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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October 30, 2012

Pros:

Cleared up my acne altogether (after a few months)!
Totally worth it!
Insurance paid for it.

Cons:

Extreme dryness; made my acne very severe the first 2 months or so (worse than it's ever been); sometimes redness; a pain in the neck to renew every month; also raised my cholesterol (not extremely, just thought I should add that as a note)

I have to admit that accutane is not the easiest/quickest way to clear your skin, but it has been very effective for me. I've had acne/backne since I was 12 (I am now 18) and I've tried almost everything. My skin cleared up for awhile while I was on birth control pills (the doctor said that those might be able to help with my complexion). I gained weight on those so I quit them. For a few months all was well and then my skin got very bad. My dad was on accutane when he was a teen, so he recommended I try it. My younger sister and I both got accutane together and when we started, our skin was worse than it had ever been. We had cystic-like breakouts as well as dry skin. The first two months we both had very low self esteem and didn't want to leave the house at times. My advice to you is to stick with it!!! It is SO worth it in the end! I now have only three weeks left and my skin is completely clear! Granted, it is still very dry but the dermatologist says that it should get back to normal the week after we finish our last dose. Even my backne (which has never improved) is gone. Very very satisfied. I definitely recommend it!
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October 26, 2012

Pros:

Cleared my acne for almost ten years.

Cons:

For me, the only side effects were dryness and one bloody nose.

I took accutane in 2000 for moderate/mild acne after my acne wasn't responding to antibiotics and topicals. My skin was beautiful until about 2009, when the combination of law school and my grandmother's death made me start breaking out pretty badly. I took proactiv, which worked for a short while. Then I went back to a derm., and asked for yaz and spironolactone after reading reviews on here. That worked pretty well, my skin wasn't great (large pores), but it was tolerable. Then I switched from yaz to lo-estrin, and my skin just started getting worse and worse. Even after switching back to yaz and upping my spiro to 100mg/day, my skin still wasn't improving, so now I'm about to start my second course of accutane. I hope to have the same results, except this time instead of almost a decade of clear skin, I hope to not have any more skin issues. This drug has worked wonders for me in the past, and I highly recommend it. Our society has a tendency to litigate everything, hence the massive warnings in relation to this drug. But, it seems that severe side effects are rare and, if monitored by a doctor, you'll be taken off of this drug if it's not suitable for your body. It's worth the chance of having clear skin and peace of mind.
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October 21, 2012

Pros:

Only product to make any difference
Cleared under the skin whiteheads
Clears redness
Clears pimples
Prevents and clears cysts

Cons:

Horrible Dryness
Adaptation period to side effects
Rare side effect Risks
Strain on liver when drinking alcohol with this drug

Products I've been on (And yes I used them all for a minimum of 12 weeks to ensure full time for effectiveness) -Proactiv -Glycolic Acids Salicylic Acids -Benzoyl Peroxides (Multiple Brands including dan's) -Sulfur Products (Multiple Brands) -Facial Masks -Doxycyclene -Tetracyclene -Minocyclene -Metrogel -Apple Cider Vinegar -Zinc Pills (As well as ALL kinds of vitamin supplements) -Retinol -Diet Changes (Cutting out dairy etc.) -Clindoxyl -Homemade Remedies (Many types) -OTC Products (Neutrogena, Nivea, Clear Pores, Acne Bootcamp) I consider myself to have persistent moderate acne. Also my face is easily reddened by working out/temp changes/eating etc. I've have 3 cysts surgically removed but cysts aren't a huge problem for me. Body acne also has never been an issue. Not one of these products or lifestyle changes have had any effect on my face over the last 7 years. I had assumed there was absolutely no way out. I should also mention a walk-in doctor put me on accutane 6 years ago but took me off it after month 2 for no reason (He gave me no explanation). My current derm explained that he "forgot" to do mandatory bloodwork so got scared and took me off. (Complete moron) I'm currently going into month 4 of Isotretinoin. Month 1 was 40mg/day. Month 2 and 3 were 40mg a day and 80mg every other day. Months 4 and 5 will be 80mg/day to achieve the 120mg/kg cumulative dosing. Knowing how to use this product and what not to use with it as well as preparing properly for the side effects has made a huge difference compared to my first round. This site helped me immensely. I am 100% clear, I feel like a million bucks and I have my life back. The redness is even almost all gone. I could not recommend this product more. Of course I was lucky not to have most side effects but the dryness sucks. I recommend Jojoba Oil mixed with Cerave for a moisturizer and only water to wash with otherwise. Also vasel
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October 16, 2012

Pros:

It works beautifully!

Cons:

I had no serious negative side effects--just dry lips and occasional flushing.

This is my second post-Accutane update. I left a positive review one month after my 6.5 month course of Claravis. Now, 6 months after my course, I am still very happy with my results. I had a few minor breakouts approximately 6 weeks after stopping the treatment, but they were just small inflammatory pimples, not cysts. I am thrilled to report that I have not had one single cyst since November 2011 (my second month of taking Claravis). My dermatologist prescribed me Renova (tretinoin) to deal with the minor breakouts and now my skin is completely clear most of the time! I still get a few tiny spots around my period, but they are usually so small I don't even feel the need to cover them with concealer. At 28 (soon to be 29!) my skin looks better than it ever has in my life. Not only am I acne-free, my complexion looks smooth and creamy since taking Claravis. No more angry red skin tone! I am so thankful for this medication and SO happy I decided to take the leap and try it after years of debating. It is a serious drug, so find the best dermatologist in your area and let him or her know all your questions and concerns. If you are in the care of a professional medical expert and if you follow the guidelines to the letter, this is a safe medication. I cannot express what having clear skin has done for me psychologically. Perhaps most importantly, it has given me the confidence to begin working through my deep-seated body image issues. As I approach 30, I feel in many ways that I am finally starting to live. I wish this could have happened for me sooner, but late is better than never (as the cliche goes--but hey, it's true!). If you are struggling with the crippling effects of acne, my heart goes out to you. I hope you can one day have the kind of healing I have been fortunate enough to find.
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October 16, 2012

Pros:

Clears acne (permanently?)

Cons:

Dryness
Requires monthly doctor visits + testing
Possible mental health consequences

Took accutane for 5 months at age 27. Since I was 17, I've have moderate but persistent acne, generally large slow-developing pustules that form on the area between my chin and my mouth. It would respond to BP, but that kind of treatment is just onerous. Having to do that twice or even once a day seemed to get my skin into this cycle that was hard to get out of. It was very constraining on my lifestyle and made it hard to travel, go camping etc. And it wasn't 100%; I would still get some pimples. I figured (and was told) that I would likely grow out of it, but that just didn't happen. I took accutane for 5 months, between January and July of this year. It is now October, and I am pretty much totally clear. I get the odd pimple now and then but they are much smaller and much less of a problem. It could be that my acne comes back after remission, but right now I'm very pleased. A few thoughts about acne and accutane. Dryness. At the end of my accutane treatment, I was still getting some pimples, more than I am now and I probably would have given accutane a 4/5 rating. Once I stopped taking the pills and the dryness went away, the number of pimples dropped dramatically. During the treatment, I was using a variety of products to moisturize: aquaphor for my hands; carmex for my lips; jojoba oil for my face. I highly recommend all three (plus sunscreen). The fact that my pimples became much fewer when the accutane-related dryness stopped made me think about the relationship between acne and skin dryness. Other people have said this same thing, but I'm really thinking now that acne is often a product of dryness much than it is a product of oiliness. If your skin is dry (from washing or whatever), your body products oil and I think that causes pimples as it gets blocked up. Putting pure jojoba oil on your face does not seem to cause pimples. If anything, it seems to obviate the need for your body to produce oil. Just a thought.
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October 12, 2012

Pros:

I had severe cystic acne and had tried all topical products and antibiotics doctors had prescribed. I live in the Philippines and must say Accutane still is not very known here yet. Finally I found a dermatologist who was willing to take the risks. Gone through all lab works, signed a waiver, did 5 months of accutane. When I was using it I no longer had to use blotting paper and my face had cleared. Now 3.5 yrs. Later i now have a baby.My baby in perfect health.No longer dealing with cystic acne

Cons:

Expensive. But definitely worth it. Monthly blood works. I was lucky I didn't get negative side effects. But the risk is still there for some.

If you have severe acne, ask your doctor if you can take this product. Very effective. You no longer have to be embarassed to go out. This is the best.
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October 9, 2012

Pros:

AMAZING long-lasting results for cystic and nodular acne. I will not recommend this product for anything less than severe acne because it is very strong. I was happy and confident again. I no longer had to cringe while looking in the mirror.

Cons:

There are many side-effects as with every prescription medication. Dry, dry skin. I was dry and itchy in all places imaginable (yes, even "those" unmentionable areas). Super dry lips, itchy everywhere, etc. I was super conscious of my health the entire time - I ate a diet high in vegetables and fruits - MINIMAL GRAINS. Avoid grains as much as possible to minimize chances of getting IBS.

I suffered from moderately severe acne (1-3 deep cysts on each cheek) for about a year. Each cyst would last a week and would leave a terrible scar. I tried antibiotics and retin-A before resorting to Accutane in 2009. I am a female and at the time of the medication, I was 115 lbs and I took 50 mg for 5 months. I lost 5 lbs during the course of the five months I was on the meds. Please, please remain hydrated (5-6 glasses of water a day) and eat very healthy food (Absolutely NO GRAINS) to be at optimal health during the course of Accutane. You will have no issues if you do that. I did not have insurance so I paid for the medicine and monthly bloodwork out of pocket. Please don't self-diagnose yourself. I did order the actual medication from overseas so it was easier on the pockets. Best decision of my life! The reason there may be a skewed amount of bad reviews on this website is because those who have had good experiences never come back! :) Good luck!
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October 7, 2012

Pros:

Perfect skin.
No blackheads.
Decongested pores.
No acne.
No oiliness.
Perfect skin.
Balanced skin.
Oh, did I mention perfect skin?

Cons:

Dry skin.
Dry lips.
Dry scalp.
Bloody nose.
Can be expensive.

Accutane is the best thing to happen to my skin since my discovery of bb cream. Long story short, I've had horrendous skin ever since I hit puberty, thanks to my lovely genetics. I tried every perscription and over the counter remedy on the market and nothing worked or had a lasting effect (and a few even made the problem worse). After six years of hating my oily, flaky, acne-ridden, large pored, red skin I asked my dermatologist if she would let me take the plunge; she was hesistent, but I was persistent. The result six months later? A woman stopped me in my tracks a few weeks ago to specifically tell me my skin was beautiful and to ask which products I used. At my last-visit-ever to the dermatologist, this is what she told me: "Your skin is like porcelian." Enough said.
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October 6, 2012

Pros:

Works fast within a week or two, cleared my acne on face & on crown area head (bald)
I feel like new person, now I go out more often

Cons:

Dry lips & dry skin around eyes area

Story: Couple years ago, I started to get acne on top of my head in crown area, two to three bump every two weeks. It grew to about half as dime size, but it would leave nasty dark brown or black scar about size of quarter. Since I am bald, it was CLEARLY visible and looked unpleasant. So ultimately affecting my self esteem. Started visit doc for cure, tried almost all basic remedies, but no luck. After some research online, I asked doc about Accutane. He told me that would be last thing to try, but it would be much more involved as in taking blood sample, more visits to doc, etc, therefore more costly. So I got bit afraid and kept on doing basic remedies. Finally I decided to take the risk, try Isotretinoin in basic form. 40 mg a day. In a week, no bumps on head. My skin texture started to improve, skin was less oily thus less shiny. It is almost a magic pill for me. So far don't have many side effect, just dryness. No mood swing or depressed like some other people say here. In fact, I am much happier and in happy mood, and see myself in mirror more often. Now, I wish I had started this regime much earlier. Will update more 2-3 months later.
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September 30, 2012

Pros:

Completely cleared my acne
Have yet to have any more spots since stopping the drug in January!
Much more confident!
Apart from dry lips, no side effects

Cons:

Very dry lips, solved with carmex
Dry eyes, problem as I wore contact lenses and had to be careful about how long i left them in for.
Spots that popped up while on accutane seemed to scar more easily, have slight marks left

I started suffering from acne in my second year of University , came almost completely out of the blue. Was an awful year in general and SHATTERED my confidence. I tried everything to try and solve the problem (Duac, tetracycline, differin, and a couple of other antiobiotics) but was determined not to go on accutane because of the 'horror stories' i read on the internet. I wish i had stopped worrying and just got on accutane as soon as i started seeing the spots pop up, I had very very marginal (if that) results with all the previous products i used, and accutane just completely solved the problem in the space of 4 months (60mg a day). Only side effect i really felt was the dry lips, which was solved by carmex. I really wanted to write this review because while suffering from acne i spent literally HOURS pouring over the internet (and this site in particular) for cures. I over thought every possible product and put off using accutane as long as possible, basically it was the one product that really really worked. My acne was completely cured and has remained cured now for 8 months. I only wish i had got on sooner to save myself some minor scarring! I was on accutane for four months, in the first month i started experiencing the dry lips, some spots started to pop up during month 1-2 and i was worried it wasn't working, but i kept on and by month 3 no new spots were popping up, and by the end of month 4 i was completely clear! and have remained clear since. If your worried about your acne at all, just get on accutane because it really does solve the problem very quickly. if i could go back I would have got on it at the very first spot i saw, even when it was still fairly minor, because 4/5 months of minor discomfort is an incredibly small price to pay for not having to worry about acne again!
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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