Cystic Acne?

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Mehita

Mehita

Joined
Nov 12, 2011
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DS is asking for advice. He's been having cystic acne, particularly on his nose, for several weeks and it's frustrating him. Not only is is painful, but having 5-6 of these large lumps concentrated in such a small area really draws attention to his nose. One is interfering with where his glasses rest.

He washes his face once per day in the evening and has been using Tea Tree oil fairly regularly. It's pretty obvious the acne is puberty related, but he's wondering what others have done. He has no other skin issues aside from his face.

My questions are:
-isn't there an acne med that should be avoided with IBD? Accu something?
-he gets Solumedrol as a pre-med with his infusions. Will this help the acne?
-I read online that sometimes antibiotics can be used as a treatment. Of course, my first thought then goes to Cdiff.

He's never seen a derm. Should he?
 
Poor kiddo, no advice really but I think I remember reading on here about a face wash someone was using. What does he use to wash his face?
 
C's CD first flared after starting doxycycline antibiotic for acne treatment.

He also had steroid induced cystic acne which we saw a dermatologist about. Most of the creams she offered weren't supposed to be used with those who have IBD and the GI didn't want C on long term antibiotics.

They referred us to an aesthetician and she had him wash twice daily with a mixture of corn meal and phisoderm. She also did peels for him monthy. I was worried the peels would really irritate his skin but they didnt. And after the second peel his face looked so much better.

There was a medical site that listed all the dermatologist meds you should avoid if you have IBD but now I can't find the link.

C's GI said if C had been in deep remission he wouldn't have been as concerned with trying a med but he didn't want to rock the boat at that time.
 
Oh there was this product that was a mask she gave us too that was awesome. I'll ask my daughter what it is because she took over C's jar when his cleared. She doesn't even have acne but her roommate does and is now purchasing this mask as it has worked well.
 
Your poor son, acne is miserable. No advice but sending hugs.

I think the acne med that people talk about is accutane. Some people say that is caused their Crohn's I think.
 
Aww I feel for him. I have the same issue but I'm past puberty (20). Haven't found a good way to manage it other than trying to cover it with makeup ( probably not an option he would try) I tried regular acne wipes, Clinique, and pre diagnosis topical antibiotics. Non of it really worked. If I didn't have IBD I would try Accutane but I have heard bad things about it with ibd. I will be watching this thread for suggestions.
 
My non IBD daughter has cystic acne. She had good luck with an aloe product but recently found this stuff called "grease lightening" It is sold at the store Lush...they are typically in malls. Anyway she swears by it now.

T got acne after she started Entocort...maybe puberty, maybe steroids but she also says the grease lightening is magical.

FWIW - our GI told us not to use Accutane for my non IBD daughter. Also tried to steer us away from doxy.
 
Antibiotics are most common treatment offered by GP. Courses are usually six month long.

Get a medical opinion to confirm your foe. Severe acne on the nose could be Rosacea. Rosacea does not like most over counter treatments if anything they make it worse.

It is possible to have more that one type of acne.

Antibototic creams and gel seems to work quite. They do cut the life cycle cystic acne. I personally would try them first over system wide antibiotics treatments.

Are your cleaning the nose pads (glasses)? If not start now. As they spread the acne.
 
Jmrogers4 said:
Poor kiddo, no advice really but I think I remember reading on here about a face wash someone was using. What does he use to wash his face?
Click to expand...

He's just using facial wipes from Costco. I can't remember if they are Kirkland brand or Neutrogena. I just realized I should check the ingredients for gluten since he's reacted badly to soaps and shampoos with gluten.

While he realizes the acne is a problem, being a boy, he isn't keen on spending too much time to actually FIX the problem (i.e. five step facial cleaning process).
 
Catherine said:
Antibiotics are most common treatment offered by GP. Courses are usually six month long.

Get a medical opinion to confirm your foe. Severe acne on the nose could be Rosacea. Rosacea does not like most over counter treatments if anything they make it worse.

It is possible to have more that one type of acne.

Antibototic creams and gel seems to work quite. They do cut the life cycle cystic acne. I personally would try them first over system wide antibiotics treatments.

Are your cleaning the nose pads (glasses)? If not start now. As they spread the acne.
Click to expand...

Have you tired the topical antibiotics? I tried before my diagnosis but I am paranoid about trying it now. (Though it didn't work but maybe a different antibiotic would).
 
Avoid dairy. I used to get horrible acne as a teenager from it cos of the hormones and inflammatory properties.

Treatment: wet a small piece of paper towel with hydrogen peroxide and paste it over the affected area. Leave it on for about fifteen minutes twice daily. Or use benzoyl peroxide cream in thick dabs instead of thin layer.

Use witch hazel for daily maintence twice a day as a natural alternative to harsh meds.
 
FrozenGirl said:
Have you tired the topical antibiotics? I tried before my diagnosis but I am paranoid about trying it now. (Though it didn't work but maybe a different antibiotic would).
Click to expand...

I use topical antibiotics are rosacea on my nose which do not heal without treatment. Topical antibiotics work much quicker than long courses of antibiotics. They only use to used until to the rosacea stop clears and for a couple more days. They works in about 4 days.

My daughter (16) used both topical and tablet antibiotic and severe cystic acne. If we could use topical alone we would. Topical antibiotic seems to heal the acne that appears. The tablets have reduced the number of acne that we need to treat with topical antibiotics.
 
My son had horrible horrible cystic acne when he was on steroids for 4 months. It was so random how and when these big places came up and stayed so long. I begged the derm for something but he knew enough about IBD to say no meds until he was in stable remission. I almost had him convinced to prescribe Epiduo so that may be an option for your son.

Some people suggested different multistep systems. How could a boy who had to be reminded to brush his teeth follow a 4 step routine?

He did end up using an organic, natural, crunchy, :) gluten free product from Australia that I thought would be a waste of time. It worked wonders along with a prescription cleanser and a few facials from an aesthetician (acne was so bad he went willingly). I'll get brave and go into his bathroom and get the names for you.
 
For those of you who have experience with cystic acne, can an itchy scalp be related? He says it's driving him nuts. I looked for lice (yuck!), but didn't see anything. Just very, very light dandruff. This is all getting weird... no change in soaps or shampoos or anything, no gluten. I'm baffled.

Remicade appointment next Thursday. Should I try to get him into a derm?
 
My regular seasonal allergies give me a very itchy scalp. I take benadryl at night and zyrtec in the morning, and that takes care of it except during the worst of the pollen season. E has an itchy scalp due to mild psoriasis, and washing her hair with a dandruff shampoo helps with that. The two times my younger daughter has complained of an itchy scalp, it has been lice. Until lice gets bad, you probably won't find anything just by looking. A comb like the Terminator Nit-Free comb is the easiest way to check for lice. (Regular drugstore combs, even metal ones, don't work very well.)

Hope you figure out what it is, and that it's an easy fix.
 
Derm who is familiar with crohns and remicade
Remicade can bring skin issues to the surface ( not create them)
Roscea and serbatic dermitis or psoriasis can cause things to itch
Tagging Crohnsinct
 
No itchy scalp here but K did have cystic acne at the hairline and approximately 3 cm into the hair. Never on top of head.

If it cystic acne you should be able to see it.
 
You could try a violet ray device. They have been around for over a hundred years and are used for an acne and wrinkles treatment nowadays.

I have the one in the link but really have not had the opportunity to test it on acne.
I did read a bunch of testimonials and it seems that most people said it worked to some degree for acne but not very well for wrinkles.

For 40 bucks it might be worth a try before more risky treatments are considered.

http://www.amazon.com/Darsonval-High-Frequency-Violet-Ray/dp/B00D820L60

If you try it, I would like to know the results or lack of results.

Good luck.

Dan
 
As an Amazon Associate we earn from qualifying purchases.
Are the white flakes big or small. Little small flakes could be dandruff or sorry nits from lice. If you shake the hair do the small white specks fall easily? Then probably dandruff. If not then likely nits.

If larger flakes and plaques are in the scalp then likely psoriasis.

Sadly I hVe lots of experience with all three. Let me know which you think it is and I will respond more specifically.

Mlp is right. Remicade does bring skin issues to the surface and scalp psoriasis is becoming more and more common with remicade use. Crohns and psoriasis share a lot of the same issues also so not uncommon to have both regardless of anti tnf use
 
crohnsinct said:
Are the white flakes big or small. Little small flakes could be dandruff or sorry nits from lice. If you shake the hair do the small white specks fall easily? Then probably dandruff. If not then likely nits.

If larger flakes and plaques are in the scalp then likely psoriasis.

Sadly I hVe lots of experience with all three. Let me know which you think it is and I will respond more specifically.

Mlp is right. Remicade does bring skin issues to the surface and scalp psoriasis is becoming more and more common with remicade use. Crohns and psoriasis share a lot of the same issues also so not uncommon to have both regardless of anti tnf use
Click to expand...

It's dandruff. Very light dandruff.

He also said his back itches, so I looked and he seems to have some sort of rash going. Raised bumps that aren't red. They remind me of tiny mosquito bites and there is a clump on his shoulder and a clump lower on his back.

Could some of this be related to sweating? He has gym class every day now, but no time to shower and according to him, no time to hardly wipe down with a towel when changing. Clogged pores? All of this has been since school started.

I know, I'm reaching.
 
Molluescum see a dermo
Most kids have immunosuppressants make it harder to get rid of but benign
Either way too many skin issue so see a dermo
 
Bingo.

Now I'm wondering if that's what is on his nose too. It's so hard to tell.

I'll call on Monday.
 
Yeah my kids had molluescum also. O's never itched though.

I agree...derm time. Good luck. A good derm is hard to fine.
 
DS is at a friend's birthday party. The mom just called me to say he's been in the bathroom a long time (at the park) and they're not sure what to do. I called him and he said he's nauseous and doesn't feel right, but he wants to stay awhile longer.

I have a bad feeling about this. Does molluscum correlate with flares?
 
Poor kiddo -- no idea about molluscum, but sending hugs. Has he had any other IBD symptoms recently?
 
Aside from the skin stuff, no. He came home early and said it feels "crohnsy", like last spring when he was exhausted all the time. I guess we'll just see how he is in the morning. It sounds horrible, but I'm hoping someone else in the family starts feeling crappy soon.

He's supposed to run the mile tomorrow for gym class and that's his biggest worry right now. His 504 says he can pull himself from gym anytime. I don't understand why he's so hesitant to do it. A teenage thing?
 
My daughter was like that too in high school. She was not supposed to do gym and the teacher just had her sit in the gym and watch the other kids which made her miserable and self-conscious.

Eventually, we talked to her guidance counselor who made it such that she could just go to the library during gym, so kids weren't constantly asking her what was wrong with her and she didn't feel so out of place.
 
My oldest just walked the mile run with another kiddo
That way he wasn't sitting but wasn't running either

Mollescum didn't flare with crohns for Ds
It just was
And got worse with remicade /humira so dermo treated it after they multiples like bunnies
 
Oh man I'm so sorry this day has been so bad for him. Let's hope it is just a virus or something? :)

That mile thing is hard to deal with in PE when they are sick. They do not want to sit and watch, do part of class, or walk.... They just want to be normal, with no attention called to them. No matter how many times you tell them other teens are probably so busy worrying about themselves that they have no mind space left to notice or care about you, they still hate to be different. It is one part of this journey that really breaks my heart. We had to make my son go to library during certain PE days, just quietly disappear and then show up for the next period. He still thought that was horrible but I think it big picture being away was a better choice. I don't think anyone every called out when he skipped.

Maybe it will rain or the gym will be booked or there will be a fire drill during pe.
 
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Fwiw O's skin stuff happens independent of what is happening with her crohns. Lots of non crohns kids get Molluscum and dandruff.

O hAs done that exhausted crohnsy thing on a few occasions and we tested her and all was fine. She would get infusion and bounce back. So probably normal teen tiredness and just coincidental that infusion fixed it?
I hope it's the same for you guys.

When is his next infusion due?

As for the mile, around here it is just something they do. Doesn't count toward grade. As a matter of fact last yeR it coincided with cross country championships and the team was tapering. Coach gave them instructions to walk it. It was kinda funny when the whole track team failed to meet the running fitness level.
 
Sorry he is having a rough time now. I agree that it sounds like he needs a derm consult. Seems there is a lot of weird skin stuff that can come with crohns. Caitlyn has been getting weird reddened bumps on two knuckles and her elbow. The doctor told us skin stuff can be weird with crohns and we are waiting for a derm referral for her.
 
Took DS to see a dermatologist today who was recommended by a Crohn's family. Thankfully, it's not molluscum, "just" acne... and a wart on his foot. He's being put on an antibiotic for eight weeks and has a prescription for Epiduo Forte. The doctor said he thinks it will help tremendously considering the amount of inflammation and number of bumps on his nose.

Unfortunately, I can't remember the name of the antibiotic, but it was one I hadn't heard of. He said we'd start with this one, but if DS gets stomach issues, he can switch to a lesser antibiotic.

His GI isn't thrilled, but understands the need for the abx. We're going to wait a couple of days after the infusion before starting them just to avoid having too much going on at once. I also don't want the abx to affect his labs.

He stayed home sick yesterday with fatigue and nausea, so no mile run. I haven't talked to the teacher, but I'm sensing the run is a requirement to pass the class.
 
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Ugh I hate to say this but M was on Ceftin was a sinus infection (for 2-3 weeks). She got CDiff, which was a pretty miserable experience.

Our GI says pretty much any antibiotic can cause CDiff. Clindamycin is apparently one of the worst offenders. You're at greater risk for CDiff if you have IBD and the risk is even greater if you've already had CDiff once. That said, M has recently been on three antibiotics for her tube infection -- Keflex, Levofloxacin, Flagyl, and she didn't get CDiff. She's been put on a fourth antibiotic (Bactrim) and we'll see how it goes.

M is on probiotics (VSL#3) which her GI recommends with antibiotics. Besides that we didn't do anything special (except pray to the Crohn's gods for no Cdiff :lol:).

Good luck!
 
Yeah, the risk of C Diff is why his GI isn't thrilled. The Derm didn't think just a topical abx would be enough. That just goes to show how severe things are I guess.

I've lost track, but I believe DS has been on Clynda w/o issue. I want to say that was one of the IV's he did at home with his PICC line. I should look it up.
 
Every kiddo is different. M has been on antibiotics about 6 times in the last two years but only got CDiff the one time. If he really needs them (and it sounds like he does), I would just watch carefully for CDiff - M had watery diarrhea that was very urgent. She was going 10-15 times a day I think.
 
Can you try Epiduo on its own first? If it going to work on it own you will notice a difference within a week.
 
Catherine said:
Can you try Epiduo on its own first? If it going to work on it own you will notice a difference within a week.
Click to expand...

We probably could. GI said wait a couple days after Remi on Thursday and he's starting the Epiduo tonight. I think we could stretch to next Tuesday. Good idea.
 
Hope the antibiotics do the trick without any problems. It is a really difficult one, we were also given antibiotics but I couldn't bring myself to risk it. However I found the Cetaphil cleansing wash (recommended on here) did enough to get rid of the cystic acne and inflammation so was able to hold off. If it had continued we would have had to do antibiotics. Acne is still there but no longer huge and bleeding.
 
Wow. Wow. Wow. Just using the Epiduo Forte creme two nights in a row and DS is seeing a BIG improvement. All the redness and inflammation are gone and everything on his nose is shrinking significantly. We're going to give it a week and then I'm going to call the derm to get a better understanding of why he px'd the antibiotic and quite possibly argue against it. DS is very happy with the results so far, so why even risk a flare or c diff?

All of today's labs came back normal and the infusion went without issue. I'm chalking up last weekend's episode as a blip.

Resuming breathing now.
 
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So glad it's working! It would be great if you could avoid the antibiotics.
 
That's awesome! And with no antibiotics it is even better. I'm going to look into Epiduo and see if it is available in Canada, I would love a non antibiotic med to try.
 
FrozenGirl said:
That's awesome! And with no antibiotics it is even better. I'm going to look into Epiduo and see if it is available in Canada, I would love a non antibiotic med to try.
Click to expand...

There are two different Epiduo's. One is regular strength and the other, which DS is using, is called Epiduo Forte, and is stronger. It just came out in September. Good luck!
 
Mehita said:
There are two different Epiduo's. One is regular strength and the other, which DS is using, is called Epiduo Forte, and is stronger. It just came out in September. Good luck!
Click to expand...

Good to know. Maybe sometime soon I can get an appointment with my primary care doc and see if she can prescribe it and which is avalible here.
 
Can someone help me think through this...

Presumably, DS was px'd the antibiotics for his skin due to infection. He had labs run at his infusion and his WBC was completely normal. That would mean no infection, right? Can you have mild infections that don't show up on labs?
 
Mehita said:
Can someone help me think through this...

Presumably, DS was px'd the antibiotics for his skin due to infection. He had labs run at his infusion and his WBC was completely normal. That would mean no infection, right? Can you have mild infections that don't show up on labs?
Click to expand...

Absolutely
 
My daughter has recently had two infections around her GJ tube. The first one showed up in her bloodwork, but the second one didn't (though it did show up when they cultured the gunk coming out of her tube). They said that "surface" infections often elevated WBC.
 

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