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Rossignol

Member Since 23 Apr 2004
Offline Last Active Dec 30 2011 11:20 AM

#300716 FAQ for Accutane Users

Posted by Rossignol on 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!)