My hope is that this thread will help someone. I realize that everyone's skin is different and may react differently, but hopefully this information may help if you have not tried isotretinoin / accutane or are afraid to.
(spelling may be off - there is something wrong with this post interface - where I am getting a delay in the keyboard when typing)
OK - I am 40 - (fit - eat relatively heathy, exercise, lots of water) been suffering with mild to moderate acne for over 25 years. For me it was on the temples and cheeks, not my forehead, not my nose, not my beard line, just this isolated area between my temples and under my eye area and cheek.areas. I have been on everything you can think of, topical and internal. In my 30s I started to develop cystic type acne and the only thing that helped me was accutane. I had to beg the Dr. to give it to me. I told him, Doc I have tried everything - I need something to control the "oil and my skin cells from sheddiing irregularly" - yeah I did my research. He gave me accutane. The only side effect I had was dry lips. I finished the course and endured the blood tests and thought I was done. As years passed I thought I beat this thing and as I was getting older I figured, acne would be a thing of the past. I then attempted to have multiple procedures (peels, microderm,derma-rolling) to improve my scars - including 1 session of fraxel which cost me $3000 which turned out years later to be a complete waste of money. So, I enjoyed a couple of years of clear (but somewhat scarred) skin and feeling more confident, but as I got even older I started to get even more oily and then sebaceosuu hyperplasia started to appear. Nothing like shiny skin with bumps? These bumps are enlarged oil glands and there isn't any cure for them. I went to estheticians and plastic suregeons who only wanted to sell me products and perform expensive laser procedures BUT WOULD NOT AND COULD SHOW ME any pictures of proof or gurantee any results for my $5500. So I said forget it. Oh and to add insult to injury I started to develop acne again as well, this time showing up in places it never showed before - my forehead and my nose. (notice I never mention anything about my diet, yet) - I go back to the derm - tell him my story and he immediately gives me Adapalene 40mg / day - (Generic isotretinoin) - OH and of course my insurance kicks it back and I have to wait another 3 weeks for the prior authorization and repeal BS - but I get it - $35 copay - tier 2 drug. No blood tests.
Fast forward 3+ weeks later and my skin is amazing, since isotretinoin somehow reduces the size of the oil glands and prevents keratinization - (hardening of cells - i think) - my pores are clear, my skin is soft and not shiny (the whole day). The sebaceous hyperplasia is almost gone too. However, I hear when I am off this drug, it may come back again, so I am considering taking a low maintenance dose.
Why is this drug so controversial? I have read that there isn't any proof that isotretinoin caused depressions, sucidial thoughts etc, just that individuals that were involved in incidents such as these were on Accutane etc. Did they ever think they were depressed by there acne or something else. isotretinoin is starting to be used to treat other conditions as well.
Little side note: While I was at the derm, he asked me - do you drink Milk? I love dairy - milk, cheese, yougurt, etc. He said - you may want to dry and cut that out. He said, years ago we used to say that food does not cause Acne, but now they are finding studies that link hormones in dairy that could somehow cause acne. Not sure what to believe here.
Post your thoughts I am interested in what you have found that helped you.
I forgot to mention that my scars appear less noticeable too and I am not sure why.
