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MyShrimpDied

Derm won't give me Accutane

I went to my derm today and told him general stuff about my acne and then asked him about Accutane. He said Accutane wouldn't work on my acne because it was for severe nudular acne. I realize this is true but does that make any sense? Why would it work for extremely severe acne and not for moderate acne like mine?

Anyway, he prescribed me a bunch of topicals like Duac, which I have no interest in using because I went on a course of Retn-A and benzaclin 2 years ago for 6 months and all they did was make my face peel off, and did not help my acne.

Overall this appointment made me very depressed because it told me there was no hope. I don't want something that is going to treat the acne, I want something that will eliminate it.

What should I do? I would like to go to a different derm but if none of them are gonna give me Accutane I will be pretty disapointed. I need to get rid of this thing, Acne and a history of depression in my family don't mix well.

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We actually have several members here who have faced the same problem. Labgirl (she's a mod) took the route of stopping all skin care in order to worsen her skin enough to qualify. Other people have tried going to different derms. You'll find lots of support here for this!

BTW, love the name!

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I've struggled with acne for years. I've experimented with different regimens and cleansers. I tried most of the home remedies and over-the-counters. I was prescribed every topical cream and gel. I even went for laser and long term antibiotics.

Looking back on the last TEN YEARS I view all that stuff as a waste of time and money. Few helped, and most made it worse. At best, a select few kept acne "under control" but the persistence of the lesions lead to scarring.

But then I found Isotretinoin (accutane). I had to do my own research. Dermatologist after dermatologist never made mention of it?. Yet they prescribed long-term antibiotics and lasers for God's sake! (BTW, the side effects of these are far worse than my Isotretinoin.)

There is FAR too much NEGATIVE HYPE surrounding this drug. It took me a year to decide to go on it; during which time I was burned by laser "therapy." I'm now in month-two of my five month dose. My acne is greatly reduced and pimples I do get are smaller and heal in a day or two (without scarring).

My face is much less oily. My pores are smaller. The blackheads are gone. The only side effect is dry lips and to a lesser extent dry face. Both are easily remedied and far less of a side effect than some cleansers I tried.

For 60 percent of patients Isotretinoin puts their acne into prolonged remission (years). Of that 60 percent, 90 percent are CURED for life. Patients that do not respond from one treatment course can be put on a second, third, and even fourth round. The percentage of acne remission goes up with each course of Isotretinoin. So the odds are it will CURE you.

It took me 9 years to find out about Isotretinoin (accutane) and another 1 to decide to go on it. I really think Isotretinoin should be given as a prophylactic at puberty. Especially in those who have a family history of acne in parents or older siblings.

There is no excuse for CHILDREN to go through what I did. My "moderate/persistent, papular/pustular acne" was a daily torment. It kept me from dating and making friends. It lead to obsessive compulsive behavior regarding clean sheets, handwashing, face touching, mirrors, etc.

I was even afraid to go to sleep at night for fear of waking up with fresh crop of zits. My mood deteriorated. I became depressed and at worst suicidal.

Of course I couldn't tell my dermatologist any of this. I'd never have been prescribed the WONDER DRUG. But I as I suspected, Isotretinoin indirectly acted as an ANTIDEPRESSANT. It gave me initial hope after so many let downs. And now finally, the acne is clearing. I am a completely different person. I have a life again. Thanks to Isotretinoin.

Sadly, the iPLEDGE program is now making it more difficult to obtain the drug. It violates patient privacy laws. There are impractical regulations you, your doctor, the blood lab, the pharmacy, and the iPLEDGE processing center must coordinate with. There is usually a gap of 3 days at the end of every month during which you will be unable to get your medication. It can be weeks if your pharmacy has to order the correct dosage or become "iPLEDGE registered."

I can't stress enough how important early intervention is. If I was put on Isotretinoin even as late as 2-3 years into my acne I would not have scarring now. New scars also respond much better to treatment than scars older than six months.

That doesn't mean one should rush into scar treatment. It is important to note: SCARS SHOULD NOT BE TREATED WHILE ON Isotretinoin and for six months afterwards. The skin is far too sensitive and scarring could worsen.

Acne scars are extremely DIFFICULT and EXPENSIVE to treat once you have them. Even with current treatments, deeper scars can never be erased. Nevertheless, there are treatments that can LESSEN the appearance of deep scars. Superficial scars can more-or-less be "erased." But it is still EXPENSIVE; I've probably spent $10,000 easy.

Before Isotretinoin I tried several lasers to ameliorate my scars. I tried the NON-ABLATIVE lasers: CoolTouch, SmoothBeam, N-Lite, Intense Pulsed Light (IPL), and a diode laser. One session with any of these lasers can cost more than $1000. NONE WORKED EVEN SLIGHTLY. Not even on superficial scars. In fact, the IRRITATION they caused exacerbated my acne and led to a few small, new scars.

I can only blame myself. I did not exhaustively RESEARCH them. The company websites are questionable and the patient stories on message boards show these lasers don't work.

For the last year or so I've been doing my homework. I looked into ablative procedures. Carbon dioxide laser has been around for 20 years and has demonstrated results. However the down time was considerable and the risks high. I've come to the same conclusion for dermabrasion and microdermabrasion (the latter just being a gimmick).

The FRAXEL laser seems to be the best choice right now. The majority of patient reports are positive. The downtime and risks are minimal. But it only got FDA approval for acne scars this month. I'm glad I have to wait at least another year to get it.

I'm not sure I believe the company's claim that Fraxel treats the skin microscopically. It's supposed to damage the skin in "microscopic" dots that are .1 millimeters wide and 1.0 millimeter deep. That's about twice the size of a large pore and still visible to the naked eye. I guess it would work for deep scar tissue. But probably will probably make normal skin seem mottled. I guess a bad complexion is a trade off for reducing scars.

I realize this is a long post. I just wanted to contribute my thoughts. I hope it's helpful to anyone struggling with acne/scars and trying to make sense of it all.

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I can totaly relate to ocb and have had mod acne for about ten years and only just started accutane. It totaly messes you up this daily fight for so long and consumes everything till it leaves you feeling like a shadow stuck in a time warp!

I would advise you to get an emergancy app with your derm and maybe print off some threads and find some pics of people on here who started accutane whos acne was less that yours - ive seen people with bearly any sports and they have been put on it. ask them to read your thread and explain that you cant bear to carry on trying to treat it. Find a new derm if you can but you have to let it out.

I was prepared to say to my derm that i would buy it over the net and do it myself if they didnt put me on it but luckily the derm was very nice and gave it to me.

I really hope that your derm puts you on it as it should be your choice - your condition is your suffering and you can say you have researched the pros and cons and want this drug.

Good luck

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Find another derm, but call and ask if that derm prescribes accutane. I wasted a lot of time going to appts with derms that did not prescribe it.

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The fact that dermatologists are now reluctant to prescribe it should be a hint that you should consider other options.

who said you need to listen to derms ;)

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i think you should listen to the dermatologist despite what a lot of people think on this board. they went to school for a reason...it just seems odd that some people on these boards don't trust there dermatologists who studied in med school for years but then trust random people on message boards. the point of acne treatment is to subdue the acne until you grow out of it. it's not to cure the acne. i would want to stray from any medication that permanently changes something in your body in order to get rid of the acne, and save that for a last option.

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The reason why I don't agree with the derm prescribing me topicals is because when I went to my last derm 2 years ago the topicals he gave me literally made my face peel off. I would not leave the house at all the during my sophmore summer because there were so many flakes of skin coming off my face.

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The reason why I don't agree with the derm prescribing me topicals is because when I went to my last derm 2 years ago the topicals he gave me literally made my face peel off. I would not leave the house at all the during my sophmore summer because there were so many flakes of skin coming off my face.

Retin-A is a very strong topical. Just because one failed you don't give up on all topicals. Also, your derm is correct, Accutane is supposed to be reserved for only the most severe acne.

How old are you? How long have you had acne? These things, along with a whole host of others, are taken into consideration when prescribing drugs. If you're 17 and only had mild acne for two years, not many a derm will prescribe Tane for you. Now, if you're 25 and had acne since 15, even though it may be mild it is persistent and you may find a derm to give you Tane.

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I'm 18 and have had Acne since I was 14. It's always been moderate but very persistent. I also have very oily skin along with a yellow crust that builds up over time around and on my nose.

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I'm 18 and have had Acne since I was 14. It's always been moderate but very persistent. I also have very oily skin along with a yellow crust that builds up over time around and on my nose.

If you were 21, I'm sure they'd give it to you ASAP. The derm is thinking that it'll clear up in 2-3 years, hormones and all calming down. Not all derms feel this way and WILL prescribe Accutane so you are not miserable day in and day out with your skin.

With all the negative publicity surrounding Accutane, many derms are cautious to prescribe it. You must call ahead and see if they participate in the iPLEDGE program (a sneaky way of asking).

Keep shopping for derms.

Or you can give up on Accutane for now and try antibiotics. They really work well in teenagers.

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the point of acne treatment is to subdue the acne until you grow out of it. it's not to cure the acne. i would want to stray from any medication that permanently changes something in your body in order to get rid of the acne, and save that for a last option.

Assuming you do grow out of acne. Not everyone does and you could waste alot of time waiting getting lots of lovely permanent scars as you do.

Big Pore - I note that you say that jojoba oil has broken you out. I find it very useful and it is supposed to be non-comedogenic as per the zerozits website, which I see you have also visited. Also, shea butter is also supposed to be non-comedogenic - the problem is more that if your skin is already oily, both of these ingredients may make it oilier.

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The first time I went to a derm I had severe acne that was mostly papulopustular and on the verge of becoming cystic (only had a one or two actualy cysts). My derm took one look at me and said I can't give you Accutane yet (I didn't even ask for it). He gave me an Rx for differin, duac and minocylin (which I have a lethal allegy to). I refused antiboitics for 6 months (and I only pretned to take the one's he prescribes).

The combo of the differin and duac helped and I did get 100% clear for a couple weeks (spent a week in Florida and in the sun). Soon the acne came back so I asked for retin-a, which helped, but the acne came back again, so I got a higher stregnth (0.10%), then the weather warmed up and my face exploded in big fat cysts. My acne was mostly papulopusutlar, but it the topicals wiped out that stuff.....but not the nodules and cysts........

A few cysts and nodules weren't enough to warrant Accutane, but were enough to warrant some more antiboitics. I let him give me an RX for Erythromycin, but decided to not take them. I was so fed up with everything that I quit using all acne treatments....I even came off the pill....

I still wash my face and wear sunscreen, but I don't treat my acne. My acne is now Accutane worthy, but I still have a hard time getting it. I pretended to switch my antiboitic to amoxicillin.......when that didn't work (duh...I never took it) I only got more topicals........

In the eyes of my derm nothing works on me......but I still don't have Accutane.......yet....

I've always wondered if a derm can find out exacttly what medications you've tried.....sometimes I've considered lying, but I think they can have access to my medical history, and can find out I've never taken and failed a cyclin, since have a history of SJS ( a potentially deadly reaction to antiboitics). I'm sure that's documented somewhere.......since I've had it twice.

The "Accutane People," according to one derm I've seen...require that you've taken and failed a cyclin since they are the most preferred treatment for nodular acne. I can't take one to find out if I fail to clear on it......so I can't qualify for Accutane unless I get special approval from the "accutane people"......I don't really believe her though.........

You may need to go derm shopping. Make appointments wil a bunch of them. "Pretend" to take stuff if you are in a hurry and not interested in anything else.....so at least you have a history of treatment..........

Good Luck....hopefullly you'll have better luck that I've had......If you are a guy it'll be easier for you......

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