Isotretinoin (Accutane®)
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Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought...

Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought to clear acne primarily through its ability to permanently reduce skin oil (sebum) production.

Isotretinoin is available in capsule form and is usually taken twice a day. Your physician will prescribe an initial dose, and this dose may increase or decrease depending on the response to treatment and side effects.

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July 13, 2012

Pros:

Cleared my skin right up
Gave me confidence back

Cons:

Dry skin around mouth
Dry lips
nose bleeds (occasional)
Acne returned a few years later, went on a second course and a year and a half later has returned again.

I Started getting acne when I was around 14 and it got progressively worse. I tried everything and having it made me very self conscious and gave me anxiety. Went on Roaccutane when i was 18 and it defiantly worked, although was left with scars. Had clear skin (occasional spot) for about 2.5 years but acne returned and had to go on a second course. Again worked very well but now 2 years later I have been prescribed a 3rd round. Hesitant to start it as I just think that my acne will return again. Also its a catch 22 as I can suffer from anxiety which can be caused by my bad skin, but the only treatment that really works can also cause anxiety/depression etc, so its just weighing up the risks. I would defiantly recommend this to anyone with bad acne that brings them down. At the very least you will have a happy few years acne free.
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June 18, 2012

Pros:

Fixed my skin

Cons:

Dry skin initially
Big break out initially

Did the job when nothing else could! As a nurse, I was worried about the possible side-effects of such high doses of Vit A, so I lived with acne for 20 years until I had finally had enough. First 6 weeks was a bit of a breakout nightmare - lived in isolation! Lips were very dry but that was it. Couldn't believe I had lived with acne for so long when there was an answer. Good luck!
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May 17, 2012

Pros:

clear skin
confidence
non greasy hair & skin

Cons:

initial breakout
dry skin/lips/eyes

I had been struggling with acne since the 7th grade. I literally probably tried every dermotologist prescribed medication on the market. Finally, my derm prescribed me accutane in 11th grade. My skin at this point was BAD. cystic acne all over my chin mostly. I was so insecure I would leave at the bell and go straight home. I was too embarassed to have much of a social life. I'm not going to lie, the initial breakout was horendous and I wouldn't wish it on my worst enemy. My skin got about 10X worse before it started clearing up. But it was worth it. By the 2nd month my skin was mostly clear. My lips however were suuuuper chapped and cracked. At the end of my 5 months of accutane my skin was completely clear and I was amazed!!!! My acne stayed away for most of 12th grade and I was back to my confident self. However, when I approached 2nd semester of college my skin started to break out agaiun. I am on accutane again and hope to see the same results. The initial breakout was, once again, horendous.but lucky for me I went on a trip and had 2 weeks off of work :) I really hope this is the last time I have to go on accutane but it did change my life for the better. You just gotta keep at it and be educated and prepared! good luck!
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May 11, 2012

Pros:

-Completely cleared acne
-Hair was never greasy

Cons:

-Constant, never-ending dry, flaky, cracked lips
-Back pain/joint pain
-Dry eyes
-Mild depression

I began taking acne not because of the severity of my acne, but for the bright red blemishes they left behind. Any pimple whatsoever would leave a scar even though I religiously refused to pop or pick at them. Accutane was amazing at clearing my skin, which gave it time to heal and diminish the severity of my scars. I was on accutane for 6 months, the last three months I was taking 80 mg/day. During these 6 months I only got 4 pimples which I think is pretty amazing. I have been off of accutane for about 10 days and I am praying my acne never returns because to be honest, I'm not sure I would ever want to go back on the drug. Yes, it was a MIRACLE at clearing my skin but the depression I experienced throughout the process was very difficult to deal with. However, thousands of people have taken this drug without any depression so I'm only saying this as a cautionary warning. The dry lips were a huge pain but my lips have already returned to their original state! I would undoubtedly recommend this drug to anyone since we all experience and react to drugs differently, but only after telling them to proceed with caution. Accutane can and will give you your confidence back!
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April 12, 2012

Pros:

Cleared it up
**but comes back after being off of it for 3 years**

Cons:

severe headaches
body ached
tired
lips were drying and chapping
lack of energy
ankles hurt
NOT a cure just will fix it for a few years**

it will be a temp relief it doesnt cure hormonal acne.
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April 1, 2012

Pros:

-Worked, completely cleared up acne all over face and body
-makes skin really dry and it peels (makes scars go away faster)

Cons:

-lips get really dry
-depression (not too severe)
-results not permanent

I took it 3 years ago, it worked really well. I was acne free for 3 years but broke out again a month ago. The break out wasn't as bad as it was before and I was able to treat it immediately with retin A
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March 24, 2012

Pros:

Gets rid of acne

Cons:

Did nothing for blackheads or pore size.
Very expensive.
Minor dryness
Reduced night vision

I was on 40mg for 6 weeks, then 60mg for 12 weeks. It cleared my acne slowly, with no major peeling/dryness and no initial breakout. I guess I'm not an average case, because I didn't experience many of the side effects that people do. I did, however, notice a pretty big difference in my night vision and was sometimes even uncomfortable driving at night. I also scarred extremely easily, and my arms got a weird rash, which was super itchy. I now have blotchy white scars all over my arms from scratching them. I still have blackheads and large pores on my cheeks, which is a little disappointing. Overall, this drug achieves what it's supposed to. Considering my lack of major side effects, I'd recommend it if you can afford it/have good insurance.
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March 18, 2012

Pros:

-acne clearing already
-smoother skin
-so easy
-nicer hair (explanation below)
-lost 10 lbs from less appetite (sweet!)

Cons:

-chapped lips
-eczema on hands
-iPledge is a hassle

I am a 19 year old caucasian female who has struggled with acne since I was 12. It's gotten worse on and off since then and sometimes been completely clear but I started college last fall and my acne got completely out of control. I had tried literally everything: Duac, Differin, Minocyclene (antibiotic), Atralin, washes, creams, lotions, etc. and nothing worked. I went to three derms who all suggested accutane. I didn't have deep cyctic acne but more like many small bumps on my forehead and cheeks that never really went away. The iPledge program is a real bummer, mostly just because you have to wait a month to start taking the pills. But it's so worth it! I've been on accutane for three weeks now and although I wasn't expecting it to work at all for eight weeks my skin already looks worlds better! Most of the little bumps have gone away and my face isn't so red and inflamed. At this point I'm getting more white heads, but they are pretty sparse and go away quickly and that's what my derm told me to expect for the first few months. To moisturize, I use buckets of vaseline on my lips (don't use chapstick because that actually dries out your lips), and CeraVe PM moisturizer on my face morning and night. I use CeraVe or Cetaphil cleanser, which is really gentle. So far I haven't experienced any severe side effects other than minor dryness, but I'm keeping track of anything that could be a symptom just to be safe. One good thing about the dryness is that I don't have to wash my hair every other day! It never gets oily and I can make a blow out last for 5 or 6 days! Hope that lasts after I stop Accutane! Bottom line is Accutane is definitely a personal choice and I'm sure it's better for some people than others but why not try something that has worked wonders for many. I feel so good! *About the high cost, my insurance is super high deductible so essentially we pay out-of-pocket prices until we hit a certain amount and the insurance kick
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March 17, 2012

Pros:

- Dried up my skin very quickly (started from day 2)
- My skin became perfect. My dad said my skin looked like someone had smoothed it with sandpaper then polished it! Haha. Poreless skin!
- My 'mucus' inside my nose dried up as well. I always had a very runny and blocked nose, accutane completely took care of that.
- Smooth skin, great increase in confidence, very quick results day after day
- Easy to swallow; smooth pill
- Allowed me to sleep better (more on that later, it is

Cons:

- Very, very tired after a week or so. Would have to take afternoon naps. But, when I slept, I would easily be knocked out for 8-9 hrs :)
- Lost a lost of hair, still losing hair. But sebaceous gland size is linked to amount of hair as well; oil glands shrink/get destroyed --> naturally less hair
- Back pain when lying down, weirdly achy joints
- Horribly itchy eczema outbreak all over my body. Had to use soap free wash for months. Had trouble sleeping b/c it was so itchy
- Mental si

17, female, Asian, moderate on face, severe acne on back (cystic). 40mg/day (20/20), 45kg, slim build. Let me start by saying this - I did not regret taking accutane at all. BUT, I would also never take it again, unless I have an absolutely terrible cystic outbreak and I get put on a VERY low dose. The physical side effects I could tolerate; but the burden of reading about its negative side effects THEN finally experiencing some of the more serious side effects personally, I decided it was time to quit. At first, I was absolutely in love with accutane. I had the most glowing, smooth skin and my oil glands/mucus secretions greatly reduced. I'm genetically predisposed to oil overproduction, and would be extremely shiny and oily all the time. Accutane really took care of that well. However, I started to get back pains - tolerable. Eczema - tolerable too, eventually disappeared completely. However, I cringe as I say this, I feel like I'm betraying such a great drug... but I did get mental side effects. I felt... I don't know how to say it, I felt like I wasn't worthy. I felt I didn't really have a purpose in life anymore (this kicked in at the 2nd month), and the feeling was just WEIRD! I had a great life and nothing to worry about; I was on holidays. But it was a sad feeling that gradually built up and got worse. Having read articles on accutane and depression, I stopped the drug at my 3rd month. I have always taken the full 40mg. After I stopped, the next 1-2 weeks I still had disturbing thoughts. However 1 month on, I am completely fine now :) Back to how I was used to be, all happy :) These days, I still lose alot of hair and I'm slowly getting mucus and oil back. I'm on Tretinoin cream currently, but my acne hasn't returned. My hair loss is decreasing and I'm really thankful for what accutane has done for me. Bottom line - listen to your body. It's better to be safe than sorry :) But, accutane - thank
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March 17, 2012

Pros:

Clears up acne

Cons:

Dry lips
Occasional new, quite inflamed spots
Must have a pregnancy test every month, and a blood test before, halfway through and 5 weeks after the course

I have tried several different prescriptions, all from a dermatologist, and all unavailable unless with a prescription, and this is the best of them all! However, it is also a last resort. Ive been on this for nearly 2 months, and in less than a month, my forehead had completely cleared up, and is now completely smooth. The rest of my acne has also "died down" a bit, although you can get the occasional new spot, which is an effect of the medicine working. I am currently on Dianette (a contraceptive pill) and my Isotretinoin course will last only four months, and it is extremely unlikely that my acne will be coming back. However, in the UK it is extremely hard to get this course of treatment, as it is considered to be very risky. But overall, it has given me amazing results, and I'm not even halfway through!
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.
Find a Doctor Using The American Acacemy of Dermatology Website

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.
Find a Doctor Using the American Society of Plastic Surgeons Website