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 16, 2012

Pros:

The number one benefit of taking this medicine is that it works! My acne is gone, period. I can honestly say that taking Accutane was the best medical decision I ever made for myself.

Cons:

For me, there were basically no "cons" related to Accutane. I had very minimal side effects-- some dryness of the lips and occasional flushing. I suppose one non-medical con is the cost; I entered $25.00 for the price paid, but that was the cost after I got new insurance. For the first three months, I had insurance (Aetna) that did not cover Accutane so a 40 day supply cost $315.00. It was still worth it. For the last 3.5 months, I had Blue Cross Blue Shield, which thankfully does cover it

I have suffered from acne since the age of 12. Most of my acne in my teens was moderate, but I began getting painful, scarring cysts in my 20s. I've tried every OTC product out there as well as prescription topicals, antibiotics, and Spironolactone. As my 28th birthday approached, I realized I had spent all of my teens and now most of my 20s worrying about my skin. I decided enough was enough and told my doctor I wanted to go on Accutane. My husband was very much against it at first, and I myself was very worried after reading all the horror stories online. We want to try to have children in a couple of years, so my main concern was the health of a future baby. My doctor assured me that the danger for pregnancy is while you are taking the medicine, not in the years following. My husband's main concern was for me--I have a history of clinical depression and he read about the controversy over Accutane and depression. I promised to be open about any change in my thoughts and moods. But honestly, the only change was that I felt WONDERFUL after seeing the medicine work its magic. I was lucky enough not to have an initial breakout, and my skin began to clear dramatically within the first two months. I still got a few cysts, but they were smaller and much less frequent. By the fourth month, I was completely clear. My skin began to look creamy and soft, and for the first time in my adult life, I didn't need to wear makeup to look normal. Now, I just wear makeup for fun on special occasions. Most days I only use a sunscreen. My doctor kept me on a 6.5 month course to ensure that the acne would be gone for good, and since I never had any negative side effects, I was happy to stay on it as long as she would allow. Now, one month after finishing my course, I am still clear! My next step is to treat scarring, but if my skin will just stay clear, I could be happy even with the scars. I would recommend this medicine to a friend or loved one in a heartbeat!
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May 14, 2012

Pros:

Cleared skin completely, gave me confidence again, made me love my skin.

Cons:

Dry lips(easily fixed with chapstick)
Dry skin(easily fixed with lotions)
Migraines

Because of accutane i got my life back. My skin is so clear and soft now. I can walk out side without worrying about make up. Socially it has greatly improved my life. Im so proud of my skin.
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May 12, 2012

Pros:

Acne 95% of acne gone in the 1st month, life changer.

Cons:

nothing

Accutane is a gift sent from God this changed my life I took 40mg of acctuane once a day i had no break outs, no joint pain or anything else i am a soccer player so even though i run a lot and weight lift accutane had no bad effects on my muscles or joints. DO NOT be scared of all of these negative reviews, the only problem i had was chapped lips but lip balm takes care of that. so please guys do yourselves a favor and get on this drug there is nothing to be afraid of and BTW the blood tests are not bad at all they only take about an ounce.
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May 11, 2012

Pros:

-Completely cleared acne
-Hair was never greasy

Cons:

-Constant, never-ending dry, flaky, cracked lips
-Back pain/joint pain
-Dry eyes
-Mild depression

I began taking acne not because of the severity of my acne, but for the bright red blemishes they left behind. Any pimple whatsoever would leave a scar even though I religiously refused to pop or pick at them. Accutane was amazing at clearing my skin, which gave it time to heal and diminish the severity of my scars. I was on accutane for 6 months, the last three months I was taking 80 mg/day. During these 6 months I only got 4 pimples which I think is pretty amazing. I have been off of accutane for about 10 days and I am praying my acne never returns because to be honest, I'm not sure I would ever want to go back on the drug. Yes, it was a MIRACLE at clearing my skin but the depression I experienced throughout the process was very difficult to deal with. However, thousands of people have taken this drug without any depression so I'm only saying this as a cautionary warning. The dry lips were a huge pain but my lips have already returned to their original state! I would undoubtedly recommend this drug to anyone since we all experience and react to drugs differently, but only after telling them to proceed with caution. Accutane can and will give you your confidence back!
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May 8, 2012

Pros:

Clearing up skin
Hair looks great

Cons:

Mild side effects
Dry eyes, lips, nose, skin
Joint cracking and aches
Headache

I'm a 25 year old female who's been struggling with acne for 3 years. I'd classify it as mild-moderate, however very persistent. I have small clogged pores that are impossible to clear. I'm taking 30mg 2x/day. This is my 5th week and I wanted to give a review on my progress, side effects, and products I've been using, so hopefully someone trying to decide to use this will. My skin stayed pretty much the same for the first 3 weeks then I started getting pus filled blemishes in my problem areas. I'd say 4 on my chin and 4 on my right cheek. However, they're drying up very quickly. My oily skin was dramatically reduced by day 5 and continues to by very dry into my 5th week. By week 2, I noticed a huge increase in blackheads that felt like they were sitting on the surface of my skin, but 2 days later I literally washed them away!!! As for side effects I've had quite a few, although they're all mild. My skin is quite dry, which isn't really a problem because not being oily is nice. I've had some nosebleeds and a dry nose. I've also had dry eyes. I have a dull headache as well. Lastly, I've had more muscle aches and joint pain. For products, I use cetaphil wash 2/day and cerave spf 30 day and cerave pm night. I also mix 1/2 scoop philosophy c powder into my moisturizers. For my body I've been using oil of olay anti aging body wash and lotion. I've been slathering aquaphor on my lips and burts bees with mango butter for day. For my eyes I've been using visine and this great product called alcone collyre bleu. Celebrities swear by this to make the whites of their eyes whiter. Takes the redness and any dullness out! I also iced those larger blemishes. This drug has been a miracle worker. I went to the derm last week and she said I was about 70% improved! My face looks good and is very soft. By the way this drug is fat soluble, so taking it with food greatly increases absorption. Try not to drink and keep a healthy diet to prevent any blood test issues
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May 1, 2012

Pros:

- Completely clear
- Only thing that's ever worked for me

Cons:

- Chapped, red lips
- Impossibly dry scalp (spent 6 months not wearing black)
- Overall unhappiness while on the medication

I've had cystic acne my whole life. Tried every Rx available (yes, I always used them properly and for the recommended duration of treatment), every OTC topical, four rounds of IPL with ALA, and as a bonus point for the "homeopathic/holistic health" crowd...yes I tried eating organic, wholesome, low GI foods, changing my exercise and sleep patterns, yoga, meditation, etc. Nothing worked. Accutane did. I found the side effects (mostly dryness) manageable using Dan's jojoba oil and moisturizer. And Aquaphor--lots of it. It also wore me out and made me pretty unhappy by the end of the regimen, but that might be attributable to its coinciding with finals week and semester's end. Hard to tell. Nonetheless, it was a miracle drug for me, and I recommend it.
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April 30, 2012

Pros:

Does everything you want it to!
Hair that basically doesn't get greasy ever

Cons:

Really dry skin which flakes
Really dry lips
Has given me a bad back
Apparently expensive (not in uk though as nhs pays)

It's been almost 10 months since my 6 months of roaccutane ended so thought I'd put an update on here for anyone who is in two minds about whether to give this a go. This sounds dramatic but it really has changed my life so much for the better. I get the odd spot now and again but they tend to be tiny and go away on their own in a day or two. If they started to come back again I would definitely ask to be referred for this treatment again. Does not get rid of all scars so do not expect that to be the case...although it does make skin production a lot quicker so will get rid of some. Being put on roaccutane is the best thing I could have hoped for and stopped me hating to look in the mirror :)
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April 30, 2012

Pros:

-Clear skin on face and body
-Reduces oil on skin and hair
-Confidence

Cons:

-Initial Breakout
-Dry skin and lips
-Initial Depression

I've been on Accutane the full 6 months and it's been a crazy journey! The initial breakout was horrible and it took a few months to clear up but it was completely worth it. It took much longer for the acne on my shoulders to clear up but now in the 6th month, I'm acne free. I completely recommend Accutane! Especially before you or your children develop acne scars which are irreparable. It's a tough journey but I have battled acne all throughout my adolescent years and 6 months on Accutane is much better than years of struggling with acne. I'm 20 now and I have acne scars that won't ever go away and I only wish that I would have done Accutane when I was younger. I went through a few days of depression during the initial breakout but it lasted no more than a few days and wasn't detrimental. I just didn't feel like going out or being with people due to the initial breakout. For those of you who are going through the initial breakout, stick with it! It hasn't been until just recently that I've seen consistent results so don't give up after month 4 and 5. Also, my doctor told me that the majority of Accutane users see more results after they get off of the Accutane. 6 months goes by faster than you think so hold on, you'll see clear, beautiful skin soon!
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April 24, 2012

Pros:

Works fast
Oil reduction
Black heads gone

Cons:

Dry eyes
Dry lips
Eczema on back of hands

First question I have to ask my self is why I waited so long to use Accutane? I have been on it for 2 months now and am extremely happy with the results. Black heads that even anti bios (which I have taken for years ) that wouldn't clear on my forehead are gone. I am taking it mostly to clear my backne which is now %80 better then it was before I started taking the Accutane. I first started at 40mg for the first month and am almost finished my second at 80mg. I have all the usual side effects like dry skin, chapped lips, daily nose bleeds, dry eyes and very dry hands. But I expected them after reading some reviews. It is manageable but for the first month this whole using moisturizer thing was pretty new to me. I had never bought a bottle of it in my life till Accutane. Either than that I get a touch lethargic from time to time but dont know if its Accutane related. I have not experienced any other side effects and still have the occasional beer from time to time. Ill list a few products that have really helped along the way. Aquaphor for lips.. amazing. Taro-Mupirocin ointment to jam up my nose for nose bleeds... pretty good. Natural tears 2 for dry eyes... amazing. Nivea ( in the jar only ) for dry skin.. amazing. Spectro eczema care... its ok.. not that it doesn't work, it actually works extremely well. But to well as it makes my skin ... soggy??.. and I can scratch it off the next day very easily. Last . for day use, Aveda chap stick ( $14 a stick : O ) But it works very well and doesn't give me that wet lip feeling I get from the Aquaphor. The next question I have to ask is, why are people paying so much for Accutane in the states? I have read people saying they had to pay up to $5000 a treatment??? Good greef, name brand Accutane in Canada is $60 a month. I have insurance but have seen the pricing if I didn't. Good luck with your treatment and we will see you pruned on the other side as thats what I feel like right now.. l
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April 24, 2012

Pros:

-Clear Skin
-Smooth skin
-Great Skin
-non greasy skin

Cons:

-depression
-dry lips
-dry skin
-sensitive skin

Understand that this is a game changer. It will clear your skin. Now im not sure about whether it will come back cuz im still on it (hope so!!!).
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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