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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December 15, 2011

Pros:

some improvement in skin texture

Cons:

dry cracked lips
body aches
worse break outs than before

I've been on Amnesteem for almost 4 months, I'm just now finishing month 3. I'm getting really nervous that its not working for me because my skin is not clearing. In fact, once month 2 hit my skin broke out and flared in places it never has before, with big painful cysts. After being put on a steroid, my skin calmed down, but I'm still waking up every morning with new cysts... THEY HURT! My back acne especially...Does anyone have any advice? Please tell me it's going to get better and I'm going to get the "perfect" skin everyone else brags about after going on this stuff. I'm really losing hope and my self esteem is really being affected. So frustrating.
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December 7, 2011

Pros:

-Good for use on acne where it's difficult to use a topical medication (back).
-Reduces cystic acne slightly.

Cons:

-VERY dry skin and lips, so much so that my face would be so dry it would bleed. (even with moisturising 5 times a day).
-The dry flakey skin is worse than original acne.
-Very painful a sore red skin.
-Dry, Itchy eyes.
-Muscle ache for first few weeks of treatment.
-Depression.
-Difficulty sleeping.
-Hair loss.

To be honest, the small improvement in acne is not worth the side effects. The dry skin around my mouth looked even worse than the acne. It make your skin VERY sore and painful, especially around the mouth and lips making it painful to talk, eat or smile. Very painful to shave, cuts skin off face. (I just gave up on shaving while on the medication) After a few weeks I noticed hair falling out which was rather distressing. Also while on the medication i felt realy depressed, isolated, I didn't feel like talking to anyone, going anywhere, doing anything, just generally really down. This is where I gave up on the treatment. Even if it did clear all my acne (which it didnt) it was still not the horrible side effects. I stopped taking them 1 week ago and I have cheered up a lot, my acne has flared up worse than ever but my skin is less painful (still a bit, but getting there) and I'm sleeping a lot better now. So if your thinking about starting on this medication, I wouldn't particularly recomend it but different people react differently to it so give it a go and you might have better luck than I did. But if you start to feel like your getting at all depressed while on it, STOP because that keeps getting worse and its not worth it.
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November 25, 2011

Pros:

A true miracle of modern medicine.

Cons:

Although very effective for the vast majority of people, I had to cease treatment after taking my 15th pill due to a relatively rare side-effect.

I want to be clear that I'm not trying to scare anyone into not trying accutane; I think it can be a miracle cure and I know many people whose lives have been changed for the better from taking it. However, I would caution anyone trying it to be very diligent and to listen to their body for the duration of their course, and to read the literature that comes with the pills. I experienced bad stomach upset during my second week of taking accutane (40mg/day) and on the 15th day noticed a very small amount of rectal bleeding, which I would not have noticed if I wasn't looking out for it. I ceased the pill immediately and told my doctor who confirmed that this drug is not suitable for me. I have no history of colitis, crohn's or IBD and none that I know of in my family either. I should be ok because I did not take it for very long. Please be diligent, listen to your body, and best of luck!
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July 25, 2011

Pros:

Clear skin
Clear blackheads, whiteheads

Cons:

Based on my experience:
Dry skin
Chapped Lips
Headaches
Joint/back pain
Only temporary, may cause long-term health risks

Like other acne products, accutane may not be for everyone. The main difference though, is that while most acne products are harmless, accutane can result in serious long-term health effects. I tried accutane about a year ago. I tried it for several months, and for those few months I was really happy because my face was clear for once and everybody complimented on my face. Yes, I underwent some side effects (as mentioned above) which were bearable, and the doctor had blood checkups with me regularly, but know that once you stop taking it, and you think that you no longer need to take it, there is a high possibility that it will come back. Like most has mentioned, your face will be really dry and you will feel discomfort as the process goes on. Your face will break out and it will be worse in the beginning before it starts to clear and get better. Basically what it does is that your skin just peels off due to it's dryness so you face thins a lot. At first it may seem worth it...and I was going to start taking it again, but then I realized it's not worth it. Shortly after I stopped taking accutane, my nipples darkened, dried up, and liquid was oozing out of it. It was serious to the point where I had to have biopsy. Whether or not this has to do with accutane, I can't be 100% sure, but why would this occur out of the blue? Then I think to myself. Those consequences listed on the package, though it is rare, it COULD happen to you. You could be the 1/10 people to experience it. Liver damage, incapable of pregnancy, whatever it will be ... I'm not willing to give this a second chance. I trust my doctor, but really, who knows? I would rather have acne all over my face (literally, as of now), than to risk my health. And I would know how important my health is, because when you personally know someone who suffers from pain through cancer everyday, you would think twice about taking this. Not trying to scare anyone...
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July 12, 2011

Pros:

Perfectly clear soft skin whilst I was taking it
Cleared up my keratosis pilaris for a year

Cons:

Severe joint pain
Constant nosebleeds
Dandruff
Headaches
Scarring
Bleeding, crusted over lips
Dry eyes
Lowered immune system leading to various infections
Bruised easily and wounds took a long time to heal
Worsening of depression

Ah, where do I even start? This was really a last resort for me, after trying every topical lotion and potion, and every oral antiobiotic my derm could prescribe. Sadly it just didn't work for me. Actually, that's a lie; It did it's just job of clearing up acne wonderfully, it just came at a really painful cost both physically and mentally. I have no idea whether a full course would have permanently cleared my acne because my derm took me off it after 6 months due to the way my body reacted to it. Now even a year after I stopped taking it many of the negative side effects have persisted, whereas any positives have long since disappeared. I don't mean to scare anyone away from taking the drug because I know it works wonderfully for some people, but just make sure you really think it through first because there's no way to predict how your body will respond!
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July 8, 2011

Pros:

-cleared acne completely!
-eliminated face oil

Cons:

-severe scarring on the face
-back pain
-depression
-chest pain
-red face
-developed eczema
-sensitive skin
-dry lips

I suffered severe acne on both my chest and back--to the point where keloid scars developed. Although I suffered with acne on my face, it was never severe. Accutane definitely cleared up my acne (i was put on the highest dose for my weight), but 5 months later, acne began reappearing on my face...and worse than ever. My skin was so much thinner that every pimple left a scar--I am now plagued with indented scars on my entire face, whereas I never scarred before accutane. I regret going on accutane; results were only temporary and there were more negatives than positives.
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June 21, 2011

Pros:

cleared acne 100%

Cons:

dry chapped lips
heart palpatations
hands were always shaky
acne returned after a year

I feel like the accutane helped in the short run with my acne which was wonderful, but for my long term health, i don't think it was a smart decision. Doctors don't even know how it exactly works, and because it is a relatively new drug, the future potential long term side effects aren't known. Use caution when putting drugs into your body. I still have problems with my acne, but I know one day that it will get better!
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March 31, 2011

Pros:

My skin was almost perfectly clear for about two years after using Accutane.

Cons:

It dried me out so bad! My skin, not just on my face but especially there, was so flakey, and I literally peeled a layer off of my lips every morning. Not to mention it has many other very serious short and long term side effects. I took it for 6 months about 5 years ago, and within the last couple of years I started breaking out again. In the last six months it has become a huge problem again.

It was nice while it lasted, but I'm upset that I went through all of that just to break out and go through the "What can I try next" cycle. You're supposed to basically never break out again after Accutane, and that's definitely not the case for me. If you're desperate it might be worth a shot, but do your research before beginning this treatment, because the health risks probably aren't worth it. This is serious stuff.
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March 21, 2011

Pros:

Continuing to clear skin from day one

Cons:

Knee pain, back pain, feel like my whole body was hit by a truck! Not pleasant at all.

Ive only been on this 6 weeks. I can see that its working but I'm really wondering whether these side effects are worth it. I keep reading about how it can lead to complications and i am battling with myself not to come off it
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March 18, 2011

Pros:

Controls oily skin very well
Skin looks fine and smooth
Minimize pores
Make up lasts and looks better

Cons:

Hair thinning
Dry skin and lips
Dry eyes
Gastric problems
Mess up my menstruation cycle (not sure if it's caused by accutane)

I had good skin for few months when on accutane and never felt better. However not sure if the risks involved is worth it. Having perfect skin used to be very important to me and I was willing to take that risk. But now that I am going to try to conceive in a few months, all of a sudden everything is about having a healthy baby. I read online about how many babies get deformed or have died if mothers took accutane during or before pregnancy which really scared me a great deal. I stopped accutane since and will wait for a few months before trying to conceive. The hair thinning part and gastric problems are definitely not worth it too. For short term, it seems to be a great product, but I would not recommend taking accutane for long term. And just so you know, since stopping accutane, my acne has came back especially on my chin - many cystic ones. So only consider accutane is you are prepared to take it for a few courses (which may cause more side effects).
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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