Hi,

I have suffered from severe acne for many years now, since teens. I have suffered from it emotionally (relatively low self esteem) and socially. I am now in my early 20s, and am now combating it actively with accutane. I am now on my 5th month, and accutane is working well on all areas of my face (no new breakouts), except the my jawline, which seems to have developed into keloids. Can anyone shed some light on why is this happening? Why is accutane not working specifically in this area? What are further steps which I can take? Any advise is greatly appreaciated. I am a guy btw, if that helps

I'm sorry that this is happening on your jaw line. I have 3-4 nasty ones on my chest from when I used to get breakouts that were quite deep into my skin. Once I got my first one, the next ones seemed to come even easier. Right now, I can still see them wanting to form, (even from small breakouts :/). What's strange is that I've only ever had this on my chest. I have no idea why I haven't had it anywhere else. It's like the body picks one place, in this case your jawline, and my chest.

Experts say that the reason keloids form in some areas/cases and not in others is unknown, but that your ethnic background, the degree of the acne breakout, and whether you've had a keloid before all affect how likely you are to get them.

I haven't found anything relating keloids to accutane, but in my experience there have been a few things that have encouraged keloids to form from my chest breakouts.

The first one is leaving my skin dry (I'm assuming your skin is dry from the accutane?). When I leave my chest dry after a breakout, it seems to make things worse. But another thing I've noticed is that moisturising over a healing area is also a bad idea. So try to find a middle ground.

Another is when I pop them and realise they look like they go deep into the skin, and take ages to heal (like an open wound). If they're those kind, it's a bad idea to pop them. I personally never popped mine, but my clothes rubbing on them was enough to cause problems.

I guess basically anything that causes inflammation/irritation and causes the healing process to be longer than it should be is what makes keloids form (for me).

Thanks for your prompt reply CookieJ. I had a dermatologist once do a couple of cortisone shots on my keloids, and they then went flat. But, I had a massive breakout after that, which got me started on accutane in the first place. This made me think that I am allergic to steroids. I saw another dermatologist about a month ago, and she said to wait for a few months after accutane before taking any more action with a cosmetic surgeon. But I have suffered from acne from such a long time, that I hope to resolve it asap, especially the keloids, since they are uncomfortable whenever I sweat. I am really not sure why is the accutane not working in my jawline?

Thanks for your prompt reply CookieJ. I had a dermatologist once do a couple of cortisone shots on my keloids, and they then went flat. But, I had a massive breakout after that, which got me started on accutane in the first place. This made me think that I am allergic to steroids. I saw another dermatologist about a month ago, and she said to wait for a few months after accutane before taking any more action with a cosmetic surgeon. But I have suffered from acne from such a long time, that I hope to resolve it asap, especially the keloids, since they are uncomfortable whenever I sweat. I am really not sure why is the accutane not working in my jawline?

That's strange, I agree.

When I went to my doctor a few years ago, he prescribed me this steroid tape (which you put on the keloids for 12 hours a day) is supposed to flatten the keloids (much like the injection). It worked, but once I stopped using the tape, my keloids actually became lumpy again, and got even bigger.

The tape caused me to break out in nearby regions. Maybe that's similar to what you experienced?