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Toxxik,

This is a bit long and slightly off subject, but I feel an obligation to help you out here.

I think you're on too many things. As a rule of thumb, you should do one thing to combat each of the causes of acne. For example, why are you taking the Cleocyn-T along with the oral erythromycin? First of all, both are antibiotics, so it's overkill. Secondly, I've heard some derms (on a message board) say that they prescribe erythromycin for its ``placebo effect.'' The B5 is supposed to prevent buildup of sebum in the sebaceous glands, and the differin gel is supposed to increase skin cell turnover rate, preventing the sebaceous glands from becoming clogged by the thick sebum (which shouldn't exist if the B5 is working).

If I were you, I'd stop the oral erythromycin and differin gel and stick with the B5 and Cleocin-T. Everything else is redundant. Time scales:

1) B5 can take six months or longer for severe acne (according to Leung's study). No problem, it takes accutane just as long to kill the sebaceous glands, and the B5 doesn't kill them, just prevents them from becoming clogged, thus reducing their size).

2) Cleocon-T takes a few months to reduce the population of P. Acnes by 90%.

Having said that, I think the medicines are only good when combined with a few other preventative measures which also attack the causes of acne. Here's the drill:

1) skilled relaxation: sounds weird, but if you do this right it removes the stress component (according to Herbert Benson's book, you get an effect which is the opposite of the ``fight-or-flight'' response) which can activate various hormones which cause the sebaceous glands to secrete. Basically, any book on meditation will tell you how to do this -- doctors recommend 20 minute sessions twice/day.

2) dietary changes: avoid refined carbohydrates (like milled grains, peeled potatoes, fruit juice) -- these cause rapid increases in blood glucose which can cause skin problems (as well as a host of other problems). This is why diabetics often have recurring skin infections (like boils). Basically, anything that is whole and unrefined (like brown rice, whole grain bread, fruit, etc.) is ok since the glucose doesn't enter the blood stream nearly so rapidly.

Also, avoid refined oils (the kind you find on most supermarket shelves) and try to get essential fatty acids into your diet. This will help prevent the sebum from becoming clogged (doctors actually recommend this to prevent sebaceous cysts). This would also probably help the B5 work better. Flaxseed oil (fresh and unrefined!) is the best source of these -- don't cook it (it destroys the oil) and use about 1 tbsp./day.

3) aerobic excercise 20 min/day -- this increases blood flow to the skin and reduces stress.

Do all of this for six months and you'll see a big difference. I know that before the meditation/diet/excercise regimen, it was impossible to control my acne with any meds. Now, for the first time since I was 14, my skin is clear (apart from scars).

-G





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