Hello! I feel ya on a lot of what you just described. I started getting acne around age 11ish and it just never stopped. My face was never severe, but definitely moderate. I do have some severe acne, cystic on my shoulders/back/sometimes armpits. But the moderate acne was extremely persistent. I'm 23 now and was just prescribed Accutane last month. I was turned down for it in my early teens because the docs wanted to persue other treatments, hormonal and topical, and turned down again around 19 because I had some depression and joint issues. Both understandable reasons to not prescribe accutane. I'm now on my fourth derm (not by choice, I move around a lot).
I think what it took was showing that the other treatments did NOT work. Hormone therapy failed me, BP stopped working, no topical or RetinA would do the trick. In fact, they just made my acne come back with a vengeance, same with antibiotics. Also to show that its persistent. I was trying to get rid of it for over 10 years by the time I was prescribed it. Another thing is the scarring, if you have a high potential to be left with permanent scarring, accutane becomes a more viable option to you. Another reason is if your parents had acne that continued into adulthood, which I did. Also if it is affecting you psychologically, which is sounds like it is. It did for me too I stopped going to the beach, going out with friends. It really affected my self esteem and confidence to look in the mirror and see my skin.
Its not a drug they prescribe lightly, because it comes with severe side effects as I am sure you know by reading around here and it is super important that you give other options a 3-6 month try each. And about the low dosage, for accutane to work, you need to be on the right dose to give you the best chance at long term remission, most doctors will agree it is somewhere around 1mg/kg I think. But your best bet is to find a dermatologist who specializes in acne, bring along a timeline of your skin and every treatment you have tried and the results you got from them, if any. Also to be honest with how the acne/scarring affects you. Be prepared to be open about other treatments but finding the right derm can also help too. I know most doctors and people will probably scoff and say that moderate acne doesn't warrant accutane but when you've been living with persistent moderate acne for 1/2 your life, I know it is a big deal. Will your doctor really not refer you? That really really sucks because a good derm can make all the difference! Have you tried going to a walk-in clinic that does referrals? I don't have a family doctor because I just moved to this city, so I had to go see a walk in clinic doctor. He was so compassionate, and had actually taken accutane himself, and was a huge advocate for me to see a good, acne specializing derm. Could you maybe see if there are any walk in clinics that you could go to? They can't prescribe it, but they can refer you to a good derm!
And I understand, totally. You aren't alone in this!
For reference I am in Canada, where the walk in clinics can't prescribe a drug that needs long term monitoring!
Edited by meowza, 30 May 2013 - 04:36 PM.