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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June 14, 2013
best decision i ever made - wish i did it sooner

Pros:

great skin
long term effects
better complexion

Cons:

really dry eyes
peeling can be a little annoying
very chapped lips

i had acne for about 3 years before i decided to use accutane. i got acne as a freshman and it wasnt bad, i was able to treat it with antibiotics and topical perscriptions. summer before my junior year (about a year ago) was when it started to get really bad and nothing was working. I really didnt want to use accutane cause its a very powerful drug and i have heard horrific things about it but it was all i had left to try and my skin was depressing me. so i did it and it was amazing, i had no initial breakout, it worked pretty fast and i havent had a pimple in months. i just finished about a month ago and everything is still going well. i was on it for a total of 7 months. my eyes are still really dry but my skin is producing oil and not peeling anymore. also another annoying thing is your lips are SUPER chapped you need to carry some sort of lip moisturizer at all times or your lip skin will peel and sometimes bleed! CHAPSTICK IS YOUR BEST FRIEND! best decision, my self confidence is a million times better. i recommend to anyone with moderate to severe acne and bad self esteem it turned my life around. if you are considering it, try it!!!
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June 12, 2013
It works

Pros:

Clear skin for the first time in probably 10 years

Cons:

Dry, red skin on face, knees, elbows, lips, etc.
Harsh initial breakout
Weird moods and dreams and increased anxiety

I grew up with acne that essentially controlled my life. It made me self-conscious all the time, to the point where I would skip school because of it--often. I started my 5 month course in January of 2013 because, entering my last semester of college, I just couldn't take it anymore. I had active legions--fewer and fewer every week, mind you--up until about the 3 1/2 month mark. Worse, I had an awful initial breakout. I looked like I did when I was 17. But now over 5 months later, after a series of pillowcases ruined by bleeding lips and skin so red it looked like I was perpetually embarrassed, my skin is completely clear--minus some hyperpigmentation. It's something you have to commit to. The initial break out period can last a while and be discouraging, it's expensive, it will increase depressed feelings, it will dry your lips and skin out a lot. But it works. Taking it and sticking to it was hard, but now that it's over I haven't felt this happy since I can remember.
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June 10, 2013
Great Acne Medication!

Pros:

Will clear you up by the end of each month while you are following the program
Will CLEAR UP most, if not all, your acne by the end of treatment (although, you may get mild acne thereafter)
Insurance will cover the costs

Cons:

It made my face quite red (rosy) while on the program
Will dry your skin out tremendously (I recommend using Cetaphil Cream Moisturizer- use a nickel amount))
May be pricey without insurance, but be sure to ask, and try to get help from the pharmaceutical company supplying it.

I highly recommend this prescription drug for those facing moderate to severe acne! This product worked wonders on my severe acne during my preteen years. Though, I still have fairly mild acne (now in my twenties), I am no longer covered in red inflamed pimples, whiteheads, or blackheads. This drug is a high risk drug, but do not let that get in the way of clear skin. You will be on this treatment plan for over a course of five months and will be required to keep monthly blood work and dermatology follow-up appointments. Should see clearer skin by the end of each month while taking it as prescribed. I was cleared by month five! Drink a lot of water, maintain a good diet, and keep a positive attitude and you will thank yourself later.
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May 31, 2013
Please, please try it!

Pros:

Clears acne COMPLETELY
Life changing

Cons:

Severely dry lips + inside of nose
Mild dry skin
Mild depression

Long story short, I am 25, male and have tried every single prescription and topical drug. I even went onto extreme diet and exercise plans and numerous vitamin supplements and herbal medicines. Certain things improved my acne a LITTLE, but essentially I wasted thousands of pounds over the years for no reason at all. My profession means I am required to be in TV, magazines etc and so my derm prescribed it as a last resort. Though my acne was mild/moderate, it was completely resistant and so I've spent 10 years fighting it, and dealing with the physical and emotional side-affects. Cue Accutane. I was highly sceptical as I thought how can mild/moderate acne be so resistant, surely it must be a different problem, perhaps an allergy. No. Accutane cures ALL. I found this out first hand. I've just finished my course, and it took 5 and a half months for me to stop breaking out (I guess I was unlucky it took so long) - the last two weeks of the course I had no new blemishes, and now 2 weeks off the course (4 weeks clear), my skin is 100% clear with next to no scarring. You MUST finish the course, even if you clear up sooner, or else you will relapse. Acne is from WITHIN, not external, and Accutane shrinks and destroys unnecessary oil glands (I've done extensive research). Even if you don't have oily skin it will work, because even unnoticeable amounts are too much for the skin to deal with - I am an example of this. The side affects for me were manageable. But even if they were more severe, I would happily go through it all because I am now 100% clear. No face wash, supplements or anything else will do as well as this drug. I can now forget to wash my face in the evening, eat fast food, drink alcohol etc and not have one single pimple, not even a small one. This is my first and last review, and I hope it can change some lives like it has mine.
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May 29, 2013

Pros:

It actually works
Hair stays 'just-washed' for ages
Drug itself is cheap in Australia (on the PBS)

Cons:

Expensive dermatologist consultations
Dry skin
Blood tests

I had moderate to severe acne for 11 years, starting at age 13. I tried everything. I have very good general health but my face didn't show it. At age 24 I was defeated and my self esteem was very fragile. I just tried to be as gentle as I could with my stubborn face and hoped it would go away as I aged. I had visited a doctor at 18 and he was very dismissive which made me reluctant to seek advice again. Years later when I saw a GP about the flu, she asked me if I was doing anything about my cystic acne. I said the best I'd tried was BP, but after 8 years its efficacy had plateaued for me and the benefits were marginal. She referred me to a derm who prescribed isotretinoin. I was very anxious about the risks but I was well-informed. Because I had suffered with this for so long (and had the scars to prove it), I felt it was worth a try and to continue with the mental anguish, social isolation and ongoing disfigurement was damaging in itself. I know it sounds vain to dramatise acne like this but I imagine it's something like obesity - observers always assume it's your fault, that you're doing something wrong and that is what makes it incredibly hard to live with. I was on isotretinoin for 6 months. The biggest cost was the derm visits and the blood tests were no fun (I used to imagine a little ant was biting me when the needle went in and that calmed me down). Everyone's experience will be as different as our own biology but for me, IT WORKED IMMEDIATELY. No initial breakout and today, 3 months after stopping, still no pimples. All side effects have since gone (creaky joints and dry everything!!) I had extremely oily skin before and now my skin is normal (some very minor oily skin on my nose at the end of the day). I am just so relieved that I will not have more scars. I do wish I had gone on it earlier, but there is no such thing as perfect and I am finally genuinely content.
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May 15, 2013

Pros:

clearn skin fast
easy to take
miracle pill

Cons:

dry lips
dry eyes
must fill out the ipledge program questions

Miracle pill. I had really bad acne when I went to visit the dermatologist. She prescribed accutane, it cleared my skin so fast. My pimples were leaing dents but this cleared my pimples within 3 month
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May 4, 2013

Pros:

Clears your acne

Cons:

Can be expensive
Quite a lot of side effects
Can have side effects years after

I had very bad acne when I was 21, I'm now 37. Endless amount of tablets and creams, my doctor finally sent me to hospital and I was given Accutane (think it was called Roaccutane back then) for 3 months (I think). It totally got rid of my acne. But when I was taking it, I lost sleep, had nose bleeds, lost my appetite and felt drowsy. Even if your acne isn't bad, I don't see the point in using anything else other than Accutane. I should have been put on Accutane earlier, but due to that not being the case, it caused scarring. But it wasn't until I got into my late 20s, I noticed that my skin started to change. It would become red and it would show up my scarring. Doing some research, it appears that you can have side effects years later. It's also been found that drinking high amounts of milk can cause acne and make your acne worse. This was found in a recent study in England.
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May 3, 2013

Pros:

Skin is MUCH less oily
Very few breakouts (1/month)
Haven't had this much self-confidence for a long time

Cons:

Extremely sensitive skin (while on the drug)
Pain in joints when doing explosive work (i.e. not warming up before sports)
VERY dry lips

So, I'm a male, 17 years of age, weigh about 67 kg and am about 1.80m. Since the age of about 15, I started getting acne. At the start it was never too severe, a few white heads every week, but blackheads all over. I went from dermatologist to dermatologist, trying over 20 products and spending an insanely large amount of money. Nothing worked. Finally, I got to a dermatologist who said they would put me on accutane, my course dosage was: Month 1: 20mg Month 2: 40mg Month 3: 60mg Month 4: 60mg Month 5: 60mg Month 6: 60mg During the course, my outbreaks were hideous. I had huge cysts all over my face, a new white head on a daily basis, and the black heads remained. Now, 4 months off the course, I get a white head every month or so, and no more cysts (thank god & accutane!). The side effects (shown below) were definitely annoying, but they're a price to pay for such perfect results.
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April 22, 2013

Pros:

Cured a lifetime of acne
Improved my confidence
Changed my life for the better

Cons:

Dry skin
Ongoing sensitive skin

I'd struggled my entire life with acne and nothing had ever fully cleared me up. The best I'd found was The Regimen, which kept me fairly clear but not completely and being 25 I knew I was heading towards adult acne. I had to go to a private Dr in London who prescribed Accutane. It felt like one of the best days of my life. I was ecstatic. It cleared my skin and it's been clear since. It was the best decision I ever made. The side effects are nothing compared to a life time of acne.
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April 5, 2013

Pros:

It WORKSSSS!! Happiness. Results.

Cons:

Chap chap lips. Dry skin. Intial breakout.

Before I went on accutain I had tried EVERYTHING... constant Cremes, Benzyol Proxide, 3 different antibiotics, retin A Creme... you name it I used it. None of these things really worked for me; it would only suppress my acne. BTW.. I should inform everyone on here that I never had awful acne, I had moderately severe acne that I was sick of dealing with. I finally decided to go on accutain and I will admit I was really scared. Thr first two months were rough not going to lie; after those two months my face started looking better and better. Now I have NO acne on my face just a couple on my back... it really is AMAZING. Don't let anyone stop you from taking this medication... it works and no one should suffer with acne!!! I have one more month so lets hope I get 100% clear!! I'm at about 88%.
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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