Isotretinoin (Accutane®)
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Side Effects

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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December 11, 2007

Pros:

acne clearing

Cons:

side effects

ive been on it for 3 months and a week or so. for the first 2 months my skin went through ups and downs. i would start to clear fairly well then break out then clear up again. the next breakout was never as severe. about 2 1/2 months to 3 months into it my skin cleared up and stayed clear, except for a few red marks. my body still has a ways to go but i am happy with my face thus far, considering i still have another 3 months to go. i am prescribed 20 mg 1st month, 40mg 2nd month, 60 mg 3rd month, and 80 mg for 4th, 5th, and 6th month. the reason my initial breakout wasnt that bad was because i was only on 20 mg. that is my experience so far but i do have a question for anyone who has been on it. trust me i know youre not supposed to drink. i havent except for twice and my blood work was fine, but i am turning 21 very soon and was wondering if going out would be alright. i have liver supplements that i bought called milk thistle. would this help? if i drank for my 21st would i be ok?
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December 9, 2007

Pros:

The only thing that work...seriously

Cons:

i am scare ,will my acne come back,,,,cos i have as long as 12 yr

ohh thank God its work now my face is clear...still scare will it come back i am still using it.in Pakistan its not affordable,it cost 1 tab. more than one $dollar.only one thing is my lips are dry.it dosnt matter
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December 4, 2007

Pros:

good price. does just that- it clears acne. and it really does.

Cons:

HUGE breakout for the first month before taking effect. hated the system. hated the blood tests which were expensive as hell. for 6 months i had lived a life of absolute torture. couldn't laugh or eat much cuz skin would peel, no sun exposure..

it WORKS, it does. but screw the statistics almost everyone has breakouts after its done. it wont stay the same way after you're done with it. acne WILL return, just not as severe as it was before. BOTTOM LINE. these small side effects seem so small at first, but they will make your social life a living hell. OH they're so small.. but think about it. 6 months of lost social life compared with having acne temporarily.
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November 29, 2007

Pros:

No more oily face and hair (I can go all day without turning into a greaseball!), acne is clearing up

Cons:

Initial flare up, peeling skin, very chapped lips, dry nose/nose bleeds, muscle aches, joint pain especially in knees and neck, rash on the back of hands, tiredness

Although I have a lot of side effects, I am SO impressed and happy with this medication. After just one month my extremely oily skin and hair are so much less greasy and my moderate acne is starting to clear up. I'm 28 and have had acne that didn't respond to any treatment since I was 12. The side effects are manageable: Aquaphor for chapped lips & rash (it's an ointment and it WORKS). Saline spray for nose issues. Advil for muscle aches & joint pain if it's bad. A cup of coffee for tiredness + lots and lots and lots of water to counteract the drying effects of it. Between the de-greasing effect and the prospect that this is actually going to work, it's totally worth the side effects!
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November 21, 2007

Pros:

Worked after only one round of treatment, and kept my skin looking great for a long time afterwards!

Cons:

Drying to the skin. Requires periodic blood tests to check for liver damage.

My acne is was moderate, but not very controllable when I went on Accutane. After one course of treatment, my skin was the clearest it had been since elementary school! My acne has never been as bad as it was before I went on Accutane, and is now much more controllable. The only real problem I had with it was an outbreak of eczema, but that was controlled with a facial moisturizer and a topical steroid for my hands and feet.
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November 16, 2007

Pros:

After a few weeks I noticed less oil on my skin. I'm seeing results that I hadn't with other medications.

Cons:

Side Effects...joint pain, dryness of everything and remembering to take it twice a day.

I have very mild acne but nothing has helped it and my doc recommended accutane. I'm sick of wasting the doctor's time with mild acne so I tried it. Been on it a little over a month and seeing great effects. The joint pain is a little frustrating especially at night but I think it will be worth it in the end. Very cheap with my insurance.
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November 15, 2007

Pros:

Completely clear skin for up to a year.

Cons:

Very dry lips, mouth, nose. It Was not a long term panacea as I expected.

I did my first session in 01' and was not as diligent as I should have been in the dosing. It still cleared my skin completely for a year. My second session 18 months later kept my skin quite clear for about 3 years. Now at 27 I am looking for alternatives to doing another session as my respawn acne is far more superficial and definitely not the deep cystic socially debilitating mess I faced before.
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November 14, 2007

Pros:

I am on my last month of accutane and could not be happier! All that annoying gunk under my skin that i would always pick at is GONE! Leaving me nothing to pick at! I pray it doest come back. If my acne did come back i would take another course.

Cons:

I am worried that it will come back and i have to take accutane again. Dry skin all over, irritating. Very dry lips. Some knee pain, cant jog for the last two months of treatment. Makes you more tired than normal.

This stuff works, it does have serious side effects (mood, joint pain, dry skin, ect.), but you have to decide what is more important to you. I had very persistent pitted pores. Would always pick at and large amounts of gunk would come out, have a few minor scars. Never really had nodule acne, but have had a couple pop us since being put on accutane, guess way of clearing out pores. I believe that everyone deserves a fresh clear face to show the world, and this medicine makes it possible for people who were born with horrible skin. In that sense it is a miracle drug. But just beware of the side effects. I am a 20yo active health nut so i though i would not experience any of the side effects, but i was wrong. I experienced mood change (manageable because I knew what it was from), dry skin, joint pain, and tiredness. DO NOT DRINK ALCOHAL WHILE ON MEDICATION. Had a friend whose husband drank while on it and his hair started falling out! Good luck if you are just starting! Goes by fast!
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November 14, 2007

Pros:

Very affordable with insurance -- I have paid $10.00 per month for two daughters and myself (I am on my second course -- it's been 23 years).

Cons:

Dry lips were the worst aspect for me. Derm said "DO NOT LICK YOUR LIPS -- YOUR SALIVA WILL DRY THEM OUT EVEN MORE" but honestly it can be hard to follow that advice when you don't have a tube of lip balm nearby. Spend lavishly on that stuff!

Nothing else could compare to the effect Accutane had on my skin. In the 1980's they only kept you on it for about 4 months. That is probably why I need it again. Regarding the initial breakout, I have this to say -- what is your priority? Do you want to look good (controlled acne) without interruption but always deal with it, or do you want to get rid of it for at least two decades? Further, accutane works by drying up those little oil wells in your face/skin. It stands to reason that in the process of expelling sebaceous matter and shrinking the pore area, there can be some disturbance! Have you ever had a facial done? You get a breakout from that too. If the IB is long in duration, I would imagine that you had a tremendous amount of oily goo that the accutance had to expel and/or dissolve. I contend it's worth the setback of the IB, and let me add, consider the costs -- can you keep ProActive and make-up manufac. rolling in $$$ forever?
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November 9, 2007

Pros:

Flawless and smooth skin. Not a bump anywhere.

Cons:

It is expensive.

This is my first course and I am actually into month 6 of accutane, I have a 8 month course due to low dose. I began clearing up at the end of week 2 and from then on my skin is perfect without makeup. It was even better then the time I took antibiotics and had clear skin because I still had blackheads then. But now I don't have any blackheads to go with my brand new skin. I didn't have much side effects either, just some dry lips and dry skin in the beginning but they ceased at the end of month 1.
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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