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lucy_87

is accutane effective for all types of acne?

i know it can be effective for mild moderate and severe acne by the look of things but what about hormonal acne? or is that a totally different kettle of fish?

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Hormonal acne (in women) has a high rate of recurrance compared to other types.

Where do you get your stats? Is there a study on this topic?

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Well, i don't know off hand where i read it previously, but i was able to find the following information on isotretinoin failures due to hormonal complication with a quick Google. http://www.medscape.com/viewarticle/453366

Hormones and Isotretinoin Relapses

Children in their early preteens and young teenagers may require several courses of isotretinoin to achieve lasting remission. In some instances, these are patients who have androgen excess. Paradoxically, young women with androgen excess may have a rapid response (within 1 month) to isotretinoin. However, discontinuation of the drug may result in a relapse within a few months.[5] It may be helpful to identify women with excess androgens. They may give a history of decreased menstrual periods per year.

It may be helpful to treat these patients with measures to lower their androgen levels. Cyproterone acetate is reportedly very helpful, but it is not yet available in the United States. Current standard therapy in the US is spironolactone 100-200 mg/day, either alone or in conjunction with oral contraceptives. Many dermatologists are reluctant to use spironolactone because of concern over possible development of breast cancer in response to unopposed estrogen. This problem may be more theoretical than actual.

On the horizon is another promising agent, Yasmin (Berlex Laboratories; Wayne, New Jersey), currently being investigated in treatment of acne. Yasmin is the combination of ethinyl estradiol, the form of synthetic estrogen used in most oral contraceptives, with drospirenone, a synthetic progestin derived from 17 alpha-spirolactone, an analogue of spironolactone. European trials of this agent appear to show promise.

When prescribing Yasmin, or other oral contraceptive agents to treat acne, it is important to remember the occasional patient with coagulopathy.[6] There is said to be a 5% incidence of factor V Leiden mutation in the female population. A personal or family history of clotting or of spontaneous abortion may indicate the need to obtain anticardiolipin antibody and the factor V Leiden mutation test before prescribing an oral contraceptive.

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