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tootle

Accutane and oily skin - permanent cure?

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Hi folks,

this is my first post, although I've been reading here for 18 months while I got up the courage to ask for a referral to the dermatologist to ask for Accutane, as I was scared of the side effects (I use contact lenses) so greetings to everyone :)

Ok, brief background - I'm F/34 and had horrendously oily skin (but only mild-ish acne) since the age of 8 which I at long last figured must be genetic (nothing worked) and persuaded the dermatologist to prescribe me Accutane for it, as I'd read here that it dries up the oil glands. He said he'd never prescribed it before just for oily skin and had to ask his head of department to get clearance for me but they both agreed to treat me, phew!

So now I've been on it for 3 months with brilliant results (30mg/day & I weigh 58kg) and only minor side effects (dry skin/rash on forearms & hands, dry lips) and am panicking at the thought of coming off it as it's given me back my self-confidence, freedom, time!!, money, etc etc. Since I've responded well to it my derm said he might end the treatment this month and not do 4 months which is his usual method - hence my panicking...

What I'd like to know is your own experiences with Accutane (or its generics) regarding the amount of oiliness you get after you finish the treatment, like whether it comes back or not, or how long it goes away for etc. I'd be especially interested if your skin was really excessively oily before - see my PS. The derm told me that acne patients ( i.e. on a higher dose than me, like 1mg per kg bodyweight) he's treated end up totally dry of oil, was this true for you?? (do i sound desperate, lol)

I had to be quite forceful but to state my case to get the treatment (he thought I might have dysmorphia) so I'd like to know if relapse seems likely, then I can ask for the 4th month on a higher dose.... I like this new life and don't want to go back to squeezing zits all evening and sneaking off to the ladies' every 1.5 hours to powder my face, bleargh!

thanks for reading! sorry it's a long one, looking forward to reading your experiences.

tootle

PS the 1.5 hours between powdering is no exaggeration, I'd wake up in the mornings looking like I was painted with oil ..... and now - I can put on makeup in the morning and stay shine free all day....bliss! *panic* lol

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I know what you mean by feel worried about coming off this pill. So far I'm really loving this medicine. Like you, I was really really oily before. Now, since I've been on 'tane, I could go the entire day with nice make-up, no oil (!!!) and look like I just applied my make-up. I don't have to blot again compared to having to blot every half hour before I went on this med. So, I hope someone can shed some light for us. Good question. Good luck. =)

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Hi dollyapples!

I was about to message you !! I just read your post in the diary section where you said that your derm prescribes accutane for oily skin - any chance of asking her the answer?! My derm has never prescribed it just for that before, so i'm the guinea pig...

cheers!

tootle

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well it definately comes back to a lesser degree

before I was horribly oily on my cheeks and chin etc

now it's back but no where as bad but in my Tzone my nose and forehead area

it's weird how it works tho but it did wonders

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im a little more then a month into accutane, and the oil ALLEGEDLY went away 3 weeks in, but now its starting to come back for some reason even before i got my dosage upped to 60 mg 2 days ago. My nose used to get fully oily within an hour, and 3 weeks into 'tane it took the whole day to find any oil on it. Now its coming back a little and on my cheecks there is a shininess/oiliness that looks like its not wipeable (if thats a word) Hopefully the 60 mg will dry me out a little more. I just have to find a good moisturizer before it does!

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Hi folks,

this is my first post, although I've been reading here for 18 months while I got up the courage to ask for a referral to the dermatologist to ask for Accutane, as I was scared of the side effects (I use contact lenses) so greetings to everyone :)

Ok, brief background - I'm F/34 and had horrendously oily skin (but only mild-ish acne) since the age of 8 which I at long last figured must be genetic (nothing worked) and persuaded the dermatologist to prescribe me Accutane for it, as I'd read here that it dries up the oil glands. He said he'd never prescribed it before just for oily skin and had to ask his head of department to get clearance for me but they both agreed to treat me, phew!

So now I've been on it for 3 months with brilliant results (30mg/day & I weigh 58kg) and only minor side effects (dry skin/rash on forearms & hands, dry lips) and am panicking at the thought of coming off it as it's given me back my self-confidence, freedom, time!!, money, etc etc. Since I've responded well to it my derm said he might end the treatment this month and not do 4 months which is his usual method - hence my panicking...

What I'd like to know is your own experiences with Accutane (or its generics) regarding the amount of oiliness you get after you finish the treatment, like whether it comes back or not, or how long it goes away for etc. I'd be especially interested if your skin was really excessively oily before - see my PS. The derm told me that acne patients ( i.e. on a higher dose than me, like 1mg per kg bodyweight) he's treated end up totally dry of oil, was this true for you?? (do i sound desperate, lol)

I had to be quite forceful but to state my case to get the treatment (he thought I might have dysmorphia) so I'd like to know if relapse seems likely, then I can ask for the 4th month on a higher dose.... I like this new life and don't want to go back to squeezing zits all evening and sneaking off to the ladies' every 1.5 hours to powder my face, bleargh!

thanks for reading! sorry it's a long one, looking forward to reading your experiences.

tootle

PS the 1.5 hours between powdering is no exaggeration, I'd wake up in the mornings looking like I was painted with oil ..... and now - I can put on makeup in the morning and stay shine free all day....bliss! *panic* lol

The oil came back for me 6 months after but I was only on 10mg a day for teh three months. I recommend going for the 4th month!

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well it definately comes back to a lesser degree

before I was horribly oily on my cheeks and chin etc

now it's back but no where as bad but in my Tzone my nose and forehead area

it's weird how it works tho but it did wonders

I'll even be satisfied with that.

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Hey tootle,

I used to be very oily. I had to wipe off my face around 8 times a day. Now, I'm going on my 3rd month (1mo 40mg x1 a day, 1mo 40mg x 2 a day) and my oil has basically diminished.

My doc told me that Accutane is the only treatment that will permanently shrink your sebaceous (oil) glands. They think that "Blue Light" therapy will do it also, but it is too new and no studies have been concluded yet. Accutane is the only way to be sure.

I hope your treatment works out well. So far mine has. I've been clear for two months!

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Thanks for your replies guys, keep em coming!

It would be interesting to know people's weights as well as dose level, to compare them directly, like.

(ooh, a scientist, argh!)

Because my derm has never prescribed accutane just for oiliness I think he's playing it safe by not increasing my dose. The last time I saw him he had a middle-eastern guest doctor there and I felt too awkward to ask for a higher dose...I thought, oh no, he'll think we're all silly and vain... but I wish I had. There's a 13 week waiting list for appointments so I'm dreading my skin going back to square one and I'll have a massive wait again, duh.

The derm people share a waiting room with the diabetes clinic and in the consulting room there's posters of skin cancer and so I feel like I'm making a fuss over nothing, even though it used to run my life.

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Hi Tootle :)

I'm roughly 100 lbs and I'm on 40 mg's of Amnesteem daily. I also wonder if that's a strong enough doseage for me. I have mild acne though but have very oily skin bothered me just as much as my acne did. So, I'm keeping my fingers crossed and praying that this medication is a permanent solution to my excessive oiliness.

About asking your derm about an increase in your dosage, I would totally do it. Don't feel too shy to ask him about anything you might be pondering about or worried about. After all, you are paying him for his services and you're taking something very strong to rid you of an unfortunate medical problem. I didn't hesistate in asking my derm for an increase but she responded by telling me she didn't want to increase my doseage because she was fearful of my body not responding well to the medication. She explained that since I'm a tiny girl that any increase would might make my side effects feel a lot worse and that I might not be able to take it and want to quit. She continued to explain that she had patients that got off the medicine because of that. Furthermore, she said that 40 mg's a day for 6 months, possibly 7 months would do the trick. So, I'm taking her advice and hopefull I won't be let down. I guess I have to follow my derm's advice.

As for yourself, ask your derm any questions you may have. Never feel as if you're bugging them. I bug my derm a lot, rightfully so. :) Good luck!

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Hi, Tootle. How's your skin coming along? Are you still on Accutane? Has the oiliness come back?

I'm in the same boat as you. I'm F/37, and have the most ridiculously oily skin. It's actually oilier now than it was when I was a teen. Like you, I wake with my face looking as if I had dipped it in oil. I get shiny all over within 30 minutes of washing, and normally go through 4 Shiseido blotting sheets in 7 hours.

I've considered requesting Accutane to combat the oiliness, but am concerned, too, that it's only a temporary fix. My acne is not extreme, but it's definitely there (small red pimples, blackheads and whiteheads).

I read somewhere that sometimes it takes 2 rounds of Accutane to make zits go away forever, and I wonder whether this sort of approach would work for oiliness, too?

Anyway, thanks to your post, I am going to talk to a dermatologist about Accutane. I thought it couldn't be done, but now I see that it can be. Thanks.

Greengirl

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So far, three months post 'tane, my oil has come back, but it's about three billion times better than it was before 'tane. I don't blot yet, just use powder. It's nice, because now my skin is more normal rather than oily. Towards the end of my 'tane course, I was getting tired of the super dryness, so having some moisture now is nice. I ended on 80 mg/day in my sixth month, so the dryness was out of control.

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almost 1 month post tane.

Oil came back but only in the T-zone and around the nose

I used to be super oily.

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Hi, Tootle. How's your skin coming along? Are you still on Accutane? Has the oiliness come back?

I'm in the same boat as you. I'm F/37, and have the most ridiculously oily skin. It's actually oilier now than it was when I was a teen. Like you, I wake with my face looking as if I had dipped it in oil. I get shiny all over within 30 minutes of washing, and normally go through 4 Shiseido blotting sheets in 7 hours.

I've considered requesting Accutane to combat the oiliness, but am concerned, too, that it's only a temporary fix. My acne is not extreme, but it's definitely there (small red pimples, blackheads and whiteheads).

I read somewhere that sometimes it takes 2 rounds of Accutane to make zits go away forever, and I wonder whether this sort of approach would work for oiliness, too?

Anyway, thanks to your post, I am going to talk to a dermatologist about Accutane. I thought it couldn't be done, but now I see that it can be. Thanks.

Greengirl

Guys,

I have been down this road (being very oily with and without acne) of wanting to go on Accutane and I did twice. The first time it stopped my cystic acne and my oily skin; the second time I went on it I was attempting to halt the shine coming back as well as the mild acne that was a consequence of the shine. The shine still came back; although the Accutane physically shrinks the sebaceous gland, it does not permanently block/impede androgens registering there, which is what you ultimately need to do, to halt the shine. If your face it really very oily, the sebaceous gland shrinking may not be enough: you MAY need to block the androgen receptor which allows the sebaceous gland to function. In a word, anti-androgens are what you need and fortunately many dermatologists are more than willing to prescribe these, especially if you are a female. The following discusses low dose isotretinoin for controlling seborrhea, but I would personally probably avoid it, if other options were available:

J Dtsch Dermatol Ges. 2003 Dec;1(12):952-8. Related Articles, Links

Very low dose isotretinoin is effective in controlling seborrhea.

Geissler SE, Michelsen S, Plewig G.

Department of Dermatology and Allergology, Ludwig-Maximilian-University, Munich.

BACKGROUND: Excessive seborrhea, coarse-pored skin, minimal acne and oily scalp hair comprise a well-known clinical entity. It causes considerable concern, has social impact, and affects the quality of life in some individuals. Some patients seek treatment for seborrhea. No effective topical sebosuppressive medication is available. Oral isotretinoin is the only remedy for men. In women, oral isotretinoin is the most effective remedy, followed by antiandrogens. PATIENTS AND METHODS: Eleven patients in three groups were treated for 6 months with very low dose isotretinoin. The influence on seborrhea was measured during oral treatment with 5 mg/d, 2.5 mg/d, or 2.5 mg 3x weekly. RESULTS: Sebum production, measured with Sebutape, was reduced by up to 64%. Acne lesions regressed by as much as 84%. Follicular filaments were reduced by 66%. Microcomedones were reduced on average up to 86%. Quantitative bacteriology showed a reduction of Propionibacterium acnes but no increase of Staphylococcus epidermidis. Biopsies revealed a 51% reduction in sebaceous gland size. With Bentonite, a reduction of lipids was demonstrated with 2.5 and 5 mg isotretinoin/d but not with 2.5 mg 3x weekly. There was a shift within the lipid fractions: triglycerides dominated, followed by squalenes and free fatty acids. CONCLUSIONS: Good results were achieved in all patients. The small number of patients did not permit a statistical analysis of the three isotretinoin doses studied, but there was a tendency toward better results with the two higher doses.

PMID: 16285647 [PubMed - indexed for MEDLINE]

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I had extremely oily skin from the age of 12 onward. Suffocating, unrelenting oiliness that could only be cut with alcohol soaked erythromycin pads which I would use just to get that oppressive sludge off my face.

At 25 I went on Accutane and the oil was gone in a week. A year after finishing my Accutane course I started getting some slight oiliness and some breakouts. I did 40mg a week Accutane microdose for 8 weeks and the oil has not come back.

I've read all sorts of stuff on this. Some people claim the oil never goes away, or that it comes back the day they stop Accutane. Some say it went away forever. Some say it went away for years but then came back.

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^^I'm glad to hear that, but as you said, it is all pot luck.

^^I'm glad to hear that you're glad to hear about what I said, and as I already said and then you said I said, it's all pot luck.

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I haven't read all the replies, but wanted to add that I was on 2 courses of accutane. I'm going on almost a complete 6 months of being off of it. And my face doesn't break out as bad, but is definately more oily now then it was before. I use retin a now, and that helps with the oil, but its horrible just like you said. I feel painted! I am about 140lbs 28 years old and was on 2, 6 month courses of 80mg..

Good luck to you sweetie!

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I haven't read all the replies, but wanted to add that I was on 2 courses of accutane. I'm going on almost a complete 6 months of being off of it. And my face doesn't break out as bad, but is definately more oily now then it was before. I use retin a now, and that helps with the oil, but its horrible just like you said. I feel painted! I am about 140lbs 28 years old and was on 2, 6 month courses of 80mg..

Good luck to you sweetie!

Mandy,

Look into the Spironolactone! Herbs like Vitex and Saw Palmetto may be worth while also.

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Tootie,

I wanted to thank you for starting this post, there are many people with acne due to sensitive skin etc, although there are really a handful of excess oil people like us( w/wo acne). To be honest, Im on my 2nd week of Accutane and to my suprise my skin is starting to become oily agian this week, its really confusing me becuase I not sure how to handle it, I actually started to use OXY face wash with 10% BP in fear that the excess oil will creat a breakout, although my younger sister had became upset and hid it from me since Im on the medication (Accutance) , so hopefully someone one day will find an effective and affordable method or cure to reduce our oil glands so we can live our lives as normal people with out having to visit the mens room (or ladies) to constantly wipe our forheads dry :cry:

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Yes brilliant post, thanks I am following with interest, though I know that my reaction to my own oiliness is psychologically excessive and I suffer from elements of body dysmorphia when it comes to oiliness and blackheads.

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Yes brilliant post, thanks I am following with interest, though I know that my reaction to my own oiliness is psychologically excessive and I suffer from elements of body dysmorphia when it comes to oiliness and blackheads.

Mine too! Post-tane two months and I am oily, and it is messing with my head. I am more paranoid of having oily skin and hair more than anything.

I think this is ruining my life :(

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I had super super oily skin, and took accutance 80 mg for 5 months.

I stopped taking accutance in February and still have no oil.

My face is back to being regularly hydrated, but it is by no means oily.

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