Discussion in 'Steroid Forum' started by Todd1234, Oct 11, 2011.

  1. TheSpectre

    TheSpectre Member

    Clindamycin is commonly commonly prescribed for acne. Bactrim, not as much. Personally, Rifampin blasted my pus filled cystic acne in a week. Online pharmacies sell antibiotics.
    Toadzyyy likes this.
  2. Ophydian

    Ophydian Member

    I just looked Rifampin up and was surprised what it was mainly used for. I’d assume it’s pretty strong since it’s used to treat TB?
  3. cfreetenor

    cfreetenor Member

    What does cystic acne around the jaw indicate hormonally if I’m not now nor ever have been on cycle?
  4. Ophydian

    Ophydian Member


    How old are you? Could be hormonal. You don’t have to cycle to get that.
  5. cfreetenor

    cfreetenor Member

    26. And ouch is right. It seems to flare cyclically so hormonal makes sense. I’ve considered 1mg Letro at the first sign of a flare.
  6. Ophydian

    Ophydian Member

    I couldn’t imagine cystic acne on my face and I’ve never used Letro so I was wondering if a less harsh AI could be used.
  7. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Valente Duarte De Sousa IC. New and emerging drugs for the treatment of acne vulgaris in adolescents. Expert Opin Pharmacother 2019:1-16.

    INTRODUCTION: Acne vulgaris is the most common skin disease worldwide, yet current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms involved in the appearance of acne lesions is key to treatment success. This paper aims to discuss the novel treatment modalities that have surfaced in consequence of new knowledge obtained in acne pathogenesis.

    AREAS COVERED: Pathogenic pathways are evaluated and discussed throughout the paper in relation to the mechanisms of action of novel molecules being investigated for the treatment of acne vulgaris. A comprehensive search was made in PubMed and using a different combination of keywords, which included acne vulgaris, treatment, therapy, and therapeutic.

    EXPERT OPINION: In the near future, more effective treatments with less side effects are expected. The use of topical anti-androgens, coenzyme-A carboxylase inhibitors, and insulin growth factor-1inhibitors to control sebum production seem promising.

    Selective RAR-agonists have the potential of becoming an alternative to the currently available retinoid therapy in the management of infundibular dyskeratosis with a better safety profile. Antibiotic use will probably decline as more effective options for controlling Cutinebacterium acnes colonization and the inflammation cascade emerge.

    Attached Files:

  8. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Severe Acne Fulminans Following Low-Dose Isotretinoin and testosterone Use

    Practice Points
    · Acne fulminans, the most severe form of acne, is characterized by deep ulcerations covered by a hemorrhagic crust. It is commonly associated with fever, polyarthralgia, and myopathy caused by rapid weight loss.
    · This rare condition is recognized as a potential complication of oral isotretinoin therapy.

    We report the case of a 21-year-old man who was referred to the Department of Dermatology by his primary care physician for evaluation of severe hemorrhagic lesions on the trunk following use of oral isotretinoin (Figure 1).

    Prior to development of the lesions, the patient had started weekly intramuscular injections of testosterone 500 mg, which he purchased online without consulting a physician, to address muscle mass reduction associated with sudden weight loss from intense physical training.

    After 8 months of testosterone supplementation along with continued physical training, the patient presented to his primary care physician for treatment of acne vulgaris on the back and trunk of 2 months’ duration.

    Oral isotretinoin 20 mg once daily was initiated; however, the patient reported that the acne lesions showed progression after 1 month of treatment. Isotretinoin was increased to a more weight-appropriate dosage of 60 mg once daily 2 weeks before admission to our dermatology clinic.


    Baranska-Rybak W, Mehrholz D, Flis P, Karpinsky G, Sokolowska-Wojdylo M. Severe acne fulminans following low-dose isotretinoin and testosterone use. Cutis 2019;103:E20-e1. Severe Acne Fulminans Following Low-Dose Isotretinoin and Testosterone Use
  9. skinnyman

    skinnyman Member

    What the hell! Is this caused because of contaminated gear ?
  10. Ophydian

    Ophydian Member

    He looks like a burn victim.

    Warning do not google acne fulminans and look at images.
  11. GruntLife51

    GruntLife51 Member

    i thought id share my story with you guys as far as acne and AAS use. my first cycle i ran a little long over 16 weeks, like a newb, anyhow i started to break out really bad on back, chest, and shoulders, mildly on neck. id give it about a 7, for whatever its worth. it cleared slightly when i came off and kinda kicked back up while on SERMS.

    my skin cleared up almost completely well after pct. i never had perfect skin, i always had a few spots here and there on my back, but it was never cystic.

    i ran my second cycle, which was a shorter cycle of i think 8-10 weeks. started to get acne again, but not bad because it was so short it kept it around a 5. i also dabbed with low dose of accutane 20mg EOD which seemed to help. i only ran this for about 4 weeks, and my supplier ran out so i didnt run it like you need to, but hey, it did its job while on. i also had a proper skin protocol which i will discuss below, which was most effective.

    my third cycle now, i started taking just test again. i continued my skin protocol which helped tremendously. i also went to a derma, who prescribed me claravis(same thing as accutane)...isotretinoin. he knows i am on testosterone, it was the first thing he asked when i took my shirt off. i am running 40mg ED, i noticed some sides compared to none the last cycle when i was only doing 20mg EOD. the sides consisted of dry lips, which feels different than good ole chapped lips. they cracked at the corners, all in all not horrible at all. also dryish skin, which i use cerave for which isnt oily. i dont really notice any joint pain. after 4 weeks of the claravis i now notice no side effects, and when i dropped the dose to 20mg a day for a few days, the dry lips started to go away. i had forgotten to keep up on my dosage. i am running 40mg ED consistent again and the only thing i notice is the dry lips.

    as for the skin care.
    -apple cider vinegar(diluted)
    -thayers witch hazel(i used with rose petal scent)
    -benzoyle peroxide(2.5% or 10%) be careful running 10% can ruin clothes and carpet etc...
    -i also would do stuff with lemon juice from real lemons(helped scars)
    -differin Adapalene .01%....i only tried this with one tube, cant tell ya if it did anything because i was already running accutane
    I did not do all these daily, i rotated them. i usually did two of each a day. i showered at night as normal, and also soft showered in the morning and usually did the witch hazel to get the skin cleared up of any oil from overnight.

    in short. there are many things you can do. DO NOT use freaking dish soap. Do not use other types of detergents that can kill good bacteria. stop eating sugar, stop drinking milk!!!! these are the first. if you dont do these then the rest is a waste of time and money. DO NOT take doxycycline. why wreck your immune system and gut health to try an kill acne causing bacteria. moreover if youre putting garbage into your body still?

    i think you will, as i had, great results with cutting out processed food and sugar, in addition to a good skin care routine. especially being on gear, you are oily and sweat a lot, which is not good.

    my cumulative dose of 40mg ED of isotrentinoin is less than 2,000 per my derma.....he said other people get prescribed 2,3,4-5 times that. i cant imagine that! i dont think its necessary if these other steps are being done, unless in severe rare cases.

    if you cant kick the acne thru a diet and skin care routine, i would recommend 20mg isotretinoin EOD, and up it from there. id take it over doxycycline any day.

    also, vitamins is another thing to get into, but ill keep it at that for now.
    gainzoclock, Toadzyyy and Kim like this.
  12. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    AKLIEF Cream is the only topical retinoid that selectively targets retinoic acid receptor (RAR) gamma, the most common RAR found in the skin. Trifarotene is the first new retinoid molecule to receive U.S. FDA approval for the treatment of acne in more than 20 years.

    AKLIEF Cream is the first topical treatment specifically studied and proven to treat both facial (forehead, cheeks, nose and chin) and truncal (chest, shoulders and back) acne, offering healthcare professionals and acne patients another treatment option.
    Wurst and strongsafety41 like this.
  13. Davidinovg

    Davidinovg Member

    Wow, good news.

    Thanks for sharing!
    Toadzyyy likes this.
  14. SaneDog

    SaneDog Member

    Yeah, the acne part of it is pretty relevant. When you mess with hormones like that there's bound to be a breakout. Good luck.
  15. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Open-Label, Long-Term Extension Study to Evaluate the Safety of Clascoterone (CB-03-01) Cream, 1% BID in Subjects with Acne Vulgaris

    Background: Androgens foster acnegenic pathways.

    Objective: To assess the long-term safety of an androgen receptor inhibitor clascoterone cream, 1%, in subjects who participated in Phase 3 studies.

    Methods: Clascoterone cream was applied twice daily for up to nine months to the face and/or trunk. Treatment Emergent Adverse Events (TEAE) and Local Skin Reactions (LSR) were evaluated at Months 1, 3, 6, and 9, and at any unscheduled visit(s). All statistical analysis was performed using SAS®, Windows Version 9.3.

    Results: There were 609 screened and enrolled subjects (n=317 clascoterone, n=292 vehicle from original studies); n=347 completed the study (n=179 clascoterone, n=168 vehicle). Overall, 110 (18.1%) subjects experienced 191 TEAEs. The most frequently reported TEAE was nasopharyngitis (n=20). Fourteen subjects had a total of 19 test article related TEAEs. Nine subjects experienced 9 TEAEs leading to discontinuation. Six subjects experienced seven serious TEAEs, none treatment related; one serious TEAE led to study discontinuation. Overall treatment emergent LSRs=18.1% (110/607). The most frequent LSRs on the face and trunk were erythema, scaling/dryness, and pruritus; most were trace/minimal or mild in severity.

    Limitations: Long-term efficacy was not a primary endpoint.

    CONCLUSIONS: A low frequency of TEAEs over 9-months of clascoterone treatment was observed.

    Eichenfield L, Hebert A, Gold LS, et al. Open-Label, Long-Term Extension Study to Evaluate the Safety of Clascoterone (CB-03-01) Cream, 1% BID in Subjects with Acne Vulgaris [published online ahead of print, 2020 Apr 26]. J Am Acad Dermatol. 2020;S0190-9622(20)30703-9. doi:10.1016/j.jaad.2020.04.087
    Wurst likes this.
  16. Tiny Mighty Joe

    Tiny Mighty Joe Junior Member

  17. Tiny Mighty Joe

    Tiny Mighty Joe Junior Member

    Hello, I am going through a course accutane, going on my third month of 40mg a day. I have severe cystic acne, mostly on my chest back and stomach. Really bad. So far it has calmed most of it down with the occasional out break of maybe one or two on my stomach. None on my face. So I have to say it has helped me quite a bit. No side affects except for the dry lips, but its minimal for me. Lots of lip balm. They say you have to do a long course of this stuff, 6 months to a year for some, with permanent results..I hope thats the case. I do have some hyperpigmintation, mostly on my stomach. It looks terrible, but the doc says he can do some sort of peeling to minimize the marks. Lets hope thats true. Good luck with your situation....
  18. bnp2

    bnp2 Junior Member Supporter

    Wtf... how is that even acne??! What is this I'm looking at
  19. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Acne vulgaris (AV) is an incredibly annoying chronic skin disease. Teenagers around the globe are tormented by it, although most grow over it. Nevertheless, it's quite common in adults too [1]. And if you've grown over it, you can still be struck by it when you start using anabolic androgenic steroids (AAS).

    This article has gotten ridicliously long, so I've included a brief table of contents with clickable links here:
    But what causes acne? Briefly, four primary factors have been found to contribute to the development of acne. These are (in no particular order) [2]:
    1. Sebum production by the sebaceous glands
    2. Propionibacterium acnes (P. acnes) follicular colonization
    3. Alteration in the keratinization process
    4. Release of inflammatory mediators into the skin
    bnp2 likes this.