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#1 Rossignol

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Posted 09 August 2004 - 12:45 PM

Frequently Asked Questions - Accutane/Roaccutane

Disclaimer: The information below is provided as a courtesy to address general questions. As we are not medical professionals, we cannot be held responsible for the accuracy of this information. By reading this information, you agree not to hold us liable for any damages that may result in your use of this information. This information should not replace information that your Doctor or Plastic Surgeon provides you. Please keep in mind that this is for general information only and results will vary for each individual.


Firstly, if you are interested in the actual chemical makeup of accutane and the medical terms in which it is likely to be discussed, please read this excellent thread by m.d.student, http://www.acne.org/...showtopic=31242 which details all of the information you will need about the exact nature of the drug itself. It might be an idea to print it off and familiarise yourself with it.


What is the difference between "accutane" and "roaccutane"?
-These are essentially two different names for the same drug. Both are manufactured by Roche, but "roaccutane" is distributed in Europe, whilst "accutane" is distributed in North America. Both will give the same results and both have the same risk of side effects.

Do I need accutane?
-Accutane is only usually prescribed for acne that is scarring and not responding to other treatments, such as antibiotics and topical creams such as retinoids and Benzoyl Peroxide. Dermatologists usually see accutane as a "last resort", and consequently, it is typically prescribed for severe, cystic or nodular acne. The general consensus of opinion among members of acne.org is that you should think very carefully before deciding to take accutane, and that it should be a "last resort" treatment.
-If your dermatologist decides you are suitable for accutane treatment, you will be assessed to your suitability through blood tests. The results of these may mean you cannot take the drug, in which case you will have to look into other avenues of treatment.

What is the normal dosage for the drug?
-In the UK, the maximum dosage in mg's relates to your weight in kg's. Accutane dosage per day in mg should not exceed to your corresponding weight, i.e.: for a person weighing 70kg, accutane dosage should not be higher than 70mg per day. In certain cases, it can be slightly higher than this, but if your dermatologist were putting you on a course where the dosage is considerably higher than your weight, it would be advisable to discuss this with them.

How long will my course last?
-Typically, accutane courses last from 3-6 months, at high doses. However, if the acne has still not been suppressed by the sixth month, the course may last up to 9 months. This can cause complications, however, and if you were still on accutane by 9 months without success, it would be advisable to discuss ending your treatment with your dermatologist.

Will I experience an initial breakout whilst taking accutane?
- Unfortunately, most people feel that this is the case. The initial breakout may be quite severe, as your body adjusts to taking the drug. However, it should have subsided significantly within 1-4 months.

How long before I start seeing results from accutane?
- You may not start to see your skin improving for several months. Do not despair, though; in the vast majority of cases, the skin WILL improve eventually.

What are the possible side effects of accutane?
-Possible side effects are many and varied. The most widely experienced side effects are: dryness and peeling of face and lips, increased redness of skin, rashes on hands and arms, dry eyes, muscle aches, back pain, headaches and increased sensitivity to sunlight.
-Other side effects that have been reported include hair loss, yellowing of teeth, blurred vision, bone changes, depression and other mental health issues.
Females taking the drug should MAKE SURE THEY ARE USING EFFECTIVE CONTRACEPTION AT ALL TIMES UP TO 6 MONTHS AFTER THE TREATMENT. ACCUTANE IS LIKELY TO CAUSE SEVERE BIRTH DEFECTS IN FOETUSES.

I am worried about becoming depressed on the drug. Will this happen?
If you are prone to depression, you SHOULD NOT take the drug. If your depression is related to your acne, your dermatologist will probably allow you to take the drug, but your mental state should be monitored closely by a friend, family member or doctor. Many people do not experience depression when taking accutane, but you should not take the risk. There have been people who have committed suicide possibly linked with taking accutane, so IT IS VERY IMPORTANT THAT YOU TALK TO SOMEBODY IF YOU BEGIN TO FEEL VERY LOW.

Is it okay to tan/use sun beds whilst on accutane?
No. Your skin will be much more sensitive to sunlight, and will most likely burn very easily. You should wear a high-factor sun block throughout the course and for 4-6 months afterwards. Good sunscreens are recommended in the "tips for accutane users" section.

Is it okay to exercise whilst taking accutane?
-Generally, yes. You may experience more muscle aches and pains after strenuous exercise, but there should not be any more serious complications. If you aches are severe, discontinue exercise and speak to your dermatologist.

Is it okay to take vitamins whilst taking accutane?
-You should not be taking vitamin A in any form whilst on accutane, as this may interfere with the drug, but other than this most other vitamin supplements should be fine to take.

Is it okay to drink alcohol whilst on accutane?
-It is not recommended, but the majority of people find they can have occasional drinks without any problems. However, since accutane impairs liver function, it is not a good idea to tax your liver with any other harmful substances, such as alcohol. If possible, avoid it.

I have heard several horror stories about accutane. Could the things they are speaking of happen to me?
-Unfortunately, there is a chance that you could experience such side effects. The drug affects people in different ways, and whilst cases of severe, permanent side effects are rare, they can happen. You have to assess whether you are willing to take the risk. Bear in mind that the horror stories are always more highly publicised than the success stories, and that people who have had success with the drug do not usually post as much on message boards, hence the amount of negative stories circulating on other accutane message boards.

Will accutane cure my acne?
-Dermatologists claim that typically 90% of patients' acne is put into remission through use of the drug, and 60% is completely cured. It is possible that your acne may return after a course of the drug, but it is likely to be much less severe.

Can accutane leave me with permanent damage?
-There is a risk of permanent side effects, such as ongoing dryness, reproductive problems, and internal organ problems, but permanent side effects are relatively rare, and typically, normal bodily function resumes within a few weeks to a year after finishing the course.

I have seen accutane for sale on Ebay. Is it okay to buy my drug here?
THIS IS NOT RECOMMENDED. ACCUTANE IS A POTENTIALLY DANGEROUS DRUG AND IF YOU ARE TAKING IT YOU SHOULD BE MONITORED BY A QUALIFIED DERMATOLOGIST TO AVOID COMPLICATIONS.


Is it okay to go on a second course of accutane?
Many people take this option if their acne returns significantly. There are no added problems with this, other than the risk of the same side effects again.

Is it okay to go on a long-term course of accutane but at a low dose?
This is not generally recommended – some people have found themselves on this kind of course for well over a year, and this can have a detrimental effect on your body. Personally, I would rather have stronger side effects, knowing that the drug will be out of my system within a year, than suffer milder side effects for years. Essentially, it is up to you and your dermatologist what sort of course you take, though.

Will accutane exacerbate my scarring?
-Many people feel that accutane did aggravate their scarring. This may be due to the fact that accutane usually causes a significant flare-up in the patient's acne, initially, and to the fact that it makes the dermis more fragile. It can also impair the functioning of the liver. However, it is highly unlikely that accutane actually CAUSES scarring. If you have been left with scarring, please check out the scar forum of acne.org for more information.

Is it okay to undergo scar procedures whilst on/after accutane?
NO. The things you can use on your skin to help with scarring whilst on or immediately after accutane are mild topicals such as copper peptides and amino-plex spray. UNDER NO CIRCUMSTANCES SHOULD AN INVASIVE PROCEDURE SUCH AS DERMABRASION OR LASER RESURFACING BE PERFORMED WITHIN 6 MONTHS OF TAKING ACCUTANE. Also, you should not be using any form of acid peels until at least 4 months after finishing your course of acne.

I have heard about liver flushing as a recommended treatment to cleanse my body after taking accutane. What does this involve?
-Liver flushing is quite a serious procedure that you can do yourself at home, but which requires careful preparation to avoid complications. Please check out the diet/holistic health forum for more information.

GENERAL TIPS FOR LIVER HEALTH FOLLOWING ACCUTANE TREATMENT:

-Avoid processed food, alcohol and additives.
-Eliminate fizzy drinks – they are loaded with phosphates and interfere with digestion.
-Eat fruits and vegetables which nourish the liver: apples, black grapes, carrots, blackberries, blueberries, asparagus, celery, cucumber, lemon, beetroot, romaine lettuce, seaweed, watercress, sweet potato. These balance the flow of emotional and physical liver energy.
-Try taking one of the following supplements for 1-2 months: soya lecithin, milk thistle, burdock root, alpha-lipoic acid, Chinese bitters, tejaswini.




USEFUL LINKS FOR ACCUTANE INFORMATION

http://www.fda.gov/c...cationguide.htm- FDA Accutane Medication Guide, with particular emphasis on side effects for females.
http://www.fda.gov/c...ane/default.htm - FDA hub page for accutane.
http://www.rocheusa....ducts/accutane/ - Roche website - info on accutane.
http://www.accutaneaction.com/ - Accutane action group. Hard-hitting site that details some of the worse cases of side effects from the drug.
http://www.rxlist.co...ric/isotret.htm- Chemical and scientific descriptions of accutane, for those interested.
http://www.rxlist.co...ric/isotret.htm - Accutane info. from drugs.comhttp://accutane.poweradvocates.com/ - 'The Accutane team' website - a group of lawyers dealing with accutane cases. Again, very hard hitting, with details of cases with extreme side effects.
http://www.roaccutane.com.au/ - Australian website that contains a downloadable PDF about the drug.





Top Tips For Accutane Users

These tips are IN ADDITION to the information that is provided on the instructions with the drug, and are in no way intended to replace these. The tips are merely recommendations based upon my experience on a seven month course of Roaccutane (the UK version of the drug) along with past comments made by other users of the drug. There is no need to follow the advice here rigidly, but some of the tips may help make your experience on accutane a little more pleasant!
The first and most important tip I could give is to take accutane or roaccutane under the supervision of a qualified dermatologist who will be able to monitor your physical and psychological health Accutane is a powerful drug and you should not be taking it unless you are under close supervision.



1) It is highly recommended to use an intensive moisturiser whilst on a course of accutane. Without a moisturiser, your time on the drug can be extremely uncomfortable and you may suffer permanent skin damage. The use of an effective, non-comedogenic moisturiser will not inhibit the results you will get from the drug – do not assume that "drier is better". Watch out for certain ingredients in moisturisers – in particular avoid synthetic lanolin and stearic acid, as these can clog your pores and cause breakouts.
Recommended moisturisers are: Emu oil - available from Ebay or Skinbiology.com, Eucerin Daily Renewal, Cetaphil SPF 15, or Living Nature's manuka day cream - available here
Here is a thread about moisturisers: http://www.acne.org/...p...ic=1477&hl=
Here is an article about moisturising. Sourced from skinbiology. http://www.skinbio.c...isturizers.html

2) Some people have advocated washing only with only water or even not washing at all whilst on a course of accutane. I would NOT recommended this. Just because you are no longer getting spots does not mean that your skin does not need to be washed. However, cleansers can leave your skin feeling very dry. A gentle cleanser is recommended. The following are very good: Puredeming's castille bar, Cetaphil gentle cleanser, Living Nature's purifying cleansing gel and most 'Simple' cleansers.

3) Use of a high factor sun block whilst on a course of accutane is highly recommended. Your skin will be very fragile and will burn more easily, so unprotected exposure to sunlight should be kept to a minimum and sunbeds/solariums should be avoided. Arguably the best total sunblock on the market is Total Block spf 65. Available here
However, I have also found Green People's SPF 15+ http://www.greenpeop...u...c=G001&cc=G and Aubrey-organics' SPF 15 http://www.aubrey-organics.com/ to be effective. Sorry for how expensive these products are, but good quality sunscreens are usually $20 and upwards.

4) Your lips will be extremely dry whilst on accutane, so use of a good lip balm is essential. Vaseline is highly effective but can be pore-clogging on some people. Members have had good results with use of Carmex and Puredeming's Gilead Lip balm (available here: Puredeming)

5) Try to keep yourself hydrated whilst on accutane to combat dryness. There are several ways you can do this. Firstly, consume plenty of water. This may sound obvious, but your body can become more dehydrated by the drug. Try to keep your intake to 8-10 glasses a day, more if exercising. No additional benefit is gained by drinking more than 12 glasses a day and excessive consumption can be dangerous. (for more info on drinking too much water, see this website:
http://www.ivillage....88681-2,00.html )
Also try to increase your intake of essential fatty acids (EFA's) whilst taking accutane. This may alleviate some of the dryness and can help keep skin supple. Good sources are all types of nuts (especially walnuts) and oily fish.

6) Try taking high dose supplements of Vitamin E in addition to accutane. There is some evidence that taking 400IU (around 300mg)– 800 IU of Vitamin E can help alleviate some of the side effects of accutane.

7) Avoid eating foods high in Vitamin A such as liver and pate on a regular basis, as this increases the risk of side effects from accutane such as potential liver damage. Instead, consume foods rich in Beta-carotene, which is only converted to vitamin A in the body if the body needs it.

8) It is quite likely that you will experience flare-ups in your acne at some point which may result in an increased risk of scarring due to the fragility of your skin. To combat this, I found using manuka honey on the active acne and wounds helped with the healing process. Manuka honey also contains anti-itching agents which can help to soothe your skin. An excellent product is Living Nature's honey and oil antiseptic gel: available here or you can buy pure manuka honey from Manukahoneyco.uk and Comvita

9) Make sure that at least one person close to you is aware that you are on the drug. This is especially important for young people going away to university/college. You should let a family member or friend know that you are on the drug and inform them of what the side effects can be, so that they will be able to keep an eye on you and ensure that you are not becoming too isolated or depressed. There are many people who go through a course of accutane without suffering from depression but it is best to be on the safe side.

10) be realistic with your goals whilst on accutane. Be prepared for flare-ups and redness which may last for several months. Do not expect instant results, but remain positive by thinking that despite the fact that your skin will usually get worse before it gets better, it almost certainly WILL get better.

Good luck to all people taking accutane or considering taking it. Please do not hesitate to post your experiences on this thread or add further tips of your own. Also, if you have any questions, feel free to send me a Private Message and I will try my best to answer.
Take Care,
Paul.



Last edited by Rossignol, 5th July 2005 - added links to useful accutane/roaccutane websites. (finally!)

#2 asdfghjk

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Posted 10 August 2004 - 01:02 PM

bb_eusa_clap.gif bb_eusa_clap.gif bb_eusa_clap.gif

very good, I might have to go on accutane so I'm gonna print this out
I am asdfghjk NOT to be confused with aksjdf DUH :lol:

glad elsaaaaaa and me are cool!

#3 elpasokidd

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Posted 13 August 2004 - 06:42 PM

excellent tips for future accutane users or current accutane users!

#4 made78

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Posted 14 August 2004 - 08:56 AM

I've been taking Accutane since 3 weeks now bb_icon_rolleyes.gif ....I'm very surprised by the results...of course I experienced alot af dryness, especially my lips will be "cracked" and red, but that is about it.

Another thing is that I'm still following my regimen with BP, I wasn't sure if I was supposed to wink.gif , but it's working out well...mousterizing alot my skin is a must.

I want to thank all you guys for your support, advise and words during the most critical moments of my life...my acne was developed my stress, I broke up with my fiance and my brother went to jail like 2 months ago...

Muuuaaaaa, love you all bb_eusa_dance.gif , sincerly


Madeleine biggrin.gif

#5 Rossignol

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Posted 15 August 2004 - 04:16 PM

Let us know how you get on with your treatment, Madeline. Glad you are feeling happier! smile.gif
I would be a little wary of continuing with your BP regimen for much longer - when the dryness really kicks in it might be best to give your skin a break from anything other than moisturisers. Just my opinion. smile.gif
Good luck!

#6 mystic face

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Posted 16 August 2004 - 02:39 PM

I've got a question here. I am on the 2nd week of using accutane, and I am suffering of a slight back pain. does that happen? and when can I noticed improvement?

Bless Ya

MF
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"The best and most beautiful things in the world cannot be seen, nor touched ... but are felt in the heart."
Helen Keller...

#7 nick_04

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Posted 17 August 2004 - 02:54 PM

I was wondering what stage does your acne have to be to start taking accutane (roaccutane-i'm in uk)
New Roaccuntane Log
http://www.acne.org/...01#entry2847801

Finished 1st Round Roaccutane on the 19th December 2006

Living with acne since 2002.

Currently on Roaccutane 70mg. Using gentle wash and moisturizer.

#8 Rossignol

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Posted 18 August 2004 - 10:27 AM

Mystic face - don't worry about the back pain - it is fairly normal to experience this on accutane, particularly lower back pain and particularly at the end of the night when you're going to bed. I'm not sure why this happens scientifically, but as long as you are not on a course any longer than the usual 4-7 months, you don't need to worry.

Nick - most dermatologists prescribe accutane as a last course of action for people whose acne has not responded to antibiotics/ topical treatments. It is most often prescribed for those with severe cystic acne, especially those who have started to experience scarring.
However, accutane is also prescribed for less severe forms of acne - although I would urge people whose acne is not severe to look into other treatments before thinking of accutane, as it is a serious drug not to be taken lightly.
smile.gif


#9 Scimitar

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Posted 19 August 2004 - 04:37 PM

QUOTE (Rossignol @ Aug 9 2004, 11:32 AM)
7) Avoid eating foods high in Vitamin A such as liver and pate on a regular basis, as this increases the risk of side effects from accutane such as potential liver damage. Instead, consume foods rich in Beta-carotene, which is only converted to vitamin A in the body if the body needs it.


I was told by my dermatologist to discontinue my multivitamin in addition to avoiding foods high in Vitamin A.
Centrum and other vitamins contain close to 100% of recommended daily intake of Vitamin A.

I've heard horror stories of isotretinoin interactions with Vitamin A, so perhaps it would be wise to avoid the daily multivitamin whilst on isotretinion?

#10 Rossignol

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Posted 19 August 2004 - 05:06 PM

Hmm. This is a difficult one. I think it is probably best to be on the safe side, as Scimitar points out, but on the whole I think it is unlikely that there will be complications from taking the RDA of vitamin A as this is such a relatively small amount.
But a dermatologist is likely to be much more clued up about these things than me, so I would probably take the advice on discontinuing supplements that contain vitamin A.
Other supplements such as vitamin C and E should be fine though (as long that they are not combined with vitamin A in the supplement.)

#11 duluxdog

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Posted 20 August 2004 - 05:45 AM

Hello. I also took a 7 month course of Roaccutane, 60mg per day.

I would definitely avoid taking any kind of Vitamin A supplement whilst on Roaccutane. My derm specifically warned against this.

Just a point concerning water: It isn't a good idea to drink large amounts of water before or straight after a meal. Try to leave an hour gap or else your vitamins and minerals in the food are not absorbed as well. If you are taking Roaccutane/Accutane with the food then this will also be less well absorbed.

Similarly, taking Roaccutane and drinking alcohol in moderate-large amounts will lessen the chance you have of absorbing all the medicine in your intestines if you consume the tables at the same time as drinking. Again, try to leave a gap. Perhaps if you plan to go out for drinks then consider taking the pills in teh morning so they won't be interfered with by the evening drinks.





#12 Rossignol

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Posted 21 August 2004 - 02:24 PM

Excellent advice. Thanks, dulux. smile.gif

On the whole, accutane users should be avoiding alcohol as much as possible, although the odd few drinks didn't cause any major problems in my case.

Please keep adding any tips or advice you have - we want to make this thread as informative as possible!

#13 TwIsTeDsTaTe

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Posted 24 August 2004 - 03:39 AM

MY ACCUTANE TIPS!!!

1. Stay the hell away from the sun. ( even with super spf moisturizers u WILL tan and burn...so no beach...)

2. Take your pills right after your meals (you need some food in you in order for it to kick in better and fatty meals supposively help this process....so mickey dees it is..)

3. Stock up on the body lotion, and hydrocortisone cream since accutane will make you prone to scrapes and cuts most likely on your hands, arms and neck area. ( I had many days where I would go to school and my classmates would ask if I had scrapped with a pack of wolves on the way.....grr....)

4. Moisturize your mug at least once a day, it keeps your skin moist and may even help with the healing process of say pimples which you had a few words with.( if your a guy you might as well, since your never gunna touch that stuff ever again after your finished our cycle.....how many MALES out there mositurize? come onnn....)

5.Do not use any topical creams, including BP gel, acids, malaysian black shark string bean root cream, or wutever the hell your thinkin of slappin on while on accutane.( Less is more here people....who knows wut kind of interractions could occur......Accutane is powerful enuff guys...leave it be...)

6. Break out the Vaseline boyz! ya know we all got wholesale sizes of it stocked up in our closets. Vaseline and lip balm is crucial because your lips will become stones so apply as much as u can without lookin like u got shininglipssyndrome guys. Its easier for gurls cus its OK to have shiny lips but for us guys....its kinda a nono.....I use BLISTEX CLEAR ADVANCE...u can find it ur friendly neighbourhood shoppers drug mart...its designed for men cus it has NO shine...yayy....( so yea...no smoochin unless u want ur significant other to rip off a chunk of ur lip)

7. Do not POP anything since your skin will be extra fragile, the smallest pimple popped will enlarge and scar very easily. (many days ive had where i thought hey why not? its so small....so ready to be popped...so i squeezee an then BAMMMM!!! ....it looks like i got shot in the face the next morning....so no...no popping...)

8. Do not take ANY recreational drugs or alcohol.( isnt this obvious? accutane already messes your mental state...do you really need to smoke that fatty and do that line of yayo to get high? and for u alkys out there.....accutane weakens your liver.....hold on! doesnt alcohol weaken ur liver?? case closed.)

9. HAVE FUN!! ITS JUST ACNE!!!

10. Honestly people...one thing that gave me strength was seeing all the things out there that acne could never even come close to being compared to like the blind, the deaf, people with deformations, the handicapped, burnt victims, people dying... when you see something like that and you take a good look at your sad face in the mirror...do you really have the right to be so sad for yourself? I dont think so...so suck it up ....and hope for the best....good luck everyone.

#14 Rossignol

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Posted 24 August 2004 - 03:13 PM

QUOTE
9. HAVE FUN!! ITS JUST ACNE!!!

10. Honestly people...one thing that gave me strength was seeing all the things out there that acne could never even come close to being compared to like the blind, the deaf, people with deformations, the handicapped, burnt victims, people dying... when you see something like that and you take a good look at your sad face in the mirror...do you really have the right to be so sad for yourself? I dont think so...so suck it up ....and hope for the best....good luck everyone


Thanks for adding your tips. Most of the info was good, but I don't entirely agree with the above sentiments. The scarring on my body has been compared by my plastic surgeon to that of a burns victim, so it is difficult for me to take the attitude of 'oh well it's just acne'.

Also, many people here are aware that there are people much worse off than us. We can be filled with sympathy and admiration for those people, but this doesn't make it any easier for most people to handle their acne. There have been a lot of threads along these lines in the emotional effects forum.

If any of the people reading this thread are of the opinion 'it's just acne' I don't think they should consider taking roaccutane/accutane. It's a serious drug. You shouldn't just take it for the hell of it. bb_neutral.gif


#15 TwIsTeDsTaTe

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Posted 25 August 2004 - 03:02 AM

good point ross...but when i said "its jus acne" i meant it sarcastically because we hear it all the time from people with perfect skin but also as a self esteem booster for everyone suffering out there, because this is what I told myself everyday ALL day to help me get through the horrible days on accutane. AND considering your scarring...even though your plastic surgeon said it can be compared to a burnt victims, you are STILL better off because a burnt victims scars could never heal but YOUR scars originated from acne so they COULD possibly heal in time...no?

This is actually my 2nd time on accutane so truss me man...ive been through the worst of it..and a second helping really doesnt make my day but I gotta do what I gotta do.....

#16 Rossignol

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Posted 25 August 2004 - 07:43 AM

Yeah I thought you were saying it in jest, but I was just worried that some people might not realise that. smile.gif

I am hoping that my scarring will be able to improve over time and with some treatments, although I don't think the scars will ever fully heal, unfortunately.

Good luck with your second course of accutane. smile.gif

#17 Night

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Posted 27 August 2004 - 08:35 AM

QUOTE (TwIsTeDsTaTe @ Aug 24 2004, 02:26 AM)
9. HAVE FUN!! ITS JUST ACNE!!!

OMG!!!!! Whatever bb_icon_rolleyes.gif

#18 TwIsTeDsTaTe

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Posted 28 August 2004 - 02:12 AM

night...read my 2ND posting

#19 Grimpeur

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Posted 31 August 2004 - 07:03 AM

I was wondering about a few things with Accutane, I have been on it for some time and feel all the side effects. I was wondering if anyone out there knew exactly what goes on with Alcohol and drugs while on Accutane. dry.gif Is it just the liver issue? or does it affect the Medication totally? Will it ruin the effects of Accutane.

#20 Rossignol

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Posted 01 September 2004 - 04:46 AM

As far as I know, it is only the liver issue, although theoretically, I suppose there could be some interaction between the different chemicals and drugs. In general, it is best to avoid alcohol and drugs altogether, I think, although I did have quite a bit of alcohol whilst on my course without too many negative side effects.
Sorry I can't provide any more info. (I might go look it up on google and get back to you)




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