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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4
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3
15.3%
2
7.3%
1
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November 15, 2007

Pros:

Completely clear skin for up to a year.

Cons:

Very dry lips, mouth, nose. It Was not a long term panacea as I expected.

I did my first session in 01' and was not as diligent as I should have been in the dosing. It still cleared my skin completely for a year. My second session 18 months later kept my skin quite clear for about 3 years. Now at 27 I am looking for alternatives to doing another session as my respawn acne is far more superficial and definitely not the deep cystic socially debilitating mess I faced before.
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November 14, 2007

Pros:

I am on my last month of accutane and could not be happier! All that annoying gunk under my skin that i would always pick at is GONE! Leaving me nothing to pick at! I pray it doest come back. If my acne did come back i would take another course.

Cons:

I am worried that it will come back and i have to take accutane again. Dry skin all over, irritating. Very dry lips. Some knee pain, cant jog for the last two months of treatment. Makes you more tired than normal.

This stuff works, it does have serious side effects (mood, joint pain, dry skin, ect.), but you have to decide what is more important to you. I had very persistent pitted pores. Would always pick at and large amounts of gunk would come out, have a few minor scars. Never really had nodule acne, but have had a couple pop us since being put on accutane, guess way of clearing out pores. I believe that everyone deserves a fresh clear face to show the world, and this medicine makes it possible for people who were born with horrible skin. In that sense it is a miracle drug. But just beware of the side effects. I am a 20yo active health nut so i though i would not experience any of the side effects, but i was wrong. I experienced mood change (manageable because I knew what it was from), dry skin, joint pain, and tiredness. DO NOT DRINK ALCOHAL WHILE ON MEDICATION. Had a friend whose husband drank while on it and his hair started falling out! Good luck if you are just starting! Goes by fast!
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November 14, 2007

Pros:

Very affordable with insurance -- I have paid $10.00 per month for two daughters and myself (I am on my second course -- it's been 23 years).

Cons:

Dry lips were the worst aspect for me. Derm said "DO NOT LICK YOUR LIPS -- YOUR SALIVA WILL DRY THEM OUT EVEN MORE" but honestly it can be hard to follow that advice when you don't have a tube of lip balm nearby. Spend lavishly on that stuff!

Nothing else could compare to the effect Accutane had on my skin. In the 1980's they only kept you on it for about 4 months. That is probably why I need it again. Regarding the initial breakout, I have this to say -- what is your priority? Do you want to look good (controlled acne) without interruption but always deal with it, or do you want to get rid of it for at least two decades? Further, accutane works by drying up those little oil wells in your face/skin. It stands to reason that in the process of expelling sebaceous matter and shrinking the pore area, there can be some disturbance! Have you ever had a facial done? You get a breakout from that too. If the IB is long in duration, I would imagine that you had a tremendous amount of oily goo that the accutance had to expel and/or dissolve. I contend it's worth the setback of the IB, and let me add, consider the costs -- can you keep ProActive and make-up manufac. rolling in $$$ forever?
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November 13, 2007

Cons:

acne got much worse scaring and damage also increased. the redness and swelling was terrible. Serious tendon and muscle damage

Don't take this medication unless your acne is so bad that it is affecting your life. my son is bound to a wheel chair and in great pain with a torn tendon in his pelvis from this medicdation. This tendon usually can only be torn from a serious accident, such as skiing. My sons tendon torn just walking. We don't know what is ahead for our son only time will tell. Right now he had to quit his job and college and lives at home
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November 10, 2007

Pros:

This works cleared acne up 100% made skin look translucent

Cons:

Severe dehydration, always carried water and lip balm with me.

This really does work but unfortunately didn't fix my acne permanently (I've been on two courses and it has still come back - only after several months though). In NZ it is subsidised if you visit a Dermatologist so the price is very affordable. Skin not only clears up on this drug but if good skincare is used in conjunction with it, becomes very translucent almost like baby skin :0)
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November 9, 2007

Pros:

Flawless and smooth skin. Not a bump anywhere.

Cons:

It is expensive.

This is my first course and I am actually into month 6 of accutane, I have a 8 month course due to low dose. I began clearing up at the end of week 2 and from then on my skin is perfect without makeup. It was even better then the time I took antibiotics and had clear skin because I still had blackheads then. But now I don't have any blackheads to go with my brand new skin. I didn't have much side effects either, just some dry lips and dry skin in the beginning but they ceased at the end of month 1.
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November 8, 2007

Pros:

Does wonders for your skin

Cons:

It is not always a long term solution

I took Accutane about 10 years ago. It did wonders for my skin with very few side effects. The shine from my skin was gone and my acne cleared. I thought it was a miracle drug until about 2 years later when my acne returned. I took Accutane a second time and it solved the acne again. Now, 10 years later, I just had my third child and my acne is back. I'm really sad that I'm dealing with acne again this late in life. I thought Accutane was a long term solution, but it sadly wasn't for me. Hopefully, it will be for you.
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November 8, 2007

Pros:

No acne. After 3 months most acne stops. By 5th or 6th month bearly any acne on my body whatsoever. Finished the treatment with 0 (thats right none) active acne.

Cons:

Dry lips, always having to carry chapstick. ALWAYS. The odd bleeding nose. By the last few months I had a extremely red face. Skin sensitivity such as minor scrapes would cause large cuts.

Accutane is the best acne drug ever. I've tried face washes, benzoyl peroxide based products, antibiotics (minocin) and NONE worked. Accutane has the best chance at taking out and PREVENTING further breakouts that any other drugs. The side effects are annoying and by the end of the treatment you just want off. BUT it's totally worth blemish free skin. DO IT
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November 7, 2007

Pros:

Can you say 99.99% clear, gorgeous skin?

Cons:

Very expensive, monthly bloodwork and doctor appointments, the evil system of IPLEDGE. Affects did not last for me; acne returned after about two years.

The pro of finally achieving clear skin --after years and years of trying to "cure" my acne through natural remedies, cutting out certain foods, perscription antibiotics, expensive creams, washes and lotions from medispas -- outweighed all the cons. I started on 40 mgs once a day, then increased starting the second month to 40mgs twice a day. I had dry lips and skin, but that was about it. I went broke paying for it, but didn't care. For two years I stayed relatively clear with very very mild acne from time to time, but it has slowly and surely returned. I wanted to see if I could tackle my acne this time on my own through healthy living and natural products, but my skin has still become a living nightmare. An obssession. I am a positive and optimistic person, but I am getting depressed and enough is enough. I am going back on Accutane at 20mgs instead of 40mgs and cannot be happier. I think this is a wonder drug. I am an Accutane Advocate!!!
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November 7, 2007

Pros:

I have been on Accutane for a little over a month. It works pretty fast. Skin is less oily. It is affordable. I have no feelings of sadness, depression or aches of any sort. In fact I feel great.

Cons:

My lips are a little chapped, however I wear lipgloss most of the time so I don't really notice.

The medication works great and it is affordable. I would have gotten it years ago but my dermatologists were reluctant to prescribe it to me because it was such a hassle for THEM. Finally, I switched doctors and he prescribed it. I have never felt better about my appearance.
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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