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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May 30, 2013
Extreme Side Effects, but Effective.

Pros:

Cleared all acne cysts
No relapse
Changed my life (Confidence/happiness)

Cons:

Extreme side effects: joint pain, depression, anxiety, mood swings, insominia, dry lips, dry skin
Get worse before it gets better (Cysts worsened in the first month of treatment)
Results were not seen until 3-4 months after treatment.

After developing severe cystic acne, I turned to my last resort, which was Accutane. The drug was extremely effective in my brother's case, so I figured I would I should at least try it. You have to realize, IT GETS WORSE BEFORE IT GETS BETTER. The side effects were terrible. During the first month of treatment, my cysts worsened and became extremely itchy and irritated. Looking back now, It is almost as if the drug was "pushing out" all the cysts at once in order for my skin to get better. Then, the dryness set it. My hands and lips were ALWAYS chapped and I was constantly applying lotion/chapstick. FOR ATHLETES: During the second month, my joints locked up and I had to stop running for the remainder of the treatment. (Mind I am a cross-country/track athlete so this was the most difficult side effect of all.) I think it would be smart for any athlete to strongly consider starting treatment during the off-season just in case any side effects affect your performance like accutane did for me. I became depressed and had a lot of anxiety., which lead to a short attention span and insomnia. I did 3 months of treatment and even though I had a large amount of side effects, I would still recommend accutane. It was AFTER I finished treatment that I really saw an improvement in my skin. It was been 4 months of being off the medication and the redness of my skin is only now leaving. BE PATIENT. From what I know, you will not see results right away. You will get frustrated, but I strongly advise you wait it out unless it is really affected your health or your doctor tells you to quit. It is worth it, my confidence has gone up and ALL the side effects left within 3 weeks of treatment. Also, after I finished treatment and all the cysts were gone, I began using bio-oil to heal my scarring. Bio-oil has helped my scarring immensely, I strongly recommend it! Don't give up, you are all beautiful!
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May 13, 2013

Pros:

can clear up acne

Cons:

dry lips and eyes
can cause depression
time consuming

I had HORRIBLE acne that was causing me to be embarrassed and very depressed. I tried several medicines and finally i was put on accutane, twice. It really did clear up my acne but it came with a price. since taking it My eyes are now dry all the time, joint pain, depression, etc. I would recommend this only as a VERY LAST RESORT. this is not something to play around with and I wont take it again because there is too much risk with this medicine. AND for a girl it is hard because of all the Birth control and pregnancy tests.
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November 1, 2012
Accutane

Pros:

Cleared acne

Cons:

Acne came back a year later

70mg a day for 5 months. Acne unfortunately returned a year later.
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September 19, 2012

Pros:

acne in remission
i feel much more confident now
Free in UK on the NHS as i was 18 yrs old when i was on the course.

Cons:

actual acne scars which i only got during the course, did not have a single one before the course
genuinely awful side effects which i'll comtinue below
skin texture just ain't the same
hyperpigmentation thats takes much longer to fade than before

i am 19 years old now amd I have had acne simce the age of 13. it started off mild but over time got to moderate. I know i never had severe acne but it was still bad and it could under no curcumstances be covered by makeup. However acne was genuinely ruining my life i was depressed i didn't leave my house i had started university but decided not to move out as i was depressed all stemming from acne, none of the treatments retin a BP etcworked apart from oxytetracycline which temporarily put my acne into remission very temprarily but it returned. So evetentually i broke down in front of my dermatologist who didnt't want to put me on isotretinoin but i made him by basically making him feel sorry for me. so yes i was happy with that, 50 mg/day for 4 months. The first month was fine my skins seemed to be slowly improving, side effectes of dry lips amd skin were there byt not unbearable. After that my skin exploded with acne the woe i'd ever had genuinely awful literally beyond severe. My skin became almost unbearably dry my face was literally swollen and my lips were crazy dry and swollen. My acne just wouldn't survive so at the end of the four months i finished with my face a mess. The worse it had ever been. I was comstantly tored and denydrated, Slowly though after the course my skin began clearing up cysts stopped forming. Eventually I was clear of acne but left with lots of hyperpigmentation and some scars. So now a year after my course has finished, a lot of my hyperpigmentation is lighter (still there) but before my course each pigmentated mark would remain for a month maximum. I now have a few indented scars mainly on my right cheek which i hate thanfully they ain't too deep and I believe I may be able to treat them eventually but not et as they have filled in a little over time so i want to leave them to mature for a while.So I am clear of acne but it was a mad experience and im not sure id recommend it,
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September 1, 2012

Pros:

Clears acne

Cons:

Do not drink alcohol whilst using this drug. In my case it caused acute pancreatitis which is very unpleasant (look it up).

Be very careful
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September 1, 2012

Pros:

Clears acne

Cons:

Side Effects:
Dry eyes
Dry nose (and bleeding)
Stomach ache
Joint pain
Extremely dry skin
Aggrivated eczema
Dry, cracked lips
Low mood (for a short period)
Social life affected - little alcohol and sun=not much fun!

I'm 22 and had been considering using this for a long time due to persistent moderate acne. I had tried a lot from aged 15 til 21 including Zineryt, Antibiotics (3 kinds), Benzoyl Peroxide, Differin and all the various OTC treatments to no avail. Started the treatment (30mg) on 11 May 2012 and started seeing reduced acne from a few weeks in, at the same time all the side effects started kicking in. After 1 month I started suffering low mood and was advised to lower my dose to 20mg for 4 weeks. This helped and my mood picked up, but my skin started getting the odd pimple again. I then went back up to 30mg for 5 weeks and then up to 40mg for a further 5. This is where I am at the moment and I would say my skin is more or less clear. I am under no delusions that I still have a long way to go and that the acne could return at any time following treatment. I thought long and hard before deciding to go on this and also looked at the various issues surrounding long-term conditions that this is suspected to cause. I will always be confident that I didn't rush or make any quick decisions. I would recommend it only if someone has tried all other options and researched the risks of taking such a powerful drug because although some have a fairly easy ride - not everyone does.
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June 8, 2012

Pros:

Clear skin
Scar reduction
Better self esteem

Cons:

Side effects:
I have mood swings , drowsiness (like I'm tired all the time/unusually tired), I don't do anything and nothing really motivates me/ lost interest in normal activity (that could be from my accident though too) I'm more irritable, lol then I dunno if this is from it but its in the book- I get headaches (hypertension), I'm more thirsty and I urinate frequently and get head rushes (that's under the signs of changes in blood sugar level) that seems to be it and most of the commo

I am still on accutane and this is my 3rd and hopefully final month they said between 3-4 months . Ill write another review after I'm off it a couple months and see if my side effects have subsided and if my acne is fully gone and what not. Another con: couldn't drink :(
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June 4, 2012

Pros:

Worked fast
Clear, glowing skin

Cons:

Acne and oiliness came back
Thinning hair (still...)
Poor night vision (still...)
Low energy
Dry eyes

I firmly believe the only people who should be allowed to write reviews on here for Accutane are those who've been off it for 6+ months. While you're on it, you can't believe how good your skin looks, and you'll happily dismiss most side effects. Of course you're going to write a rave review. I did exactly that three months into my course. But it doesn't last. Oil glands recover. Within a few months of finishing my skin ramped up the oil production again and I started breaking out. My acne started when I came off the Pill after many years on it. I think I have an underlying hormonal imbalance as a result and have come to face the fact that any medication is just going to augment my system even more, and it will take longer to right itself. I'm also worried about the long term effects people report, not beginning until years after they've taken their last dose. I know what it's like to hate your skin and if the results were lasting I'd even say it was worth it for me.... but to have my skin return to what it was awful - to know I made my body put up with months of toxicity for nothing. I wish there was such a thing as a miracle drug - and it does work permanently without bad side effects for SOME (far fewer than they'd have you believe though) - but I'm going the clean diet, gentle exercise, natural skincare, low stress, general wellbeing route. Not as easy as popping a pill, but protecting your health is priceless. Good luck to everyone in their quest for clear skin.
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May 22, 2012

Pros:

-Cleared up cystic acne
-Worked quickly
-Skin stayed completely clear for about 6 months

Cons:

-Extremely dry lips and skin
-Developed eczema after first month
-I still have acne about a year and a half after last dosage
-Huge commitment

I do definitely recommend accutane for those with severe cystic acne. It is a huge commitment, but it clears up those big, painful zits right away. It's been a year and a half after I took my last dosage, and I have been developing acne again. Not as bad as before accutane, but moderate. It's worth a try, but be sure to ask your dermatologist for eczema cream!
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May 21, 2012

Pros:

Cleared my skin completely
Built up my confidence

Cons:

Dry eyes
Dry lips
Very dry nose
Skin rash
Hair loss
Depression & mood swings

I started taking this medication in January I was on 30mgs a day to start with, my acne has been ongoing for a few years now, controlled my some medication for a while but my body soon got us to them, I ahve been on many different drugs over the past 6 years and I was due to get married April this year so I was refered to a derm which said my last resort would be Accutane, after giving this some serious though I decided to take the drug. The first month was fine no real side effects and no bad breakouts, I went back for my second month and the derm doubled my dose to 60mgs this made one huge difference! After a few days my lips cracked, my eyes dryed and the sores up my nose were so painful I couldn't even rinkle my face without it hurting, I came out in a bad rash all over my arms and I started to get really bad pains in my back and legs. I suffered it for the month and went back for more tablets the derm reduced my dose to 40mgs which helps but the problems still persisted. Into my 3rd month here comes the depression, along with sorting out my wedding my mood swings were uncontrolable screaming one min and crying the next I have never felt so bad and after waking up one morning and not even being able to face going to work I rang my doctors and got an oppointment to be taken of the medication the same day! The effects soon got better the rash dissappeared and the cracked lips and dry eyes got better over the next couple of weeks. Also my moods improved greatly I was back to my old self within a couple of weeks. At this point my skin looked amazing just a few scars which I could cover with make up, I felt great and my wedding pictures look fantastic which was what all this was for! If it wasn't for the fact I was getting married and having to look back on my photo's for the rest of my life I would not have taken this medication the effects are to dangerous and i hate to think what it has done to the parts of my body I can't see.
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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