Effectiveness: dose and case dependend. High dose (0,75-1 mg/kg) treatment provides more benefits and a reduced likelihood of relapse (10-30% depending on severity/type and root of acne) but more severe side-effects. Low dose (0,1-0,4) is recommended in less severe cases but relapse rate increases (50-60%) – with significantly less side-effects. Gradual increase of the dose and intake with food (50-100% better bioavailability!!!) is recommended.
Side-effects: dosage dependent, mild and NOT permanent in 99,8% of cases. 0,2% are usually unique cases e.g. 400% elevated starting triglyceride level results in permanent liver damage – can be avoided. Can be dermal or systemic.
Dermal: isotretinoin causes dramatical reduction in sebum production, thinning of the stratum corneum, and alterations in the skin barrier function. So your skin becomes dry and very vulnerable. Damage to the skin can leave scars because of this so take care.
Dryness of the face and lips (95-100%). Dryness of the nasal (50%) and oral mucosa (40%), photosensitivity (40%), eczema (25-35%), nose bleeding (20%), dry eyes (20%), acne flare (8-20%), itching, rash, erythema (15-20% mild), hair loss (5-15%, reversible), peeling of finger tips (10%). They are usually mild, temporary, and respond well to symptomatic treatment. If you experience severe adverse effects just decrease the daily dose calmly or visit your derm.
Systemic side-effects are much less common (pregnancy must be avoided of course). Osteomuscular pain (10-15%), headache (5-10%), elevated liver enzymes (0-5% reversible), decreased night vision, psychological disorders, pseudotumor cerebri (0-0,5% presumably not even side effects, very poor evidence of casual relationship).
In the end I would like to warn you about getting information from laymen. You can get very distorted info here since these reviews are based on subjective experiences -mainly from unsatisfied people- so treat them with much caution.
.
Pros:
- As a med student I did a research to evaluate my isotretinoin treatment (starting today). So I can’t give you my own experience (I will do that later :) but some facts I came in possession and would like to share.
- I consider this as a very safe and effective treatment if done with circumspection. If you experience severe adverse effects just decrease the daily dose calmly. It is the cumulative dose that matters after all (which ranges 90-150 mg/kg).
Cons:
- Never should you underestimate the power of placebo effect. If you are preoccupied with suicide ideations and lower back pain because of accutane ... there you are, sitting with a sore back and a major depression :)!
- To AS4 (below) I have lots of questions! :) Did you experience drieness of your face and lips? Did you get examined by an endocrinologist? Did any unusual happen when you were 17? Have you used ANY other treatment for your acne? What kind of chemicals have you put on your fa