Ok, you probably don't want to hear this, but until you figure out the cause of your acne, drugs like accutane will only temporarily keep the acne away. It's worrying that you are experiencing these side effects, so maybe it's time for a new approach.

If your acne is mainly on your forehead, perhaps it's caused by an allergic reaction to something you are using, like your shampoo?

I am a 36 year old male from London.

I have had acne since I was 13. Been on Roaccutane 4 times, age 16, 20, 30 and now on a low dose of approx 10-20 mg per day dependent on how bad it is.

Between ages 20-30 I only really suffered from Folliulitis around jaw /neck and no real acne on Forehead. Since 2010 I have suffered terribly with ridiculosuly oily forehead and red spots under skin on forehead. I am nearly bald so it is more noticeable.

Having tried laser to no effect as well as epiduo, duac, etc I saw a new derm who put me on low dose roaccutane.

While the skin initially mainly cleared up, when I lowered my dose to 10mg every other day, the oil returned in full force and I suffered large breakouts again.

The Roaccutane is making me anxious and slightly depressed but I am worried that I will be even more depressed if I come off it and my acne and oily skin flares up again.

I am also suffering with a blocked right ear (Eustachian tube) and numb jaw/cheek which I believe is directly related.

I am at my wits end and don't know what to do/try next.

The only treatment other than roaccutane that worked in the past was Differin gel but that stopped working after a couple of years.

Any sensible ideas, please ?

For folliculitis, please read Jeff's research on the topic.

You should know that Accutane lowers testosterone temporarily as well as shrinking sebaceous glands. Considering you have been on it 4 times, I doubt your sebaceous glands are the issue. Many people with acne suffer from a sensitivity to DHT (dihydrotestosterone). By the way, combating DHT is the main method of treatment for balding, assuming your near-baldness is not a choice. Drugs like Propecia are very very potent anti-DHT medications.

For acne, there was a study done involving males where 320mg daily of saw palmetto (a natural anti-DHT herb) reduced their acne and oily skin. Saw palmetto was first used for prostate health, but has made its way into acne treatment for males. There are lots of other herbs that have similar effects, too (stinging nettle, pumpkin seed oil...). You can also use saw palmetto topically.

I am a 36 year old male from London.

I have had acne since I was 13. Been on Roaccutane 4 times, age 16, 20, 30 and now on a low dose of approx 10-20 mg per day dependent on how bad it is.

Between ages 20-30 I only really suffered from Folliulitis around jaw /neck and no real acne on Forehead. Since 2010 I have suffered terribly with ridiculosuly oily forehead and red spots under skin on forehead. I am nearly bald so it is more noticeable.

Having tried laser to no effect as well as epiduo, duac, etc I saw a new derm who put me on low dose roaccutane.

While the skin initially mainly cleared up, when I lowered my dose to 10mg every other day, the oil returned in full force and I suffered large breakouts again.

The Roaccutane is making me anxious and slightly depressed but I am worried that I will be even more depressed if I come off it and my acne and oily skin flares up again.

I am also suffering with a blocked right ear (Eustachian tube) and numb jaw/cheek which I believe is directly related.

I am at my wits end and don't know what to do/try next.

The only treatment other than roaccutane that worked in the past was Differin gel but that stopped working after a couple of years.

Any sensible ideas, please ?

For folliculitis, please read Jeff's research on the topic.

You should know that Accutane lowers testosterone temporarily as well as shrinking sebaceous glands. Considering you have been on it 4 times, I doubt your sebaceous glands are the issue. Many people with acne suffer from a sensitivity to DHT (dihydrotestosterone). By the way, combating DHT is the main method of treatment for balding, assuming your near-baldness is not a choice. Drugs like Propecia are very very potent anti-DHT medications.

For acne, there was a study done involving males where 320mg daily of saw palmetto (a natural anti-DHT herb) reduced their acne and oily skin. Saw palmetto was first used for prostate health, but has made its way into acne treatment for males. There are lots of other herbs that have similar effects, too (stinging nettle, pumpkin seed oil...). You can also use saw palmetto topically.

Hi

Firslty thanks you for taking the time to reply, much appreciated.

I have ordered a bottle of 320mg Saw Palmetto pills so will try it.

The research I have read looks promising, but as always with these things, I have to be honest that I don't hold out much hope.

I will update this post over the coming weeks to report my results,

Thanks again

Hi!

We have a similar history -- I'm a 35 year old female and have had acne since i was 13. I have also been on multiple courses of accutane, as well as on a long-term, low-dose regimen, and have tried everything else in between (oral antibiotics, spironolactone, broth-control pills, topical antibiotics, retinoids, benzoyl peroxide, salicylic acid, sulphur, tea tree oil, elimination diets, tanning, not tanning, etc.) The only things I haven't tried are laser and light therapies. Anyway, between all these things, I've managed to have ok-ish skin for the last ten years, thanks primarily to accutane. Today, I'm managing with only 25mg of spironolactone per day. Spiro is mainly prescribed to women, due to potential feminizing side-effects.

However, I have heard of finasteride being used for hormonal acne in men. Have you considered it and can you consult your dermatologist about it?

Here is some basic info: http://www.livestrong.com/article/107837-finasteride-acne/

I bet the search function on this site will turn up some results too.

Hang in there!