Benzaclin Log - how it's working...

[claudia]

I hope that by using Benzaclin I can eventually stop using an oral antibiotic (Bactrim --- took it for a year). I've started this log to track my progress in case anyone else is interested.

I got the idea to try Benzaclin from my niece who has extremely sensitive skin and was getting redness with breakouts very similar to mine. She's been using it with great success. I researched the web and noted that some studies have been done on it showing it was well tolerated by rosaceans and very good at stopping the breakouts. Then I started a thread "Anyone used Benzaclin?" and got really favorable responses from especially bkjr and sharron sprinkle, among others.

My biggest fear is using benzoil peroxide again since when I used it before (Proactiv) it really irritated my face...but of course the Proactiv regime includes an abrasive cleanser and glycolic acid toner, both of which didn't help things. I was also using it 2x/day. My derm has been trying to get me to try benzoil peroxide again since she thinks that in addition to rosacea I struggle with acne vulgaris too. She's repeatedly told me that the perscription grade benzoil peroxide she'd give me is formulated to be milder to the skin...if only used 1x/day. Proactiv claims it uses perscription grade BP but I guess it really doesn't.

So my experience is probably more interesting to those of us who have rosacea that manifests with nasty breakouts and then redness...at least that's the way it works for me. I also have an extremely oily t-zone that will probably benefit from a bit of drying.

I'm only putting the Benzaclin on my forehead, nose and chin...which is where the breakouts and redness happen. I'm going to continue taking the Bactrim and very slowly phase it out so that the Benzaclin has time to start working (...research indicated several weeks). I'm also going to continue to take Spironolactone "forever" since I also have cystic acne and I think the Spiro really takes care of that...we'll see...when the Bactrim is totally stopped I'll find out.

So last night was my first night. The Benzaclin went on ok...didn't sting or cause any redness. I noticed a very slight tingling on my upper lip but that was all and it went away. This morning my skin was doing fine. A little whitehead that had appeared yesterday was almost gone (...before it would've hung around for several days...).

I'm using the lotion below during the day.

Wish me luck!

CV

[claudia]

Day Two

The grainy little whiteheads on my forehead are gone! Amazing. I never really counted them as "breaking out" since they weren't inflamed but it's still very nice to be rid of them. Still no redness or any negative reaction.

[claudia]

Day Four

Still no irritation - amazing! And no whiteheads or other problems. It's a little drying where I've applied it but I needed that since I have such oily skin in those areas.

[orangehorizon]

Does your skin feel 'tighter' than usual?

[claudia]

Does your skin feel 'tighter' than usual?

Day Five

Yes it does - just a little. And it feels a little itchy but not much...no redness. I'm using "Neutrogena Oil Free Moisture for Combination Skin" (hypoallergenic, non-comedogenic, etc.) in the morning and that helps. I only put Benzaclin on my t-zone so the rest of my face is not affected.

Last night I put on Neutrogena Oil Free Moisture after putting on the Benzaclin and letting it dry (15-20 min)...just in case there might be any dryness starting to happen.

Since starting the Benzaclin I have not had any whiteheads, redness or bumps at all. This week I'm also starting to slowly decrease my oral antibiotic, Bactrim...so only taking 6 this week (1 tab a day).

CV

[orangehorizon]

According to the info here

http://www.benzaclin.com/Index.jsp

(click on 'Full Prescribing Information For BenzaClin')

They compared the Benzaclin gel with ordinary 5% Benzoyl Peroxyde gel. According to the tables summarizing the results of the study, Benzaclin is slightly more effective than ordinary Benzoyl Peroxyde gel.

That info is important cause I know Benzaclin is very expensive and 5% Benzoyl Peroxyde gels are avalable over the counter and dirt cheap.

[claudia]

Thanks for the info! That was one of the sites I checked out before trying this new regime. It made me think using benzaclin might be possible given the results...which I think were 95% reduction in lesions! I can live with that :wink:

I think the clindomycin acts as an anti-inflammatory, besides being an antibiotic. I'm thinking if this works I may at some point just try a 2.5% solution of benzoil peroxide (perscription grade) without the antibiotic topical part...but there's the thought that the antibiotic is what makes the difference in working with rosacea vs just acne. It may not be much but just eneough to keep things calm.

My reg doctor said that if benzaclin is too expensive then I could get a perscription for clindomycin gel and mix it with benzoil peroxide myself...that'd be real cheap he says! Gotta love him...

For now I'll keep using the samples.

CV

[orangehorizon]

Didn't you use metrogel before for pimples? Wasn't it effective?

[claudia]

Didn't you use metrogel before for pimples? Wasn't it effective?

Yes - I was using metrogel 1%. I'm not sure what it did for pimples, as I was also taking spiro and bactrim. I know it felt very cooling on my skin and calmed down irritation. I still got little inflammed whiteheads tho. However compared to what I had been dealing with before (major irritation, deep red cysts, etc.) to me that was clear skin!!!

A little over a year ago I had this horrible flare-up...one of my worst ever (...think it was due to stopping spiro, overusing Proactiv, then trying salicylic acid in desperation along with acne cleanser and my skin FREAKED out to put it very mildly). This was when I got the formal rosacea diagnosis - although I've probably had it for decades.

I started spiro again but it takes 4-6 months to become effective...so it wasn't helping anything. Mino and doxy weren't really working and metrocream was too oily. So I switched to metrogel...it helped reduce redness and SOME of the surface pimples but I was still getting the deep cystic ones...not as many but one a week was still too many for me (...I'm pretty neurotic about my skin...). Then I tried bactrim and it immediately cleared up the cystic breakouts. But I was still getting these grainy whiteheads on my forehead. I tried to lower the bactrim dose as per my derm's request but then started getting several inflamed whiteheads (small pustules?) on my nose and/or chin each week (...this was last month).

This is when I realized that unless I could safely take an antibiotic like Bactrim at almost full strength for the rest of my life (NOT)...that I had to find some other way to take care of the breakouts. But I'd been taking Spiro for a year now so it was probably working and so here I am, at the next stage of my "experiment"...my hope being to be able to take just Spiro and use a topical.

I'd have to say that Spiro is probably my cornerstone in treatment. Even my regular doc says that spiro is pretty amazing and safe...very helpful for menopausal women to take care of excess hair and androgens. The only downside is that it takes forever to become effective!

Long answer...sorry :shock:

CV

[claudia]

Day 10

My forehead and nose are looking great...no redness, irritation, flaring, whiteheads or break outs. And the spider veins are less visible - wonder why?

My chin has been very flaky in the morning the past 2 days and it stings when I apply the Benzaclin in the evening but that subsides. One teeny tiny microscopic whitehead below my chin...can't see it except for my magnifying mirror!

So far so good, although I don't like all the flakes on my chin. I'm thinking of switching to Cetaphil Sensitive Moisturizer...might help more with the flakes. I love the Neutrogena Moisturizer for Combination Skin but it is extremely light...maybe too much so.

This week I lower the Bactrim to once a day for five days.

[claudia]

Day 11

Talked with my derm yesterday and she said to decrease the Benzaclin use on my chin...use less or every other day...that I had used too much to start, especially with my sensitive skin. I think that she sometimes assumes I know what to do because of my (advanced) age :?

The teeny whitehead from yesterday is GONE...totally and my skin is clear. I also switched to using Cetaphyl products below at my derms suggestion. They stopped the flaking on my chin. The rest of my face is looking great.

Also the veins on my nose are less visible...hoping that works on my chin too.

This week I'm only taking Bactrim once a day for 5 days...technically nothing.

[claudia]

Day 19

My skin is clear and amazingly the little spider veins seem to be less visible. It's as if the combo of topical antibiotic + gentle BP is actually soothing to my skin! I'm using the Cetaphil products in the regime below and they have made my skin very smooth.

I read somewhere in some research (sorry I didn't earmark it) that there's a kind of rosacea that occurs from having acne...i.e. breakouts happen first and then redness, inflammation, and finally broken blood vessels. It gets worse and worse without treatment. This is what happened to me.

My regime:

AM --- wash extremely gently for 10 seconds with Cetaphil Face Wash for Sensitive Skin. Pat dry. Allow to dry for 5 minutes or so and then very gently apply Cetaphil Lotion.

PM --- wash and dry like above. Wait 5 minutes. Apply dots of Benzaclin to affected areas and very gently with fingertips smooth into skin...not rubbing. Wait 5-15 minutes and apply Cetaphil Lotion.

That's it.

CV

[dallascowgirl]

I'm so glad Benzaclin is working so well for you!!!! It's my topical med of choice for 20 years.

[claudia]

Day 23 (3 wks)

The Benzaclin is working great...wish I had known about this 20 years ago like you Sharron!

Now I'm only taking 2 Bactrims a week, which is basically nothing but I'm lowering the dosage really slowly. Week after next will be 1x/wk and then stopping completely. In the past 3 weeks I've only had 2 teeny tiny whiteheads that were gone within 24 hours.

I've streamlined my daily routine even more:

AM - Wash very gently with Cetaphil Sensitive Skin Wash for less than 10 seconds. Pat dry and wait about 5 minutes, then very gently apply Cetaphil lotion with fingertips.

PM - Wash like above and allow to dry. Apply dots of Benzaclin to affected area and gently pat in, without rubbing. That's it :wink:

My spider veins continue to be much less noticable. Also, there was a dime sized small area on my chin that was a tiny bit swollen (no inflammation, just swollen) and now it has gone down to normal...hard to explain but I didn't even realize it was a bit swollen until using the Benzaclin and the swollen area went away! The only thing I can compare it to is perhaps what happens to people's noses...not as bad but still a swelling kind of thing.

If things keep going this well and I don't have to take oral antibiotics then I'll consider this tx regime nothing short of a miracle!

CV

[claudia]

1 month My skin looks fantastic!

I've had only 3 teeny tiny whiteheads in the past month and they disappeared in a day without inflammation. The residual redness on my chin and nose is GONE. If I look really really closely I can still see some spider veins but they seem to have calmed down as well. I'm now taking only 1 Bactrim for next week and then I'll be finished with the oral antibiotic. I'd say my skin is looking as good as it did when I was taking full strength Accutane years ago.

Now I'm hoping that everything continues to go this well when the Bactrim is totally out of my system.

I found the article that talks about Benzaclin being a good treatment for p&p rosacea:

http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp;jsessionid=GtHn2yc2RvRQTNBvP18Zj bLvQvq4T9fN8pdMKBysL2bGtJ9hqRFk!-1094713266?id=53452

P. Acnes Possible Factor in Rosacea
BenzaClin a significant Tx in lesion reduction

"San Francisco - Based on the theory that rosacea shares the same inflammatory features of acne, a recent study showed that, just as the combination of benzoyl peroxide 1 percent and clindamycin 5 percent gel is a powerful treatment modality for reducing Propionibacterium acnes levels, it also significantly reduces the papules and pustules of rosacea, according to Debra L. Breneman, M.D.

"The primary efficacy evaluation, a greater than 70 percent reduction of the combined number of papules and pustules from baseline to week 12 (through the use of BenzaClin) was the most important finding of the study," said Dr. Breneman, lead author, private practitioner with University Dermatology Consultants in Cincinnati, and a faculty member of the department of dermatology at the University of Cincinnati.

"While no head-to-head studies have been performed against BenzaClin, the greater than 70-percent reduction of papules and pustules is much greater than results reported for the other topical products used to treat rosacea, such as topical metronidazole and azelaic acid. This will give dermatologists an additional choice to treat their patients with rosacea."

The double-blind, multicenter, randomized, placebo-controlled study of benzoyl peroxide and clindamycin's efficacy in treating rosacea, conducted by Drs. Breneman, Ronald Savin, and James Leyden, was presented at the annual meeting of the American Academy of Dermatology. With a total of about 55 patients participating, the patients applied either BenzaClin or placebo topically to the face once daily for 12 weeks. The primary efficacy evaluation was the percentage reduction of the combined number of papules and pustules from baseline to week 12. Treatment with BenzaClin showed a statistically significant superiority over placebo treatment with a reduction of greater than 70 percent of inflammatory rosacea lesions.

Mirroring P. acnes Results In a previous study conducted by Dr. Leyden, it was determined that use of the two combined topical medications, an antibiotic and an antimicrobial, resulted in an unprecedented reduction of P. acnes bacteria levels by 90 percent after only 24 hours. Additionally, progressive declines were observed throughout the two-week study period, with a 3 log10/cm2 reduction (99.9 percent inhibition) from baseline in P. acnes at the end of the two-week treatment period. The combination of clindamycin and benzoyl peroxide was also found to significantly reduce the formation of clindamycin resistant strains of P. acnes.

"If P. acnes is truly a significant factor in rosacea, it seems logical to use the most effective agent to reduce P. acnes levels, while avoiding development of antibiotic resistance," said Dr. Breneman.

Further noteworthy findings from the study also include the patients' ability to tolerate BenzaClin. "It was originally feared that benzoyl peroxide would be too irritating for the skin of patients with rosacea," Dr. Breneman said. "Most likely, the anti-inflammatory action of clindamycin helps to lower the irritation profile of BenzaClin. Interestingly, there was a statistically significant difference in flushing and blushing found in this study. We are still evaluating the data, and have not drawn any conclusions (based on these symptoms) yet."

In terms of future studies, there is the possibility of further comparing the efficacy of BenzaClin directly to either topical metronidazole, or oral medications such as tetracycline.

Looking toward the impact of this study's findings on the future treatment of rosacea, Dr. Breneman and her colleagues point to their original theory as basis for application of their results. "Benzaclin, once daily, was found to be well tolerated and effective in the reduction of papules and pustules in patients with rosacea," said Dr. Breneman. "This lends credence to the theory that P. acnes is a potential aggravating factor in rosacea. This gives dermatologists a very effective treatment for rosacea."

[Melissa W]

Congratulations Claudia!
That's great!! :D

Best wishes for continued success!
Melissa

[claudia]

5 weeks Bad news...

I was so hopeful Benzaclin would work. I was doing so well but then four days ago I started getting this red area on my chin...lots of vascularization. Then it started welling up and then it started breaking out. I got one particularly deep p&p that was very inflammed. I called my derm in a panic and she asked about the flaking. I told her it was still happening every morning (my chin and forehead were peeling but no redness and the Cetaphil lotion smoothed it out). She said that wasn't good...that if my skin could tolerate the Benzaclin, the flaking should've stopped a couple of weeks ago. She said to stop the Benzaclin because my skin would just get worse. She said it was worth it to try Benzaclin because it works really well for some people but I'm not one of them.

She told me to go back on Bactrim 1x/day, Metrogel and continue the Spiro. She said that for my skin I need an oral antibiotic and a soothing topical. I reminded her that she had told me to try to lower the Bactrim dose and get off it if possible. She said that's a goal but it differs for everyone and my skin appparently needs Bactrim to function properly. I asked about safety of using Bactrim "forever" and she said it's relatively safe if you're not allergic to it. She said that there's other conditions where Bactrim is used as a daily med forever.

I gave it a good shot, did everything right but oh well...

Anyway, good news...my skin's looking good again. Red area subsided, p&p's cleared up. Bactrim is really fast acting, thank goodness.

CV

[Melissa W]

Hi Claudia,

Sorry for the disappointing news. But I'm glad at least the oral works for you and your skin is calm and clear again!

The main thing is that something works. At this point I don't care so much what it is but as long as it continues working.

All the best,
Melissa

[claudia]

Thanks for your reply! Is there something that works for you?

CV

[Melissa W]

Hi Claudia,

I've been on solodyn (timed release minocycline) since Oct 2006 and so far it's been keeping the p&ps (mostly) under control. I had a little oubreak a few weeks ago with what I think were p&ps but I also tried a new sunscreen (oil of olay) and it didn't agree with me.

Solodyn does nothing for my flushing and burning unfortunately so I'm currently doing VBeam and that has helped somewhat. I still flush and burn but with less frequency and intensity.

It's scary because I know people can become resistant to treatments that previously helped them. I know it's not helpful to dwell on that but it is in the back of my mind.

I hope your current treatment is working well for you, Claudia.

Best wishes,
Melissa

[Kathy S]

Good Luck Claudia!!!!!!!!!!!!!! :D Miserable but getting better!

[claudia]

Thanks so much Melissa and Miserable!

Yes, I'm doing much better. Skin's cleared up and calm again. I too had a bad reaction to Olay. Had used it no problem for a very long time and then they changed their formulation this spring and I had a reaction. Have been trying Neutrogena Oil-Free Moisture spf 15 (hypoallergenic, fragrance free, non-comedogenic, etc.) and it seems to be ok.

Never heard of time-release Mino but that seems like a good idea!

CV