I'm considering doing a second round of Accutane. My acne was moderate when I first went on it, not cystic but it was all over my face. Accutane was a miracle worker. Got off a 6 month course in February 2012. I'm considering a second course because some of my acne is back. Especially around my chin. The chin is pretty decent sized zits but my forehead is covered in tiny dots.
What my question is- how to dermatologists generally feel about 2nd courses? I will have to go to a different doctor because my original one is not in my health insurance plan anymore. My thing is if I go see a new one they will not think my skin is bad enough for Accutane.
Anyone else had this problem? Are they hesitant or do they generally let you do what you want? Haha
Hey! Sorry some of your acne came back- I was in the same situation about a year after I finished my first course - I was about 21. First of all, my derm was ok with prescribing Accutane to someone with mild-moderate acne. Here was my experience:
My acne had been moderate before Accutane and mild-moderate when it came back. It was never too bad but it was persistent and really frustrated me and made me depressed. I tried to go back on Accutane when it came back and my derm was very hesitant. He said that he wanted me to wait until I was 24 or so because for most of his patients 24 was like the "magic age" - meaning his patients that took Accutane after the age of 24 tended to have permanent remission. I was 21 or 22 at the time. He still prescribed it to me though. However, in the next couple days I made another appointment because I decided I didn't want to do the second course without trying out something else first.
I never thought my acne was hormonal (It doesn't have the normal hormonal pattern of being on the jawline - it's more on my t-zone) but I tried Spirolactone. And it acutally worked! After about 2 months I was totally clear and stayed pretty clear for about 3 years. But recently, at 25, I started breaking out again and now I'm 2 months into my 2nd course.
So that's my experience! I'm planning on doing something for maintenance after this course - maybe Retin A - and I'll start the Spiro again. Are you using any topicals or other medications now?
On the off chance you live near Seattle, I can recommend my Dr.!
Hey! Sorry some of your acne came back- I was in the same situation about a year after I finished my first course - I was about 21. First of all, my derm was ok with prescribing Accutane to someone with mild-moderate acne. Here was my experience:
My acne had been moderate before Accutane and mild-moderate when it came back. It was never too bad but it was persistent and really frustrated me and made me depressed. I tried to go back on Accutane when it came back and my derm was very hesitant. He said that he wanted me to wait until I was 24 or so because for most of his patients 24 was like the "magic age" - meaning his patients that took Accutane after the age of 24 tended to have permanent remission. I was 21 or 22 at the time. He still prescribed it to me though. However, in the next couple days I made another appointment because I decided I didn't want to do the second course without trying out something else first.
I never thought my acne was hormonal (It doesn't have the normal hormonal pattern of being on the jawline - it's more on my t-zone) but I tried Spirolactone. And it acutally worked! After about 2 months I was totally clear and stayed pretty clear for about 3 years. But recently, at 25, I started breaking out again and now I'm 2 months into my 2nd course.
So that's my experience! I'm planning on doing something for maintenance after this course - maybe Retin A - and I'll start the Spiro again. Are you using any topicals or other medications now?
On the off chance you live near Seattle, I can recommend my Dr.!
Your acne sounds pretty much like mine! Moderate before Accutane, mild-moderate after. And yes, it's frustrating! Any amount of acne is frustrating in my opinion so I know how you feel too. Plus were past our teen years, I want to be rid of this!!!
That's what I was wondering. I don't want to try and other topicals or medications when I know Accutane works you know?
I am currently using Differen on my forehead, and that really helps keep the tiny bumps down but not nearly as well as Accutane did. And I'm not using anything on my chin because sometimes I feel like that just makes it worse 
So I avoid it all together.
Thanks so much for replying and giving me insight!
I also want the second course because I wanna do things the right way this time now that I know how it affects me. When I got off Accutane the first time I thought my skin was invincible and tried different birth control pills, new face washes, and all just to experiment. And for me thats pretty much the main reason I think my acne came back.
I want to try the second course just to clear up my skin again and not mess with it at the end of this course.
What mg were you on for your first course and then what mg are you on now? And what's the length of your course?
Yeah I definitely understand just wanting to go through with the Accutane since you know it works! With other medications it's so frustrating having to go through the initial breakout without even knowing if it will even get better or if it's going to make your skin worse! Breaking out on Accutane is still annoying and disappointing but at least I know it worked for me the first time so I'm sure I will be completely clear soon enough.
The first course was 5 months total: the first was 40 mg/day and the rest was 80. I'm about 115-120 lbs.
This time I'm supposed to have the same dosage but I've just completed my second month and I did more like 60 mg/day instead of 80 on average. I had no problems with doing 80 before but my skin was much oilier back then. Around when I turned 25 my skin became a lot drier for no apparent reason besides getting a bit older I guess. Also from what I've been reading on here the average dosage is more like 1mg per your weight in kg which would be closer to 60 for me.
Well good luck with whatever you decide to do! I hope whatever derm you find is understanding. Some are real sticklers about not prescribing Accutane unless you have cysts all over your whole face. But there are more lenient ones out there too!
Yeah I definitely understand just wanting to go through with the Accutane since you know it works! With other medications it's so frustrating having to go through the initial breakout without even knowing if it will even get better or if it's going to make your skin worse! Breaking out on Accutane is still annoying and disappointing but at least I know it worked for me the first time so I'm sure I will be completely clear soon enough.
The first course was 5 months total: the first was 40 mg/day and the rest was 80. I'm about 115-120 lbs.
This time I'm supposed to have the same dosage but I've just completed my second month and I did more like 60 mg/day instead of 80 on average. I had no problems with doing 80 before but my skin was much oilier back then. Around when I turned 25 my skin became a lot drier for no apparent reason besides getting a bit older I guess. Also from what I've been reading on here the average dosage is more like 1mg per your weight in kg which would be closer to 60 for me.
Well good luck with whatever you decide to do! I hope whatever derm you find is understanding. Some are real sticklers about not prescribing Accutane unless you have cysts all over your whole face. But there are more lenient ones out there too!
I'm with ya there! Good luck on your course! I did a 40mg dosage first go-round and never bumped up to 60 or 80...which could have kept me clear for longer but who knows! I know I never will!
I am your same weight as well.
Yeah that's also the problem, takes so long to get in with a doctor that if it doesn't pan out you have to wait for another appointment all over again!
Hey, I just thought I would add in that my derm told me that some people need a second or third course. My derm said because of the type of acne I had, and my history with acne, I might need a second course (just finished my first course on the 2nd of May). So I doubt there should be any problems with getting a second course, just obviously say it would be your second course (it will just show how persistent your acne is). There have been numerous people of this site who have taken second courses, someone is currently taking his third course. These people have been from various countries, so you should be sweet no matter were you live. If you get prescribed Accutane again I hope it leaves you permanently clear this time.
Hey, I just thought I would add in that my derm told me that some people need a second or third course. My derm said because of the type of acne I had, and my history with acne, I might need a second course (just finished my first course on the 2nd of May). So I doubt there should be any problems with getting a second course, just obviously say it would be your second course (it will just show how persistent your acne is). There have been numerous people of this site who have taken second courses, someone is currently taking his third course. These people have been from various countries, so you should be sweet no matter were you live. If you get prescribed Accutane again I hope it leaves you permanently clear this time.
Thanks for that- much appreciated! I did have my derm appointment and am scheduled to start my second course in 3 weeks!
Good luck with your second course! My derm wants to start me on a second course too at the end of June if im not seeing any improvments. Ive been trying topicals again first but NOTHING works as well as what Accutane did for me.
Yes that's exactly how it went for me!!! Topicals suck!