Hey guys,

I'd like to ask you how I could get my dermatologist to prescribe me a generic version of Isotretinoin, formerly the US version of Accutane.

My acne today is between mild and moderate severity. It fluctuates, but I usually break out badly a handful of times each month. On a normal day, I consistently get almost a dozen new white heads everyday and my nose is plastered with blackheads that won't scrub off. In 2014 I had my first unusual experience with Cysts. I have 4 of them last year in unnoticeable places that weren't very raised but took a month for each to go away. It was my first time having cystic acne. Even in my teenage years when my acne was severe, I never had a cyst before until last year. I haven't had a cyst in the last 6 months though. I have extensive skin discoloration on my cheeks, temples, and chin/mouth area due to acne scarring and prolonged usage of prescribed Retin-A and I'm afraid I'm starting to get some pitting in my cheeks because of my larger white heads over time. I used Retin-A for about three years and it's pretty much made my skin blotchy shades of pink and red for months on end before it heals, if it does at all. I also have red bumps scattered around the top of my back and lower neck, along the front of my neck I have a couple, and occasionally I'll get acne on my chest, arms, and even legs...

A little backstory:

My acne started in 8th grade (I'm a male who is 19 now) and was very severe, although non-cystic. I had a mixture of red bumps and dozens of white heads that covered nearly 60-70% of my face, back, and shoulders. Just dozens upon dozens of white heads, huge ones, it was really a miserable sight to see... My Pediatrician at the time was very interested in acne treatments for his patients so he decided to take it upon himself to prescribe a low dose of Tetracycline for a year. No results, just lessened the inflammation, not the zit count. He then referred me to a great Dermatologist who immediately put me on Minocycline, Retin-A, and a prescribed medicated facial wash. I was on those for about three to four years with continued need for something to fix my acne, he rose the dosages of the Mino and Retin-A. He originally said that he wasn't too keen on using Accutane as a go-to drug of choice. He wanted me to try the antibiotics with fewer side effects first. Although every single day I was on Minocycline (which was for much longer than I should have been on it.) I had a migraine like clockwork. But it was my skin or a beating headache, I chose my skin. I got off the prescriptions completely in November 2014. I say overall it worked well enough, but never curbed my acne. The last year or so I was on Minocycline, it basically began to be completely ineffective. I had no power of getting rid of my acne anymore. I imagine I became antibiotic resistant to it at some point.

I've always tried everything to get rid of my acne since I was 13/14 years old, but since this past fall I really have tried every treatment under the sun. I've tried every sort of topical cream, face wash, moisturizer, gel, lotion, oil, etc. possible. I've dieted on Paleo. Cut out dairy, chocolate, soda, peanut butter, all nuts, all excess sugars, caffeine, limited fruits from my diet. I drink so much water now that these days the bathroom is a revolving door to me. I've tried the following vitamins/minerals with no luck, or caused some side effects to make me stop taking them: Vitamin A, B5, Biotin, C, D3, E and Calcium and Zinc.

Heck, I've even bought a new pillowcase for every night and bought a really expensive shampoo just to remove the hash additives.

Frankly, I don't know what more I can do. It's so persistent that it just won't stop. I've become sad and depressed every morning when I look at my face in the mirror. Acne has prevented me from pursuing a career in broadcast journalism and has caused an immense loss of self-esteem. I've missed out on many social events in high school and even today because I'm still afraid to leave the house when I don't have to because of my terrible skin.

While some of you may think, 'oh he just has light acne, it's not a big deal and certainly not severe enough for Accutane', I tell you that it's extremely demoralizing when you have acne in general, especially for years and when it makes you give up on things you love to do in life because of the way you look. And when it consistently occurs for years without effective treatments, you really give up all hope on anything that would work and then you spiral. I've researched and understand all the side effects of this powerful, toxic drug. I just want something that will give me a better quality of life, happiness, and possibly that one permanent fix so I can stop going bankrupt on all these useless acne treatments that simply don't work and I end up getting much more sad about it not working, and in turn get just another breakout.

Really, how can I get him to prescribe Isotretinoin? I'm at my wits end these days.