Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
Katielou

Anyone out there on low dose isotretinoin therapy?

Recommended Posts

Hi - Im new, very briefly - I am now 30 and have been struggling with acne/rosacea since my teens. It is no word of a lie to say it ruined what should have been the best years of my life. Self esteem was rock bottom and I believe it held me back in so many ways. Initially it was your typical moderate but very persistent acne, the rosacea bit came later but this was only mild I guess. However, put the two together and you have one hell of a mess on your hands! Try and treat the acne and you aggravate the the rosacea and sensitivity of the skin etc etc.

To cut a very long story short - I became very interested in ultra low dose isotretioin and after looking at a number of studies went along to my derm (Im in UK) and pretty much begged him to try this. Like a lot of derms, he was not convinced low dose was the way to go so he put me on 40mg a day - big mistake aggravated the rosacea and I had severe dry eye problems (that took 2 years to rectify - but it did). I came off it for awhile and acne problems returned so I eventually went back and begged to try the ultra low dose I had originally asked for. He relented and gave me the prescription.

I have been on it now for 2 years (5mg/day going down to 5mg every other day) Ive had the odd short break in between courses but I feel the dose I take is more of a maintanence dose and that I may need to stay on it for a good few years.

The transformation in my skin has been nothing short of amazing with NO side effects whatsoever. It actually scares me coming off this drug because of how it has transformed my life. I am nearing the end of my current course and my derm did mention last time he wanted me off it for awhile. Not looking forward to that.

I personally think there should be more studies done on ultra low dose therapy as Im sure this is the way to go for a lot of people, all the derms Ive seen however seem not to want to explore this. I have had to fight to get it every step of the way. The only reason he did prescribe the low dose was because he did admit higher doses can induce or exacerbate rosacea type conditions.

Sorry for the long post - I would be very interested to hear from anyone who also has experience with low dose and where you are currently at with it.

Thanks!

Share this post


Link to post
Share on other sites

I AM!!!!! 10mg a day.

I can not express what low dose is like so let me try with emoticons......

:wub::dance::boogie::catdance::banana::clap::Siava:

I had about 100 more of love & dancing happy things but apparently I can't add that many.... :naughty:

Edited by Beauty Bot

Share this post


Link to post
Share on other sites

There is no question that low-dose treatments can indeed clear your skin.. However, it is generally believed that lower-dose treatment plans yield a higher chance of a relapse sometime after you've completed your accutane course. On the contrary, most derms believe a higher-dose treatment course yields a much better chance of keeping your acne gone permanently.

I was on 80mg per day (high dose) for roughly 5.5 months (I was supposed to go 6 but randomly decided to stop a few weeks early, haha).. And it has been like 2 years since I finished my accutane course.. I have yet to have it come back at all. So far so good.

My side effects for my high dose really weren't that bad.. Aside from the ridiculously dry lips, I was just REALLY tired/fatigued all the time.. Like I would need 12 hours of sleep per night to function well enough. It was a drag being tired lots, but it was worth it. The tiredness went away after I finished my course.

Edited by Jxr

Share this post


Link to post
Share on other sites

Katie,

wow, we have the same problem. On my 3rd course to try and knock out this stubborn moderate condition. On 40 mg a day but like you, it causes flushing spells for me. I actually have some small facial veins which appeared after the first course in 2000. (80 mg a day) I decided last week after a lot of research regarding low dose therapy(a lot of Europeans prescribe it this way) that I am going to take matters into my own hands. I am going to take 40 mg a day three days a week. mon-wed-fri and see how the flushing does. In Europe it's been prescribed many times at 10mg a day.

The very odd thing is that according to all my research. Accutane is sometimes prescribed at the low dose to treat rosacea and prevent flushing. Yet at the higher dose it exacerbates the problem. Very weird.

We'll see how this goes, anyone think I am wrong for taking it a different way than it was prescribed? the way I look at it is that I did it "their way" twice before, what's wrong with doing it my way this time and just take 3 pills a week?

Share this post


Link to post
Share on other sites

Hello everyone,

This is my first post on this forum, Im Hector (26yo) I live in Lima-Perú and english is not my first language so i expect to make a lot of mistakes when writing.... XD

well...I have been dealing with bad acne since I was 14 yo... I had acne on my face, on my chest on my back... even on my legs and shoulders.... I tried everything... (Antibiotics, adapalene, benzoil peroxide, etc etc) i even took Isotretinoin 3 times but on low doses (20 mg every day for about five months each treatment aprox).... but sadly, acne and extremely oily skin came back after 6 months... the positive thing is that it was not that bad as it was before... but even if theres just a few pimples on my back, they cause hiperpigmentation since im latin and my skin is darker (Hiperpigmentation spots can be there for years...)

So i felt really depressed when my last isotretinoin course finished and after some months i saw a few pimples ruining my back again... leaving their mark for years.... I thought my problem would be over... Im 26 and Im not a puber anymore.... but WTF this problem came back....

Thats why I start reading abouth long term treatments with isotretinoin, I read a lot of forums where people are doing this ...mostly on their owns, without a doctor prescription.... and they were having good results... even with really low doses like "2mg per day" others on "one 10mg pill per week" ...Then i found some reasearch where they stablished that this micro dose regimen was safe, and I also found that some dermatologist prescribe it.

So i thought, this is my last chance to fight acne, to get a normal life and to become happy again, like i used to be before fucking acne came to my life. I even considered to take another isotretinoin normal regimen and take another and another and another until my acne gives up (Without prescription) . But luckily i found this Microdose regimen....

I bought 60 "20mg" pills and i taking one pill per week since a month ago.... Now my skin is less oily and my acne has desapeared... Finally im seing a light at the end of this damn tunnel... Im gonna take this dose for about a year and if everything goes well im gonna tell my brother to take it too... i feel really bad for him.... he is dealing with the same acne than me... when i see him, its like watching myself years ago... depressed, isolated.... I persuade him to go to the dermatologyst and he gave him isotretinoin... everything is gonna be happy for him until 6 monts after the treatment... when acne and oily skin come back.

Hope this Microdose treatment will help everyone one day, and i hope that our experiences and suffering can help to make this regimen popular, thats the only way traditional medicine can focus on this, research and confirm long term microdose safety!

Bye!

Share this post


Link to post
Share on other sites

Hi - Im new, very briefly - I am now 30 and have been struggling with acne/rosacea since my teens. It is no word of a lie to say it ruined what should have been the best years of my life. Self esteem was rock bottom and I believe it held me back in so many ways. Initially it was your typical moderate but very persistent acne, the rosacea bit came later but this was only mild I guess. However, put the two together and you have one hell of a mess on your hands! Try and treat the acne and you aggravate the the rosacea and sensitivity of the skin etc etc.

To cut a very long story short - I became very interested in ultra low dose isotretioin and after looking at a number of studies went along to my derm (Im in UK) and pretty much begged him to try this. Like a lot of derms, he was not convinced low dose was the way to go so he put me on 40mg a day - big mistake aggravated the rosacea and I had severe dry eye problems (that took 2 years to rectify - but it did). I came off it for awhile and acne problems returned so I eventually went back and begged to try the ultra low dose I had originally asked for. He relented and gave me the prescription.

I have been on it now for 2 years (5mg/day going down to 5mg every other day) Ive had the odd short break in between courses but I feel the dose I take is more of a maintanence dose and that I may need to stay on it for a good few years.

The transformation in my skin has been nothing short of amazing with NO side effects whatsoever. It actually scares me coming off this drug because of how it has transformed my life. I am nearing the end of my current course and my derm did mention last time he wanted me off it for awhile. Not looking forward to that.

I personally think there should be more studies done on ultra low dose therapy as Im sure this is the way to go for a lot of people, all the derms Ive seen however seem not to want to explore this. I have had to fight to get it every step of the way. The only reason he did prescribe the low dose was because he did admit higher doses can induce or exacerbate rosacea type conditions.

Sorry for the long post - I would be very interested to hear from anyone who also has experience with low dose and where you are currently at with it.

Thanks!

Hey this is the best review ive read.. ive been on here for ages trying to see if the ultra low dose causes hair loss in any form what so ever...?? as i lost mine in the higher course and my skin in bad again and im so tempted to go on the low course again but really dont want the hairloss side effect ?? x

Share this post


Link to post
Share on other sites

Please guys, stop suffering... im gonna share with you a secret... the acne cure... just google: Long term micro dose Isotretinoin.... do a lot of research... be aware of the risks(especially for women)... get the pills ... take em and enjoy life. theres a lot of info out there.

look at this:

Low Dose, High Rates of Success

Ultra-low dose isotretinoin is all many acne patients need

San Francisco - Low and ultra-low doses of isotretinoin are an effective therapy for many acne patients. This safer and cheaper solution can even be used continuously.

Gerd Plewig, M.D., believes that the doses of isotretinoin typically used in the United States and Europe are far too high. For many patients, as little as 2.5 mg twice a week, which he describes as "a drop of rain on a dusty road" is adequate.

Dermatologists all over the world already are treating some patients continuously with low doses of isotretinoin, according to Dr. Plewig, director, dermatology and allergy clinic, Ludwig-Maximilian University in Munich.

"When you talk to doctors in this country and other countries of the world, they use 10 mg twice a week or three times a week, which is a low or ultra-low dose. But nobody ever bothered to show and demonstrate that it works," he said. Thus, he and his team performed two clinical trials to assess its efficacy.

Study Spotlights Low Dosing In the first trial, 28 patients with acne conglobata and inflammatory acne took a low dose of isotretinoin: 20 mg/kg, 10 mg/kg, or 0.5 mg/kg body weight daily for six months. In the second study, 11 acne patients took an ultra low dose of isotretinoin: 2.5 mg to 5 mg daily or 2.5 mg twice a week for six months. Both trials involved multiple endpoints, including clinical grading, lesion counts, counts of follicular filaments (believed to be precursors to lesions), bacterial colonization, patients' opinion of seborrhea levels, two objective measurements of sebum levels (Sebutape and Bentonite clay), qualitative assessment of sebum using high power, thin layer chromatography, and biopsies to assess size and configuration of sebaceous glands.

Trials Yield Significant Improvement Results of the first trial in which low doses of isotretinoin were used revealed significant improvements in all parameters tested. Numbers of follicular filaments, and lesions dropped, as did levels of bacteria and sebum. Sebaceous glands shrank, as well.

At the end of the second study, which investigated ultra-low doses of isotretinoin, efficacy was maintained on many of the parameters. There were significant reductions in numbers of active lesions and follicular filaments as well as objective measures of sebum levels. Patients' ratings of seborrhea improved, and levels of P. acnes on the skin diminished.

"The endpoint or the lowest point of a retinoid being effective for the treatment of seborrhea, persistent low grade acne, or maintenance therapy for patients with bad acne probably is around 2.5 mg or 2 mg, or maybe even 1.5 mg," Dr. Plewig said.

The best candidates for low and ultra-low doses isotretinoin therapy, Dr. Plewig said, include patients with severe acne who were controlled with higher doses and require a lower-dose maintenance therapy, individuals whose facial acne has persisted from adolescence into adulthood, and people with sebaceous gland hyperplasia. "Some patients come only because of their oiliness. ... For these patients, I think the low or ultra-low dose is very good, and it's cheap, too," he said.

Severe Patients Still Receive Low Doses Dr. Plewig keeps doses of isotretinoin relatively low in patients with severe acne. "I pretreat patients with severe inflammatory acne with systemic corticosteroids to begin with...about 1 mg/kg body weight for about seven to 14 days, taper it off, and then give an antibiotic, usually an erythromycin, a macrolide," he said. "And then I start with the isotretinoin [0.2 mg/kg to 0.4 mg/kg body weight]. It is so much better. We used to start immediately with isotretinoin or tried antibiotics, but often it takes too long, the patients are miserable, and it is so much better for them because you can have a faster final result, a better final result with cooling down the skin first, then adding your active treatment."

Continuous Use Offers Versatility A great benefit of using lower doses of isotretinoin is that it can be used continuously. There are other important advantages, as well. "In terms of pharmacoeconomics, it is cheaper to use lower doses, it is better tolerated by patients, has fewer side effects, fewer laboratory abnormalities, and of course the patients like it when they have continuous elegant treatment," Dr. Plewig said.

Despite the safer side-effect profile with low-dose isotretinoin, Dr. Plewig emphasized that, at any dose, the drug should still be considered teratogenic and be used with great caution in women of childbearing age.

http://www.dermatologytimes.com/dermatolog...il.jsp?id=65528

Prof. Dr. Dr. h. c. G. Plewig

Klinik und Poliklinik ;>für Dermatologie und Allergologie

Ludwig-Maximilians-Universität München

Frauenlobstraße 9 – 11

D-80337 München, Germany

Tel.: +49-89-51 60 60 00

Fax: +49-89-51 60 60 02

E-mail: [email protected];derma.med.uni-muenchen.de

Background: Excessive seborrhea, coarse-pored skin, minimal acne and oily scalp hair comprise a well-known clinical entity. It causes considerable concern, has social impact, and affects the quality of life in some individuals. Some patients seek treatment for seborrhea. No effective topical sebosuppressive medication is available. Oral isotretinoin is the only remedy for men. In women, oral isotretinoin is the most effective remedy, followed by antiandrogens.

Patients and methods: Eleven patients in three groups were treated for 6 months with very low dose isotretinoin. The influence on seborrhea was measured during oral treatment with 5 mg/d, 2.5 mg/d, or 2.5 mg 3× weekly.

Results: Sebum production, measured with Sebutape®, was reduced by up to 64 %. Acne lesions regressed by as much as 84 %. Follicular filaments were reduced by 66 %. Microcomedones were reduced on average up to 86 %. Quantitative bacteriology showed a reduction of Propionibacterium acnes but no increase of Staphylococcus epidermidis. Biopsies revealed a 51 % reduction in sebaceous gland size. With Bentonite™, a reduction of lipids was demonstrated with 2.5 and 5 mg isotretinoin/d but not with 2.5 mg 3× weekly. There was a shift within the lipid fractions: triglycerides dominated, followed by squalenes and free fatty acids.

Conclusions: Good results were achieved in all patients. The small number of patients did not permit a statistical analysis of the three isotretinoin doses studied, but there was a tendency toward better results with the two higher doses.

Zusammenfassung

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×