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 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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7.3%
1
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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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February 21, 2011

Pros:

cleared my severe acne, both face and back when absolutely nothing else worked.

Cons:

the obvious, severly dry lips, dry eyes, dry spots on hands

I had severe acne for a few years and it started to get realllly bad just over a year ago, i tried every prescription out there seriously, i started on a low dose of isotretinoin 30mg and only went up to 40mg. The first two months were hell as my face broke out soooo bad but my derm put me on a steroid to calm the swelling and then the isotretinoin started to work its magic, 4 months later i was completely clear. I get a few blemishes now and then but they arent the huge pustules i used to get. SO happy i used this medicine definitely a life changer.
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February 21, 2011

Pros:

fast acting, supposedly very effective. didn't have any initial breakout.

Cons:

only side effect i'm having now is pretty dry lips. if i forget my chapstick they can get pretty damn dry and start cracking, but that's about it. maybe a little drier shoulders too. no head aches, falling out hair, joint pain, mood swings or anything.

taking 80mg/d now. started of with 40 the first week, 60 the next, and 80 the third. after the first day i started to notice a difference. everything was drying up and healing nicely. my cheeks and jawline and pretty much smooth now, and the forehead is healing as well. still got lots of spots and red marks though. probably gonna have scars. hopefully they will fade. Bottom line for me? i absolutely recommend this. it is definitely doing its job and i'm not having any severe side effets
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February 19, 2010

Pros:

It has saved my life! Taking low doses (20mg or even 10mg) during several months has done wonders for me! How I missed having soft baby skin! Damn I´m twenty and I can only remember feeling like this when I was 13/14. Since then..Acne has took over my life.

Cons:

Dry lips? Well..to be honest...what is this compared to waking up every morning...touching my face and feel new bumps?

Low doses are the key! Experiment starting with 40mg..and then slowly bring it down to 10mg(p/day)
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February 15, 2012

Pros:

Cleared acne completely within a couple of months

Cons:

Extremely dry skin
Skin redness
Can't drink alcohol

I read a lot of reviews about how dangerous this drug could be an it got me really worried. My dermatologist however said that there is very rarely any problems. I think that if it works people just carry on happy with their lives and don't write reviews, so you only end up seeing negative comments about it. Overall this drug made me go from getting spots nearly every day to having flawless skin. I really feel like a new person it's fantastic. Sometimes I have a dream that I am still infested with acne on my face... and to then wake up and look in the mirror with perfect skin is such a great feeling.
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March 22, 2011

Pros:

- gave me my life back
- oily t-zone completely banished
- pore size diminished
- stubborn under-the-skin cysts completely gone
- uneven skin tone improved greatly
- my confidence and self esteem have gone up a lot

Cons:

- achy, tight muscles and joints
- appetite would go away at times
- it was slightly painful to pass a stool
- dry eyes
- dry, flaky face
- eczema on the backs of my hands
- slight mood swings

I just wanted to thank Accutane for restoring my face to how it used to be. I have never seen my skin so clear. It has only been this clear when I was 11 and had beautiful, untainted pre-pubescent skin. I am so confident right now, and it is so easy for me to leave the house without makeup on. I only need a very minimal amount of makeup now. I have always felt that acne has held me back from my highest potential, that it made me seem like less of a person. Acne was very debilitating for me and made me very paranoid at times. I would constantly poke and prod at my face just hoping that it would go away. No at home remedies worked and the 3 antibiotics that I was previously put on stopped working after the 2nd month. My dermatologist was very thorough with the process of Accutane and told me that it was a last resort treatment. I am glad that I took it. It worked so well on me and it truly is a miracle drug. I am happy to say that it no longer takes me one hour and a half to do my makeup in the morning. I am very comfortable with where my current skin condition is at and am very fortunate to not have to use makeup as my crutch any longer. I am very happy. Please be sure to do an ample amount of research before you go on it. I did about 1/2 a years worth of research on several websites including this one before I asked for the prescription.
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December 30, 2009

Pros:

It works.
The ultimate exfoliator!
For some reason it's cleared up my dry skin related eczema on my back instead of making it worse!

Cons:

Initial breakout (thankfully it was mostly on my scalp and I have hair to cover it up)
Dry lips (tolerable with frequent lip balm app)
Dry face
Would've been very expensive had it not been for my insurance ($1300/month!!! but with my copay it's only $10)

Here's my story- I don't know what hit me but at age 33 I had my first acne outbreak and my face and forehead were covered with dreadful cystic acne. I tried all the OTC stuff first like benzoyl peroxide, salicylic acid and sulphur. The salicylic acid wash followed by BP cream irritated my skin so much I developed periorbital cellulitis and had to be on Augmentin and Bactrim. Bactrim made the acne stop but it left a bunch of unsightly hyperpigmented spots. As soon as the antibiotics were over my acne came back. Then I wrote myself a script (I'm an MD) for topical clindamycin. Nothing. I didn't want to wait another few months with topical retinoids because I knew it'd take that long even to see if they'd work and my face was still pimple central. And I wasn't thrilled about the prospects of being on a tetracycline class antibiotic for years. So I went to a dermatologist; he didn't fool around and immediately recommended isotretinoin. With my medical background, I went in already knowing all the worst case scenario badness like hypertriglyceridemia related pancreatitis, inflammatory bowel disease, DISH, pseudotumor cerebri, etc. But both my derm and I knew adult onset acne tends to be recalcitrant and my options were running out. So I bit the bullet and went on it. I'm on 20mg twice daily. I'm skinny so actually it's somewhere btw the recommended 0.5-1mg/kg/day regimen. The drug made my face peel like crazy and I had some initial new pimples in the weirdest spots (on my scalp!), but after that all the acne on my face just arrested and is now starting to fade away. I was so amazed. I never got depressed. In fact, I'm ecastatic because I finally found something that worked. I haven't developed any liver or lipids issues. Dry lips and face are minute nuisance compared with the benefits (in my case anyways). So far I'm very encouraged by the results.
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October 14, 2011

Pros:

-Cleared Face
-Cleared Back
-Cleared Chest

Did pretty much everything that I wanted it to!

Cons:

-Initial Breakout
-Dry Lips (
-Bloody Noses
-Back Aches
-Face Dried Up
-Blood Test were Costly

Coping with Cons:
For my dry lips I used Aquaphore it is like Vaseline but works a lot better. Before going to bed make sure to put a lot on so when you wake up you lips are fresh. Only reason I used chapstick in the day was because Aquaphore is thick and kinda messy.

Curel Ultra Healing: Best lotion I used for my face get the big bottle :)

Accutane practically saved my confidence! I was very hesitant at first to start the medication because of all the "side effects." Thank goodness my mom and derm persuaded me to start the medication. Being a 16 year old kid with acne was the worst, I could never swim with friends because I always thought they would make fun of me. Accutane changed all of that, it made me a confident individual with clear skin. It was all a roller coaster ride, it has its ups and downs but the ups for me surpassed any of the downs. If you are ready to be clear and can deal with dry lips and some body aches on occasion, this drug is right for you. It took me 6 months to complete but oh man the after is amazing. Just take it seriously because it is not something you can mess around with you have to be devoted and ready to become clear. Accutane was right for me because no topical or any other oral drugs like Minocyclin did the trick. I am here if you ever need any advice, I did it and I promise with dedication you can too!
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April 30, 2010

Pros:

Very powerful
Begins to work within the first week
Better than anything else i have tried (i've been on everything.)
The only thing that works.

Cons:

very dry lips and skin
itchy skin
nausea
dry hair
but so worth it.

I'm 16 years old and have had acne since the age of 11 or 12. The severity of my acne has varied throughout the years. I have been on various oral medications, including oxytetracycline for 3 years, which did not work. After trying everything, i was finally referred to a dermatologist 3 months ago who was willing to do something productive. There are generally 3 strengths of the medicine: 20mg, 40mg and 60mg. The strength of pill you are prescribed depends on your weight and the severity of your acne. I began on the 40mg dose. After one month, they wanted to up my dosage but you have to weigh at least 60kg to take the 60mg pill, so i am one of the rare patients on 50mg pills. GPs can't prescribe it so you'd have to get a referral to the dermatology department at a hospital. Female patients are required to go on the contraceptive pill at the same time as taking accutane, because pregnancy during a course of accutane would probably result in a severely deformed child. In the first couple of days, my face was red and hot as if i had been sunburnt. My lips were immediately dry. Another few days later, the spots began to clear. Everyday my skin became clearer and clearer. All Blackheads disappeared. After taking the tablets now for under 3 months, i now have 3 or 4 spots on my face. I'm really happy with the results and think all severe acne sufferers should use it.
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April 20, 2010

Pros:

Skin looks the best it has in years. Confidence.
No messy creams/gels to apply multiple times a day.
You take it with food. No starving yourself for hours before taking it like you have to on antibiotics like tetracycline.
THE ONLY THING THAT HAS WORKED FOR ME. It finally feels like I'm not wasting money on some chemical junk that never works.

Cons:

Like everyone else says... Dryness of everything. The lips and nose don't bother me as much as my eyes. it has made my vision much worse.

The biggest side-affect for me has been insomnia. About 2 months into the course I started sleeping less and less. If I'm lucky, I get up to 2 hours of sleep per night. The weird thing is that I feel wide awake throughout the following day... Kinda wondering if it's all going to catch up to me when I finish my 5 month course next week.

As far as the deal with depression and suicide/mental effects goes, I went into this thing thinking that most of the people that took the drug and reported depression were just doing so because it was all in their head that it was possible to become that way just because someone else did. I have to admit that there were a few times where I felt "weird". I don't really know how to explain it but it didn't start until I was well into the second month. I swear I was the biggest skeptic (sp?). I guess the best I could describe it is a feeling of being "empty" but that doesn't really do it. I suppose it could of been the stress of moving to the new house. But the low of it all was when I woke up in the old house on the last day I was in it before moving the last few things over in the morning. It was about 1 in the morning an literally it was just me and my bed in the room. I just had this creepy feeling like everything was "done", like there was no reason to do anything anymore. to me all of this is weird as I'm a very positive person. I'm usually the one that doesn't take anything to serious and I'm always making a joke out of everything. Idk, I just had random weird feelings like that. This was just my experience and wanted to share it because I was kind of shocked by it all. If you are debating whether or not to take accutane. DO IT!!!!!! It will make your skin look amazing. Don't be scared of the side effects, stay strong and it will be better before you know it... Life will be better before you know it. just remember that if you are one of the unfortunate who do experience strange feelings, it's just the medicine making you feel that way and your not going to have to feel that way forever (some of you are probably going to argue that statement). The truth is that we are all different and the accutane is going to affect us all differently. Without giving it a second thought, I would ta
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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