My acne got really quite bad and was one of the reasons I decided to stop.
I was getting 3 or 4 puss filled spots each week and they were also accumulating because they hadn’t healed before the next dose.
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i have always been doing topical rapa at .5% for couple of years, though have read .2% is optimal but… , anyway never had any increase of pimple like breakouts with that alone. It is only when i do internal rapa injections also that i get increase in pimple like breakouts along with mouth sores etc.
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Erythromycin ointment (2%) works well.
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works for exactly what
to clear acne caused by rapamycin.
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I have had a problem with scalp acne that I have never had before in my life for the past … 6 months? I finally went to the dermatologist who prescribed a month of doxycycline (100mg twice daily) and two weeks of Clobetasol Propionate (0.05% solution applied to scalp twice daily). I have also noticed increase breakouts on my back and have adjusted some hygiene routines (always scrub back when showering, always shower after workout, never wear any shirt (work, sleeping, workout) twice. Always wash hair daily. Also during the period that the problem arose I started eating peanuts which (I forgot) caused me to break out in college. So many variables that its hard to pin this one on Rapa but it could be a contributor.
57 year old male. 6mg weekly rapa dose occasionally with grapefruit.
Has anyone else had acne or other scalp irritations that they believe were caused by rapa?
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Cut out the grapefruit. No need for it and it is exacerbating the effect.
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Probably the Rapa. My Rapa acne is head and neck. Did your Dermatologist know you were taking Rapa?
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Can we just start calling it Rapacne?
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I did not think to mention it. I am not sure the information would have been received or if it would have altered treatment. How are you managing your Rapacne? Did you adjust your does of Rapa?
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I was curious what a Dermatologist’s opinion and treatment would be. If you haven’t read the article noted in the first post of this thread do that.
I just use otc salicylic acid gel, but several other treatments have been mentioned. My acne seems time related rather than dose. It will start up after about a month of weekly Rapa no matter what dose.
From what I’ve read and my personal experience, this acne is mostly inflammatory rather than infectious.
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I was on Rapa for about 9 months —6 mg weekly—and had annoying problems with acne. But it was manageable. I took a hiatus because I was having a sort of complicated tooth extraction and didn’t want to risk infection. The acne went away completely.
So, after the dental incision was completely healed—about 6 weeks total—I restarted. That was two weeks ago. Since then, I have not had annoying acne. I have had disfiguring and painful cystic acne spots. Not tons of them, but the handful are bad enough that I can’t tolerate it. I have been using Minocycline to try to ameliorate the rapacne, but it is only minimally helpful. And, I really don’t want to take antibiotics that often.
Any ideas? Is it worth trying to titrate the dosage? Has anyone found a difference depending on brand? Or anything else?
I suspect that the acne is a function of opportunistic infection. Maybe the Rapa effect on some of our immune systems is more powerful than in others?
Also, I’m small and female. So could the dosage be incorrect? Since dosing is so opaque this is a big question. Should a 55 kilo woman take the same dose as an 80 kilo man?
Looking for your thoughts!
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Acne is an infection in the largest organ in the body. Yes, it’s inflammatory. But the root cause is bacterial. It makes perfect sense to me that altering the function of the immune system would lead to potential infections. And the least well-defended organ for infection is the skin. It is constantly exposed to all kinds of pathogens. One of the things that Matt Kaeberlein has regularly said is that the effect of Rapa on the immune system is less a reduction than a rebalancing. But, in the absence of real clinical data in humans, I don’t know that it’s clear exactly how each person’s own immune system will respond, and whether while “rebalancing” some aspects of immunity might be changed in less beneficial ways. For example, I would (and have ) discontinued Rapa for surgery.
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That’s what I get. Much more cystic/inflammatory than what I had as a teen. I haven’t excluded MRSA which is inflammatory.
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Lol. I do not think that MRSA is likely here. If ever there were a place for an application of Occam’s Razor it is in diagnosing painful red cysts as acne vs MRSA.
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I suspect it’s the combination of rapa + hormone replacement. It seems to kick up the replacement hormone activity based on reading your and others’ experiences. I’d titrate that while keeping the rapa the same.
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The only facet of HRT that causes acne is testosterone. And I’m on a barely measurable amount it. So, I’m skeptical about that connection…although it’s certainly possible.
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59vw, You’re saying that erythromycin ointment (2%) works well for rapamycin rash? If so, how long have you been using it for rapamycin rash and how often do you apply it? Thanks.
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Hydrocortisone cream (1%) has been noted in several topics other than this one as a way of relieving rapamycin itch (pruritus). From my experience it is very effective and also reduces the size of the rash. Hydrocortisone cream is a common treatment for any type of pruritis. I generally apply it once daily after a shower to any areas that are irritated, meaning reddish in color, itchy, scaly or raised (whelt). It works great for me. From my past reading the rash is said to be an allergic reaction to rapamycin (a common side effect), but I’m not going to research it again. I’ve already found what works for me. I’ve been doing this for a couple of years now and don’t expect the problem to totally disappear unless I reduce my weekly dose of rapamycin which I will probably not do. I accept the rash as an unwanted side effect, but a minor one. Oh, one more thought, you could try an antihistamine cream to see if it works for the itch. It wasn’t very effective for me, though.
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The 100mg of Doxy I take with the Rapa dose has prevented any acne. I used to not take doxy pre-hip replacement and I got a little acne.
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