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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September 15, 2008

Pros:

Months of no oil production. Can go more than 1 day without washing hair. Cleared acne quickly.

Cons:

A plethora of side effects: dry lips, skin, and eyes, fatigue, joint pain, fragile skin, photosensitivity, diminished night vision, mood swings.

This is not a drug for the faint of heart. It can cause serious issues and should only be taken after serious consideration. Maintaining good communication with the dermatologist is crucial. I'm sorry I didn't go this route before. After 12 years battling persistant acne, I finally feel care-free about my skin. I used Sotret, the generic, and it worked great.
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September 15, 2008

Pros:

Temporarily lessens acne

Cons:

Caused crippling muscle/joint pain, connective tissue disease

I took 40 mg of Isotretinoin for 4 months. Within 1 week had pain in hip joint and leg. Intensified over next month. Spread to other hip. Couldn't walk distances, had trouble rolling over at night. Hurt 24/7. After came off medicine pain did not go away. 1 year later pain spread to elbow, then to shoulder, wrist and fingers. Nothing stops the pain. Have seen 4 specialists (2 orthopedic surgeons, 2 rheumatologists), had blood work, x-rays, MRIs, 2 rounds of physical therapy, 5 cortisone shots and taken 5 different NSAIDS. The pain is still there and seems to be spreading! This is poison!!!!
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September 14, 2008

Pros:

clear skin

Cons:

EXCESSIVE FACIAL HAIR

i really really wish someone told me this..thats the only reason im on here to write this post is to maybe help someone thinking about taking htis medication. i have never had hair on my face, well other than eyebrows, but about 4 monthsinto this medication, i started growing hair under my chin that went from just a few, to almost half of my under chin looking like a GUYS. i swear that on my life. it causes more depression than acne. ance you can cover, hair you CANT. i have to wax it weekly and it grows in, literally, like a mans hair, that THICK n BLACK look. its really depressing. i would rather have acne than depressing thick man-like facial hair..which i believe my doctor called 'hirsutism'. please, jjust take something else, i wish someone told me this. im getting married in a few weeks and im so depressed as to how i can cover such thick/black/frequent facial hair.
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September 12, 2008

Pros:

Clear Skin. Fast Results!

Cons:

Dry Skin, Nose-bleeds, increased moodiness :)

When I was 18, I had tried everything for my acne. My zits began getting zits of their own! :) I tried every over the counter and prescription drug available. Finally, I went back to my Dermatologist, and he told me about Accutane. He warned that some people experience side effects, and took a blood sample from me for testing. After the test came back, he gave me my prescription and told me to take two pills per day. I took my first two right away, and when I woke up, my skin was 1/2 clear! The next day, almost no sign of acne! My skin was, however, very dry. After my skin dried completely, I made another appointment, and my doctor told me to only take one pill every other day. My acne was completely gone! The only side effects that I noticed was I had two nose-bleeds (never happened to me before), and I could get moody at first. To me, those were small prices to pay for clear skin. My self esteem was boosted, and people now compliment my skin all the time! (Didn't expect tha
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September 12, 2008

Pros:

At the end of my treatment (6 months) I had basically perfect skin.

Cons:

Dry skin, nose bleeds, fatigue, headaches, dry lips, bad breakout at first, monthly blood tests are a pain, and now that I've been off it for 6 months my skin is as bad as it was before it. Not worth it.

It's too much effort. I thought it would fix my skin forever and I am already breaking out like normal and looking for a new treatment. Don't do it, it's not worth it.
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September 12, 2008

Pros:

Been on it for 1 month so far and haven't had any major breakouts. My skin looks 100x better, it doesn't get oily and my pores shrunk. Aside from all of the "depressesion side effects"..those are wrong..Ive never been so happy (30mg) 2x a day

Cons:

Dry Lips. I go through a chapstick a week. Other than that everything seems normal, but then agian it's only been a month. The only drawbacks are taking blood once a month, and the way the pills are packaged

DEFINITELY GO ON THIS MEDICATION if you have bad acne. My body acne is 100% perfect and just taking this medication with positive thoughts makes you so happy and confident. Trust me, I read 500million reviews and was extremely nervous to try the pill considering all the terrible side effects. I am an extremely nervous person, but this drug so far seems harmless to my body. I smoke weed occasionally and take adderall sometimes and drink sometimes and even then, I act and feel normal. This medication is highly recommended.
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September 11, 2008

Pros:

It worked. 5 months post accutane my skin is beautiful and I rarely break out.

Cons:

Dry skin and lips. Major sensitivity to the sun. I flushed really easily. Aches and pains. Thin fragile skin. ipledge is a pain in the ass. Blood tests and birth control.

Going on accutane was definitely a long drawn out journey, and I had a love-hate relationship with it while I was on it. After I was off for a month or two my skin started looking wonderful. I rarely break out and I don't have to do much to keep it clear. I get compliments all the time. It's a pain, especially with the dry lips (aquaphor sucks too...make sure to get something better) but it was worth it in the end and I would do it again if I had to.
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September 11, 2008

Pros:

Decreases production of oil, not as many major breakouts

Cons:

Very chapped lips throughout treatment, bad headaches at the beginning of treatment

I've been on a low dose of 10mg/day for 2 months. I've had severely oily skin for as long as I can remember, and no topical or BCP has worked in the slightest to decrease oil production. While my complexion isn't totally clear (still have some minor breakouts), I don't have to blot my face every hour/worry about looking like an oil slick/makeup sliding off within an hour. So far, so good.
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September 11, 2008

Pros:

It works

Cons:

It makes you dry!!!!!!!!! dryness causes early set of wrinkles

You're going to go through hell while you're on it! but it works. I had to apply carmax lip balm every 30 minutes, hand lotion and body lotions were my best friend. Needless to say those were not comfortable times. Make sure you stick with the program. I went through it two times before i finished (it was that difficult for me). The only drawback: wrinkles under the eyes that i didnt have before accutane and dry eyes all the time (even after the program). Acne is almost gone... continually using topical cremes. Even with insurance, it gets really expensive- with all the doctor appointments and blood work. Plus Ipledge is a hassle just like everyone else said...
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September 9, 2008

Pros:

This is the only thing that has worked since I became immune to minocycline! Inexpensive since I was given a prescription for the generic (Sotret) and have a low copay for generics.

Cons:

Very dry lips- I think I used more chapstick during the five months on the medicine than the entire 27 years prior put together. Headaches (at least once a week). Felt some moderate fatigue at the highest dose (60 mg/day). Dry/bloodshot eyes.

If you're willing to put up with some fairly minor side effects, this treatment is definitely worth a try. I had dry lips and eyes for five months, but it was totally worth it for me. I haven't ever gotten compliments on my skin until now, and it really does wonders for self-esteem after having years of acne problems. Stock up on chapstick and eye drops (Visine Tears are great!) and you'll be fine :)
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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