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 27, 2012
I'm only in my fourth month of treatment, but I thought it might be helpful for others to have some information about what this will cost if you do try it. Clavaris, 40 mg, for 3 months -- $288.70 X 3 Clavaris, 80 mg, for 3 months -- 570.88 X 3 Labwork, once a month, 8 months -- 129.70 X 8 Doctor visits, once a month, 8 months -- 100 X 8 Total cost - $4,416.34 I called all the approved pharmacies listed on iPledge and found Walmart by far the cheapest, and the lab I used said they were giving me a 50% discount for not having insurance. So far it hasn't helped my acne at all, but I'm hopeful things will be clearing up soon. Good luck to you all.
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August 13, 2012

Pros:

Clears up acne

Cons:

Doesn't last
Severe dry skin
flakyness
Itchyness
Regular appointments mean taking time off work

I started off taking 30mg a day and my skin started to clear up really quickly. However i also developed severe eczema over my face/hands/arms/legs/feet. Before the treatment i only ever had slight eczema patches on my hand but 4 weeks into treatment i was covered in it. The eczema looked a whole lot worse than the acne did! I also suffered an extremely itchy scalp and dry lips throughout treatment. Having regular appointments is also a pain, two appointments a month - one for the blood test and another for a pregnancy test/ represcription. Taking time off work for these was a hassle. Overall the treatment was good at first however the side affects / blood tests were not worth all the hassle and a few months after stopping treatment my acne came back anyway. If you suffer from eczema i would really reccommend trying something else :(
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July 3, 2012

Pros:

Clears acne
No oily skin for years

Cons:

Only lasted 5yrs after treatment
Extreme dryness (skin, hair, mouth, sex, ect.)
Hair loss
Depression
Monthly blood tests

I've had moderate-severe acne since I was 8yrs old that did not react to antibiotics or birth control. I went on Accutane when I was 13yrs old. My acne cleared up immediately. In fact I had clear, not oily skin for 4 yrs after that. The dry skin was treatable with lotions. However the dry hair and hair loss was not as treatable. It took 3yrs for my hair to grow back completely and had to deal with embarrassing clumps of hair coming out (in a 8th grade class room...so embarrassing) Now I'm a freshman in college and my hormonal acne is back to the same severity as before Accutane. I was told 13% of users have to go on a 2nd round but I can't deal with the hair loss, monthly blood tests, and mood swings again. I still suggest taking Accutane for acne suffers but it has serious side effects and may not last.
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June 9, 2012

Pros:

Clears acne for a period of time; Decreases production of skin oil

Cons:

Acne coming back after some time; oil production restoring to the same level; flushing, facial redness; dry skin; eczema; Hives; bloody nose; sore joints.

Accutane does help with acne but sadly the acne returns after some time- can be up to a year. So considering all the side effects (apparent and possibly long term not so apparent) this drug fails to live up to its miracle status. During the accutane treatment the side effects worsen the longer you take it, and it does clear up the skin, but my face was terribly red all the time, so hard to enjoy disappearance of acne during this period. The other major concern I had is hives which I got twice. There is no official link between hives and accutane, but I never had it before and researching the Internet I found lots of other people who suffered from it while (and after) they were on accutane. Hives is basically this terribly blotchy rash popping up all over your body that itches like crazy. I would not mind side effects if the oil and acne have not come back since. After stopping the accutane you will see oil gradually building up again and after some time you realize that you are back at square one. The oil glans recover over time. I've read the reviews and most of the positive ones are written by people who have just finished accutane or even still taking it. One reviewer even has been on it for only two weeks (please). It's been a year since I stopped taking accutane, my acne is not as bad (yet) but its back and the oily skin too. So I do not believe accutane can change how your body produces oil forever. And considering the side effects you can't keep taking it to control your acne.
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March 29, 2012

Pros:

- Cleared skin while on the medication.
- Made me so confident about myself and life once my skin had no active breakouts. Covered the remaining red scars/marks with concealer; it gave the illusion that I had always had 'perfect' skin.
- Works for most people; but there are other alternatives if you have time to research yourself.

Cons:

- 4 months after finishing the medication acne came back. Went on it again a year later and although it cleared my skin while on it the acne came back again once finished.
- The lifetime effects it can have on your body.
- I did have to see a psychologist while taking the first course of the medication, which wasn't a bad thing; but being a teen I felt embarrassed.

This is not a miracle drug, you still need to look after your skin. I regret taking this medication now; even more so for taking it twice! I wish my dermatologist didn't give up on retin-a after 3 weeks and put me on this medication. Although I was clear while on Accutane (after 2 months my acne cleared completely) it then came back after a few months of finishing the 8 month course. This is a very serious medication. I would only recommend going on it if you are healthy - don't drink or smoke etc. Although, without this medication I wouldn't be where I am today. I first started the treatment when I was 16; my skin was disgusting and my confidence was so low. Once my skin cleared I was doing so so much better at school in my senior year (it didn't come back til after I had finished school). So I do recommend you give this a go if you have tried everything else, but only go on it once. Side Note: I now use Tretinoin 0.1% (Alcohol Free*) at night and 2% salicylic acid liquid (leave on) in the morning after cleansing with La Roche-Posay Effaclar Purifying Foaming Gel. *You may need to use a Tretinoin gel that is Alcohol Free, because the Retin-A brand had more negative effects to my skin than good (because its a Alcohol based gel). I recommend using products that are alcohol and fragrance free, most acne treatments contain these things which actually (in my case) make things worse. Always! use a sunscreen SPF 30 or higher no matter what acne treatment you are on. Despite what some may say; the sun (and tanning) is not good for acne or skin as it thickens the outer layer making acne harder to get rid of acne (plus gives you wrinkles, blah!). Also wearing sunscreen stops the production of vitamin D3 from the sun, you should take a supplement instead. Always! Always! be gentle and kind to your skin. You only have one skin in a lifetime; treat it well.
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February 29, 2012

Pros:

Clear skin

Cons:

Photosensitivity terribly
Constant dry skin
Eczema rashes occur at times

I would not recommend this at all. The distress and negative it has caused definatly outweighs the no acne situation. I am currently on holiday with my fiancé FOUR MONTHS post tane. And it has been a nightmare. I cannot expose my skin at all in the sun as I made the mistake of doing so and I am now severely sunburnt with blisters etc even though I used factor 50 SPF. I know for a fact it is because of the tane as i had very good skin in the sun before accutane. I cannot stress enough the negatives that can come from this medicine I regret taking it. Please read all of the negative comments about accutane before thinking it is a miracle drug. There are real people out there who have a lot worse outcome than myself which could happen to you.
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February 27, 2012

Pros:

This stuff DOES work!!
Cleared my face in 3 weeks

Cons:

Dont underestimate the side effects especially the serious ones!!
Dry lips
Small flares up of ezema on hands and feet
dry skin
Extremely dry eyes (i do wear contact lenses)
gastro-problems
always thirsty (which isnt a bad thing)
nose bleed (only on 2 occasions)
joint pain (which did come and go and wasnt constant)

Was prescribed ro-accutane jan 2012........side effects dnt take long to kick, by the end of the week i noticed everything drying up. So by week 3 my face which at this point i was still getting spots just cleared right up....i mean like literally over night my existing spots popped and never had a spot since. So when i say it works...it really does and 3 weeks is a really quick time to clear the skin up, my face was lovely and dry . Unfortunetly in the same week my spots cleared up was the same time my eyes dryed up to the point they were red, sore, irritated and vision was blurry with my lenses in. i went to the opticans and he suggested to only wear glasses. my gut instincts told me to stop the medicine in which i did. Went to a nurse she said very rarely it affects vision but is more of an intolerance to contact lenses...she gave me the option of trying accutane on a really low dose so from 40mg to 10mg or try antibiotics(which i have tried in my teens) i went away from there and thought if the oil comes back in my skin it would come back in my eyes and maybe then i would consider re-taking at a low dose so here i am i havnt taken it for 17 days havnt had a spot since but i still dnt have any intentions on taking it, because my vision is more important than anything and it really isnt worth risking any damage to eyes. i cant wear contacts atm because they irrtiate my eyes so am wearing my glasses.. that is the only side effect left, the rest have gone. Please remember it is a serious drug....listen to your body because you will do it a favour in the long run. Some people have had permanent side effects...there is a drug for us all you just have to experiment until you find it....you have to keep strong and keep fighting!! Im happy for those who have have had really postive reactions...but for me ive tried it and wont be going down that route again, there are safer medicines and i dnt want to live regretting anything that compensates my hea
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January 22, 2012

Pros:

Worked very well while I was on it.

Cons:

Dry skin/eyes. (I wear contacts).
Sore joints, sore muscles.
Decrease in appetite.
Acne starting coming back 2 weeks after a 5 month course (40mg daily).

If it works for you great. If it doesn't it is a huge pain for nothing.
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January 12, 2012

Pros:

Completely clears your skin up within a matter of months

Cons:

Risk of dangerous side effects in addition to dry skin and extreme sensitivity to the sun, acne may come back a few years later

I used this when I was a teenager and it completely cleared up my skin. By my early 20's my acne came back though and it was worst then ever. I went to the dermatologist and they told me that some people need another treatment later. So I tried it again, but even on the lowest doses it burned the skin inside my nose. Very weird and painful. It's definitely not worth the risk and pain of using it, just to have acne resurface again later. I would try zinc supplements and benzoyl peroxide first. Eliminating diary from my diet drastically reduced the amount of cystic acne I get so you could try that first as well. And to think, all those years of drinking milk for healthy bones. Ha, what a load! Good luck!
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January 1, 2012

Pros:

better results than other prescription treatments

Cons:

expensive
had to get blood drawn every month
results were temporary

I'd tried other prescription treatments, but none of them did much for my acne. Accutane did more than they did, but the results didn't last. After taking Accutane for a year, I thought that I wouldn't have to worry about acne any more. I was wrong. Within a few years, my acne was back in full force. Conclusion: Accutane is a big pain, and it's not a permanent solution.
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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