Saturday, June 8, 2013

Types of Acne Antibiotics

my stash of doxycycline 2 weeks ago.

I have good days and bad days. today is kind of a bad day. things are just harder. i've gotten messages, encouragement and love following my previous post and i was honestly really touched :'). it means a lot to me. really. even though it doesn't mean that things get any easier for me i know and feel less alone. and i'm in constant knowledge that i have very supportive friends and family.

yet the fact is, i still face myself everyday. it's the first thing i see in the morning, before i sleep, or whenever and wherever there's any form of reflection. it's hard to avoid and i sometimes feel that it's almost like a breakup. no matter where you want to hide or how you want to avoid, there's always painful reminders in some quiet corner that you can't run from.

i used to tell G that i think acne scarred me as a person. kind of ironic considering the fact that i eventually cleared myself of surface acne scarring. but the effects of acne go beyond skin deep. and as i said, not everyone recognises that. i've never taken my clear skin for granted for that short year or so that i had it. because i knew how it may be so out of reach for some people. people like me, now. which is why i still stayed away from fastfood, fried foods, and tried to sleep early (i say try because i did go for a number of late night suppers). and i would frequently look into the mirror and feel immensely thankful for my clear skin.

the painful and depressing thing about acne does not stay within the fact that it is in your face, pun intended. it is also the fact that despite medication and creams and attempts, success is not always guaranteed. it's hard to give a fixed timeframe to know when it'll completely be gone or healed, if it does. there's so much uncertainty and that causes distress. especially when the process is hardly easy. okay enough of my ranting and rubbish. let me get on with the purpose of this post.

so i wanted to blog about my last bake last week. but i fell sick. i actually did Baker's Girl Oatmeal Chocolate Chip Cookie (from G). and i honestly have no idea why i made cookies because i'm not a big fan of cookies. i don't even really like eating cookies (because they are heaty). i think it was because i had chips in the fridge so i decided to just go ahead. but it was awhile back and i didn't manage to take any pictures. so i've left the link above if anyone is keen. G did an awesome interpretation of it which is why i decided to give it a shot in the first place. my family likes it. so i hope it works well for you(:

anyhow. i decided to write about the various antibiotics i've taken, for anyone who may be considering, or not. or just for general knowledge.

but i am clearly not a medical practitioner or have any expert knowledge in how it works or anything. what i am about to write is solely based on what i have read online, explainations from doctors and my personal experience. it is also important to realise that different medicine works for different people and have different effects on different people. my cousins and i all take different medication. some worked for them, not so much for me. i got some horrible side effects. they didn't. (lol maybe it's just me ya.) but you get my gist.

so i'm going to share about the various antibiotics that i've tried (you probably won't find many people around you who've tried 4 different acne antibiotics) and my opinion on taking oral antibiotics for acne and the different kind of antibiotics, how they worked for me (or not), what i think of them and why i stopped (including one of which which could have been fatal).

i also talk about Accutane, which is something i've not tried, at the bottom.

so if you've awesome skin you probably won't have any idea what i'm saying and i sometimes think this is my geeky side. yes i think i'm secretly geeky with things like these. *geekspecs*

About Oral Antibiotics & My Opinion:
i'm not sure if i mentioned (i tend to be repetitive and long-winded if you haven't already figured lol). but i was initially against taking antibiotics because of the side effects. and i mean, who would want to go on long-term medication when it probably can be avoided. i only caved when my breakout got quite bad last year and how i saw it worked for my cousins. and personally, i feel that once the acne is starting to affect me sufficiently as a person, emotionally, i probably really need to do something about it. in extreme words, i don't want to live not actually living my life. if that makes any sense at all.

i've also grown to realise that it may not be uncommon. let me explain. Claire who just returned from Cambodia is on the same antibiotic as i am to prevent Malaria. her course lasts for 3 months, once daily. i was prescribed for an initial month (probably will be extended), twice daily. because medications for acne are not solely used for the purpose of treating acne but varies from treating UTI (Urinary Tract Infection), preventing Malaria as mentioned, reducing inflammation (when i fell sick last week my family doctor didn't prescribe any additional antibiotics because he said the one i'm on should help). i also checked with my family doctor regarding the particular antibiotic i'm taking and he did mention that i've taken it a couple of times in the past (to treat general illness) so i shouldn't be allergic or shouldn't have any unbearable side effects or anything. so i do feel more assured.

i am not saying that we should take medication lightly or anything because all medication/drugs will affect the liver because of detoxification/neutralisation/whatever we call it. it's just the severity of it. yes, like our daily painkiller Panadol. i don't advocate oral antibiotics. avoid if you are able to. but if you can't, you don't have to beat yourself up for having to take it. I HOPE I AM MAKING SENSE. ok.

ultimately it is a personal choice. if you're uncomfortable taking it. don't. i always go through a lot of consideration, weighing of pros and cons and deciding what i want (i.e. my priorities) just like a business student, to eventually decide if i want to give this particular drug a shot. this explains why i do so much research before i decide if i'm okay taking a certain drug. my own research and knowledge is certainly inadequate which is why i check and clarify with my doctor. i may not know everything or the full effects but at least i know i'm doing my best to protect myself. i care about my body and i want to know what i'm putting into my system.

there are certain drugs that i know i am unlikely to agree to take because of what i've read about it. i don't just take any antibiotic. #justsaying

the main way that these antibiotics work, i would think, is to reduce inflammation and bacterial growth. this is generally what i've seen across for all the antibiotics.

this is the antibiotic i'm currently taking and on my 14th Day (i.e. 2 weeks) and i've been the prescription for a month.

it belongs to the 'Cycline family' and according to my dermatologist, is an improved version of the two i've taken last year (mentioned below) because there's no diet restriction in taking it. the only requirement is that i take it after a full meal or i may risk gastric or stomach issues.

the main side effects are probably nauseousness. i have been feeling rather nauseous frequently and get carsick far too easily recently. or when i stare too long at the computer or concentrate or something for awhile. this is especially when i don't take enough food. but it is tolerable as compared to other side effects that i've experienced before. my appetite has also shrunk (not an issue for me ^^).

i've also been extremely sensitive to light (photosensitivity) these couple of days. it wasn't so bad for the first week but i really have been feeling it these days. i find the sun too bright and i've to have shades on almost all the time i'm out. it isn't so bad now that i'm working since i'm indoors 80% of the time but on my way to work or when i'm out for lunch, i need to have my shades or be under some umbrella or something. so if you do see me out and i'm in shades, i'm not trying to be cool or anything. i just REALLY can't stand the sun. #justsaying

i've seen various forms of the capsule so i'm not sure if they are the same or anything. but my cousin who took it for her back acne for about 2-3 months found it eventually intolerable as she started encountering digestion issues related to diarrhea and vomiting. claire who is taking it to prevent malaria has been instructed to take it before meal. so i'm not sure if the forms of the capsule affect the way you should take it.

Feb 2012:
I was prescribed Minocycline for 2 weeks for a start. twice daily.

if i'm not wrong, this has to be taken on an empty stomach.

Side Effects:
at 2 doses a day, i experienced giddiness, breathlessness and finger numbness which left me tired and unable to do anything for the whole day. so i called the clinic and they got me to take it once a day instead (which i took at night before i sleep so that i won't feel the side effects). it was much more bearable after that. i eventually took this for a month (2x2=4)

however, i was told that this works for 95% of patients and more than one derm has told me that this is 'the best', in their words. i think 'best' is subjective. it certainly wasn't the best choice for me. but i do believe that it is probably effective for most people?

this was more pricey than Tetracycline.

Feb/Mar 2012:
I took this twice daily for 2 weeks (i was supposed to go back for more but i didn't).

this has to be taken without milk/calcium.

Side Effects:
stomach issues. i lost 2kg and slipped to 47kg while taking this because it made me perpetually bloated, nauseous and queasy. i lost my appetite and didn't eat a lot. i suspect that this made me depressed as well. but then again, acne makes people depressed in general so it may not have been the medicine. i don't know. this may have also been more severe for me because my stomach isn't or wasn't in the best state to begin with.

the doctor did tell me that this may cause more gastric issues which is why i picked Minocycline in the first place.

Trimethoprim aka Bactrim
May 2013:
This was to be taken twice daily and i was given a bottle of 50 pills. i took 3 doses and stopped.

Reason for prescription:
Trimethoprim belongs to a separate family from the Cyclines, which is why my 4th and current dermatologist decided to prescribe this to me because of my history with the Cycline family, he was afraid of resistance to the cycline antibiotics (since i stopped abruptly last year). which is why he felt that this was probably the next best option.

Side Effects:
rashes are apparently common side effects.
i experienced fleeting rashes. fleeting because they lasted for less than an hour. i got them twice on my left arm, once on my back. and further research made me uncomfortable enough to stop.

Side effects and allergies are different. there are people who may be allergic to the active ingredient. and the only way to figure out if you're actually allergic is to be allergic. at least that's what i think. and it could take as long as 2 weeks, from what i read. i've cross checked with my family doctor who did mention that it is more common for people to develop an allergy to this. if i am not wrong, (this i really am not certain:) it is called Steven Johnson Syndrome and i don't suggest you google images for this.

i'm not sure if the allergy is this, or allergy could cause this. but point is there is a risk of getting this. and in serious cases people are hospitalized and ICU-ed. i also read that the local polytechnic student who died from acne medication last year died from this syndrome. yes it's a lot scarier when it hits so close to home isn't it. so i stopped. i was feeling uneasy to start with. so it wasn't that hard of a decision to stop.

However, i have also read online that when it does work, it works fast. and it has been effective from what i read.

**i am aware (and you should be too) that more often than not, people who took the medicine and it didn't work for them are probably more likely to post online than those who took and recovered. so there is an inherent bias in this. human nature to say something bad about it than saying how it worked. however i also realised that there could be fatal cases which will probably never be posted. for obvious reasons.**

i've asked myself plenty of times why this is still legal. but G and i came to the conclusion that the bad cases could probably still be relatively insignificant out of all the cases. i mean, there might be a whole lot of other people taking it and they are fine. if yknow what i mean.

Also, Trimethoprim is also used in the treatment of UTI if i'm not wrong. and probably other illnesses. in fact, acne treatment is not it's main use. it is a third-line antibiotic (not sure what that means) and if you google Trimethoprim you probably will get results going along the lines of urinary tract infection treatment etc etc.

because i was aware of the possible side effects and consequences, i was exceptionally alert to any sign of rashes, any slight itch or bump. since my skin is sensitive and i've had my share of allergic reaction to rubbish things like sweat and dirt, it wasn't hard for me to identify rash. when i related to my dermatologist, which was weeks after i stopped, he gave me a refund for the rest of the pills and explained to me why he prescribed it to me in the first place (above) and told me that he would have stopped me too. (even though it may seem to be just a side effect and not an allergy).

i paid about SGD$40+ for a bottle of 50 tablets.


About Accutane:
I have never taken Accutane. but Accutane is by far, from what i know, the harshest acne drug in the market. it was designed and started out as a Cancer/Chemo drug for cancer patients. (this scares me enough). i think that makes it quite apparent that it's a really harsh drug.

it is meant for severe acne which has failed to respond to other acne treatments and are starting to cause deep scarring acne. in my opinion, it should be sought as the last resort. although so, i do know that Accutane has been used more commonly than i would have expected and i've also read of people taking Accutane just to prevent and keep themselves acne free. it is not a cheap drug and is often prescribed for months and has to be taken for a long period of time even after the skin clears.

there's always a breakout period in the first few months from what i've heard (and seen) as well. Accutane is also some form of Vitamin A, if i'm not wrong. which can be stopped at any time once you're uncomfortable and can be continued whenever you like if i'm not wrong. obviously i don't think it's a good idea to take it whenever you like. i mean it's still a drug.

How it Works:
it essentially shuts down the sebum production system in your body. most of it anyway. which means you will get dry. everywhere. i'm talking not only about the skin on your face, but your hands, legs, joints etc. because there will be no more, or insufficient lubricant being produced. so there may be discomfort with the joints. i've also read of headaches and hair loss which i think are the worst. because the hair loss may or may not be temporary. i love my hair. which is why i don't think i'll ever risk my hair for my skin. i think.

it is also one of the few (actually the only) acne drug i've heard that requires you to take a blood test and be approved to be on the drug. this is to ensure that your liver is functioning ok, your fat level, cholesterol level etc are suitable to take the drug. not everyone is a suitable candidate for Accutane.

in the US, it is necessary to take a monthly pledge to declare that you are not pregnant, won't be pregnant and be put on birth control pills in conjunction with Accutane because the birth defects are apparently very serious.

Accutane can be very effective. from what i've seen and heard. after the intial few months of breakout, once the skin starts clearing up, it clears up rapidly and will also helps in skin texture and making the skin look super good. radiant. etc. however, it does not promise a permanent cure and there are cases of acne returning and people going for a second course. but the results are really pretty damn good from what i've seen (you could do a quick Youtube search and see glowing radiant pretty girls post-Accutane). very tempting i have to say.

the dosage is dependent and calculated based on your weight. the total amount that you ultimately will take is fixed however, so it is just divided by the dose that you are able to take at a time. and that determines the duration of your course. e.g. if i've to take a total of 100mg throughout the course, and i can only take 20mg/pill. 100/20= 50. so 50 doses. if i take one dose a day i've to take it for 50 days. numbers are completely arbitrary. just an example ok. i don't think anyone takes Accutane for only 50 days. the minimum i've heard is 3-4 months.

my quoted duration was 8-10 months.

Side Effects:
the side effects vary with the individual and the prescribed dose. as mentioned, side effects are dryness. lips dryness, skin etc. some side effects are more serious than others like aching joints, muscle aches (these are not uncommon). other reported side effects include both temporary and permanent hair loss.

eczema due to acute dryness is also not uncommon.

if not taken with care, Accutane can lead to some sort of bowel damage or something like that, if i'm not wrong. there are people who've gone to irresponsible dermatologists who don't carry out the necessary blood test and led to really horrible consequences.

depression and suicide is also often associated with Accutane (i can understand why). the initial breakout with Accutane can be quite severe and since acne can already lead to depression, i don't see why this won't. however from what i've read, it is involuntary sometimes. hallucination etc etc.

actually there are all sorts of reported side effects from Accutane.

again. i take all these with a pinch of salt.

i know of friends on Accutane, or friends of friends. and besides severe dryness they don't really experience any other significant side effects. so again, it is probably dependent on the individual and the dosage.

Why I refuse to be on Accutane
  1. i honestly don't think my skin condition warrants/warranted Accutane. weighing the pros and cons, the possible side effects and everything else, i don't think i am serious enough to be put on Accutane.
  2. the possible side effects scare me 
  3. i don't want to be dry. lol. i know it sounds ridiculous but i just don't like the idea of it shutting down my sebum system and i've already got an old knee injury. i don't think it's wise to risk it.
reviews that i've read include cases of people talking about how they are suffering years after taking Accutane. like they've got some illness now or some issues with their body which they say came about for no particular reason so they suspect it may be due to the consumption of Accutane in the past. of course, i sometimes believe that they may just be looking for something to blame and conveniently pushed it on the drug. but the more common serious issues i've read involves permanent hair loss and that scares me a whole lot. if you google you'd be able to find a number of anti-accutane sites and arguments against taking Accutane.

However, i recognise that all these reviews are mostly from the US which makes it a little different because:

the minimum and typical dosage that US derms prescribe are significantly higher than that of SG derms. locally, if i'm not wrong, dermatologists are typically more conservative in their prescribed dosages. the minimum is at 20mg/dose at twice a day. while in the US, i've seen people taking 40mg-80mg/dose.

  • the higher the dose, the more serious and significant the side effects will be. so the side effects that they experience may be more serious depending on the dose they took.
again, reviews tend to be biased depending on the site you visit.

i wasn't, and am not comfortable in putting something like that in my system. and i didn't think my acne was serious enough to warrant it. it is a personal choice, as taking all medication are. i am not against taking Accutane because i know, and i've seen cases which i agree may require such a harsh drug. there are cases of people with really serious cystic acne and Accutane may be a very viable option for them.

however, the uncertainty of the side effects and possible detrimental effects to my body was not something i was willing to risk or sacrifice simply because i knew i still had other options. however, i completely understand the desperation of situation that acne may cause someone and it honestly may be the best option for them at that point in time. but not for me.

so that sums up my lengthy post of oral antibiotics and skin, again. i hope that helps someone, anyone at all. and i'll try not to post about skin again. i can't help it when it's so part of my life and always in my head and something i almost always think of so i've to talk about it like all the time. so I WILL TRY NOT TO POST ABOUT ACNE AGAIN. at least not in the near future heh :D

here are a couple of people i follow who are currently struggling with skin related issues, and i emphasise with them and can completely identify with how they feel. it really helps when i see that i'm not alone in this and people do feel the way i do so i know i'm not going mad or depressed or things like that.

i hope they don't mind me linking them and sending some (if any) traffic over. i didn't link a private few which i came across on my own because i'm not sure if they'd be comfortable with more people staring at their pictures..... (on Accutane)
just a note: i came across her blog when people started sharing her video on covering acne with makeup on facebook and people started to comment on how she should stop using makeup and how horrible it is what she should do etc etc and i got really mad. i saw her acne and had a hunch that she should already be on Accutane which explains the breakout. and she ALREADY IS DOING SOMETHING ABOUT IT are people crazy to think that she isn't doing anything about it? seriously. and she is right. she said that she'd rather be judged for tons of makeup on than having people judge her for her acne. people really.

Cassandra Bankson:


written from 5 June 2013, published on 8 June 2013

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