What Causes Inflammatory Acne Lesions After Having Temodar?

Posted on Wed, 18 Mar 2015

Question: I have developed severe cystic acne since starting Temodar. In the past I developed cystic acne as a response to stress/anxiety, however it was never this severe. I'm even using Proactive + (benzoyl peroxide 2.5% and salicylic acid 0.5%) with no noticeable improvement. I finished 30 rounds of radiation in late October. Could the Temodar be the culprit, or is it a lasting side effect of the radiation?
I first noticed the increase in cystic acne after the first cycle of Temodar, I'm going to start the next cycle next week on Thursday.

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
I would have added an Oral antibiotic in addition to topical Rx.

Detailed Answer:
Hello. Thank you for writing to us

I have taken note of your query and I have also reviewed the Images.

I can see inflammatory acne lesions but these are not cystic acne except a single big nodular lesion on chin (right side).

Acne is a not a known side effect of temozolomide. The association that you noticed with temozolomide is probably a coincidence.

Though, radiation acne is known side effect of radiotherapy.

Stress/ anxiety are also the likely responsible factors that might have added up to cause an acne flare.

-Are you on any other drugs?like oral steroids etc?

The topical that you are using is a good choice and I would suggest that you continue with it.
It may take some time to take control of acne activity but it ultimately would.

In addition, I would have added an Oral antibiotic e.g either Roxithomycin Or Azithromycin for 2-4 weeks, since you seem to have inflammatory acne and that would certainly be better controlled with a combination of Oral and Topical antiacne preparations.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (22 minutes later)

No, no steroids of any kind since mid-October. I have a follow-up MRI on Thursday and a follow up afterward with my neuroradiooncologist, I will bring up the question. Thank you for your advice!

Answered by Dr. Dr. Kakkar (22 minutes later)

Brief Answer:
You are welcome

Detailed Answer:
Hi.

Does that mean you were on Oral steroids prior to that (mid-october)?
Oral steroids too can cause an acneform eruption... and it can last for some time after they are withdrawn.

Regards
Thank you for asking on healthcaremagic

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (7 minutes later)

I was on a 1 week course of decamethasone in mid October for radiation induced inflammation. I also was on dex for 2 weeks after my surgery.

Answered by Dr. Dr. Kakkar (4 minutes later)

Brief Answer:
Oral steroids can cause acneform eruption

Detailed Answer:
Ok.

Oral steroids might have been a factor too in causing a flare of acne.

Regards
Take care
Wish you good health!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 minutes later)

Thank you!

Answered by Dr. Dr. Kakkar (0 minute later)

Brief Answer:
Welcome

Detailed Answer:
Thank you!

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar