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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May 25, 2011

Pros:

Skin so soft and acne free!!
(length of time being acne free can result from the dosage..get a good doctor that has experience with accutane. Then, your acne may never come back)

Cons:

Dry skin, noise, hair, etc.
DRY LIPS. Chapstick is a necessity
Depression
Acne scars can appear if you mess with/pop your pimples
General scars can appear if you get cut. (even a small cut can scar)

Accutane is great, but it is a LAST resort. I look back and wonder why I even went on it, but of course, it cleared up my skin. Bottom line: the possible side effects are scary. Depression seems to be common with this drug.. I had depression on this medication, but I would always tell myself, "calm down, its the medication." I am not sure if the medication caused the depression or if I would of been depressed regardless. I think that a lot of people are depressed on this medication because clear skin does NOT solve all the problems associated with it. For example, I thought all my social problems would go away with clean skin, it would solve all my problems...That sounds stupid, but it is a big change from having acne to having none. Just like a fat person becoming skinny. lol Realizing that as freeing as being acne-free is, it does not mean that your crush will like your or that people will treat you differently. WARNING: make sure that your doctor puts you on a high dose in order to get clear completely. I was not put on a high enough dose and not only did some of my acne return, but it never was completely cleared. Now, I am currently on Tazorac and Solodyn. I want to clear up what accutane didnt because of the low dosage. I want to go back on accutane with a different doctor, but the side effects are concerning. I am just not sure. Overall, it is a personal choice. Acne is a disease and is depressing. Weigh the pros and cons, then make your own choice. Accutane is the only cure for acne. (when on the right dosage.) I personally recommend Tazorac and Solodyn as a way to go if not Accuntane. Hope this helps!
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May 23, 2011

Pros:

-clears ALL acne
-skin and hair oil-free
-skin texture improves almost immediately

Cons:

-very dry lips
-dry eyes- bright light such as sunlight or an oncoming car is painful
-drowsiness
-joint pain
-very dry/bloody nasal passages
-super sensitive skin
-dry/flaky/painful scalp
-lots of canker sores
-rash on the backs of hands
-the doctor appts and bloodwork every 30 days/ iPledge hassles

I took 40mg/day of the generic Amnesteen for 5 months. Before starting my course I had frequent dermatologist appointments for over 7 years....I was put on every topical possible, several different antibiotics, birth control, spironolactone....EVERYTHING. Finally, my derm decided to put me through a course of accutane. I was well-prepared for the side effects, but I had a very hard time with them. Obviously everything was very dry, but there were several things I wasn't expecting. First, I had severe joint pain in my neck, lower back and hips, knees, wrists and ankles. I tried going to a chiropractor, getting a massage, and both external and internal joint lubricants.... nothing helped. I also was extremely tired a lot of the time, and even when I didn't feel tired, my eyes felt tired because they were so dried out. Being outside in the sun or driving at night with other car's lights made my eyes sting pretty bad. The last thing that really gave me a hard time was my nose....bleeding and just being painfully dry and raw on the inside. Nothing seemed to moisturize the skin up there and it was a constant, very painful annoyance for 5 months straight. However, it was nice to not have oily hair for once, and when I did break out while taking it, the pimples went away very quickly. On accutane your skin is constantly renewing itself, so breakouts last half as long. I am a very healthy, fit, young girl- I'm extremely careful about what I eat, and I workout 4-5 days a week. My doctor told me that her healthiest patients have the hardest time with accutane. Not sure why, but it seems like if isotretinoin is the only bad thing you're doing to your body, your body notices it a lot more! Just a warning to the fit and active- working out gets a lot harder with achy joints. Even though the side effects are NOT fun, I have totally clear skin, which is all I've wanted since middle school (I'm a third-year college student now) and I am completely happy with t
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May 8, 2011

Pros:

No more oily, shiny t-zone - astonishingly so!
Clear skin
No more painful acne
I feel more confident

Cons:

Dry eyes, lips & nostrils - lips & nostrils crack & bleed
Dry & irritated anus. That's right. Butthole.
Developing dandruff
Depressive episodes
Muscle & joint stiffness & pain
Difficulty seeing at night
Audio hallucinations

I have a family history of very oily skin (great for thick glossy hair) and 15 years personally of painful cystic acne. I had tried altering my eating, the prescription birth control, every lotion. I had tried the low level antibiotics Oxytetracycline (which worked well but then I moved countries and it was no longer available), Monocycline and Doxycycline (which didn't work). I started on 10mg/a day (I am a fit person in the healthy weight range for my height who exercises regularly) on 1 Nov 2010. The first side effects were the usual *dry, cracked and bleeding mouth, nostrils/anus *dry scratchy eyes Which can be tolerated with the help of a lip balm with beeswax in it - I carry one at ALL TIMES and eyedrops for the eyes as well as vaseline for the other areas. On 6 May 2011 I stopped as I was suffering from the following side effects; *depressive episodes *audio hallucinations *muscle/joint stiffness to the point I was unable to walk without pain I did this - fairly low level being only 10mg/day) course as a LAST RESORT. Was it worth it? In this country it is subsidized by the health system so financially the costs were monthly visits to the doctor and the amount I spent on lip balm & vaseline. I love not having skin that is covered with an oil slick every couple of hours. And that I can wear minimal amounts of makeup. I love that I do not have deep, very painful lesions on my face - because I think that was the worst of it. I hope that it is the only course I have to do of it though! To sum up; To be used as a LAST RESORT on PAINFUL acne. Be prepared to deal with painful, embarrassing and confusing side effects. Be closely monitoring yourself with a diary and let your love ones know if you are on a course so they can watch out for you too.
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April 9, 2011

Pros:

No oil, no acne and a renewed confidence. No more acne...even 4 months after my last pill.

Cons:

Everything dries out, mild concentration issues, nose bleeds and

Accutane is a serious drug, but to me, it was so worth it. Weigh both the pros and cons before you make your decision. Please realize the horror stories are grossly exaggerated and rare. I'm clear 4 months later and my face looks great.
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April 6, 2011

Pros:

-non greasy hair to wake up to
-no oily face
-black heads on nose all gone
-spots on shoulders have gone and back (were very few

Cons:

-nose bleeds (first 2 weeks)
-chapped lips occasionally
-dry skin
-facial spots no real improvement
-insomnia

I have been on accutane for 2 whole months now, not had any real problems whilst on it which bother me, i am going to see my derm in 6 days and hopefully during the 3rd month i will see a severe improvement as most cases thats when they get there ( AHHH moment ) fingers crossed eh guys...good luck to everyone else who are on it i hope you see desired results soon :)
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April 4, 2011

Pros:

-reduction in greasy face
-acne going away slowly
-increased confidence b/c of less zits
-possibility of acne totally gone at end of treatment.

Cons:

-red sunglass face look
-shedding skin
-difficult to establish a skin cleaning regimen (reduce zits, but not irritate skin)

-30ish male, 5 weeks into treatment -had good luck with...(1) drink only non-chlorinated filtered water and drink 8 glasses/day, (2) installed a whole house water filter that takes out chlorine and other stuff, (3) washing face for no longer than 10 seconds, (4) stopped eating sugar, (5) stay out of the sun. These 5 things have reduced my facial redness significantly (or maybe just a coincidence???). 40mg 1st month, 80mg currently scheduled for remaining 5 months. I hate accutane, but I have no other better options. It's going as good as it can I guess.
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March 27, 2011

Pros:

Skin no longer oily at all
Spots healing more quickly
Old scars fading
Skin smoother & softer
Hair never gets greasy
Available on NHS so only £7.20 per month

Cons:

Dry/split lips
Dry & sometimes peeling skin on face
Eczema on backs of hands (although now gone) also on tops of arms
Occasional back ache
Some joint pain
Occasional crying spells/feeling depressed
Tiredness

I've listed quite a lot of cons, however, I am very optimistic that the outcome will make these side effects all worth it in the end. Also, I do not feel that the side effects are all that severe and are quite easily managed & easy to put up with in comparison to the feeling of having bad skin. I have only been on roaccutane for 10 weeks now and was previously on a very low dosage of 20mg/day so had not seen any improvement, if anything it seemed worse than before. However, my dosage has been increased to 40mg/day & despite only being on this dosage for 1 week, I can see a massive increase in the condition of my skin & amount of blemishes/spots already. I'm very hopeful that it will continue to improve and hope that I will one day be able to go out without make up and not feel self conscious about it. If anyone is faltering about whether to take roaccutane, I say try it as if it doesn't work, you can always stop taking it anyway.
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March 17, 2011

Pros:

Acne cleared up completely

Cons:

Acne back after 3 years-but think it may be due to hormones
Dry skin-but manageable

I can not say enough about Accutane. I went to see my P.A. in a derm's office and she immediately suggested I take Accutane. I had just a few (but enough) cystic/nodule like acne bumps all on the left side of my jawline and chin. I also had serious acne on my upper and lower back. I was worried about all the possible side effects so I opted to wait and try the topical treatment with oral antibiotics. They did not work at all. I ended up taking the Accutane with Yaz. I was on Accutane for about 8 months. My skin was dry but I could deal with that. I have acne again now but think that it may be hormonal. I never had acne growing up and just got it in my 30s. I am now 37. The only reason I did not give it 5 stars is because I have acne again. But again, I am thinking mine is hormonal and I have read that sometimes people need to have a second and/or third try for longer success.
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March 2, 2011

Pros:

Wonderful skin

Cons:

Acne (dependent on your situation) can come back
SEVERE dryness
Cracked lips
Gets worse before it gets better

I had beautiful skin whilst taking the contraceptive pill, but I after 10 years of taking it I wanted to give my body a break. As soon as I stopped it my acne returned, so I started Isotretinoin. My skin got really bad before it got better, so awful that I could hardly open my mouth because of the spots around my mouth. My skin started to get very very dry and some days I'd look like my face was flaking off. My lips would crack, especially at the corners and I found keeping a small tin of vaseline in my pocket saved the day, I'd freak out if I didn't have it with me. I had facials each month and got my beautician to use the most gentle but moisturing Dermalogica and techniques she could. I used Dermalogica Intensive Moisture which helped a lot. Its a very natural moisturiser that won't create spots but was good for my skin. I got very miserable and moody on Isotretinoin so make sure you get your friends and family to support you. I found I put on a bit of weight whilst on it, not much though. Always wear hats if it summer and I used Dermalogica Super Sensitive Sunblock daily, it is 30spf, is really really light but works well for day to day protection. I hope I don't sound like a Dermalogica advert (but it is good though)!! Sometimes my eyes were sensitive to the sun when driving, but nothing major. Bit of a major hassle having blood tests and pregnancy tests and you have to be on the pill as it can case major deformations in babies. Having been off isotretinoin for 2 years my acne has returned but a lot better than before. I can live with it as it is but I'm going to try Isotrex and some antibiotics as my acne is more moderate than before. It is definitely the best thing if you have acne, you won't get anything better.
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February 26, 2011

Pros:

-erases all active acne from skin
-for a time keeps skin looking insanely perfect after use

Cons:

-take many months of patience
-it will get worse before it gets better
-monthly blood drawing
-an array of often mild side effects
-acne can come back after use

When all else fails this is the ultimate sure thing for obliterating acne. it will make your skin beautiful and baby soft in time and will honestly change your outlook on life, not to mention boost your confidence 100%. However the catch is that it takes time to fully clear your skin and many people suffer mild to sever side effects on the medication. Also, for people like me, its possible for your acne to come raging back some time after youre done. Bottom line: although my acne came back (likely because im 17 and still hormonal) i loved my results so much that im considering going on it another time
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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