Acne

[Casca]

You’d do well to run yourself a course of Accutane, obviously bloods every month as are required. Nuetralizing the over developement of sebum from the sebaceous glands. Stay out of the sun during treatment and get something for your dry nose and lips.

 

[Tiny Mighty Joe]

Can you explain what was harsh about it? I do know it messes with lipids and possibly slows down the HPTA, but I've never heard of anyone explain why it's so harsh besides the fact that it dries skin out (but that's how it works).

I am going through a course of Accutane, 40mg a day.Its been almost 4 months now, and ti has clam downed most of my acne. Mostly cystic acne. It was pretty bad. I'm 66 years old, and never had acne in my life. I am on low dose trt. The only complaint I have is the dry lips. No other side affects. I get my blood work done every month,and all show good, considering I take other meds for other health issues. I know this medication is harsh, but its different for everyone. I would consider taking it, but blood work is imperative... Good luck.

 

[Flaming Dragon]

It's best not to run a cycle and use Accutane at the same time, as the amount of pressure and harsh conditions it puts on your liver. If you're having acne issues during cycle then clears up after PCT. I would recommend you run 6-8 months of 20-40mg per day and allow 60 days before you run another AAS cycle. As for doxycycline, I've used it and have great results. But it's not a long term treatment like Acctane and will wreck your immune system if taken more than 30+ days

 

[Michael Scally MD]

Androgens, Androgen Receptors, and the Skin: From the Laboratory to the Clinic With Emphasis on Clinical and Therapeutic Implications

The effects of androgens on human skin include growth and differentiation of sebaceous glands, terminal hair growth, epidermal barrier function, wound healing, and modification of the cutaneous microbiome. Androgens exert their activities via ligand formation with intracytoplasmic androgen receptors which can then translocate to the nucleus and interact with genetic androgen response elements to influence signaling cascades.

Differences in tissue distribution and activities of enzymes that modify androgen synthesis and catabolism, variations related to gender and ethnicity/race, and genetic polymorphisms that affect androgen receptor functionality directly impact androgen physiology and the pathophysiology associated with a variety of disease states.

This manuscript reviews the fundamentals of androgen physiology, androgen synthesis and catabolism in local skin tissue, androgen receptor activity, as well as the impact of genetic polymorphisms and gender. Emphasis is placed on the roles of androgenic activity in sebaceous gland development, sebum production, and the pathophysiology of acne vulgaris.

Del Rosso JQ, Kircik LH, Stein Gold L, Thiboutot D. Androgens, Androgen Receptors, and the Skin: From the Laboratory to the Clinic With Emphasis on Clinical and Therapeutic Implications. J Drugs Dermatol. 2020;19(3):30-35. Androgens, Androgen Receptors, and the Skin: From the Laboratory to the Clinic With Emphasis on Clinical and Therapeutic Implications

 

[Michael Scally MD]

Game Changer in Acne Treatment

Of the four primary pathogenic factors that drive acne vulgaris—
1. androgen excess,
2. increased sebum production,
3. faulty keratinization, and
4. overgrowth of C. acnes—

androgen excess has been the most elusive therapeutic target.

Oral contraceptive pills (OCPs) have direct effect on circulating hormones, but their potential use is limited to a subset of women. As such, a sizable portion of the population affected by acne vulgaris cannot even consider treatment with OCPs.

While these systemic agents are generally associated with a low risk profile and have a history of safe and effective use, they are not entirely risk-free. Indirect androgen modulation through the use of spironolactone has become increasingly popular

Kircik LH. Game Changer in Acne Treatment. J Drugs Dermatol. 2020;19(3):28. Game Changer in Acne Treatment

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

 

[Michael Scally MD]

[OA] Acne Related to Dietary Supplements

Multiple prescription medications may cause or aggravate acne. A number of dietary supplements have also been linked to acne, including those containing vitamins B6/B12, iodine, and whey, as well as "muscle building supplements" that may be contaminated with anabolic-androgenic steroids (AAS). Acne linked to dietary supplements generally resolves following supplement discontinuation.

Lesions associated with high-dose vitamin B6 and B12 supplements have been described as monomorphic and although pathogenesis is unknown, a number of hypotheses have been proposed. Iodine-related acne may be related to the use of kelp supplements and has been reported as monomorphic, inflammatory pustules on the face and upper trunk.

Whey protein supplements, derived from milk and used for bodybuilding, are associated with papulonodular acne involving the trunk and sometimes the face. Finally, AAS-induced acne has been described as acne fulminans, acne conglobata, and acne papulopustulosa.

With studies indicating that about half of US adults report using dietary supplements, it is important that dermatologists directly ask acne patients about their supplement use and educate them on the potential risks of even seemingly innocuous dietary supplements.

Zamil DH, Perez-Sanchez A, Katta R. Acne related to dietary supplements. Dermatol Online J. 2020;26(8):13030/qt9rp7t2p2. Published 2020 Aug 15. Acne related to dietary supplements

 

[shipman]

It's from test converting to e an then dht lower your test dose dht causes me acne also untill ingot smart an stopped running 400plus of test a week ..lower test and add a stack of shit that won't convert to dht prob solved

 

[e90fs]

I always had issues with acne and had nothing to do with steroids. And I dont want to jinx it, but I might have found something that works for me.

Tea tree oil. I have scalp acne and whenever I use it there, the pimples are gone by the next day. Now, probably it would be different if you are on cycle. But nevertheless, give it a try. I stopped using accutane thanks to this.

 

[Al3s]

I always had issues with acne and had nothing to do with steroids. And I dont want to jinx it, but I might have found something that works for me.

Tea tree oil. I have scalp acne and whenever I use it there, the pimples are gone by the next day. Now, probably it would be different if you are on cycle. But nevertheless, give it a try. I stopped using accutane thanks to this.

I've heard about tea tree oil and may give it a go. Do you buy it pure? how do you apply it and how much?

 

[e90fs]

Pure, and I apply it on top of the pimple and around it. Just a personal preference. A few drops do the work.

It has a strong smell. Better use it while you΄re at home.

 

[Al3s]

Pure, and I apply it on top of the pimple and around it. Just a personal preference. A few drops do the work.

It has a strong smell. Better use it while you΄re at home.

Thanks for the warning; I have barely any sense of smell

 

[AvA182]

I use doxycycline

 

[Michael Scally MD]

Clascoterone: How the Novel Androgen Receptor Inhibitor Fits Into the Acne Treatment Paradigm

Many patients with acne remain unsatisfied with results from the various topical treatments available and often do not improve, because of poor adherence. Even if topical clascoterone, a safe and effective treatment, were more potent than existing topicals, it could face the same poor adherence hurdle as existing treatments.

Real-life efficacy will likely not reflect trial results because, for several reasons, adherence is better in trials than in real-life practice. Although topical clascoterone may be exciting initially for its promise to improve acne outcomes, the long-term place in therapy may be another topical option that minimally enhances patients' treatment outcomes.

Purvis CG, Balogh EA, Feldman SR. Clascoterone: How the Novel Androgen Receptor Inhibitor Fits Into the Acne Treatment Paradigm. Ann Pharmacother. 2021 Feb 5:1060028021992055. doi: 10.1177/1060028021992055. Epub ahead of print. PMID: 33543640. SAGE Journals: Your gateway to world-class research journals

 

[Michael Scally MD]

Clascoterone Cream (1%) Topical Androgen Receptor Inhibitor For The Treatment Of Acne

Introduction: The efficacy of clascoterone cream was demonstrated in two phase three vehicle-controlled clinical trials that enrolled over 1,400 subjects. Its safety profile allowed it to be approved for treating patients as young as 12 years old. During clinical trials, the occurrence of local skin reactions (edema, erythema, pruritus, dryness) was similar to treatment with vehicle alone.

Areas covered: All publications describing the clinical development of clascoterone cream (cortexolone 17α-propionate) are reviewed and discussed in relation to with existing topical and systemic therapies for acne vulgaris.

Expert opinion: Clascoterone 1% cream is a novel first-in-class topical androgen receptor inhibitor for the treatment of acne vulgaris. Topical clascoterone 1% cream represents the first new type of therapy for acne treatment in almost 40 years and may become first-line therapy.

Gold MH. Clascoterone cream (1%) topical androgen receptor inhibitor for the treatment of acne in patients 12 years and older. Expert Rev Clin Immunol. 2021 Feb 22. doi: 10.1080/1744666X.2021.1894131. Epub ahead of print. PMID: 33616473. https://www.tandfonline.com/doi/abs/10.1080/1744666X.2021.1894131?journalCode=ierm20

 

[LittleD90]

Clascoterone Cream (1%) Topical Androgen Receptor Inhibitor For The Treatment Of Acne

Introduction: The efficacy of clascoterone cream was demonstrated in two phase three vehicle-controlled clinical trials that enrolled over 1,400 subjects. Its safety profile allowed it to be approved for treating patients as young as 12 years old. During clinical trials, the occurrence of local skin reactions (edema, erythema, pruritus, dryness) was similar to treatment with vehicle alone.

Areas covered: All publications describing the clinical development of clascoterone cream (cortexolone 17α-propionate) are reviewed and discussed in relation to with existing topical and systemic therapies for acne vulgaris.

Expert opinion: Clascoterone 1% cream is a novel first-in-class topical androgen receptor inhibitor for the treatment of acne vulgaris. Topical clascoterone 1% cream represents the first new type of therapy for acne treatment in almost 40 years and may become first-line therapy.

Gold MH. Clascoterone cream (1%) topical androgen receptor inhibitor for the treatment of acne in patients 12 years and older. Expert Rev Clin Immunol. 2021 Feb 22. doi: 10.1080/1744666X.2021.1894131. Epub ahead of print. PMID: 33616473. https://www.tandfonline.com/doi/abs/10.1080/1744666X.2021.1894131?journalCode=ierm20

Do we have date when Dr’s in the US can prescribe it ?
gonna ask my doc about this