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foxygoddess

Long-term side effects

Okay, so I'm seriously debating accutane but I am still kind of scared of the horror stories.

What are the chances/percentages/numbers of people on accutane suffering long-term problems, such as really dry lips/skin and joint problems and even "down there" lubrication problems? I'm really nervous about these things. At the same time, I can't stand my acne.

I know someone who was on accutane in her teens and she's now 50 years old. Back then, I assume not as much was known about the drug and she may have been "over" dosed for a longer amount of time than is necessary. She has stiff joints and trouble getting around (especially in the evenings) and her lips have stayed dry ever since her accutane course. She's always applying vaseline.

Has there been a change in dosing since then, and are the chances lower of these things happening? I'd really like some reassurance before I dive into this.

Thanks. :)

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Usually, a lot of the effects associated with Accutane dissipate after 3-6 months after finishing a course. It's not often that someone experiences long-term effects.

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Usually, a lot of the effects associated with Accutane dissipate after 3-6 months after finishing a course. It's not often that someone experiences long-term effects.

yea, generally speaking.

but how can you say that with 100% certainty?

or to what degree of certainty can you say that?

and what gives you the credibilty to gaurantee such a statement?

Im not trying to give you a hard time just stating a point.

Like for real though, there really is no way to know. unless you do it or have talked to alot of people that have taken it years ago.

I can tell you that there are many cells in your body with retinoid receptors that also are affected by accutane, if it changes your skin, it changes other things too that you cannot see.

This is not meant to scare you its just information to look into if you are really interested in what 13-cis retinoic acid is and what it actually does to your body, and is also something that the drug companies claim to have no knowledge of , maybe its their way of playing dumb with the public to cover their ass, i mean come on like 25 years and they still claim to not know of how it works, its hard to believe but what do i know, just what they tell me.

Accutane has helped many people get on with their lives and may be my only option as well, but im trying to paint the most accurate picture that i can, thats all.

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found some studies that may help.

Low-dose isotretinoin in the treatment of acne vulgaris.

Amichai B, Shemer A, Grunwald MH.April 2006

Huzot Clinic of Clalit Health Services, Ashkelon, Israel.

BACKGROUND: The efficacy of isotretinoin at 0.5 to 1.0 mg/kg per day in the treatment of acne is well established and considered safe, although it is sometimes not easily tolerated because of its cutaneous side effects. OBJECTIVE: The purpose of this study was to determine the efficacy of low-dose isotretinoin in the treatment of acne. METHODS: In this prospective, noncomparative, open-label study, 638 patients, both male and female, with moderate acne were enrolled and treated with isotretinoin at 20 mg/d (approximately 0.3-0.4 mg/kg per day) for 6 months. The patients were divided into two age groups: 12 to 20 and 21 to 35 years old. Patients were evaluated at 2-month intervals by means of clinical and laboratory examinations. A 4-year follow-up was also carried out. RESULTS: At the end of the treatment phase, good results were observed in 94.8% of the patients aged 12 to 20 years, and in 92.6% of the patients aged 21 to 35 years. Failure of the treatment occurred in 5.2% and 7.4% of the two groups, respectively. Twenty-one patients dropped out of the study because of lack of compliance, and another patient discontinued participation because of a laboratory side effect. During the 4-year follow-up period, relapses of the acne occurred in 3.9% of the patients aged 12 to 20 years and in 5.9% of the patients aged 21 to 35 years. Elevated serum lipid levels (up to 20% higher than the upper limit of normal value) were found in 4.2% of the patients and abnormal (<twice the upper limit of normal values) liver tests were observed in 4.8%. LIMITATIONS: This was a noncomparative, open-label study. CONCLUSION: Six months of treatment with low-dose isotretinoin (20 mg/d) was found to be effective in the treatment of moderate acne, with a low incidence of severe side effects and at a lower cost than higher doses.

here a study follwing patients for almost five years, there was no mention of side effects persisting after the course was finished.

Isotretinoin use in acne: prospective evaluation of adverse events.

Hull PR, Demkiw-Bartel C.

Division of Dermatology, Department of Medicine, Royal University Hospital, and the University of Saskatchewan, Canada.

BACKGROUND: Isotretinoin is an effective treatment for severe acne. Although the spectrum of side effects has been well documented, the changing incidence of such side effects over the course of treatment has not been studied in detail. OBJECTIVES: The purpose of our study was to examine a group of patients monthly over their course of treatment and prospectively document the side effects experienced. METHODS: Over the period between January 1991 and July 1996, 124 courses of treatment with isotretinoin for severe acne were followed. The patients were treated for 4 months at a dose of 1 mg per kg body weight. A questionnaire was administered monthly, inquiring specifically about side effects known to be associated with isotretinoin. Any additional side effects were also noted. RESULTS: The majority of patients experienced persistent dryness of lips. Dry eyes affected 40% of patients; this continued throughout treatment in 25%. Contact lens wearers were more likely to develop conjunctivitis. Lower back pain was reported early in about 30% of patients and fewer than 10% of patients would develop it later in the course of treatment. Arthralgia was noted in 16.5% of patients at the first visit and there was little change with ongoing treatment. Hair loss was experienced in a small percentage but was rarely noted on more than one occasion. Headaches occurred in less than 10% and were occasionally severe, but most often intermittent and recorded at a single visit. Depression occurred in 4% of patients and tended to persist throughout the treatment. All these patients completed the full course of treatment. CONCLUSION: This prospective analysis has shown that patients treated with isotretinoin experienced a predictable series of side effects. Some occurred fleetingly, but several persisted for the duration of treatment.

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So the first one shows a low incidence of side effects persisting after the course, and the second one doesn't even address side effects persisting after the course and this shows what he said was wrong how?

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Thanks AutonomousOne for the studies...may I ask where you found them? Also, would 40mg/day be considered a low dose for being 110 lbs? My derm wants me to take 40 mg the whole way through, for a 5 month period.

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Thanks AutonomousOne for the studies...may I ask where you found them? Also, would 40mg/day be considered a low dose for being 110 lbs? My derm wants me to take 40 mg the whole way through, for a 5 month period.

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So the first one shows a low incidence of side effects persisting after the course, and the second one doesn't even address side effects persisting after the course and this shows what he said was wrong how?

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What i don't understand is this - if you aren't finding studies to contradict Roche's position that side effects persisting after the course are fairly rare, why do you seem to assume that they are lying about it? Why take issue with Walk the Wire's statement when as far as i can tell, what he said was factually correct and used the proper modifiers to indicate that he was speaking generally?

Maybe i'm just reading you wrong or something.

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If it does come to it and I take up accutane, I want to go on as low a dose as possible to minimise any possible side effects. I've read reports that very small doses are just as effective in the long term as the high doses.

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Hmm. Well, apparently that state drug card is not applicable to me for some stupid reason, so I'm back at square one. I'm thinking of just paying out of pocket, I have the money but I was trying to save it up in case I run out of scholarships and need a backup. *sigh* I did the math and at $208/month for 5 months (including derm appointments and bloodwork) I'm looking at $1340. But with how much I spend on over the counter treatments and topicals and herbs etc., eventually I'd probably end up paying that anyway. It sucks that it costs so much, but what can you do? I want clear skin for once in my life. And I'd rather do this now while I'm young than wait until I'm older and then decide to go on it when I have insurance. I may be calling my derm very soon to set up an appointment.

So all of you who have taken Accutane, what herbs/supplements did you take to help with the side effects? Do you think taking these would help deter long-term side effects? Please list everything that helped you. Thanks a bunch.

*Oh, and EzyRyder, you've been on lots of antibiotics it looks like. I'd say if the current one isn't working out for you, you might want to try Accutane because bacteria are notorious for becoming resistant to antibiotics and if you ever need the drug for an illness, like Lyme disease, you will have difficulty finding something that will work on the bacteria. Just a thought! Maybe we could take Accutane together?

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What i don't understand is this - if you aren't finding studies to contradict Roche's position that side effects persisting after the course are fairly rare, why do you seem to assume that they are lying about it? Why take issue with Walk the Wire's statement when as far as i can tell, what he said was factually correct and used the proper modifiers to indicate that he was speaking generally?

Maybe i'm just reading you wrong or something.

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