40mg isn't low dose it's avg dose. 20mg would be low dose. And no don't do anything to the skin while on accutane.

26 minutes ago, harmlessboy1441 said:

40mg isn't low dose it's avg dose. 20mg would be low dose. And no don't do anything to the skin while on accutane.

What if I stopped for a week (or maybe 2) and then proceeded? When Im not on Isotretinoin, I break out constantly. When Im on Isotretinoin, I dont break out at all but have less-than-ideal conditions for a scar treatment. What are your thoughts on resolving this catch-22? How can I help my ice pick / box scars given the aforementioned?

You're not supposed to go on and off accutane week to week. You take it in courses of months. Also don't touch your skin for several months until fully off it.

6 minutes ago, harmlessboy1441 said:

You're not supposed to go on and off accutane week to week. You take it in courses of months. Also don't touch your skin for several months until fully off it.

I see your point of view. But there has been a developing trend backed by peer reviewed research for long-term low-dose administration of Isotretinoin.

I underwent 3 normal 6-month treatments of Isotretinoin of 80mg a day spread throughout my years. My acne and oily skin would always come back, however. So my dermatologist and I decided to do a low(er) dose of 40mg twice a week for an indefinite amount of time (with regular blood checks).

In 2017, The Journal of American Medical Association (JAMA) gave the green light for various procedures while patients are using Isotretinoin. There was a blanket rule/prohibition against microneedling while on Isotretinoin, but that has now changed. But the mentality still remains due to the previous prohibition. Also, many people dont know about the 2017 JAMA release.

For anyone who has tried microneedling while on Isotretinoin, what was your experience like?

18 hours ago, harmlessboy1441 said:

You're not supposed to go on and off accutane week to week. You take it in courses of months. Also don't touch your skin for several months until fully off it.

As per dr rullan, accutane has very old literature in terms of safety requirements. The reason for not allowing treatment on accutane was in 80s people were on a very high dose of accutane while having cosmetic procedure done. The science hasnt kept, dr rullan said that microneedling are one of the low category treatments. Also since you are not consuming accutane daily you have to count consumption on weekly basis. I have had phenol and erbium combo abrasion on accutane recently, I am on a low dose of 20 mg three times per week ie 60mg per week. I stopped a week before my session and havent restarted my dose yet. No issues with healing or anything. Also if you really want to play real safe the correct way to measure safety is not by the rubbish literature of 6 month 1 year. Its by seeding when your body start producing back oil ie when your skin starts to become oily again. For instance someone can start back producing oil in one month while the other person take 3 month. That will be your safest point of treatment initiation time

Infact dr rullan has mentioned that he had put patients on low dose of accutane after deep phenol peel.

8 minutes ago, getsmart121 said:

As per dr rullan, accutane has very old literature in terms of safety requirements. The reason for not allowing treatment on accutane was in 80s people were on a very high dose of accutane while having cosmetic procedure done. The science hasnt kept, dr rullan said that microneedling are one of the low category treatments. Also since you are not consuming accutane daily you have to count consumption on weekly basis. I have had phenol and erbium combo abrasion on accutane recently, I am on a low dose of 20 mg three times per week ie 60mg per week. I stopped a week before my session and havent restarted my dose yet. No issues with healing or anything. Also if you really want to play real safe the correct way to measure safety is not by the rubbish literature of 6 month 1 year. Its by seeding when your body start producing back oil ie when your skin starts to become oily again. For instance someone can start back producing oil in one month while the other person take 3 month. That will be your safest point of treatment initiation time

Infact dr rullan has mentioned that he had put patients on low dose of accutane after deep phenol peel.

Can you explain more about timing with procedures and the oil production you mentioned? When Im off Isotretinoin, my skin becomes extremely oily in about 20 - 30 days.

Knowing that information, what would you say is the safe way to proceed with my microneedling session? In other words, how many days should I stop before the procedure, and how many days after should I restart my Isotretinoin?

4 hours ago, getsmart121 said:

As per dr rullan, accutane has very old literature in terms of safety requirements. The reason for not allowing treatment on accutane was in 80s people were on a very high dose of accutane while having cosmetic procedure done. The science hasnt kept, dr rullan said that microneedling are one of the low category treatments. Also since you are not consuming accutane daily you have to count consumption on weekly basis. I have had phenol and erbium combo abrasion on accutane recently, I am on a low dose of 20 mg three times per week ie 60mg per week. I stopped a week before my session and havent restarted my dose yet. No issues with healing or anything. Also if you really want to play real safe the correct way to measure safety is not by the rubbish literature of 6 month 1 year. Its by seeding when your body start producing back oil ie when your skin starts to become oily again. For instance someone can start back producing oil in one month while the other person take 3 month. That will be your safest point of treatment initiation time

Infact dr rullan has mentioned that he had put patients on low dose of accutane after deep phenol peel.

Right I agree somewhat and believe doctors and literature is ambiguous surrounding scars and acne, but at the same time everyone is different and it does affect healing or lubrication from oil and so on so erring on the side of caution is prudent whether 3 months or 6.

That said you can take accutane under different situations but mainly the effect is over a course or two. After that perhaps it helps to do low doses sporadically if remnants continue since other meds stink.

39 minutes ago, harmlessboy1441 said:

Right I agree somewhat and believe doctors and literature is ambiguous surrounding scars and acne, but at the same time everyone is different and it does affect healing or lubrication from oil and so on so erring on the side of caution is prudent whether 3 months or 6.

That said you can take accutane under different situations but mainly the effect is over a course or two. After that perhaps it helps to do low doses sporadically if remnants continue since other meds stink.

I think you didnt got my point, 3 to 6 month was random gibberish guideline. The logic was the side effects while being on accutane will resolve during that time which is kind of true. For instance accutane stays in the system for 1 months after u stop taking it but the side effects could linger. But the assessment by dr rullan came out was the treatment time is decided by when your skin starts producing oil back. For instance if the oil production is still not back by 6 month u are still not ready from the safety standards

4 hours ago, DaveJTR said:

Can you explain more about timing with procedures and the oil production you mentioned? When Im off Isotretinoin, my skin becomes extremely oily in about 20 - 30 days.

Knowing that information, what would you say is the safe way to proceed with my microneedling session? In other words, how many days should I stop before the procedure, and how many days after should I restart my Isotretinoin?

 

Dr rullan mentioned you can do microneedling even on low dose of accutane. Only deep peels or full ablation could be risky. But if you really want to be safe, if you are saying that your skin becomes oily in one month then that is the time your body has recovered from accutane side effects and can begin treatment. Again thats my opinion based on what I have learned. I dont want to give any medical advice.