Isotretinoin (Accutane®)
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Side Effects

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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4
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3
15.6%
2
7.4%
1
6.6%

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December 18, 2013
It's the cure.

Pros:

Cured acne
Simple to use
Cured acne, did I mention that?

Cons:

Costs (will vary by insurance)
monthly blood tests
dry skin and minor aches

My version of accutane was called Claravis. I took it for about 6-7 months twice in my life so far. I took once as a teenage boy and again 15 years later. I've have 97% clear skin now for about 1 1/2 years. My insurance did not cover cover accutane, because my insurance sucked. So, I paid out of pocket each time, like $400 dollars. However, this is not the norm. It was the best $2,400 I ever spent. I paid $2400 for a cure to acne. If your insurance rocks, you may around $450 for a cure. I think the office visit to the dermatologist alone is $300 without insurance. The most annoying thing was about one week of a breakout. Then, after that, it was just dry skin and some minor aches in my back. Also, you have to take the monthly blood tests. Totally worth it.
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November 23, 2013
Dissapointing

Pros:

Clears Cystic Acne
Pores look smaller

Cons:

Depression/Liver problems
Dry flaky skin
Acne comes back

I have suffered from bad cystic acne for about a decade. about 3 years ago I decided to take some time off from college and come home and give Accutane a shot. I was excited to see that my face was clearing up rapidly (I started on 30mg). However, I was constantly nauseous even though I was on a special diet. I also became extremely depressed. I would spend days at a time laying in the couch not being able to move. At this point my blood results were crazy and indicated that my liver was extremely irritated. I stopped treatment immediately for about a month, and then went back on it at 10mg. The side effects were pretty much gone except for super dry lips and dry skin. My skin was so dry that the soles of my feet would flake. After I finished the treatment, my skin looked amazing. I was happy to be done with acne forever. EXCEPT it came back about 2 months after I stopped taking the pill. First mildly, and within a year it was as if I had never done the treatment at all.
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November 22, 2013
I love this drug!

Pros:

Beautiful clear skin in 2 weeks!

Cons:

Hair loss
Eczema on hands

I am 26/ female and have suffered from adult/ hormonal acne since I was 22. Cystic acne on the jaw, neck and chin, as well as small pustules on my forehead that just kept reappearing no matter what I did. I tried everything under the sun (Yaz, spironolactone, antibiotics, topicals). A new dermatologist finally convinced me to try Accutane. I am so grateful to her! Accutane has been amazing for my self esteem. I've been on the drug for 1.5 months (first month at 30 mg and second at 40). I had a small initial breakout the second week, but I normally breakout that week (thanks, hormones). After that, NO ACNE! I haven't had a new pimple/ cyst anywhere on my body/face since then. My old acne is practically gone. I am still left with some hyperpigmentation from past acne, but I expect that to fade over time. The side effects aren't nearly as bad as everyone says they are. My skin isn't that dry, just not oily any more. I used to blot my forehead at the end of the day and it would douse the paper in oil like a french fry. My lips peel a bit, nothing extreme though. And I now have eczema on my hands but it's pretty easy to manage with very thick lotion at night. My only real concern is hair loss. After a few weeks on the drug, I noticed visible thinning of the hair around my forehead. My hair was already thinning a bit before I started Accutane, but I believe the drug is exacerbating the loss. My dermatologist said this is extremely rare; I guess I'm unlucky. But I'm willing to cope with that side effect to keep this beautiful skin. I'm so happy I finally took the plunge with this drug.
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November 16, 2013
only 17 days in, amazing results

Pros:

Cleared/clearing acne
no IB

Cons:

Hair was falling out first week or two, not anymore.
Dry lips and face.

Tried everything, nothing working. Started Accutane 17 days ago and it's been uphill from there. My doctor started me on 20 mg once a day and it seems to be enough. My acne dries up so quickly and basically falls off my face in 1-2 days. Before accutane I had mild-severe acne. Anywhere from 2 to 10 huge cysts on my chin and around my nose. After a few days of Accutane, it all started to go away! No initial breakout, my derm said I wouldn't get one on 20 mg but I didn't believe him. Only thing negative about this is my face and lips are dry, all managable tho. Not clear yet, but everyday it gets better and better ha! I'm pretty stoked. Go listen to STS9!!!!
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November 14, 2013
Best thing for acne

Pros:

it works
new confidence
no major side affects

Cons:

hyperpigmentation takes longer to fade
dry skin/lips

I'm on my third month of accutane and I love this product. Why I never went on it earlier is beyond me. I have noticed a SIGNIFICANT improvement in my acne in only 60 days. While my skin is not 100%, it's a hell of a lot better and the only side affect I've ever experienced was the normal dry skin/lips which was fixed with a good moisturizer. The only down fall is the hyper pigmenation that shows once acne fades.. This isn't from the medication. It's just the natural process of healing however it does take longer to fade on Accutane but does eventually. Over all, glad I found this. ($8.90 on extended medical plan in Canada)
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November 8, 2013
Works if you will die with it

Pros:

all, still looked like human, probably not the worse
over 10 years

Hello, this product will work as long as you keep using it, after that it does not, I used it for 6 months(I do not want to throw my life away)(maybe it's because i had acne problems so long, don't know)), and it's really dangerous product so I better use BP without any problems now, it's a miracle product (just use BP like smart people not like desperate people and it will work. !!!! About the BP miracle (I had acne over 10 years, now my skin has scars) -- I have noticed more better results than BP clean solutions, I recommend Dr. Wolf , Acne fug (it's was the only thing with BP in my country, and now I can not stop using it!!!), Acne fug is 5% BP and has alcohol and some other clearing skin agents(it's stored something like 2-7 decrees) (the paper recommends it for hormonal acne (hormons cause acne etc), the acne that other products can't fight), I use it once a day and works much better than any BP solution so far (It can't get any better, so I stay at this product. If I will not use acnefug for several days(and not showering) the acne comes back, some pimple or pimples appear, but if using this product they disappear after 2-3 days completely), no flakiness or anything(BP makes skin look a bit lifeless, but this product not). Only once a day!!!!(I shower once a day!)(it's quite effective so please not use that often) I also use moisturizer with lipids and after that my skin is not try and feels good. Note: I am promoting healthy living and am exercising a lot. ///
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November 7, 2013
Finished Accutane and now scars?

Pros:

cleared acne
confidence

Cons:

scarring
redness/redmarka
dryness

I finished Accutane in April of this year, it worked good, was on for 5 months. Then this September I asked my derm about my facial scarring and redness, and she suggested Palomar laser. So I did 2 treatments 4 weeks apart, I had breakouts after both treatments, thought it was from laser but im not sure anymore, because I am still breaking out on places where I did not even get the laser done, my next appointment is next Friday, and I don't know what to do, the 2 treatments have filled in my pick scars pretty good, but still could use more treatments, but these breakouts... im debating if I should just ask to go on Accutane again? suggestions? opinions? I can also provide pictures if needed. Thanks
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October 8, 2013
Only on the first month, nearly at second

Pros:

it clears acne quickly
keeps excess oil level.

Cons:

time consuming and need patience
dries skin out
gets bad before it gets better.

I started off with a few spots in year 8, in between my eyebrows. (this was when i was around 13) and then it gradually got worse. however, some products like OXY, did the trick for about a few weeks, then it got immune to the ingredients in the product of OXY, so got worse again. I tried everything, like the Dianette pill, creams, tablets, gels, and so on. I then found this website, (acne.org) and tried the regimen. now i only did about 3 months is of it, so didnt really give it chance. however it did do some improvement whilst on the 3 months. which boosted my confidence. but then i found the accutane drug, and so i researched about it, the side effects and such, and asked my mum to book a doctors appointment. so we did. i spoke to them and they said yeh, they are happy to give me it. so went to the dermatoligist.. blah blah blah. and then finally got it. now like any other person, when it comes to acne and the path to clearing it, youre inpatient right? yeh, i am too. im only on my first month, about to go on second.. (my mum keeps track, i have no idea). and i am getting a few pimples, but mum says it shows its working, as its taking all the bacteria out from under the skin and pushing it out. but it is upsetting me, and i just want it to hurry up and clear. but cant just wish for that. so then, to make myself feel better, i look at peoples pictures before and after, and give me that reassurance, that it will clear eventually in the next month ish.
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September 6, 2013
Accutane for sebaceous hyperplasia

Pros:

Sebaceous hyperplasia resolves in 3 weeks
skin not oily while taking the medicine

Cons:

dry lips
dry nose
blood tests

I had multiple sebaceous hyperplasia (overgrowth of oil gland) on my face and chest. Very annoying and I felt so upset that I couldn't even look at others while I was talking to them. Because these bumps won't go away at all which is worse then acnes. I trying laser, and Tretinoin. Both failed. These bumps just keep coming back. Finally I heard about Accutane from one dermatologist. I decided to try it right away. The doctor started it with a very low dose as 20 mg/day. I thought it was too low comparing to other cases, but it actually worked great! all the bumps were gone in 3 weeks. I was really happy even though I still have old scars from acnes which I regret didn't do anything when I was younger and having the acne problem. So I took the Accutane for 7-8 months at low dose 20-40 mg. And the hyperplasia never came back. However I experienced dry lips, dry skin(which I feel good because I have very oily skin :(), dry eyes and some weight gain I not sure if that's caused by the drug. So 1 month ago I decided to stop taking the drug since I want to have the bumps on my nose removed in 6 months. Then I noticed that the hyperplasia lesions are coming back :(... Not sure what to do now.
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June 12, 2013
At least it did something

Pros:

Lessened my acne

Cons:

Still have acne
Outrageously expensive in the US

After a five month course of accutane... I still have acne. Just not as much as before. I still break out every day though. I simply do not have the time and money to keep on treating it. I had to spend thousands on accutane. For that kind of money, I am very disappointed that I still have an acne problem.
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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