Rebif and Acne

[roo613]

I don't think that acne is an official side effect of Rebif, but has anyone else experienced it? The only change I have made in the past 3 months has been to start Rebif, so I don't know what else is could be....

My face is just full of bumps, and I hate it. I don't even want to touch my skin.

[CocoH]

Hmmm...........it's interesting that you bring this up. I had a really bad break out about a month ago which was when I increased to the 22 mcg dose of Rebif. Luckily, it has cleared since. Who knows if it was related but I would think it's possible. A little tip I got the last time I got a facial was to mix a little baking soda with your cleanser a couple of times a week. It's a good, cheap way to clean your pores/exfoliate. May be worth a try...

[Redwings]

It's said that skin is the barometer of the body. It will act up in conditions like acne and eczema if it isn't happy (e.g., illness, toxins, food allergies). I always go through an acne phase after a Solu-Medrol 3-day as the steroids are on their way out.

Based on that, it's possible that your skin bumps are your body's way of telling you it isn't happy with Rebif. If that's the case, there isn't much you can do on the outside of your skin to prevent the bumps/outbreaks, because they're coming from deep on the inside. Hopefully, it will pass.

[roo613]

It's said that skin is the barometer of the body. It will act up in conditions like acne and eczema if it isn't happy (e.g., illness, toxins, food allergies). I always go through an acne phase after a Solu-Medrol 3-day as the steroids are on their way out.

Based on that, it's possible that your skin bumps are your body's way of telling you it isn't happy with Rebif. If that's the case, there isn't much you can do on the outside of your skin to prevent the bumps/outbreaks, because they're coming from deep on the inside. Hopefully, it will pass.

That's what I was afraid of. I, too, went through the acne phase after both of my rounds of Solumedrol, but it did clear up. This has gotten progressively worse.

You always have great answers, so let me ask you this: Today, I went and picked up a copy of my bloodwork that I had done on August 5th. My WBC and platelets were abnormally low, and both liver enzyme tests were extremely high. I never heard from my neuro, so I assumed my numbers were good. I guess I was wrong.

How dangerous is it to continue on the Rebif if it is causing these problems? I have been extremely fatigued the past 2/3 weeks, the acne has gotten really bad over the same time frame, so I think youa re right that my body is not liking the Rebif (which is why I wanted to see the copy of my labs).

So I guess my question is this: Do I need to call my neuro tomorrow and figure out what is going on? I am thinking that it can't be too healthy to have had elevated liver enzymes for a month....

[Redwings]

I always find it interesting how different doctors -- who supposedly had the same medical education -- can react so differently to the same situation. About a year ago my white cell count suddenly dropped significantly. My neuro-ophth, who prescribes my meds and follows me, was quite unnerved by it. He cut the dose of one of my meds in half and made me get a CBC every week for two months until my counts came back up to normal again. At the same time, my neurologist looked at the same abnormal results an didn't think anything of it.

Some docs will be disturbed if liver enzymes are more than about 50% elevated, and others will allow someone's enzymes to be twice the allowable maximum for long periods of time without being concerned. Go figure.

Sometimes with Rebif liver enzymes elevate for a couple of months, then go back down. Sometimes they don't. Your doc might not think it's so bad to let your enyzmes be up in the 60s for a couple of months, then test you again. But I'm with you -- I wouldn't feel right about letting mine be that high for much longer than that.

As for WBCs and platelets, it depends on how low is low. A lot of docs will ignore a result that's, say, only 10 or 20% too low (or even too high) for awhile, depending on what else is going on. But if your WBCs are still low at your next test, that could be a sign that Rebif might not be the med for you. Anything that leaves a person with an autoimmune condition vulnerable to infection if there are alternate drugs to take might not be the best way to go.

It sure couldn't hurt to call your neuro and ask for a review of your test results. Not only will it help you make plans for managing your medications, but it will give you some insight into his/her thinking process. it might be interesting to see what your doc says about your acne and fatigue, too.

Dealing with a chronic health condition is a bit like playing chess in that you have to be able to think a couple of moves in advance. Knowing how the other player (your doctor) thinks helps you plan your strategy.

[roo613]

I always find it interesting how different doctors -- who supposedly had the same medical education -- can react so differently to the same situation. About a year ago my white cell count suddenly dropped significantly. My neuro-ophth, who prescribes my meds and follows me, was quite unnerved by it. He cut the dose of one of my meds in half and made me get a CBC every week for two months until my counts came back up to normal again. At the same time, my neurologist looked at the same abnormal results an didn't think anything of it.

Some docs will be disturbed if liver enzymes are more than about 50% elevated, and others will allow someone's enzymes to be twice the allowable maximum for long periods of time without being concerned. Go figure.

Sometimes with Rebif liver enzymes elevate for a couple of months, then go back down. Sometimes they don't. Your doc might not think it's so bad to let your enyzmes be up in the 60s for a couple of months, then test you again. But I'm with you -- I wouldn't feel right about letting mine be that high for much longer than that.

As for WBCs and platelets, it depends on how low is low. A lot of docs will ignore a result that's, say, only 10 or 20% too low (or even too high) for awhile, depending on what else is going on. But if your WBCs are still low at your next test, that could be a sign that Rebif might not be the med for you. Anything that leaves a person with an autoimmune condition vulnerable to infection if there are alternate drugs to take might not be the best way to go.

It sure couldn't hurt to call your neuro and ask for a review of your test results. Not only will it help you make plans for managing your medications, but it will give you some insight into his/her thinking process. it might be interesting to see what your doc says about your acne and fatigue, too.

Dealing with a chronic health condition is a bit like playing chess in that you have to be able to think a couple of moves in advance. Knowing how the other player (your doctor) thinks helps you plan your strategy.

Thanks. I just wanted to make sure I shouldn't be in panic mode! My WBC and platelet counts are barely below the "normal" level. What has me worried is that the ALT and AST levels are like 3 and 4 times the normal level. One level is 270, and the other is 364. I think I'll call this morning and just double-check that we can wait until the end of September to discuss this.

[karinnech]

I am the opposite.

For years, I have always had problems with acne. Since I started Rebif, I haven't had any break-outs at all. My skin has never looked better.

[roo613]

For years, I have always had problems with acne. Since I started Rebif, I haven't had any break-outs at all. My skin has never looked better.

Like you, I have struggled with Acne since my teens. But over the past 5-7 years, my skin has been the best it has ever been. That is, until I started the Rebif. BUT, I did my last Rebif shot last Wed. (doc wants me off of it until we figure out what is going on), and my acne is already starting to magically disappear.....

[BigA]

Roo,

it just occured to me that what your doc may be looking for is a fatty liver. That will get your alt and ast up.

The cure can be to stop drinking if you're an alcoholic or to eat less otherwise. I had high ALT for years until I stopped eating saturated fat.

[roo613]

Roo,

it just occured to me that what your doc may be looking for is a fatty liver. That will get your alt and ast up.

The cure can be to stop drinking if you're an alcoholic or to eat less otherwise. I had high ALT for years until I stopped eating saturated fat.

I think they were checking that AND gall bladder or anything else just to be safe and make sure it was the meds and not anything else. I don't drink (I've never even had a taste of alcohol), and I really eat pretty well. So I think the results of the u/s will be o.k.

Today is the first day in weeks that I have felt good. I have had energy, and I have been able to eat without feeling nauseous. So I truly believe it really was the Rebif. My last shot was 10 days ago....My acne has all but disappeared, and I feel good as of today. The area where I did my last shot has a huge knot under the skin and is pretty painful to the touch. I guess my body just decided to reject the meds...