg Journal of Hormone, Steroid and Lipid Metabolism. Therein, I feel, lies the key.

Jenny, In MGD and acne, what we're doing is trying to improve the lipids and the sebum and diet is one of the ways to do this (poor LM has what she's eaten written all over face and coming out of the MGs some days, so I know a good clean nutritious diet helps). We are listening to EyeAllergyKids on diet, esp not eating processed foods, esp not with the enemy, glucose-fructose corn syrup, (but without the enemas, lol). But you've got a lot more going on than MGD, haven't you, so health-wise you'd be building your strength, esp immune system <hug>

Despite all this trailing around the best available derms in UK, I've just finally given in and booked a naturopath to see if they have a clue what's happening, lol. I'm expecting them to say it's the thyroid-adrenal-pancreas axis (and a few more bits not working), and there's food intolerance and hypersensitivity. Yeah, but what do we do about it.

I still think using various steroids for immunosuppression, eg for acne, can trigger acne rosacea (search PubMed 'steroid acne') and in some people it hasn't rectified (this is proven for children, search PubMed 'child steroid rosacea').

Jenny, didn't your acne start after you started N Acetyl Cysteine? I'm wondering what the heck that is doing to you (mucolytic).

If it is rosacea more than acne, Tiff, you'd be looking at helping the skin maintain a good barrier with compatible moisturisers (pH neutral, perfume and paraben free etc).

Again, not a doc, not a derm. Just trying different things too, trying to work out what's gone wrong

[jenny2008]

when i was gluten free-and so strict my skin looked grea-but i wasnt breaking outmuch beforethat.. also, i do have a treat now and then but other than that i eat very healthy-almost gluten free (i know not 100%).. anyway, i gave up the diet cause it didnt helpmy eyes or glands...

but i think i did start taking NAC around taht time ... i thought maybe it was from that too but the derm said no its not! i already took a pill today but am gong to stop it and see if my skin clears up..

ps. i tried tea tree oil but it just made my skin purge even more all over my neck!

[jenny2008]

also.. does anybody know anything about Finacea (azelaic acid) ? its not a retinoid so safe for the eyes/????? of course the doc and the pharmacist said that topical retinoids do not penetrate into the body.. its hard to find info online re: that.. most say its just from accutane.. ahhh.frustrating..

[jenny2008]

Ok i looked in my calender.... i went to the derm right when i started NAC and i know it took a few months to get the apt so i am prob not breaing out due to NAC but i may still stop it as the acne has gotten worse..

[spmcc]

I think the Rosacea is not to blame for the blackheads and large pimples. I don't get any flushing or other facial Rosacea symptoms, but I do have a very slight pink tone to my skin.

Hi Tiff,

I see on your profile page that your diagnosis is ocular rosacea. Is this self-diagnosis or did a doctor tell you this? If it's a doctor's diagnosis, do you not believe it?

Personally, I don't have acne. I have facial rosacea and ocular rosacea. I get rosacea pustules when my skin is annoyed (e.g., flush/blush). I have very typical rosacea... I react to everything here: http://www.rosacea.org/patients/materials/triggers.php and more.

I feel that acne and rosacea are very different. Because of my personal experience, I can only speak for rosacea. The main treatments for papulopustular rosacea (supported by lots of research) are

1) oral antibiotics - you must take these for a long time... not a week or two and expect to be clear. Your doctor may prescribe doxycycline 100mg twice per day until things are under control (could be 6+ months) and then reduce to a "sub-microbial" dose of 40mg per day. Follow your doctor's orders and be very, very patient (don't stop treatment).

2) topical metronizadole - there are different concentrations (.75% and 1%) and different bases (gel, cream, lotion). You may need to try out different ones to figure out which is best.

3) trigger avoidance - this should be #1, but it's the hardest to do. If you can do #3, often #1 and #2 can be kept to a minimum.

As for peels, acids and benzoyl peroxide, they make rosacea worse.

Sorry I can't be of much help regarding acne.

All the best,
Sheila