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English_Rose

Isotretinoin - 4Th Round?

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Hello fellow acne sufferers, so it's been a while since I was last on the forums but here I am again!!

Brief history:

Female, live in UK, now age 36

Over the decades (yes, you read that correctly...DECADES!!) I have tried antibiotics of all sorts, hormone/birth control, skin care, beauty therapy, natural therapies, diets, lifestyle.

The ONLY thing that works for me is Isotretinoin (also known as Accutance or Roaccutane)

I've now had three Isotretinoin courses - each time it has made a huge difference and has had a positive impact on my life.

Round 1: 1990

Round 2: 2010

Round 3: 2011

Acne is here yet again, had referral from my GP back to my lovely private derm (costs me a fortune but worth every penny) and I have an appointment for 13th July...I'm hoping for another (fourth round) of Isotretinoin.

Anyway, I just wanted to come and say hello to everyone and let you know that I'll be back with a blog/diary of my progress over the coming weeks.

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I am sorry that accutane has not been the solution for you. I too have done 3 rounds that have not ended with lasting success. What alternatives have you tried. I honestly don't think a fourth course will produce remission for a long period of time.

Good Luck with whatever you decide though.

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Hello EnglishRose,

I too am on my 4th sortie of isotretinoin. I am having great success on a low dose maintenance course, complete with little to no side effects. Please see my previous posts for my story etc as I've written about it a gazillion times now! :)

Regards,

Rob

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Hi, Thanks for the replies smile.png

It's great to hear from someone else on their fourth encounter with isotretionoin. Like you Rob, I'm on a low dose, long term maintenance course now. I'll definately read your other posts! I'm currently at 20mg a day to build up the drug in my system but with a bit of tweaking/trialling over the next couple of months I will be reducing the dose down dramatically to just a trickle. I did this in 2012 and the results were great, no side effects and I was so pleased with my skin.

Isotretinoin has been a very positive experience for me and I do call it the wonder drug. My acne is nowhere near as severe as it was in 1990 or 2010 and I'm really fortunate that I have a fantastic dermatologist.

Edited by English_Rose

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post-145613-1306382695_thumb.jpg

(Click graph)

In your previous courses, have you guys taken enough Accutane to reach the ideal cumulative dose of 120-150mg/kg that minimises the chance of acne returning post-Accutane?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/pdf/de0103_0162.pdf

http://www.acne.org/messageboard/index.php?app=core&module=attach&section=attach&attach_rel_module=post&attach_id=34574

http://www.acne.org/messageboard/index.php?app=core&module=attach&section=attach&attach_rel_module=post&attach_id=34069

_________________________________________________________________________________________________

For the women who have used Accutane multiple times, have you had your hormones checked by an endocrinologist to see if you have any underlying hormonal issue that may be contributing to your acne?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923944/pdf/jcad_2_12_16.pdf

Edited by biggs881

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Hello! I am curious as to how long after you stopped taking Accutane your acne returned. I have been off Accutane for almost a year and it has been like a miracle for me! I don't want to get too excited though because many people seem to say their acne comes back. Curious how long you stayed clear before it came back.

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Hello! I am curious as to how long after you stopped taking Accutane your acne returned. I have been off Accutane for almost a year and it has been like a miracle for me! I don't want to get too excited though because many people seem to say their acne comes back. Curious how long you stayed clear before it came back.

If acne comes back after Accutane, it usually happens within 3 years of stopping:

The purpose of this study was to assess the long-term benefit of isotretinoin in otherwise therapy-resistant acne. We also assessed risk factors which might influence the long-term outcome. We studied 88 patients (mean age 20.8 years), most of whom had suffered from acne for many years (mean 7.4 years). They received isotretinoin in an initial dose of 0.5 or 1.0 mg/kg/day. The dose was subsequently adjusted according to response and side-effects. Most patients only required 4 months' therapy to produce at least 85% clinical improvement. The patients were seen up to 10 years post-therapy (mean 9 years). Sixty-one patients were still virtually clear of disease. Of the others, 16% required further treatment with conventional antibiotics and 23% required a second course of isotretinoin. Of those who relapsed, 96% did so within 3 years of stopping therapy. The patients' age, sex, and duration of acne did not influence outcome. However, in patients with predominantly truncal acne, especially when severe, there was an increased incidence of relapse. Sebum excretion is known to correlate with acne severity, but the long-term degree of sebum suppression was found not to be related to relapse. The dose schedule, in particular cumulative dose, was an important factor in determining relapse rate. Those patients who received 0.5 mg/kg daily, or a cumulative dose of < 120 mg/kg, had a significantly higher relapse rate than patients receiving a larger dose. We did not elicit any long-term systemic or biochemical side-effects. We conclude that isotretinoin is a safe and effective therapy.

(Quote from here)

Edited by biggs881

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Hi. I am starting my third course today. I have had success w accutane and have tried everything else. Bc, spiro, doxy, retina, lasers. Accutane is the only thing that works. First course 2006 then 2009 now again. It seems after I have kids (I have 2) my skin goes crazy again. Anyway, back to the beginning again. 40mg for 2 mo then 60 for 3. Usually dry lips, eyes but tolerated great. But we shall see this time. I'm 32 and weigh 117!!!

Ps. If anyone has any suggestions for other bc pills, would live a tip. I've tried Yasmin and yaz. Thinking of orthoti lo. Spiro does nothing for me nor does doxy. Bc gives me melasma so it's a lose lose situation. I have hormone free iud so not worried abt pregnancy

Also, if anyone is in the Columbus oh area and knows a good derm plz let me know. I'm so over my dr and looking for a good one who's used to rx'ing accutane:) thanks

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