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 5, 2010

Pros:

Made my skin better. Did not stop acne but diffidently reduced the severity.

Cons:

Dryer eyes (contacts are no fun)
Red, sensitive skin while on the treatment.

While not completely stopping my acne, it did reduce the number of pimples my face makes by a lot. Went from 5-6 pimples in a day to 1-2.
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April 17, 2010

Pros:

The only thing that completely got rid of my acne.

Cons:

My acne is coming back. It's not as bad, but accutane works for people differently.

Totally worth the chance. Just make sure you do it correctly and be honest with your doctor. I'm glad I did it. I was scared because I was sufficiently warned beforehand, which is always good, but it turned out well. My acne was completely clear for months, but it's coming back but not as strong. Only do this if you have insurance though because it is expensive.
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April 14, 2010

Pros:

Clearer Skin
Less Oil

Cons:

Extremely dry and irritated skin
Chapped lips
Dry, bloody nose
Sun Exposure
Joint Pain

Ive just finished my 5th month on accutane, 1 more month to go. Ive been optimistic since the day i started. I had severe acne for most of my adult life. I was on several antibiotics, topical medications, exercise, diet and topical medications. The affects of these were only minimal, it never went away. Finally i was able to obtain accutane from my Dermatologist. He started me at one a day for a month and that didnt do much for me. Followed by 2 40mg a day. Thats when it got worse. He told me it would get worse before it became better so i stuck through it. The extra acne diminished and was left with a smaller amount than when i started. After the 4th month my dosage was upped to 3 40mg a day. Reading forums i havent seen many who have had to do 120mgs a day. Ive still got clusters on my cheek area and under my jaw. My optimism is diminishing. Most of the other reviews reported that most of it was gone in the first few months and then a small amount towards the end, but mine seems to be a stalemate. The side effects are annoying but bearable. I started in the winter so the sun exposure wasnt apparent until spring. i was driving around with my arm out the window and after an hour i had a sunburn. Needless to say I purchased some sunscreen after that. The chapped lips can be solved with CONSTANT chapstick applications, and the dry skin needs to be moisturized several times a day. Also cortisone cream was a life saver. All in all im better of than i was 5 months ago. A lot can happen in the next month so im going to stick out the duration of the medication. I would def try this if you have the insurance seeing as blood tests and generics are costly.
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April 1, 2010

Pros:

-STOPS oily skin
-Drys up acne
-WORKS!

Cons:

-Side affects
-dry lips, mouth, and nose.
-headaches
-itchy skin
-Monthly blood work

~I have had acne for 13 years and have lived with a new pimple or severe breakout every waking moment of those years! My self-confidence was crushed and I was so envious of clear, smooth, beautiful skin. It wasnt until now that Im 25 that I wanted to do something about it. I visited my derm and she RX me every cream, wash, and antiobiotic known to man. When nothing worked she recommended Accutane. I was really skeptical at first cause the side affects sounded harsh and not something I wanted to live with. But what else was I going to do? Nothing worked! ~So I have now been on Accutane for little over a month and I cant believe the DIFFERENCE. I have never seen a medicine that works right away! Within 2 weeks my acne was drying up and skin wasnt oily. WOW!! I was so pleased! And thats just 2 weeks I still have 4 months of treatment to do and I cant wait to see the result at the end :) ~To ALL who are afraid of the side affects, those are affects that MAY happen and are not gaurenteed. The only side affect that I have experienced is dry skin and lips. ITS def worth it if your tired of acne and nothing seems to work. You wont be disappointed with this treatment. And the side affects arent anything you cant tolerate.
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March 17, 2010

Pros:

clears skin to perfection

Cons:

nasty side effects including depression

My mother had acne when she was pregnant with me for the first and last time in her life, the fact that my acne was contracted genetically has made it almost impossible to clear, i tried antibiotics (2 types) the pill, topical creams/ointments (differin, duac, ect...) plus over the counter remedies which of course did nothing, my acne showed up at age 12, at age twenty i was offered accutane from a private dermatologist, it took five months to take effect with some harsh side effects including depression, hair change, and extreme dryness, but after the course my skin was clear, and for a year it was perfect, one year on exactly and my spots have started to return, but no where near as bad, and at the moment i blame the irritation from my latest face wash, i would definately recommend this drug becuse even though its a long haul, it gave me the confidance i never had in over a decade. you wont be perscribed it unless your skin is severe but i promise it WILL work, and probably never return, as it shouldnt, unless your acne is genetic too :)
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March 11, 2010

Pros:

90% clear skin

Cons:

Some joint pain
Some hairloss
Tired when I wake up.
Dry eyes, lips and scalp
tiredness, muscle ache
mood swings

My dose was 52mg/kg so it was a low dose. I think a lot of people underestimate how powerful this drug is. Start with a low dose and if that doesn't work then bump up the dose. I also ate a lot of healthy fats while on Accutane, I think that made it more effective. Only use this medicine after you have tried everything else. The pros won't outweigh the cons if your acne isn't severe and you haven't tried everything else before trying Accutane.
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February 27, 2010

Pros:

Clear Skin :)
No more oily skin!
No more oily hair!

Cons:

Initial Breakout-DRRYY Lips- Flaky Skin- Lots of redmarks left after pimples that last for a really long time- headaches-leg pains-eczema rash on hands and arms-hair loss :(

This medicine was no picnic for me. I started to get really bad cystic acne around 18 when I got off of Yaz, and right away my dermatologist recommended Accutane. I really wasn't afraid of the side effects, and the dry lips didn't bother me too much mostly because I just don't really care about that kind of stuff. While my cystic acne really hurt and got REALLY bad by November '09, it was never on my cheeks. Rather, I would get 10-15 deep cysts all on my forehead, chin and around my jawline. I had a REALLY intense IB for the first three months of accutane. It was horrible, I had HUGE, painful cysts pop up all on my cheeks when I was bumped up to 80 mg on my second month. Thankfully, I have a great dermatologist who tried to help me in everyway and put me on a Septra and a couple of courses of prednisone to help with the severity of my initial breakout. Oh boy. I wanted to quit this medicine and flush it down the drain SO many times because the breakouts were truly heinous. Thankfully, I listened to the advice of about 5 dermatologists and stayed on it. After my third month, everything started to clear up and the red/purple marks slowly started to fade and my skin looks better and better everyday. STICK IT OUT. EVEN IF IT SUCKS, REALLY REALLY BAD. There is a reason dermatologist absolutely RAVE over accutane. It's because 9 times out of 10 it produces DRAMATIC results that are long term. Don't give up! I know it's hard. But you will be so happy with the result in the end :)
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February 19, 2010

Pros:

clears skin up completely

Cons:

dry lips, blurred vision

i've only been on this for a week now but my skin is looking better than it had been for YEARS. my lips are dry already and on the first day i had blurred vision, but i had just had a drink of alcohol and they do recommend you reduce this. but seriously, for ages i haven't had even an inch of skin on my face that is spot free, and now i have about 8 spots which is an incredible change. my scars actually look reduced aswell - i look ok without makeup. and this is after A WEEK.
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January 1, 2010

Pros:

Less Breakouts.

Cons:

dry face, dry lips, Leg acheness, ITCHING, contact irratation, high blood pressure.

I've only been on this product not quite a month yet so i cant really say how good its working. I have noticed i am getting less breakouts but my acne is really red. Im guessing its the dryness. Im only on 40mg so im hoping they will up my mg when i go back to the derm in a couple weeks. Im hoping accutane will clear my acne and make it so it never comes back again. Its very embarressing. It does give you very bad chapped lips and very dry skin especially around ur mouth area. Its usually driest when i first wake up in the mornings. Another thing ive noticed is my arms are really red and bumpy from them being dry and itching them like crazy. I also have to wear glasses because accutane tends to dry my eyes out making my contacts irratate me. It'll all be worth it if accutane is the miracle acne medication they say it is. If your as desperate as me and want your acne gone try it like i am :]
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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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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