So I'm wondering...how do I convince my derm in a soon-to-be visit to allow me for like, 10mg? I'm fairly sure from the studies I read that it would knock my acne on its ass, and I'm tired of having acne. The hyperpigmentation is awful because I get like 3 new spots a day, so my skin never has a chance to heal, and it leaves deep red marks, plus I have two moon shaped indents now ( for those who think moderate acne doesn't rip up your face sometimes).
I still use salycylic acid but it just makes my face look more red and my skin seems to not give a crap because it's deeper acne.
I know this is standard protocol in other countries, but American docs are so stubborn. I've recently had to move so have a new derm, and the previous offered a low amount of 20 mg at the LOWEST ( which I rejected due to caution about Accutane) but I think 10 mg is sufficient from studies I've seen. Did anyone have to convince their American derm and how'd ya do it?
I just basically came in with a list in hand of everything i had tried and i do mean EVERYTHING. I relayed to her how devasting this condition was for me and that i didn't know where else to turn. I had been on an incomplete course of accutane so i told her that had been helping. She then asked me if i wanted to go down that route again and as they say, the rest was history.
Be genuine, don't put on a show and if you have honesty tried many things, be upfront about it. I should caution you though that many derms that i have met in the US are not that open to low doses. They want you on and off accutane ASAP.
Good Luck with everything.
Accutane is hard to get prescribed because of it's potency and potential extreme side effects. If a doctor is willing to prescribe you a high dose of Accutane, there is no reason they wouldn't (at the request of the patient) prescribe a low dose.
But if you want to get down to economic incentives for the derm, he should realize that a lower dose course over a longer treatment period would require more monthly visits (monthly blood tests are required) and you/your insurance has to pay for every visit.
EDIT: Do not take this as medical advice, but if your doctor refuses to prescribe less than 20mg tablets, why don't you accept the prescription and only take one tablet every other day? At the end of your many months of treatment, you will have half of the pills left over and can continue your low dose treatment. I would recommend monitoring triglyceride levels monthly, though.
You could also take the 20mg and tell the Derm the side effects are unbearable and plead with him to give you a lower dose. A lot of times, they just want you to *try* their suggestion but if it doesn't work for you they are open to new ideas. Who knows, maybe you will take the 20mg and have no side effects. I took 80 mg daily for 4 months and had no side effects. I'm one of the lucky Accutane users.
I would shoot for getting a dose higher than 10mg. You have to reach a cumulative dose of 120+ to put your acne into remission. If you use 10mg, you'll either be on Accutane for a very long time, or it may not clear you. If you are getting three large pimples a day, it shouldn't be difficult to get a higher dosage. My dermatologist gave me Accutane after I told him that I had used every topical and oral medication EXCEPT for Accutane. And I got the prescription without a problem. You may have to hunt for a derm who is an advocate of Accutane (I had to do that), but the process is worth it. I think very highly of Accutane.
