What is causing my terrible acne?

Redcanoe

Hi! I was diagnosed triple-positive November 2020. I completed TCH chemo in May and I have been receiving just Herceptin since then. In August, I started tamoxifen without ovarian suppression.

I have HORRIBLE acne. I get cystic acne on my chin and forehead and every morning I have whiteheads on my nose, upper lip and chin. I have also found whiteheads in strange places like my arms and legs and the side of my chest. I did have really bad acne as a teenager and I had to take accutane twice but my adult acne hasn't been THIS bad.

Do you think this is the Tamoxifen causing it or the Herceptin? I am hoping it is the Herceptin as I only have two cycles left. Help!

MinusTwo

Redcanoe - I don't really know but Herceptin did not cause any acne for me. Please do call your MO and discuss it.

jhl

Redcanoe,

Sadly, both tamoxifen and Herceptin can cause a drug induced acneiform rash. Have you spoken with your MO? He/she may know of a local dermatologist familiar with drug induced outbreaks like this who can give you guidance on treatment. The etiology is different from acne as an adolescent so the treatment is also different. The biggest concern is an outbreak that may lead to a Staph infection so it is wise to get physician input.

Best of luck & congrats on almost finishing Herceptin.

Jane

Salamandra

I got/get acne with the SERM treatment. It sounds like yours is worse though so worthwhile to check out the rash thing. For me it was more just like hormonal acne, but since it was tamoxifen related, my insurance was willing to pay for retin-a for me. I think my skin is still not as good as before the treatment (it also gives me some melasma) but overall with the right products (and not overdoing it), my skin is looking great.

Sampy661

What a nuisance on top of everything you're going through. I can only vouch for 2months worth of Tamoxifen and my skin has never looked better on the stuff, I should add, chemotherapy likely put me in menopause, so it may be a combination of menopause and Tamoxifen that's contributing to my skin.

Good luck with finding a solution

ChiSandy

I'm 70 and in a couple of weeks will have been on an AI (Letrozole) for 6 years. At first, as my estrogen levels dropped, I got a few sebaceous cysts. They receded, but as I age (and spend an hour or two a day masked) I am getting some increased chin milia. My esthetician says it's a form of rosacea (which makes sense given my very fair & sensitive skin) exacerbated by changes in weather. Of course, AIs impair tumor cells' access to estrogen by actually reducing its production in the fat cells & adrenals, which is a very different mechanism from the way SERMs (e.g., Tamoxifen) work.

From what I understand, all cells, not just breast cancer cells, have hormone receptors. Tamoxifen works by blocking cells' estrogen receptors so that the estrogen in the body can't get into the cells. Unfortunately, just as chemo kills all fast-growing cells and not just tumor cells, SERMs block all cells' (not just the tumor cells') access to estrogen. So when cells are deprived of estrogen--whether by blocking the receptors (like locking the refrigerator door) or reducing estrogen production (like not stocking the fridge)--testosterone's effects can predominate: thinning head hair, and acne--often cystic.

Beats dying, though.

1982M

I just finished 12 weeks taxol and now am on Herceptin only. I start tamoxifen after surgery.

Im like you- I've always had good, youthful skin. I've aged a ton- but I have cystic like acne on my face. I look terrible. It's harder then being bald.

I thought it was steroids, then taxol, and now I'm wondering if it's Herceptin! Maybe it’s just a combination of all that my body is going through? Not to sure.

MinusTwo

As usual we're all different. I had 6 rounds of TCHP, then 3 rounds of AC, then rads & Herceptin for the rest of a year. My Dermtologist was sooooo excited about how all the chemo drugs made my skin smooth & knocked out all the AKs and SKs that I usually have to have frozen twice a year. Best my skin has ever looked.

kris_2000

Redcanoe - are you getting any premeds for chemo that include a steroid? I developed terrible acne too and when I asked my MO about it, she said it is called acneiform from the steroids. She said unfortunately I was just going to have to deal with it and use acne creams because she wasn't about to take me off steroids due to my reaction to the chemo.

I've been off steroids for a couple of months now and I still have a little but it's a lot better.