OldogNewTricks

Hi Mosey Mom, 

We saw the post by Lastlazarus about your son's initial break out and the issue concerning the dosage. We posted a response to your question about your son's 80mg initial dosage and commented that this seemed really high to start. We think the posting by Lastlazarus shows how important this site is; we have read that a large dose is sometimes necessary for severe acne and the "norm of 120mg/kg" dosage is not for everyone. I think what happened to her bears this out. Hopefully other readers will do their research on the dosage and determine what is best for them.  

As you discovered; the higher dosage can result in more severe side effects like the high cholesterol and impact it can have on the liver; and these are just two of the more severe side effects. (we have found that taking red rice yeast helps reduce our cholesterol; if your son's levels remain high, ask your derm and/dr about this?).  

As to the IB, we didn't see any improvement in our daughter the first 3 months. In fact, her face acne was worse than it  had ever been on the anitbiotics or topicals she was prescribed; she almost quit taking the accutane in month 3. We asked our older daughter to come home for a weekend to talk to her little sister and re-assure her the IB will pass. Seeing is believing.  Our older daughter went thru the exact same thing when she took accutane and her skin is beautiful today. 

Our daughter is now into her 4th month on 40mg and her face is completely clear of any acne. The marks the IB caused are already starting to fade; it is incredible. She just had a small break out on her back (it had completely cleared up in month 3) which we think is just the final IB. For both of our daughters, it seems that once they exceed the midway point of their cumulative dosage, the drug really kicks in. Is your son at his midway point yet? 

As to the rash, we find an otc of 1% cortisone cream works best. We also think taking an omega 3 really helped with joint pain and the IB; make sure the omega has real fish oil. As to the joint pain, our daughter stretches every morning and nite and this helped significantly with her back and knee pain. 

We really hope your son is able to stick with the accutane and he has no severe side effects going forward. We really struggled with increasing the dosage from 40mg to 60mg after month 3 b/c we weren't seeing any improvement. We opted to add an additional month b/c of some weight gain and we are so happy we didn't change the dosage b/c the results in month 4 are so incredible. The main reason we didn't increase dosage is b/c our daughter had the side effects under control and it made no sense to us to take the risk of causing more side effects since she had them under control.

The IB will pass and your son will see improvement; give it time.

Good luck. 

Hi Mom, saw your post as a parent and it encouraged us to join for our daughter, who is 14 and started her acutane treatment in Nov.

We agree with leere (sp?) 80 mg seems really high. Our 14 yr old daughter is on a 5 month 40mg plan (110 lbs). From everything we have read, and as leere points out; it's the accumulation of the correct dosage of accutane for your specific body weight that counts; not the monthly dosage amt b/c you can change the dosage so long as you hit the cumulative total for your weight. As to the BP on accutane, goes against everything we have read and what our derm is telling us. There are always 2nd opinions if your son isn't happy with the current progress......based upon everything we now know, we would seek a second opinion. 

This is our second child that has used acutane; we have a 20 yr old that completed a course in high school for moderate acne and her results were incredible. Today, you can't even tell she had acne. But, unknown to us until years later, she went thru a bout of depression as a Jr. in high school about 18 months after completing the acutane; we never attributed the depression to the acutane. With her, it started with migraine headaches, which she never had, and progressed so bad we had to see neurologists and nobody was able to figure out what triggered it. Eventually, the migraines went away and have never returned but she was so down, she was out of school for about 3 months. that has been the only negative with accutane and we now know better for our second child and what to watch out for. You don't have to talk about acutane; acne; or any of this with your son b/c it's just too embarrassing for everyone-acne is just such a taboo subject. Please just try to keep an open dialog with him and try to keep tabs on what's going on in his life. I know, easier said than done, but pay very close attention to his behavior while he is on it.

The drug works but i can't imagine the side effects on 80 mgs.  Will your son even read this website so he can figure out how it works for himself? Just b/c he is taking 80mgs doesn't mean his acne will improve that much faster. For us, we are hoping our derm for our 14 yr is on the mark with his plan: 1st mo, was 40mg w/o food; as leere points out-this was only 50% absorption. We think dr did this taking into account her sports (club volleyball 2 hr practices x 2 times week and 1 extra practice); joint pain on accutane is bad anyway but athletics can compound this. for months 2&3 40mg with food. She is still having good days bad days with breakouts, but this is b/c she has not reached even 50% of her total prescription  intake. since she is still growing and gained a little weight, we are considering up'ing months 4&5 to 60mgs. We are reading this site for as much info as possible to make this decision. So you see, it's not too late to change the dosage; we believe what the studies show it's the accumulation for your weight that matters; not the duration of time. 

Hi,  we are parents (u may not want to listen to us-we are mid 50's ) of 2 girls (our first is age 20) and our youngest is 14. Some background first, my husband's side of the family has a history of acne; moderate to severe. My wife's side has very mild acne. We are both hispanic so the hyper-pygmintation is an issue b/c we have darker skin. As to us as adults and for our children, we tried EVERYTHING out there for our acne. Ointments/antibiotics/home remedies, i mean everything! Nothing worked. With that being said, here is what we can tell you about our experiences for our children who took and are currently taking acutane: IT WORKS! But, you and your PARENTS NEED to educate yourself about this drug and the range of possible side effects. 

1. Research this post and get facts about what to expect. here is the link to the page to read first before taking acutane.  i wish we would have had this web site when my oldest took acutane. http://www.acne.org/...ge-information/   THIS IS A REALLY IMPORTANT LINK! READ IT! UNDERSTAND THE CALCULATIONS! If this link doesn't work, search " acutane dosage".

2. After you read the do's and dont's figure out what is the best time period to start. Duh, my 14 yr old just started her 5 month course in Nov 2012 and this is really important. For example, she had to take a private school entrance exam and we never figured the acutane could affect her ability to focus. So make a 5-6 month plan.

3. Make sure your dermatologist,  not a regular DR, knows their stuff! Acutane is based on the cumulative intake; your body weight is what determines how much you can take. KNOW WHAT YOUR INTAKE SHOULD BE! If your derm doesn't discuss this in length with you plus any possible increase or decrease in dosage that you can take during a course of acutane, FIND A NEW DERM!

4. SIDE EFFECTS.  Each person varies. For our girls, my 14 yr old is in good health, weighs 50 kilgrams (you need to know how to convert) and is on 40mg of acutane for a 5 month course. She is very athletic; she plays club volleyball and this is intense! Here is what she is experiencing: Extremely sore knee joint pain; back pain; initial headaches which went away; on going rashes on elbows and hands; and we believe an inability to focus like she could before starting acutane (hence, time it with your school plans). Dry lips and eyes (she wears contacts), dry body. Nobody tells you this, but your skin becomes really tender and sensitive; like baby-skin so be extremely gentle: FOLLOW THE REGIMEN for washing; 10 seconds to wash and no more; very gentle foam cleanser AND USE NO OTHER ACNE PRODUCTS! Your skin cannot handle it.

"My derm prescribed accutane to me yesterday and she gave me the iPledge booklet and everything and I had a urine/pregnancy test. She gave me two forms for blood work in the booklet and I forgot what she said about them... I'm confused, am I supposed to get one blood test now and then another in a month, or did she accidentally give me two forms and I'm only supposed to get one blood test in a month?

Also, I logged into iPledge and it said on the calendar "March 10, First day you may have your next pregnancy test", and in the iPledge booklet, it said "within the first 5 days of your menstrual period"... what if my period doesn't come then? Mine is a bit irregular. Can I still get the blood/pregnancy test then?"

sorry for putting those 2 other responses before answering your initial questions; we didn't start on the right foot with both of our daughters and we wanted you to avoid some of the mistakes we made. Get your parents involved if you can; they should be doing the ipledge logon/questions with you; but we are reading your posts so here's what we remember:

1. Since you are registered with ipledge, you have 7 days to get your prescription (rx) filed after your dr appt every month starting now!  Remember, you have 7 days from your dr appt each month to fill your rx,  if you don't fill the rx within 7 days of your appt, you have to go back to your derm and you have to start all over again! Timing is critical! the 7 days to fill the rx can't be missed or extended.

2. as to the  two blood test forms, we assume you took your first blood test thru your dr or you couldnt register and why the two forms, we don't know why you need two forms; we get 1 form each month and for us, our daughter takes her blood test one time per month at least 7 days before her next dr appt. so the results are sent to him by the time of our appt. check w/your lab how long it takes to process to get it to your dr for you appt.  

3. Check the "March 10 first day to have pregnancy test"; for us, this means a urine test for our daughter, and this test is done at her derms office every month and this has no connection to her menstrual cycle.

For our daughter, she does the blood work once a month about 7 days before her next dr appt; and 

at the dr appt, she takes her urine test for the pregnancy results. Her menstrual period for our Dr has no bearing to the urine pregnancy test. 

We hope this answers your questions and yes the ipledge and dates are VERY confusing! Call your dr's office and make them explain better! You are paying them!  Don't feel inadequate, EVERYONE goes thru this the first time! 

Hi,  we are parents (u may not want to listen to us-we are mid 50's ) of 2 girls (our first is age 20) and our youngest is 14. Some background first, my husband's side of the family has a history of acne; moderate to severe. My wife's side has very mild acne. We are both hispanic so the hyper-pygmintation is an issue b/c we have darker skin. As to us as adults and for our children, we tried EVERYTHING out there for our acne. Ointments/antibiotics/home remedies, i mean everything! Nothing worked. With that being said, here is what we can tell you about our experiences for our children who took and are currently taking acutane: IT WORKS! But, you and your PARENTS NEED to educate yourself about this drug and the range of possible side effects. 

1. Research this post and get facts about what to expect. here is the link to the page to read first before taking acutane.  i wish we would have had this web site when my oldest took acutane. http://www.acne.org/...ge-information/   THIS IS A REALLY IMPORTANT LINK! READ IT! UNDERSTAND THE CALCULATIONS!

If this link doesn't work, search " acutane dosage".

2. After you read the do's and dont's figure out what is the best time period to start. Duh, my 14 yr old just started her 5 month course in Nov 20 2012 and this is really important. For example, she had to take a private school entrance exam and we never figured the acutane could affect her ability to focus. So make a 5-6 month plan.

3. Make sure your dermatologist,  not a regular DR, knows their stuff! Acutane is based on the cumulative intake; your body weight is what determines how much you can take. KNOW WHAT YOUR INTAKE SHOULD BE! If your derm doesn't discuss this in length with you plus any possible increase or decrease in dosage that you can take during a course of acutane, FIND A NEW DERM!

4. SIDE EFFECTS.  Each person varies. For our girls, my 14 yr old is in good health, weights 50kilgrams (you need to know how to convert) and is on 40mg of acutane for a 5 month course. She is very athletic; she plays club volleyball and this is intense! Here is what she is experiencing: Extremely sore knee joint pain; back pain; initial headaches which went away; on going rashes on elbows and hands; and we believe an inability to focus like she could before starting acutane (hence, time it with your school plans). Dry lips and eyes (she wears contacts), dry body. Nobody tells you this, but your skin becomes really tender and sensitive; like babyskin so be extremely gentle: FOLLOW THE REGIMEN for washing; 10 seconds to wash and no more; very gentle foam cleanser AND USE NO OTHER ACNE PRODUCTS! Your skin cannot handle it. Ok out of room but will post a second link with what to expect.

Well, if you got thru that, here is what you can expect: remember, your derm will really focus on the pregnancy issue, liver issues, cholesterol etc. Yes these are all extremely important but they won't tell you the side effects or really how to handle the course of treatment so continue to post questions. Here are the answers your seek

1. YES there will be an initial breakout (IB). My oldest daughter didn't have one but my 14 yr old after 3 months continues to have good and bad days. So expect things to get worse before they get better. i have read it can take up to the entire course before it kicks in.

2. As to the hyperpygmintation, for my 20 yr old, WOW, as best as we can recall, after 6 months, she was 100% clear and soft as a baby's bottom.Today, at age 20, you would never know she ever had any acne; her skin is so beautiful as parents who suffered acne, it makes us feel so good that we could do this for her.

3. Your course of treatment, figure it out! Question your derm, but 4-6 months seems to be the norm. Here's the issue: The shorter the course, the higher the dosage. I don't think my 14 yr old could have handled a higher dose than 40mg. Only you know how much you can handle.  Start low and if necessary build up; that's what we are considering for months 4&5 for our 14 yr old. Her 1st mo was w/o food, this meant about a 50% absorption rate; thereafter she took with food. That's how it's supposed to be taken with food. We think our derm knows what he is doing b/c 1st mo at 50% w/ later increase in mos 4-5. will get her the cumulative amt she needs.

4. Results. Who knows; each person varies and it takes time to build up the cumulative amt in your body for it to work; have patience b/c it is worth it!

5. Is acutane worth it? ABSOLUTELY! But, you need to do more research on this site; for example we forgot to mention our 20 yr old suffered from depression after taking it; we never made the connection until years later with the help of websites like the one DAN THE MAN has made here. It is a serious drug, but if taken with proper medical derm advice and educating yourself of the wide range of effects it can have, you can do it! It can be life changing. read the blogs and good luck if u go for it!