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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August 3, 2007

Pros:

It cleared up my skin very quickly and while on the medicine, I felt great!

Cons:

Once I came off the medicine, I started having side effects. I'm now on medicine for anxiety and my hair is thinning

I used it for five months. It's good for a LAST resort and if you have adult acne. People in highschool -- if you can, WAIT! It's likely your skin will clear up significantly within the next few years.
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August 3, 2007

Pros:

For the 7 or so months that I was on Accutane I had absolutely flawless skin. I suffered from cystic acne for a few years and during treatment I had invisible pores, no oil, and not a pimple.$15 per month w/ insurance. Hair held a great blowout!

Cons:

Can't drink Alcohol, Bags under eyes, Constipation, Dry lips, When blushing got a HUGE red rash on chest, Constipation. ACNE RETURNED AFTER 6 MONTHS. Was told 80% of users have to do a second round. Baby yourself on this. IPledge is a pain.

A little upset I have to do a second round, but during the treatment had flawless skin. To me, the side effects were well worth it.
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July 26, 2007
I'm 23 years old and have been suffering with acne for about 12 years. I was on accutane twice. The first time was when I was 18 years old and along with the minor side effects (dry lips and skin) it worked wonderfully. I had clear skin up until a year later when it all started coming back again but this time worse. I went to the derm and he prescribed me all sorts of creams like Differin,rentin A, tazorac, antibiotics and nothing seemed to work. I even tried pro Active which did nothing for me (although some of my friends swear it's the best product.) I was put back on Acutane with the highest dose and was on it for about a year. My skin cleared and looked great. About a year and half later my acne came back. Frustrated, I went back to the derm and he prescribed me Tazorac along with an antibiotic Monocyclin. I explained to him that I already been on Tazorac but he told me that after Accutane, your skin changes. Hopefully it works. I don't reccomend Accutane because it comes back.
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July 24, 2007

Pros:

In mon 7 now. Very slow to react for me but it finally seems to be actually working! My insurance covers it so all I have are co-pays but that's still $40 for doctor and $15 for rx. Doesn't matter if it works! Confidence is much higher!

Cons:

Hurt Hurt Hurt! Dry lips, cracked nose, my skin started to peal even on my ears. Joint aches, thinning, hair mood swings. I'm on the maximum dose of 120 mg a day and it's hard to put up with.

If it works completely it's going to be worth it. My self esteem had gotten very low and I was very self conscious, even when I was at home with family, I didn't want them to look at me. I can look people in the face now without any make up on and concentrate on them and what we're saying instead of what they might be thinking.
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July 21, 2007

Pros:

Less oil on the face and pores seem to look smaller.I am still not finished treatment so can't comment on the full result yet.

Cons:

My face was VERY dry with flakes. Lips are TERRIBLE and constantly peeling- can't go out without petroleum jelly. I get two nosebleeds each day.Dry feet and arms,eczema became torture.Very sore and flaky ears.Sometimes feel sad and have no confidence

I think it is working, but very slowly in my case.It is month 7 and I am still suffering with existing cysts, although they have reduced in size.You have to be patient and think of something else.I avoid make-up so the drugs can work better,plus the skin is so dry that make-up flakes away.My social life and confidence are suffering alot as I feel inadequate about my skin.Sometimes I feel quite sad and fed up, the waiting is very frustrating.Hopefully I will see better results soon and it will all have been worth it.Overall I would reccommend people to try it because atleast now I am seeing changes, whereas before my skin just didn't respond to anything and I hated my appearance.The side effects are harsh and they do make you feel frustrated but I think the untreated acne itself does that, so why not suffer these feelings while you are fighting it rather than suffering from it.
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July 6, 2007

Pros:

cleared up cystic acne 100% by the 3rd month.

Cons:

Possible emotional side effects, although hard to tell b/c there were other stresses in my life; dry lips, dry nose, back pain.

I was hesitant to go on Accutane b/c of the side effects. I have had persistant cystic acne on my face for over 10 years (I'm 27 now). I would get approx. 1-3 new cysts per week. I tried EVERYTHING else. W/in the first month of taking Accutane, my skin was improving. I wasn't getting pimples as often, and when I did they actually popped, as where I used to have to get them injected. I only have about 5 weeks left to go with the course, so I can't say how long these results will last. Lastly, the side effects. I have had a lot going on in my life and am having trouble dealing with these issues. I have had terrible anxiety, aggressive, short-tempered, and had crying spells. I don't know if I would be able to deal with these issues better if I was not on the drug. The physical side effects are a breeze. Dry lips and nose and back pain -- but all well worth it. I will post again after I'm off the drug to give an update on my emotional state.
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July 1, 2007

Pros:

Works like a charm! My skin never looked better than it did after I finished Accutane...

Cons:

... but all my acne came back after a year of being off Accutane. I would have to go through a second treatment of this stuff if I wanted clear skin again.

I'm guessing my case is rare because for most people it works the first time. I'd say try it, definitely. I hated having to get up at weird hours to take it (because of conflicts with eating times) and 2 pills a day was just so much work for such a long time without guaranteed results (for me). But otherwise, the medicine is a God-sent.
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July 1, 2007

Pros:

Works for some people.

Cons:

Extremely dry lips and everywhere else, soreness

I had really bad acne and my doctor recommended Accutane as the last thing after nothing else worked. Initially it got a lot worse than it was and by the 5th month it was a little better than it used to be. My doctor told me I was taking it for too long of a time period and I had to stop the treatment and now my acne is just worse than ever. It didn't work for my buy my other 3 friends that took have completely clear skin that you could never even tell they had a pimple. I would definately try it but it doesn't work for some pepole.
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June 29, 2007

Pros:

really cleared up my severe, constant acne mostly by 3 months.

Cons:

Made me very aggressive and impulsive, a way i would not naturally act NOT on the drug creating harmful situations where i was VERY unpredictable. and of course the normal side affects such as dry lips.

My docter had to stop writing my prescription for me because my family and friends believed i was a threat to myself or others. i was truly addicted to the drug emotionally. i did not want to live again with acne. I HAD TO GET THE DRUG. the emotional strain has forced me to get a psychologist. I'm thankful my acne cleared but regret how i acted toward myself and others...
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June 24, 2007

Pros:

Cleared up my skin beautifully for months during treatment and about two years after. Breakouts started returning after that but haven't reached as bad as they were before.

Cons:

While dermatologists would disagree, I believe it's responsible for the keratosis polaris I've developed. Only a month or so after the end of my treatment KP started. Also horribly chapped lips started almost immeadiately and remained thru treatment.

If your acne is bothering you, use this stuff. It really does work wonders. I've seen friends with horrid acne have smooth skin and I know how good it worked for me. The KP I've developed may or may not be a result of acne but it's definitely much less of a problem than my acne ever was.
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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