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mameha

Accutane recommendation - is my derm nuts?

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This is how my skin currently is:

100% clear except for a few red spots from previous acne and one large cyst by my nose.

My dermatologist took one look at that and said, "You should try accutane, it'll work wonders!!"

This was after I told him that I'm very prone to depression. His response was, "Oh pfft, those reports about suicidal Accutane users, those are really misleading because most people on Accutane are young and more susceptible to suicidal thoughts."

I've had four cysts in my entire life (only brought on by stress) and otherwise super mild acne.

So all I can think about my dermatologist is: O_O

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Yes I agree. I don't think you need the medication at all and the risks of depression are not worth it in your situation. I'm not a doctor but I would not take it if I were you.

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It sounds like you already know the answer. If you're looking for reassurance....you have it.

There are REAL side effects with Accutane that should not be ignored. It doesn't sound like your dermatologist "cares" a lot about you as a patient; I'd find a new derm.

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Question: If your acne is so mild, why do you have a dermatologist?

My acne goes from mild to severe when I'm stressed out. I've gone in to have a couple of cysts injected.

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There are REAL side effects with Accutane that should not be ignored. It doesn't sound like your dermatologist "cares" a lot about you as a patient; I'd find a new derm.

Yeah the derm I normally see was out having knee surgery. She would actually sit down and advise me about skin care and ask me further questions to help me. This guy had his head up in the clouds.

Yes I agree. I don't think you need the medication at all and the risks of depression are not worth it in your situation. I'm not a doctor but I would not take it if I were you.

I'm glad it's worked great for some people but the side effects just aren't worth it for me.

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I would take it if I were you....just think about the possibility of never getting a zit ever again in your life! Just take accutane. I wish I had your derm- I had to go to three different ones just to get the prescription.

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"just think about the possibility of never getting a zit ever again in your life!"

accutane is NOT magic

"most people on Accutane are young and more susceptible to suicidal thoughts."

lmao, idiot

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Guest tenshigirl25

maybe he just thinks u are prone to getting cysts..accutane will clear it up though and it shrinks your pores. maybe low dose? its up to u, since u have the green light..

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maybe he just thinks u are prone to getting cysts..accutane will clear it up though and it shrinks your pores. maybe low dose? its up to u, since u have the green light..

Yeah it is incredibly tempting. I just want something to get rid of this one cyst, it's like this big glaring "Ha ha you'd have great skin if it weren't for me" mark on my face.

I think I'll try draining it and see how things go. Accutane's probably gonna be my last resort.

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Hi,

I have mild to moderate persistent acne. The persistency of it is what killed me. Everytime I'd get one little bastard cleared up, another would appear....and then this summer all hell broke loose on my face and that's when I'd say I went to moderate....but then my dr. put me on bcp and antibiotics and retina....I think the combo of all 3 was helping, but I had done all of these before for acne and it always just came back and never truly got rid of it 100%.....

Also, I am prone to depression and actually take anti-depressants. My derm was very leary to give me tane, but I talked to my GP and she talked to my derm and said I was *stable*, but my dh has seen me at some low depressive points in my life, and he knows what to watch for, and is to call the derm if he thinks there is an issue. But honestly, I have to say that I haven't felt this good about myself in a LONG time! If you read my journal you'll see my raves about how my confidence has come back. I couldn't be happier to be on the stuff.

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i would get a second opinion from another derm...i dont think accutane is worth it especially if you only have mild acne....my derm told me that if anyone has any history of depression then she definately wouldn't prescribe it for them..

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get outta there!! that derm is bad news. I have uber mild acne that sounds very much like yours most of the time thats totally managed with antibiotics and an occasional topical when i flare up. I wouldn't dream of trying accutane because it would fry my liver (i had mono over the summer and so my liver is pretty messed up). If you don't think you need it you don't. Find a derm that will at least put you on antibiotics instead to treat flare ups

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First of all, you should post some pictures, so we can see for ourselves what your derm was looking at. It never ceases to amaze me the number of people who turn up in the acne.org gallery with cystic, scarring acne who are able somehow to delude themselves into thinking their "mild" acne couldn't possibly make them candidates for Accutane.

I'm not saying you yourself are minimizing your acne problem, but it's possible.

Secondly, it's a complex decision whether and when to take Accutane.

If you have a cyst, you have cystic acne. That is significant. You don't want to fool around with cystic acne because it only takes one cyst to leave a nice big crater.

Maybe you won't scar. Maybe you'll never have another cyst ever again. But then again, maybe 6 months down the road you'll get three in one week and your face will be disfigured permanently.

When a derm sees any sign of cystic acne, it's perfectly reasonable to discuss Accutane. Some are more aggressive about treatment than others, but it's certainly not "nuts."

Accutane is what you take when you have cystic acne. You have cystic acne. It's impossible to predict how your condition will evolve, or if you will scar. But Accutane is a fairly surefire way to stop cystic acne and prevent possible scarring.

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This was after I told him that I'm very prone to depression. His response was, "Oh pfft, those reports about suicidal Accutane users, those are really misleading because most people on Accutane are young and more susceptible to suicidal thoughts."

Well, this part is true. The most recent study of Accutane and depression found that depression actually improved in Accutane patients as their skin cleared up. And the incidence of suicide while taking Accutane is actually lower than in the general population. The warning is only on the box because some senator made Accutane the scapegoat when his son commited suicide, even though there is actually no statistically significant evidence that links Accutane to suicide or depression. Hell, here in Tampa some kid ran a small plane into a building downtown, commiting suicide and leaving some note indicating admiration of Osama bin Laden. The media immediately went into Accutane frenzy and blamed it all on Accutane since the kid had an Accutane prescription. But it turned out at his autopsy that while he had a prescription, he hadn't actually taken it - there wasn't a trace of isotretinoin in him. Apparently just having an Accutane prescription written for you can cause you to commit suicide, eh? :rolleyes:

That said, your acne definitely doesn't sound severe enough to even consider Accutane.

Accutane is what you take when you have cystic acne.

It's for SEVERE, persistent cystic acne, not for one cyst. That's what injections are for.

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First of all, you should post some pictures, so we can see for ourselves what your derm was looking at. It never ceases to amaze me the number of people who turn up in the acne.org gallery with cystic, scarring acne who are able somehow to delude themselves into thinking their "mild" acne couldn't possibly make them candidates for Accutane.

I'm not saying you yourself are minimizing your acne problem, but it's possible.

Secondly, it's a complex decision whether and when to take Accutane.

If you have a cyst, you have cystic acne. That is significant. You don't want to fool around with cystic acne because it only takes one cyst to leave a nice big crater.

Maybe you won't scar. Maybe you'll never have another cyst ever again. But then again, maybe 6 months down the road you'll get three in one week and your face will be disfigured permanently.

When a derm sees any sign of cystic acne, it's perfectly reasonable to discuss Accutane. Some are more aggressive about treatment than others, but it's certainly not "nuts."

Accutane is what you take when you have cystic acne. You have cystic acne. It's impossible to predict how your condition will evolve, or if you will scar. But Accutane is a fairly surefire way to stop cystic acne and prevent possible scarring.

Well this cyst was brought on by my own stupidity - I went to bed without washing my face. Yes it was dumb and I'm paying for it dearly. The other cysts were brought on when I was stressed out. Otherwise I don't break out at all. No body acne, with maybe one or two pimples a month.

My family's history of acne: zero. My 17-year-old brother gets one zit a year and he doesn't even wash his face.

I think I've found something that works for me. I tossed all my medications in the trash and started using the Jessfoliation regimen. For two weeks I've been 99.9% clear and I can see the cyst shrinking by applying hydrocortisone and neosporin creams.

If I get even one more cyst I'll consider going on accutane but for now it's not worth it for me. Why should I go on something so drastic if I respond to other treatments (e.g. antibiotics)?

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This is how my skin currently is:

100% clear except for a few red spots from previous acne and one large cyst by my nose.

My dermatologist took one look at that and said, "You should try accutane, it'll work wonders!!"

This was after I told him that I'm very prone to depression. His response was, "Oh pfft, those reports about suicidal Accutane users, those are really misleading because most people on Accutane are young and more susceptible to suicidal thoughts."

I've had four cysts in my entire life (only brought on by stress) and otherwise super mild acne.

So all I can think about my dermatologist is: O_O

Accutane for one cyst??

I had a derm put me on accutane once...I was getting about 1 cyst per month.....after 3 weeks, i was sick as shit and felt so bad and achey, i could hardly get out of bed. I stopped and switched derms....my current derm said i was NOT a candidate for accutane, especially since my cysts tend to come and go (stress induced, like yours) ...I had great success with clearing my cysts in the past by a combination of microdermabrasion and Tazorac...when i did that, I was clear for about 8 months!! While i couldn't afford to continue the microderm ( at $115 a pop!!) I am going to try the jessfoliation, continue the tazorac ( Avage) and keep reading this site to get tips...

I just wouldnt recommend accutane for 4-5 cysts per year.....

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Accutane for one cyst??

I had a derm put me on accutane once...I was getting about 1 cyst per month.....after 3 weeks, i was sick as shit and felt so bad and achey, i could hardly get out of bed. I stopped and switched derms....my current derm said i was NOT a candidate for accutane, especially since my cysts tend to come and go (stress induced, like yours) ...I had great success with clearing my cysts in the past by a combination of microdermabrasion and Tazorac...when i did that, I was clear for about 8 months!! While i couldn't afford to continue the microderm ( at $115 a pop!!) I am going to try the jessfoliation, continue the tazorac ( Avage) and keep reading this site to get tips...

I just wouldnt recommend accutane for 4-5 cysts per year.....

Yeah I got 4 cysts over a period of three years, I dunno if it was purely coincidental but if I applied Proactiv's repairing gel to a pimple it would sometimes blow up into a cyst heh. The other derm I saw didn't say anything about accutane.

I'm sorry you had to go through that with accutane :/, if your acne's like mine you'll probably respond really well to the jessfoliation, good luck with everything!!

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Accutane is what you take when you have cystic acne.

It's for SEVERE, persistent cystic acne, not for one cyst. That's what injections are for.

It's for acne that can scar.

Cysts scar. And injecting a cyst is not even close to a reliable method of scar prevention. Go on the scar forum and ask how many people were left with inch-wide craters on their face after a cortisone injection.

Listen gang, we all know it's fun to play it fast and loose and second guess everybody's "idiot" derm, but at the end of the day, consider the possibility that after 10 years of schooling and intensive training, and however many years of day-in-day-out clinical practice and hands-on experience with acne and its treatment, these people might know a thing or two.

Maybe he's seen one too many cystic acne sufferers forego Accutane only to deeply regret it later. It's not uncommon; there's plenty of people like that on this board.

It's obviously his opinion that the benefits of Accutane outweigh the risks in your case. The bottom line is that you can find another derm who agrees with him and another who says the exact opposite if you like. It's your decision. How confident are you that your cystic acne is under control, or can be controlled with antibiotics or whatever?

It's a gamble either way. Accutane can give you about a 60% assuredness that your cystic acne will be eliminated and you will never have to worry about it, or scars, ever again. On the other hand, there's about a 1 in several thousand chance that something will go wrong. About the same odds of being in a fatal car accident the next time you go to the store to get milk.

The dry lips do suck though.

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accutane dosnt cause depression and it has about an 85percnet chance to keep you clear for the rest of your life.

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From the indications text:

Accutane is indicated for the treatment of severe recalcitrant nodular acne. Nodules are inflammatory lesions with a diameter of 5 mm or greater. The nodules may become suppurative or hemorrhagic. "Severe," by definition, means "many" as opposed to "few or several" nodules. Because of significant adverse effects associated with its use, Accutane should be reserved for patients with severe nodular acne who are unresponsive to conventional therapy, including systemic antibiotics.

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