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NeyaNey

Help finding an accutane friendly doctor

I've reached my wits end today when I went to derm who said my skin looked better (it's so much worse. I've been on mino for what seems like forever). He later told me that next step is to drop all medications and put me on Yaz even though my cystic acne is not linked to my cycles.

He again recommended a low glycemic diet, when I've already been on one for 6 years. It became apparent he just doesn't listen.

I'm not saying Im demanding accutane but I would like an accutane friendly doctor. How do I go about finding one? All derms I've had in the past won't even talk about it as an option(but I don't find this out until 6 months into my failed treatment plans)

I live in MA If anyone has a recommended doctor.

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No one has tips for finding a derm? Should I ask a pharmacist? Should I ask the receptionist on the phone when looking for a new derm? Do I just go in and say "I want accutane"

I'm scared, I tend to get shot down because I make the appointments, but the wait time around here in MA is like 2-6 months to get in for first appointments. Every time I've gone in to my derm my cysts have cleared(although, the redness/spots remain). I bring pictures but the doctor wont look at them.

I'm 26 so it's doubtful I'm going to grow out of it. Right now its just getting worse and I'm starting to scar. I also using paragard IUD. Although most of my acne treatments have helped the tiny whiteheads in some form it's never assisted in my cystic acne.

Since being a teen I've been on tetracycline(1 yr+), doxycycline(bad side effects), minocycline (2 courses totalling over 1yr back to back), BP %10 wash (4 years), BP cream/gel, clindamycin gel (made blackheads and whiteheads much worse, stopped after 6 months), Now recently on mino(dropped to 50mg), Tretinoin cream 0.025 (upped yesterday to 0.05, but I asked for a gel and he said no way - is keeping me on cream form), and was told to add in BP gel again. The derm said in so many words he cannot help my cystic acne and that if it continues by next month he's reached the end of the line and sending me to a gyno for yaz. (I left in tears)

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right now im currently googling all the derms in my area, calling them and asking if the derm is able to prescribe accutane. got a few yes's so ill be looking further into those and pick which one i think is best. goodluck

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Thanks for the advice, i never really thought to ask during a call. I was able to make an appointment in January with a highly rated dr who's receptionist says that he does perscribe isotretinoin to some of their patients.

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Thanks for the advice, i never really thought to ask during a call. I was able to make an appointment in January with a highly rated dr who's receptionist says that he does perscribe isotretinoin to some of their patients.

This is going to sound really awful, but go to a doctor in a more wealthy area. I saw a number of doctors and none of them ever said anything about Accutane when I was there, and finally I asked about it, and all they could say is that they don't prescribe it in their office.

Just last week, I went to a new doctor in a very wealthy area a few towns over, where they do prescribe accutane, and she explained to me that a lot of offices wont do it because of the iPLEDGE system and how much work it is. She said for a lot of offices, its more work then its worth because a lot of patients can't afford to come in every month as part of the program so they just don't offer it.

Now I can't say this is true everywhere, and I live in MI so I don't know about other states, but that seems to be how it is around here.

I would also try independent offices that aren't directly affiliated with a certain hospital or health system. All of the doctors I had seen previously were, and maybe that has something to do with it.

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I wanted to update.

I had a long wait to get into the derm (very normal in MA, usually 3-6 month wait).

We talked, a very long time. Maybe because of the snowstorm a lot of people cancelled and he had a lot of free time, or maybe he usually spends a long time with a new patient.

The absolute first thing he said to me was "You're 26" and something along the lines of that I'm too old to be suffering from acne any longer. This made me very excited. We talked about previous medications, topicals, my everyday makeups and my moisturizers.

He also said he was quite happy I used paraguard IUD as its not only effective BC but also non-hormonal. He doesn't like using hormones to control acne, except where there is an actual hormonal issue. He sent me to the lab ASAP to test for male hormones (first derm out of several to ever do this).

He also explained he thought I'd fully run my courses with the "cyclines" and that they'd "crapped out" on me. Essentially, no longer worth any effort. He asked if I ever used Bactrim and talked a very very long time about possible reactions and side effects.

He wants all his patients to be VERY proactive, ask questions, give suggestions and to know every medication they are putting on/in their body. He even requested I keep a copy of it in my purse or phone just in case.

Then he told me the future plans (which made me even happier, that he HAD a plan).

So here it is!

Bactrim 2x day (dosage unknown until I pick it up) - take with food if it hurts my stomach. Discontinue use and call immediately with any reaction or even if I feel weird (my mom has porphyria - so theres a %50 chance I have it also. Sulfas are a huge no-no, but I've never had an issue with them before when taken for infections)

Tretinoin cream - reduced dosage back to %0.025

Benzoyl Peroxide wash %5 - use if needed, or wanted. If the above works alone its not as important. If skin gets too irritated discontinue. He said it wasn't a big deal but it might help.

Call in a couple days for hormonal blood test results. Visit again in 2 months, if there in no improvement we will then begin blood testing, extra birth control, and iPledge for Accutane.

Edited by NeyaNey

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