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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December 22, 2016
Estrogen levels
I took Accutane about 10 years ago. Since then I have been battling with my estrogen levels being too low. Causing long drawn out periods that come early and can last for 2-4 months without stopping. I also am at a lower chance of being able to get pregnant. This means I take artificial estrogen on top of birth control which is an increase to developing cancer. Wondering if anyone else has had these issues or similar after taking this med?
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WishClean
January 9, 2017
I have no experience with accutane, but I have experienced low estrogen levels due to PCOS & other hormonal imbalances. Do not take artificial estrogen, it's very risky. Instead, look into the DIM supplement or bioidentical estrogen.
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November 4, 2016
Works wonders
I've struggled with cystic acne since the beginning of my teen years and into my adult years as well. My dermatologist first placed me on a round of Doxycycline as a precautionary measure, but that didn't help much so the next step was Accutane. I took 1 course in my early high school years and another towards the end of my high school years. Miraculously, my acne was gone after the first treatment and stayed that way for a while until it started to creep back a year or so later. This is quite normal in severe acne patients. Since my 2nd course ended years ago, I only struggle now with the random hormonal bumps around that time of the month (Caziant bcp has helped tremendously with that). Yeah the monthly blood draws suck and skin dryness is a pain, but it's well worth it. Just stock up on tons of Aquafor (a TRUE lifesaver and something I still use today). I didn't have any other adverse side effects except for mild joint pain and hemorrhoids from time to time.
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June 13, 2016
Ugh
I hope my review will be helpful to anyone. So I have been on 30 mg per day dose, which is the minimal dose for my weight, I am 58 kg, it makes about 0.5mg/kg. I have stubborn acne on my jaw that would never leave no matter what I tried. I have been on isotretinoin for 1 months- I have lots of break outs, since the begining of treatment, the whole month, it is very depressing. I am trying to stay positive and patient, but I didnt have a break from increased zits since I started the drug. If it is an IB, how long does it usually lasts?
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S33kingS0lution
June 22, 2016
My lasted 3months. Worst initial breakout. Worse than my acne before i started.
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May 15, 2016
Accutane two months in
Hi, I've just started on Accutane in April I started my first month on 20mg and now I've got up too 40mg not really seen much of a difference if anything my skin has more spots and bumps under my skin :( and I'm suffering from dry lips and inside of my nose is dry too. I hope I see an improvement in my skin after these 6 months and the spots that have came out now will they stay till the end because I can't take any more bumps on my skin? I've been using clinque anti blemish moisturiser it's brill for the dry patches and cetaphil cleanser as its gentle on my face and so my skin doesn't flake too much and blistex for my lips it really does help.. If there is anymore tips to help me along this Accutane journey please let me know. And another question I take my tablets at ten clock every night but sometimes I'm ten or 15 minutes late taking them but I read you have to take them on time will it affect my treatment if I'm late by 15 minutes. Many thanks Melissa
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April 30, 2016
Does what it promise
I took it mainly for scarring though my facial acne was a little worse than mild-moderate with monthly cysts*can't really call mild when having cysts).Acne on back was extensive but again,no bad lesions.Just the average pustules and papules.Has been on accutane for over two months and seeing less acne as time goes by.My back is almost clear and my face and arms get little weekly zits.But the truth is the skin peeling due to the excessive drying made my scars worse. Giving it a 4 stars now and will give it 5 once I get clear and continue to be that way.
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February 18, 2016
Wouldn't reccommend
After trying just about everything under the sun I decided there was no other choice but to revert to Accutane. I'm 31 and have had cystic acne since I was 18. Unfortunately it did not cure my cystic acne however the 9 months I was using the drug it did improve my skin by around 50%. Now that I am off it my skin has gone back to being inflamed and red. Very frustrating. Given the noticeable side-effects and damage it does on your internal organs I would advise people to stay away. Soon enough someone will have to break the acne-vinci code, hopefully it isn't too long.
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November 14, 2015
Slowly getting my confidence back
I read loads of reviews the first time I thought about taking Accutane and freaked myself out. If I have started it then I wouldn't have gotten 100 times worse and been driven deeper into depression. My only regret is that I didn't take it sooner. My side effects were normal. Dry nose, lips and sometimes eyes. I bought Elizabeth Arden 8 hour cream on ebay for 13 euro usually 34 in store and it is amazing. It's basically, I think, a nicer smelling Vaseline. I found it worked a lot better to, but that's just me. Use it on your lips nose and skin. It's unreal made my Accutane journey a lot easier. I know when I read all the side effects I thought no way, but if you buy any drug they all have side effects the length of your arm. Some people don't feel any side effects. I was very lucky. My back was sore the first few months but I started Pilates on youtube and it helped. Also mind your teeth! Stay strong!!!
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ann jones
November 24, 2015
I am 45 and have been suffering with cystic acne for 20 years. Once a month I would get a very large cyst on my chin which would last for 2 weeks and the scar would last for much longer. Often times I would have the cysts injected with cortisone. My skin was also overall very oily. Throughout the day, I would use oil blotting pads. My skin also was flushed with tiny broken capillaries on the nose and rosacea. I have been on Accutane for 2 months and am soooooo happy. The results are amazing. The first couple weeks I started acutance I got 3 small pimples on my cheeks. They went away quickly. After that I NEVER had one more pimple or cyst. I still wake up and feel my skin waiting for that hard lump under my skin but it never comes. I weigh 105 and I am on 40 mg a day of Zenatane (20mg after breakfast and 20mg after dinner). The only sides effects are dry lips and skin. I use aquaphor on my lips and Dan's ([link removed]) moisturizer on my skin. Both products take care of the dryness. It is no big deal at all. I only wash my hair every 4th day now. I used to have to wash it every day. I love not having greasy skin. My skin is no longer flushed and the tiny veins by my nose have disappeared. For the first time ever, I am getting compliments on my skin. I don't want to stop taking Accutane ever! My doctor has put me on it for 6 months. I have to have blood work and a pregnancy test done every month and have to answer about 10 minutes worth of questions for the Ipledge program. Although a pain, I much prefer doing this than fighting with my acne. I give Accutane a 10 plus. It has been a life saver for me. In the past, I have tried EVERYTHING from diet to being on antibiotics for over a year. Love Accutane:)
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April 6, 2015
45 year old female on accutane
I have been on accutane for 9 months (40mg/day first 6 months and 60mg/day last 3 months) and this is my last month. My cystic acne has cleared up very early on but I keep getting these little pimples. I have about 2 pimples a week although they go away within a day or two without leaving any marks, I am very discouraged. I was hoping I am 100% clear by now and I worry what is going to happen when I go off accutane. My derm said accutane is not as effective on middle age patients, what is your experience?
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March 6, 2015
Accutane palying tricsk on me...
Since I was 14 I had a few occasional very mild breakouts on my cheeks but as I started to get older my acne got a little worse I remember when I was around my 8th grade the acne got a little severe but they were all white heads and by severe I mean 3- 5 white heads. Then again it got less severe and I had 2-3 white heads every few days max. Suddenly when I turned 18 my acne got a lot worse suddenly there were around 8 -10 white heads which slowly turned into pustules and more of these started pop out specially on my cheeks or cheek bone area. My first dermatologist prescribed me doxycycline. It didn't make it any better but after 2 months on this, my acne was worst than ever. I changed my dermatologist went to another one and asked him to put me on isotretinoin he did that without further question but only on 20mg maybe because my acne was not severe it was moderate and I was affected with acne on only around both of my cheeks region that time I had around 15 acne. I was prescribed on Sotret 20mg per day. It has been now 33 days, my experience... to be honest its the same no improvements or deterioration. During the end of the first month towards maybe between day 23-28 I had a initial breakout which were like some white heads would pop up where there were previous acne and I would pop them it would go and then slowly form a hyperpigmentated bump. One thing I noticed that my face almost had no oil towards the end of the first month but after day 29 oil would start to come back again specially on my nose. Really want to know is this a normal , expected experience or not ???? I really hope this accutane does the trick for me because I just had it with acne!!!!
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January 31, 2015
Best decision I have ever made
I am a 32 yo female who has had worsening cystic acne from about 25. Having progressed through all the usual over the counter products and also prescription medication like retin a, my GP referred me to a derm for the 'last resort'. And I am so glad she did- 6 months later I have perfect skin for the first time in years. I took 20mg a day for the first months and 40mg a day after that (I am finishing my course in the next month or so). I have experienced a number of the usual side effects- dry lips, headache for the first two weeks, and occasional eczema on my hands when I don't moisturise enough- but none of them have been unmanageable. Remembering to drink lots of water and moisturise, moisturise, moisturise are the key. I was scared to take this medication for so long because of all the negative press, however I wish I had taken in years ago. If you are considering this medication I would suggest finding a good dermatologist and talking through the pros and cons with them to see if it might be a good fit for you. And if you decide it is, go for it and don't look back! A note on costs- in Australia this medication costs me around $35 for a box of 60 20mg capsules.
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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