50. Prom Pills
Doctor Jacob, and we're talking today about prom pills.
Patients sometimes know that an important in life is coming up, and they're called prom pills but of course they can be used for weddings, engagement photos, whatever event that's important.
A patient who has acne which is inflammatory or cystic sometimes says, "Well, you know, I want to be clear for a certain day, so that I can take great photos and I don't have to worry about acne interfering with my life just for one particular day. What can you do for me, doctor?" So there is an answer: a short course of prednisone started a few days before the important day. I usually prescribe 40 mg, which comes as 20 mg tablets, you have to take two of them. So you take two of these 20 mg tablets or 40 mg altogether, in the morning, for five days in a row, with the fifth day being the important day. So you start it a couple days in advance, the fifth day is the important day that you want to be clear for, and then afterwards you discontinue.
These prom pills, as they are called, they do work. They don't unclog pores, but for short courses of them they do actually clear up the inflammation. I often give them when asked by patients about being clear for a special day. Usually, it's the high-school prom, a patient's wedding, engagement photos, something of that extent.
Side effects sometimes can include menstrual irregularities for women, sometimes can include difficulties sleeping or feeling like you want to conquer the world instead of sleep, this type of insomnia, and that's kind of it for short-term side effects.
For patients who take very long courses or numerous repeated courses of steroids, then there's other side effects to consider, but at this point we don't need to consider those for just a five-day course of prom pills.
To summarize - prednisone 40 mg every morning for five morning, starting four days before the big day is usually what I recommend. If there are any pimples or cysts that haven't gone away 48 or 72 hours before the big day, then we can do some injections of steroid right into those. That's usually not necessary, but sometimes for more severe cases it happens.
That's it for today. I'm Doctor Jacob, we'll see you next time.
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