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mamaof3

A concerned Mama...

My 16 year old sons derm recommended accutane today. This is our second derm we've seen in the past two years and my son has done three different types of treatments that didn't work. The last one made his face worse and before that he was already showing scarring on his face, not too bad except on his chest the scarring is kinda bad. He's been a real trooper through it all, even before he started meds. I just feel bad for him cause I know how it feels to have acne at his age and he started washing his face more 6 years ago because he feared one day he could end up with a bad case of acne like his cousin, sadly he ends up with a worse case. Thankfully he doesn't get picked on about it that I know about, but I did read the other night he mentiioned to a friend he wanted his face clear so he could get a girl friend. I was reading on here Un Named's blog, my son face reminds me how unnamed was when he started the treatment maybe not as bad. My son had heard of accutane way before I did and he has wanted to try it, but he is on meds for adhd and his first derm said we could not mix meds plus his doctor told me accutane was a potent med and recommended another derm which we did and really like him. Derm said today since the other treatments didn't work it was time we tried accutane and left the decision up to me. I had no idea what all was involved. It really throw me for a loop and scared me. I went ahead and set up another appointment for next week to talk to him again and give him our decision. I went ahead and took him to have the blood work done just in case we decide to try it. I also stopped by to speak to his regular doctor she and his derm checked the adhd med out and he can take accutane with it. Reg. doc doesn't have many patients on it, but had one case where a boy had muscle cramps really bad and he was fine after stopping the med. Derm didn't get into details on that. I really wants stats, numbers of how many out of how many have this and that side effect. I have read the booklets the derm sent home with me and I don't know what to do. I have felt sick over this. I was the same way when he started adhd meds, but this accutane seems to have a lot more. Is it worth it to maybe risk his life? Are there warning signs before someone takes their own life when on this meds. That is the main that thing scares me. I also worry about him getting cramps and body aches cause he plays highschool football. I know there is a lot of info on birth defects, but I can't seem to find any info on whether down the road there could be a problem with that in boys, I certainly don't want him to have a child ten years down the road that is born with birth defects due to something he took ten years ago. I wish the booklet had gave more details on the side effects, like percentages and how rare they were. I'm really scared to put him on this med. But at the same time I want his face to be clear and for him to feel good about how he looks. I would love to hear the side effects experienced and if they went away or long term and any info you have on my concerns, really anything would be hopeful.

Thanks

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If i were you, i would put him on the accutane.

to answer your questions:

Birth deffects this is a non-issue for males, accutane only causes birth defects if the fetus is actually exposed to accutane while the woman is taking it. after the accutane clears her system (within one month of taking the last dose) there are no (accutane related) risks to future pregnancies. accutane does not affect the reproductive system in males or females, only direct exposure to accutane through the blood stream can affect pregnancies. females are required to use two forms of birth control starting one month before treatment, during treatment, and for one month after finishing treatment.

Suicidal thoughts Speaking for myself, accutane in no way affected me mentally. there really is no evidence that accutane can cause these thoughts or behaviors, only speculation. the rate of suicide among accutane users is actually no higher than that of the general population. still this should be taken seriously, just watch for signs of depression ect.. i wouldn't worry too much though.

accutane can take it out of you, especially at the beginning of treatment. your son may not be able to work out as rigorously for a while. it makes you become tired very easily and can give you some aches ect... this usually goes away once your body gets used to taking the medicine, but at first it can be tough.

the iPledge book really is unnecessarily scary, accutane is a wonderful, very effective drug, with minimal risks. if your sons course is monitored closely (with blood tests, ect..) he will do fine. he does have to be patient with this drug though, and give it time to see the full effect, some people don't see the full results until one or two months after stopping accutane. but the results are stunning. it could even cure your sons acne permanently after just 20 weeks (about half the people who take one course are completely cured for life, and require no further treatment.)

i am definitely happy with my decision to take accutane.

if you have any more questions feel free to ask me.

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Ok i read your post but didn't so much read jordans...

It sounds like he needs accutane. Now, from experience, the side effects can be real. However the bad ones a pretty rare and there are no chances of your son passing on birth deffects, that is only in a developing fetous e.g. onlu women who become pregnant whilst on the drug...

Now i would have to say, try and insist on a LOW DOSE course, this keeps the chances of serious side effects to a MINIMUM and i would say there is little to no chance of serious side effects on a very low dose course, so maybe mention that to your derm. I know several people who have experienced serious side effects who wished they had also been on a much lower dose course, we all feel we could of avoided the sides we experienced.

All in all though, i think your son should definently go on accutane. It crippled me from the age of 16 and as i got older i only became more self concious, so i would say it is worth hitting it on the head now..

Either way, best of luck to both you and your son!!

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If i were you, i would put him on the accutane.

to answer your questions:

Birth deffects this is a non-issue for males, accutane only causes birth defects if the fetus is actually exposed to accutane while the woman is taking it. after the accutane clears her system (within one month of taking the last dose) there are no (accutane related) risks to future pregnancies. accutane does not affect the reproductive system in males or females, only direct exposure to accutane through the blood stream can affect pregnancies. females are required to use two forms of birth control starting one month before treatment, during treatment, and for one month after finishing treatment.

Suicidal thoughts Speaking for myself, accutane in no way affected me mentally. there really is no evidence that accutane can cause these thoughts or behaviors, only speculation. the rate of suicide among accutane users is actually no higher than that of the general population. still this should be taken seriously, just watch for signs of depression ect.. i wouldn't worry too much though.

accutane can take it out of you, especially at the beginning of treatment. your son may not be able to work out as rigorously for a while. it makes you become tired very easily and can give you some aches ect... this usually goes away once your body gets used to taking the medicine, but at first it can be tough.

the iPledge book really is unnecessarily scary, accutane is a wonderful, very effective drug, with minimal risks. if your sons course is monitored closely (with blood tests, ect..) he will do fine. he does have to be patient with this drug though, and give it time to see the full effect, some people don't see the full results until one or two months after stopping accutane. but the results are stunning. it could even cure your sons acne permanently after just 20 weeks (about half the people who take one course are completely cured for life, and require no further treatment.)

i am definitely happy with my decision to take accutane.

if you have any more questions feel free to ask me.

Thanks so much for your reply. They do need to improve the ipledge book. I've read through it once and will not open it again, just freaks me out. If he started the meds on june 14th do you think they will have worked into his system by the end of July? That's when practice starts. Do you or anyone else know how long accutane has been on the market and how many years of research? I'm sure that info is on the internet, but honestly the couple of pages I barely read scared me so I think it's best I don't go reading online too much, stick to here and his doctors. Again, thanks so much and don't be surprised if I'm not bugging you again.

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Ok i read your post but didn't so much read jordans...

It sounds like he needs accutane. Now, from experience, the side effects can be real. However the bad ones a pretty rare and there are no chances of your son passing on birth deffects, that is only in a developing fetous e.g. onlu women who become pregnant whilst on the drug...

Now i would have to say, try and insist on a LOW DOSE course, this keeps the chances of serious side effects to a MINIMUM and i would say there is little to no chance of serious side effects on a very low dose course, so maybe mention that to your derm. I know several people who have experienced serious side effects who wished they had also been on a much lower dose course, we all feel we could of avoided the sides we experienced.

All in all though, i think your son should definently go on accutane. It crippled me from the age of 16 and as i got older i only became more self concious, so i would say it is worth hitting it on the head now..

Either way, best of luck to both you and your son!!

Thank you! I'm glad you mentioned the low dose. What is the lowest dose? From the very little I have read online I was thinking he would take different mgs through the treatment. So he would be able to stay on the same dose through out the treatment, if not is this something you have to wean off? If we go with accutane I will insist on the low dose. Thanks!

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Thanks so much for your reply. They do need to improve the ipledge book. I've read through it once and will not open it again, just freaks me out. If he started the meds on june 14th do you think they will have worked into his system by the end of July? That's when practice starts. Do you or anyone else know how long accutane has been on the market and how many years of research? I'm sure that info is on the internet, but honestly the couple of pages I barely read scared me so I think it's best I don't go reading online too much, stick to here and his doctors. Again, thanks so much and don't be surprised if I'm not bugging you again.

accutane was approved in the US for the treatment of acne in 1982. they started researching it in the mid 70s.

Thank you! I'm glad you mentioned the low dose. What is the lowest dose? From the very little I have read online I was thinking he would take different mgs through the treatment. So he would be able to stay on the same dose through out the treatment, if not is this something you have to wean off? If we go with accutane I will insist on the low dose. Thanks!

i definitely do not recommend a low dose, it is a waste of time and money in my (an most doctors) opinion. accutane has the best results when given at 1mg/kg/day for 20 weeks. with low dose courses, you have to be on the drug for very long periods of time (including monthly dr. visits and blood tests) and the results usually don't last once the drug is stopped. it is best to let the doctor decide what dose is best for your son. you can stay on the same dose throughout the entire treatment i was on 60mgs (40/80 on alternate days) for my entire 26 week course.

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I think with any drugs (even simple painkillers) there are risks involved for a minority of people. For every bad experience with accutane there are hundreds, maybe thousands of good experiences.

I really think the risks of accutane outweigh the benefits when your acne is severe and persistent. There are things you can do to alleviate some of the side affects and anyway, not everyone gets all of the even really common side affects.

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Ok i read your post but didn't so much read jordans...

It sounds like he needs accutane. Now, from experience, the side effects can be real. However the bad ones a pretty rare and there are no chances of your son passing on birth deffects, that is only in a developing fetous e.g. onlu women who become pregnant whilst on the drug...

Now i would have to say, try and insist on a LOW DOSE course, this keeps the chances of serious side effects to a MINIMUM and i would say there is little to no chance of serious side effects on a very low dose course, so maybe mention that to your derm. I know several people who have experienced serious side effects who wished they had also been on a much lower dose course, we all feel we could of avoided the sides we experienced.

All in all though, i think your son should definently go on accutane. It crippled me from the age of 16 and as i got older i only became more self concious, so i would say it is worth hitting it on the head now..

Either way, best of luck to both you and your son!!

Thank you! I'm glad you mentioned the low dose. What is the lowest dose? From the very little I have read online I was thinking he would take different mgs through the treatment. So he would be able to stay on the same dose through out the treatment, if not is this something you have to wean off? If we go with accutane I will insist on the low dose. Thanks!

Whether its low dose or not, its not up to the user to decide but rather the doctor. So its better to do whatever the doctor tells you to because he knows what's best. As for the side effects, nothing really major just drying skin and if you are unlucky, you will get the initial breakout. I was lucky, I didn't get one.

It's quite hard to tell when your son will actually clear because different people react to the drug differently. Some say they clear within a month and some cleared almost at the end of their course.

As for the depression and stuff, I haven't heard anyone who committed sucide while on accutane. Moreover, I feel I'm more depressed when I actually have a face full of acne. I'm clear after 1 month on this and throughout this 1 month, I didn't feel depressed or have any sucicidal thoughts. On the contrary, I actually felt much happier then I did in months.

I say go for accutane, it was also the last option for me after trying so many acne treatments in the past.

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Thanks so much for your reply. They do need to improve the ipledge book. I've read through it once and will not open it again, just freaks me out. If he started the meds on june 14th do you think they will have worked into his system by the end of July? That's when practice starts. Do you or anyone else know how long accutane has been on the market and how many years of research? I'm sure that info is on the internet, but honestly the couple of pages I barely read scared me so I think it's best I don't go reading online too much, stick to here and his doctors. Again, thanks so much and don't be surprised if I'm not bugging you again.

accutane was approved in the US for the treatment of acne in 1982. they started researching it in the mid 70s.

Thank you! I'm glad you mentioned the low dose. What is the lowest dose? From the very little I have read online I was thinking he would take different mgs through the treatment. So he would be able to stay on the same dose through out the treatment, if not is this something you have to wean off? If we go with accutane I will insist on the low dose. Thanks!

i definitely do not recommend a low dose, it is a waste of time and money in my (an most doctors) opinion. accutane has the best results when given at 1mg/kg/day for 20 weeks. with low dose courses, you have to be on the drug for very long periods of time (including monthly dr. visits and blood tests) and the results usually don't last once the drug is stopped. it is best to let the doctor decide what dose is best for your son. you can stay on the same dose throughout the entire treatment i was on 60mgs (40/80 on alternate days) for my entire 26 week course.

Dude you need to do more research before you talk. Long term lower dose course, reaching the same cumulative dose is safer and more effective. You tend to think accutane is far safer than it is, just because you experienced no side effects, doesn't mean they don't happen to other people. Do some research into longer low dose accutane courses. In europe it is administered this way and is seen to be just as, if not more effective than the normal courses...

I'm sure if you had the same side effects as other people you would be recomending the same thing....

I have a friend who has the worst acne i have ever seen, he was on a 7 month course at 35 mg a day (0.5mg per kg) and he is still clear to this day (3 years later).

"Six months of treatment with low-dose isotretinoin (20 mg/d) was found to be effective in the treatment of moderate acne, with a lower incidence of severe side effects and at a lower cost than higher doses," they conclude.

Unless your son has severe truncal acne, i still recomend a low dose course. It is far safer (and has been proven so through studies) which i feel is your main concern here...especially in a 16 year old boy

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First off I want to say thanks to everyone for their input and kind words.

I would be more comfortable with him on a low dose, especially with him taking another med for his adhd. But I will listen to what his derm thinks is best on doses and his regular doc.

I read this last night, I believe this doctor is from webmd.

Member question: Can't some acne meds cause suicide?

Lopez: What you are talking about is Accutane. Accutane is somewhat controversial because there were cases of teenagers who were taking Accutane who were also depressed. One very famous case involving the son of a United States senator who committed suicide raised the issue of Accutane and suicide. As a result of the concern the manufacturers have been forced to put a warning label that this is a possible correlation.

Currently, there is no 100 percent proof that taking Accutane raises the risk of suicide, and it is also important to remember that patients with severe acne may well be depressed because of the disfigurement of the acne. Most physicians will err on the side of caution, and a depressed teenager will often not be given Accutane to play it extra safe. However, the proof that Accutane causes suicide is not in.

I'm going to list the past two treatments my son has been on to see if anyone thinks there is something else that might work before going accutane. I think his derm is worried about the scarring and thats why he wants to put him accutane. He pretty much said it was our last resort. Of course a friend of mine is all over me since i haven't tried proactive, but I just don't see that working for him.

benaclin, tazorac 0.05% and a 100mg pill that I can't remember the name, it was mino something once a day.

the last treatment... clindamycin gel 1%, tazorac 0.1%, 400mg erythromycin es twice a day and washed with panoxyl.

Those two treatments were by two different derms. He ran out of panoxyl (soap bar) the other day and we both noticed his face is looking just a tiny bit better, I wonder if he was washing too hard with the cloth.

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He is scarring and scars last a lifetime and will be painful reminder of acne. If you are curious, check out the scar forum and see how many people are suffering severe depression due to bad acne scarring.

Don't take this the wrong way, but I think perhaps you are overanalyzing the situation. He is 16 and although not an adult, capable of understanding the risks that are involved. I know you are likely just an over bearing mother and it is obvious that you do care a lot about him, but I think you should help to educate him on the risks and side effects and then let him make an informed decision. It is already evident that acne is affecting his confidence.

For the most part, acne scarring and the life long psychological trauma that goes along with it is preventable with Accutane.

If he had already tried various treatments and the doctor has recommended it and he wants to try it, then I really think you should step back and trust your doctor. Just make sure he goes to his regular check ups and watch for any sort of psychological side effects (these are rare).

I hope everything works out.

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Oh and in regards to dosing, I wouldn't insist on anything...trust and listen to your doctor, he is just that - a doctor and will know what dose is best for your son.

There are lots of various methods for dosing. Some start out with a high dose, some a low dose, some increase the dose over time, some stay with a set dose the entire time. Every doctor will take several factors into account before deciding on a dose. Some of these may include but are not limited to; age, weight, gender, length of time one has had acne, severity of acne and most importantlly the derms Accutane experiences with other patients that have had similiar characteristics.

Trust your doctor or find one that you are comfortable with and do trust.

Hope this helps.

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I've got to say that the poster does not sound like an overbearing mother, just a concerned and loving one.

Go with what the doc/derm suggests and watch for signs of side effects without being too paranoid about the whole Accutane thing.

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Thanks so much for your reply. They do need to improve the ipledge book. I've read through it once and will not open it again, just freaks me out. If he started the meds on june 14th do you think they will have worked into his system by the end of July? That's when practice starts. Do you or anyone else know how long accutane has been on the market and how many years of research? I'm sure that info is on the internet, but honestly the couple of pages I barely read scared me so I think it's best I don't go reading online too much, stick to here and his doctors. Again, thanks so much and don't be surprised if I'm not bugging you again.

accutane was approved in the US for the treatment of acne in 1982. they started researching it in the mid 70s.

Thank you! I'm glad you mentioned the low dose. What is the lowest dose? From the very little I have read online I was thinking he would take different mgs through the treatment. So he would be able to stay on the same dose through out the treatment, if not is this something you have to wean off? If we go with accutane I will insist on the low dose. Thanks!

i definitely do not recommend a low dose, it is a waste of time and money in my (an most doctors) opinion. accutane has the best results when given at 1mg/kg/day for 20 weeks. with low dose courses, you have to be on the drug for very long periods of time (including monthly dr. visits and blood tests) and the results usually don't last once the drug is stopped. it is best to let the doctor decide what dose is best for your son. you can stay on the same dose throughout the entire treatment i was on 60mgs (40/80 on alternate days) for my entire 26 week course.

Dude you need to do more research before you talk. Long term lower dose course, reaching the same cumulative dose is safer and more effective. You tend to think accutane is far safer than it is, just because you experienced no side effects, doesn't mean they don't happen to other people. Do some research into longer low dose accutane courses. In europe it is administered this way and is seen to be just as, if not more effective than the normal courses...

I'm sure if you had the same side effects as other people you would be recomending the same thing....

I have a friend who has the worst acne i have ever seen, he was on a 7 month course at 35 mg a day (0.5mg per kg) and he is still clear to this day (3 years later).

"Six months of treatment with low-dose isotretinoin (20 mg/d) was found to be effective in the treatment of moderate acne, with a lower incidence of severe side effects and at a lower cost than higher doses," they conclude.

Unless your son has severe truncal acne, i still recomend a low dose course. It is far safer (and has been proven so through studies) which i feel is your main concern here...especially in a 16 year old boy

i have done plenty of research. and i'm sure the prescribing doctor has done more than plenty of research as has the company that makes accutane and developed it's prescribing recommendations. so, to the original poster, i would listen to your doctor, he will decide what dosing regimen is best suited for your son. i wouldn't "insist" on a specific dose.

benaclin, tazorac 0.05% and a 100mg pill that I can't remember the name, it was mino something once a day.

the last treatment... clindamycin gel 1%, tazorac 0.1%, 400mg erythromycin es twice a day and washed with panoxyl.

Those two treatments were by two different derms. He ran out of panoxyl (soap bar) the other day and we both noticed his face is looking just a tiny bit better, I wonder if he was washing too hard with the cloth.

i'd definitely go for accutane after those medications. all those prescriptions he was on were much stronger than proactiv, trying that would be a waste of time.

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Overbearing was a probably a bad choice of words...I meant to say Overly concerned or something along those lines - I did say that it is out of concern beacuse she cares about him a lot.

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Overbearing was a probably a bad choice of words...I meant to say Overly concerned or something along those lines - I did say that it is out of concern beacuse she cares about him a lot.

;) I've got the classic textbook 'overbearing mother'. So that one little phrase just jumped out and grabbed me around the throat and squeezed slightly. :D I am sure the OP realizes you meant quite well. :)

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I wouldn't say I'm overbearing, but I can see how my post could be takened that way. Like any other Mother my kids are my life and I want the best for them and make the right decision for them. I'm educating him on the meds, but he isn't mature enough to make the decision on his own. Yeah he is 16, but he is a 16 year old with learning disabilities so that really puts his mature level and decision making back a few years. On overanalyzing, well I have to agree with you on that somewhat, but that's just me I worry about everything way too much. I do feel more trusting towards his new derm compared to the other one we were seeing. Good doctors are hard to come by these days.

I have only read through the ipledge book once, but I remember reading something about family history. How much of a role does that play in whether he could take the med or not? We haven't gotten into everything with his derm yet cause he wanted me to read and do research before I made a decision so I haven't given him our family medical history yet. He wants us in next week to sit down and talk and decide whether to give it a try or not. Reason I ask this is because I don't have all my family history due to adoption. We do have most of my birthmoms now, colon cancer and diabetes runs horrible on her side.

Again thanks to everyone.

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If your son has severe cystic acne that is already causing scarring at such a young age, please seriously consider Accutane.

If Accutane had been available when I first started getting cystic acne, I would have taken it then and spared myself the large numbers of scars, permanent scars, that I have now. At the age of 40.

If you monitor him daily at home for side effects (and there WILL be some, all drugs have side effects) and the doctor monitors him regularly for lab values and so forth, all should be fine. The regular side effects are: extremely dry skin, chapped almost bleeding lips (if one doesn't get religous about applying lip balm regularly), dry eyes, high risk for birth defects in a pregnant female (doesn't apply to your son). If he develops side effects that concern you, you can always post here or call the dermatologist to see if it is something to be concerned about.

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If your son has severe cystic acne that is already causing scarring at such a young age, please seriously consider Accutane.

If Accutane had been available when I first started getting cystic acne, I would have taken it then and spared myself the large numbers of scars, permanent scars, that I have now. At the age of 40.

If you monitor him daily at home for side effects (and there WILL be some, all drugs have side effects) and the doctor monitors him regularly for lab values and so forth, all should be fine. The regular side effects are: extremely dry skin, chapped almost bleeding lips (if one doesn't get religous about applying lip balm regularly), dry eyes, high risk for birth defects in a pregnant female (doesn't apply to your son). If he develops side effects that concern you, you can always post here or call the dermatologist to see if it is something to be concerned about.

The other treatments he was on dried his lips out, will the accutane be worse. chapstick helped with the other treatments, will it or another product work so it's not so bad. I'm learning more towards giving it a try.

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what other treatment dried his lips out? while he is on his accutane his lips will be DRY, and extremely chapped if he doesn't use chapstick regularly. he will have to use it constantly, also a thick layer of aquaphor while he sleeps will also help. he should also use a moisturizer at least twice a day (and may need more.) the oil on his skin will be completely gone. he should moisturize his hands and face, and use vaseline or aquaphor if needed

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i'm just curious, how bad is your sons acne? what type of acne does he have? i just think going on accutane will make him much happier in the long run.

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what other treatment dried his lips out? while he is on his accutane his lips will be DRY, and extremely chapped if he doesn't use chapstick regularly. he will have to use it constantly, also a thick layer of aquaphor while he sleeps will also help. he should also use a moisturizer at least twice a day (and may need more.) the oil on his skin will be completely gone. he should moisturize his hands and face, and use vaseline or aquaphor if needed

It was the 400mg erythromycin es twice a day that caused his lips to chap. He's pretty much in the habit of using chapstick due to the other med and moisturizes his face several times a day.

Thanks

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i'm just curious, how bad is your sons acne? what type of acne does he have? i just think going on accutane will make him much happier in the long run.

ya know I don't think the doctor has ever said a type, just severe. I'll ask when I'm in there next week. I can't find the photos I had on the computer at one time, but if I do I'll post them and maybe see if he will let me take some new ones. I really wish we could get the redness down. I'll have to look for the post on Unnamed here, he has a blog with photos and my sons face reminds me of his before unnamed started treatment.

thanks for your replies.

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i looked at unnamed's pictures, if your sons acne is like that i think accutane would be an excellent choice for him.

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I'm the mother of a 14 yr old son who has been on Accutane since February. Like you , I had alot of reservations about my son using this treatment & resisted it for quite a while. After about 2 yrs of trying just about everything else known to treat acne & after doing lots of research & talking to others who had been on accutane, I decided to let my son try it. He was made fully aware of the possible side effects & monthly blood tests & decided this was something he wanted to try. The results have been wonderful. He goes back to the derm next week & this should be his last visit. The only side effects he has experienced is dry lips & a couple of nose bleeds in the beginning. He plays football, basketball & baseball & accutane has not affected that at all. He does take fish oil & vitamin E just to be on the safe side. All of his blood work has been good. He used to say that his skin did not bother him (he had it on his face, chest & back) but I know that it did -ever since his skin has cleared up, he takes alot more care about the way he looks. He will be starting high school this fall & I did not want him to start feeling self-concious about the way he looked & now he doesn't have to. We both know that due to his age, there is a good chance that the acne will come back but the derm said if we catch it soon enough, it may be able to controlled with other meds & if not, I will have no reservations about doing a 2nd dose of accutane. He takes the brand due to his derm feels this is better than generic. I would suggest trying accutane. Just make sure your son understands the possible side effects. One thing that I was very concerned about was if accutane stunted growth - my husband's entire family is over 6 ft & we anticipate my son being tall also. So far, his growth has not been affected at all. He wears a size 12 shoe & has grown at least a half inch since he began accutane in Feb. Hope this helps.

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