4 hours ago, homedesigner879 said:

I saw a post from 2011 titled "Taking Accutane for a Third Time" that was unfortunately closed to further replies. I was wondering if anyone has taken Accutane for a third time. If so, did your acne significantly improve? Accutane is the only medication that has significantly improved my acne.

I've taken Accutane about 1 and a half times. The first time I took it, the dermatologist miscalculated my dosage and brought me up to 95mg/kg, which is insufficient since the requirement is 120-150mg/kg. My dermatologist cited this article stating this dosage requirement:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970835/

However, my dermatologist said that this range is an overestimation for moderate acne and an underestimation for severe acne. I had severe acne. So, after confirming that I had received an insufficient dosage and that my cystic acne was returning, my dermatologist prescribed me more Accutane to bring me up to 205mg/kg. She said that for insufficient dosages, 200-220mg/kg total is advised, citing this article:
https://www.ncbi.nlm.nih.gov/pubmed/24173086

The "second" time I took Accutane, I experienced reduced effectiveness. Whereas the first time I took Accutane, I got nosebleeds every day. I didn't get a single nosebleed the second time I took it. My body had built up an immunity to the medication, so my insufficient dosage the first time had permanently reduced the potential of the medication to get rid of my acne. However, taking Accutane for a second time still helped with the acne. After taking accutane the first time and relapsing after 1 month, I made it 8 months before relapsing after taking it the second time and to a less severe degree.

My dermatologist originally had me use differin and aczone for several months (after taking accutane "2" times) but is now considering putting me on Accutane for a third time. It depends on how bad my acne is at my follow-up appointment in 2 months. She thinks this may be justified, because in her opinion I only took Accutane once (because of the insufficient dosage the first time and the fact that the second time was a touch-up dosage). Also, although the insufficient dosage permanently reduced the potential of the medication to get rid of my acne, it also improved my body's ability to tolerate the medication.

Keep in mind that I've had problems with acne for 10 years. I stopped drinking milk and switched to sugar-free (and dairy-free) almond milk. I eat plenty of fruits and veggies, get the right amount of sun at 5-10 minutes per day, exercise, do not use protein powder (which can cause acne), and eat healthy. The severity of my acne is significantly worse than average.

Another concern people have is that accutane causes birth defects. However, I'm male and accutane actually increases fertility in men:
https://www.ncbi.nlm.nih.gov/pubmed/26653640

Peoplealso get worried that Accutane causes depression. I have problems with depression, but Accutane didn't affect my mood. I have a female friend who took Accutane, and she said that Accutane made her moody. I believe that the difference may be that women's hormones change every month. Accutane has actually made me happier, because it has significantly reduced my acne.

So, if you [censored] have taken Accutane, especially if you've taken it for a third time, please let me know if it worked! My dermatologist said that the more Accutane people take, the more it works. So I believe that it is simply a matter of achieving the right dosage. Thanks!

Just now, hatetane said:

4 hours ago, homedesigner879 said:

I saw a post from 2011 titled "Taking Accutane for a Third Time" that was unfortunately closed to further replies. I was wondering if anyone has taken Accutane for a third time. If so, did your acne significantly improve? Accutane is the only medication that has significantly improved my acne.

I've taken Accutane about 1 and a half times. The first time I took it, the dermatologist miscalculated my dosage and brought me up to 95mg/kg, which is insufficient since the requirement is 120-150mg/kg. My dermatologist cited this article stating this dosage requirement:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970835/

However, my dermatologist said that this range is an overestimation for moderate acne and an underestimation for severe acne. I had severe acne. So, after confirming that I had received an insufficient dosage and that my cystic acne was returning, my dermatologist prescribed me more Accutane to bring me up to 205mg/kg. She said that for insufficient dosages, 200-220mg/kg total is advised, citing this article:
https://www.ncbi.nlm.nih.gov/pubmed/24173086

The "second" time I took Accutane, I experienced reduced effectiveness. Whereas the first time I took Accutane, I got nosebleeds every day. I didn't get a single nosebleed the second time I took it. My body had built up an immunity to the medication, so my insufficient dosage the first time had permanently reduced the potential of the medication to get rid of my acne. However, taking Accutane for a second time still helped with the acne. After taking accutane the first time and relapsing after 1 month, I made it 8 months before relapsing after taking it the second time and to a less severe degree.

My dermatologist originally had me use differin and aczone for several months (after taking accutane "2" times) but is now considering putting me on Accutane for a third time. It depends on how bad my acne is at my follow-up appointment in 2 months. She thinks this may be justified, because in her opinion I only took Accutane once (because of the insufficient dosage the first time and the fact that the second time was a touch-up dosage). Also, although the insufficient dosage permanently reduced the potential of the medication to get rid of my acne, it also improved my body's ability to tolerate the medication.

Keep in mind that I've had problems with acne for 10 years. I stopped drinking milk and switched to sugar-free (and dairy-free) almond milk. I eat plenty of fruits and veggies, get the right amount of sun at 5-10 minutes per day, exercise, do not use protein powder (which can cause acne), and eat healthy. The severity of my acne is significantly worse than average.

Another concern people have is that accutane causes birth defects. However, I'm male and accutane actually increases fertility in men:
https://www.ncbi.nlm.nih.gov/pubmed/26653640

Peoplealso get worried that Accutane causes depression. I have problems with depression, but Accutane didn't affect my mood. I have a female friend who took Accutane, and she said that Accutane made her moody. I believe that the difference may be that women's hormones change every month. Accutane has actually made me happier, because it has significantly reduced my acne.

So, if you [censored] have taken Accutane, especially if you've taken it for a third time, please let me know if it worked! My dermatologist said that the more Accutane people take, the more it works. So I believe that it is simply a matter of achieving the right dosage. Thanks!

I thought that a third course was not advised, in the UK at least.
Your derm is misguided - the more accutane you take the more likely you are to suffer from severe side effects and Vit A toxicity( google this). I would look at other articles if I was you; no one as yet has tested the fertility of the men suffering from sexual sides.
We know that testosterone, LH, and FSH are all reduced indicating that fertility may well be an issue.

Also if you suffer from depression you are NOT a candidate for accutane so if you derm knows this and still prescribes it for you he is acting recklessly and should be reported!

On 4/29/2018 at 2:23 PM, hatetane said:

I thought that a third course was not advised, in the UK at least.
Your derm is misguided - the more accutane you take the more likely you are to suffer from severe side effects and Vit A toxicity( google this). I would look at other articles if I was you; no one as yet has tested the fertility of the men suffering from sexual sides.
We know that testosterone, LH, and FSH are all reduced indicating that fertility may well be an issue.

Also if you suffer from depression you are NOT a candidate for accutane so if you derm knows this and still prescribes it for you he is acting recklessly and should be reported!

Hi everyone reading this! I think that it would be a disservice to the acne community to not address this response to my post titled "Taking Accutane for a Third Time."

The user who posted this, hatetane, has presented you with misinformation. I respect and appreciate the attempt to help provide advice, but I've had three dermatologists who've provided me with more accurate information:
-vitamin A toxicity is uncommon in Accutane patients (although must be considered of course):
https://www.ehealthme.com/ds/accutane/vitamin-a-toxicity/
-all 3of the dermatologists that I've gone through over the last few years have said that patients tend to build up an immunity to the medication as time goes on anyway but that vitamin A toxicity is uncommon. However, they draw your blood once a month just to make sure!
-patients with depression take Accutane frequently. Dermatologists will typically prescribe Accutane to people with depression as long as they regularly see a psychiatrist who's in contact with the dermatologist. Both the psychiatrist and dermatologist will monitor the patient's mood. This was done with me.
-male sex hormone levels and fertility are not negatively affected by Accutane, as described by the article in my post from the National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/26653640

Thank you all for educating yourself on Accutane! Again, I appreciate replies from dermatologists and people who have taken Accutane. Replies from other people may be misguided. Please cite your sources as I did. I appreciate a difference of opinion if it comes from a reputable source and/or is cited.

23 hours ago, homedesigner879 said:

Hi everyone reading this! I think that it would be a disservice to the acne community to not address this response to my post titled "Taking Accutane for a Third Time."

The user who posted this, hatetane, has presented you with misinformation. I respect and appreciate the attempt to help provide advice, but I've had three dermatologists who've provided me with more accurate information:
-vitamin A toxicity is uncommon in Accutane patients (although must be considered of course):
https://www.ehealthme.com/ds/accutane/vitamin-a-toxicity/
-all 3of the dermatologists that I've gone through over the last few years have said that patients tend to build up an immunity to the medication as time goes on anyway but that vitamin A toxicity is uncommon. However, they draw your blood once a month just to make sure!
-patients with depression take Accutane frequently. Dermatologists will typically prescribe Accutane to people with depression as long as they regularly see a psychiatrist who's in contact with the dermatologist. Both the psychiatrist and dermatologist will monitor the patient's mood. This was done with me.
-male sex hormone levels and fertility are not negatively affected by Accutane, as described by the article in my post from the National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/26653640

Thank you all for educating yourself on Accutane! Again, I appreciate replies from dermatologists and people who have taken Accutane. Replies from other people may be misguided. Please cite your sources as I did. I appreciate a difference of opinion if it comes from a reputable source and/or is cited.

http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf

Trust your derm mate = good luck with that!!

Why don't you ask them if they have seen this report?

Real report on actual accutane victims!

9 minutes ago, hatetane said:

http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf

Trust your derm mate = good luck with that!!

Why don't you ask them if they have seen this report?

Real report on actual accutane victims!

Thank you for the article! Also, I've trusted all of my dermatologists and am happy with their service.

I've seen articles such as this, but my personal experience has been that Accutane hasn't had any negative effects on me other than excessive dryness. The only issue I have with this article is that "the 689 events in 471 patients" doesn't state out of how many people those people were sampled from. Were these 471 patients out of a group of 1000, 10,000, etc? It gives no idea of what proportion of people taking Accutane experience this symptoms.

But it is important to trust (or not trust) your dermatologist based on whatever you're comfortable with. I trust my dermatologist, because she made sure I got my blood drawn every month while on the drug. She was professional and acted in a way that would be expected by law. A responsible dermatologist would end treatment if there were serious side effects.

However, some side effects occur several months to years after treatment, so even a fully-qualified dermatologist can't predict that-they can only assess potential risk factors. Luckily, it's been 2 years since I first took Accutane and I've been fine! My Mom took the medication when she was younger, so I felt comfortable taking it.

But again, major side effects such as vitamin A toxicity are rare. As I showed with this article:
https://www.ehealthme.com/ds/accutane/vitamin-a-toxicity/
4 out of 29903 Accutane patients experienced vitamin A toxicity.

So, my conclusion is that Accutane is probably harmless for most people, but you need to talk to a dermatologist to access whether you're at a high risk of developing side effects during or after treatment.
My condolences to you if you've experienced major side effects, which is my guess since you seem to be very anti-prescription drugs in general (based on your profile).

I think that prescription drugs are often abused and can be dangerous, so I only feel so positively about Accutane because of my experience.

1 hour ago, homedesigner879 said:

Thank you for the article! Also, I've trusted all of my dermatologists and am happy with their service.

I've seen articles such as this, but my personal experience has been that Accutane hasn't had any negative effects on me other than excessive dryness. The only issue I have with this article is that "the 689 events in 471 patients" doesn't state out of how many people those people were sampled from. Were these 471 patients out of a group of 1000, 10,000, etc? It gives no idea of what proportion of people taking Accutane experience this symptoms.

But it is important to trust (or not trust) your dermatologist based on whatever you're comfortable with. I trust my dermatologist, because she made sure I got my blood drawn every month while on the drug. She was professional and acted in a way that would be expected by law. A responsible dermatologist would end treatment if there were serious side effects.

However, some side effects occur several months to years after treatment, so even a fully-qualified dermatologist can't predict that-they can only assess potential risk factors. Luckily, it's been 2 years since I first took Accutane and I've been fine! My Mom took the medication when she was younger, so I felt comfortable taking it.

But again, major side effects such as vitamin A toxicity are rare. As I showed with this article:
https://www.ehealthme.com/ds/accutane/vitamin-a-toxicity/
4 out of 29903 Accutane patients experienced vitamin A toxicity.

So, my conclusion is that Accutane is probably harmless for most people, but you need to talk to a dermatologist to access whether you're at a high risk of developing side effects during or after treatment.
My condolences to you if you've experienced major side effects, which is my guess since you seem to be very anti-prescription drugs in general (based on your profile).

I think that prescription drugs are often abused and can be dangerous, so I only feel so positively about Accutane because of my experience.

I looked at the article you provided again: http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf
It does not say that those observations were under controlled conditions, such as whether those observations were made during the course of Accutane treatment. In contrast, my article:
https://www.ncbi.nlm.nih.gov/pubmed/26653640
states that observations were made during the course of Accutane treatment and under other controlled conditions. This issue with the study in your article is that those observations may've been reported well after the course of treatment. This means that the symptoms experienced could've been a result of any number of other issues that those patients experienced that had nothing to do with Accutane, such as other prescription medications. The article you provided is not reputable.

Finally, I have looked at your replies to my posts so far and I believe that there is a bias against Accutane that is so strong that you're not willing to see the other side of the argument. On the other hand, I've looked at your article and conceded that the sexual dysfunction symptoms probably are in fact sometimes caused by Accutane. In order to have credibility, you have to address my arguments and articles, not just present your own arguments and articles. You have to at least acknowledge the other side to have credibility. Furthermore, I have no personal agenda, marketing agenda, or religious agenda, but I feel that you may have some other motivation. That's fine, but I have no interest in that. For that reason, I look forward to reading your future replies but I will not be replying to them. I think you're a good person, but your language makes me think it's time to move on. Respectfully, homedesigner879. Have a professional day.

On 5/3/2018 at 12:45 AM, homedesigner879 said:

I looked at the article you provided again: http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf
It does not say that those observations were under controlled conditions, such as whether those observations were made during the course of Accutane treatment. In contrast, my article:
https://www.ncbi.nlm.nih.gov/pubmed/26653640
states that observations were made during the course of Accutane treatment and under other controlled conditions. This issue with the study in your article is that those observations may've been reported well after the course of treatment. This means that the symptoms experienced could've been a result of any number of other issues that those patients experienced that had nothing to do with Accutane, such as other prescription medications. The article you provided is not reputable.

Finally, I have looked at your replies to my posts so far and I believe that there is a bias against Accutane that is so strong that you're not willing to see the other side of the argument. On the other hand, I've looked at your article and conceded that the sexual dysfunction symptoms probably are in fact sometimes caused by Accutane. In order to have credibility, you have to address my arguments and articles, not just present your own arguments and articles. You have to at least acknowledge the other side to have credibility. Furthermore, I have no personal agenda, marketing agenda, or religious agenda, but I feel that you may have some other motivation. That's fine, but I have no interest in that. For that reason, I look forward to reading your future replies but I will not be replying to them. I think you're a good person, but your language makes me think it's time to move on. Respectfully, homedesigner879. Have a professional day.

I have to laugh. You very clearly do have an agenda so I am wondering exactly who you are.
I am glad you do not want to discuss it further - pretty much what MHRA have to say.
I didn't roam the internet and find my article - it's the one MHRA(regulators if you don't already know lol) referred me to. They commissioned the study (I assume) and I absolutely agree that they do not provide us with any adequate data - not much transparency there I'm afraid!
You say you trust your dermatologist(s) that's fantastic, I hope they are there for you IF things go wrong.
Can they bring the dead back?
Do I think doctors are intentially bad - no
You, like many think doctors have all the answers! Doctors think they have all the answers!
Patients have the right to be informed and doctors generally are not informing them and they act as if they know better than the patient. For many reasons, including lack of time, doctors are not able to give their patients the care that they deserve so I appreciate they have a difficult job.
What is wrong thought is that a dermatologist would prescribe a medication, some, ignoring every safeguard, and actually describe a known controversial drug as a MIRACLE.
Then when you tell them that the drug gave you heinous side effects that destroyed your life they treat you like you are a crazy person. They don't acknowledge your side effects and they continue to prescribe the medication to innocent young people with no conscience at all.
If I was a doctor and I accidentally or inadvertently hurt even just one patient i would consider a change of career. At the very least I would be asking many questions of the regulators and undertaking research so that I could make sure my patients were fully informed and safe.
Accutane should continue to be available to very severe cases but research should be undertaken to find safer ways to treat acne. Certainly no kid should be prescribed accutane.
And the regulators should prepare a contract for every dermatologist to share with a patient so that every
dermatologist is accountable and able to prove that they informed patients of the true risks and adhered to the safeguards that are apparently in place.
Doctors are not gods and this mentality needs to be nipped in the bud so that patients take responsibility for their own health instead of entrusting it to random medical professionals.
Would you like to share with us what your agenda is?

No don't bother - I am not interested!