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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1
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January 9, 2011

Pros:

As a med student I did a research to evaluate my isotretinoin treatment (starting today). So I can’t give you my own experience (I will do that later :) but some facts I came in possession and would like to share.
I consider this as a very safe and effective treatment if done with circumspection. If you experience severe adverse effects just decrease the daily dose calmly. It is the cumulative dose that matters after all (which ranges 90-150 mg/kg).

Cons:

Never should you underestimate the power of placebo effect. If you are preoccupied with suicide ideations and lower back pain because of accutane ... there you are, sitting with a sore back and a major depression :)!

To AS4 (below) I have lots of questions! :) Did you experience drieness of your face and lips? Did you get examined by an endocrinologist? Did any unusual happen when you were 17? Have you used ANY other treatment for your acne? What kind of chemicals have you put on your fa

Effectiveness: dose and case dependend. High dose (0,75-1 mg/kg) treatment provides more benefits and a reduced likelihood of relapse (10-30% depending on severity/type and root of acne) but more severe side-effects. Low dose (0,1-0,4) is recommended in less severe cases but relapse rate increases (50-60%) ' with significantly less side-effects. Gradual increase of the dose and intake with food (50-100% better bioavailability!!!) is recommended. Side-effects: dosage dependent, mild and NOT permanent in 99,8% of cases. 0,2% are usually unique cases e.g. 400% elevated starting triglyceride level results in permanent liver damage ' can be avoided. Can be dermal or systemic. Dermal: isotretinoin causes dramatical reduction in sebum production, thinning of the stratum corneum, and alterations in the skin barrier function. So your skin becomes dry and very vulnerable. Damage to the skin can leave scars because of this so take care. Dryness of the face and lips (95-100%). Dryness of the nasal (50%) and oral mucosa (40%), photosensitivity (40%), eczema (25-35%), nose bleeding (20%), dry eyes (20%), acne flare (8-20%), itching, rash, erythema (15-20% mild), hair loss (5-15%, reversible), peeling of finger tips (10%). They are usually mild, temporary, and respond well to symptomatic treatment. If you experience severe adverse effects just decrease the daily dose calmly or visit your derm. Systemic side-effects are much less common (pregnancy must be avoided of course). Osteomuscular pain (10-15%), headache (5-10%), elevated liver enzymes (0-5% reversible), decreased night vision, psychological disorders, pseudotumor cerebri (0-0,5% presumably not even side effects, very poor evidence of casual relationship). In the end I would like to warn you about getting information from laymen. You can get very distorted info here since these reviews are based on subjective experiences -mainly from unsatisfied people- so treat them with much caution.
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January 9, 2011

Pros:

Acne Gone
Skin prettier than ever!

Cons:

Dry Skin
Chapped Lips
Had to be careful with what I drank

I had to make a review about this medicine that changed my life forever! BTW! i didn't use accutane i used "isophase" it's the same thing just a difeerent name, ask your dermatologist about it and remember every one is different. try it Since I was 12 years old i've always suffered with bad acne at times but always had white heads, black heads etc.. About a year ago I finnaly decided to go to the dermatologist and she said I had to take Isophase (a medicine just like accutane but with lower side effects) the doctor said I had to take 10 mg per day for 3 months. My mom was freaking out because when she was my age she was put on accutane and has had dry skin ever since so she was not very happy with the idea and the dermatologist had to explain that i was getting a very low dosis, and it was very unlikely for me to get side effects blaah blaah. So I started searching reviews and they were terrible! I was so AFRAID! but i decided to take the medicine anyways and i had to get a blood exam. ps. i'm terrified of needles but my acne won my biggest fear haha So it took about a month for my skin to start to get better. The first month, my face was as usual but then by the end of the second month my face was clear. What i did notice was that my face got VERY dry that it hurt! So I researched and started using Cetaphil Cream. It didn't break me out and I still use it in winter. Then I stopped taking "isophase" when the 3 months ended and then 3 months later I started to break out again but no worries I went to the dermatologist and they put me on the medicine again but this time 10 mg per weak and let me tell you it's been 5 months and my face is great! I only get a few zits here and there but nothing very noticeable. So if you want to try this medicine go ahead try it! But my recommendation is that you ask you dermatologist about "isophase" and if you start the treatment remember.. Chapstick and Cetaphil cream for your fac
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January 9, 2011

Pros:

-My skin is finally beginning to clear
-Only thing i have found at all effective

Cons:

-Really dry skin
-Lips constantly peel and bleed

Works very slow but will work Extremely dry skin and lips
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January 8, 2011
I would like to share my experience with Accutane in hopes that someone that may be or has gone through the same thing as me and could give me some advice or just let me know im not alone on this. Throughout my teenage yrs I had a few pimples here and there like most teenagers, otherwise I had pretty nice skin. I started getting cystic acne at 18, I am now almost 23. I started Accuane in July '10. I am still on it and have a month left. I have been taking 80mg a day since Sept. and I am 90lbs so I think that is a pretty high dose for me and it has done nothing for me, I am still breaking out pretty much as much as I did before I started it and it makes me upset because so many people with worse conditions than me have cleared up within a few months and I just think what's wrong why isn't this working for me? I never broke out on my neck except for 1 or 2 cysts at a time at the most and they didn't last long or leave scars. Ever since I started accutane I break out pretty much the same on my face and I broke out like crazy on my neck and now not only do I have red marks all over my cheeks, I have them all under my chin and top of my neck. I know there are worse things in the world but for those who suffer from this know how I feel. I just dont understand, why did it start when it did? What causes it? Is it ever going to stop? Obviously Accutane isn't going to help me, so now what?
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January 7, 2011

Pros:

REALLY works
works pretty fast
only thing that worked for me

Cons:

expensive
drys out lips and face badly
makes acne worse at first
long process (5 months for me)
blood work every month

After trying EVERYTHING on the market, including OTC products as well as prescription products, I had enough. So i asked my dermatologist to prescribe me Accutane and even though he listed a lot of side effects, i didnt care, i had to get rid of my acne. So im about to complete my 3rd month and my acne is GONE! Unfortunately im left with many red scars which i am now working on trying to get rid of, but im just happy i have no more large painful nodules. With only 2 more months left, i really hope i get completely clear! The only side effects ive experienced is really dry lips and face and some lower back pain, but thats it! I would recommend Accutane to anyone i know and I am so glad i am taking it! I wouldnt change anything, im so happy!
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January 7, 2011

Pros:

Gets rid of acne.

Cons:

Serious side effects.
Expensive - in Australia requires doctor referral, then monthly dermatologist appointments. Over $100 an appointment.
Can take some time.

I went through high school with acne, generally hating life. I tried everything, from over the counter stuff to prescription creams & oral medicine. Nothing worked. I went on Roacctuane (I assume it's the same as Accutane, just a different name in Australia) when I was 20-21 to clear up the last of the acne I had; it was still fairly bad, particularly across my back and I still got severe breakouts on my face. Honestly? It's the best thing I've ever done with my life. The only regret I have is that I didn't do it sooner. I started off with the 20 ml pills once a day, then increased to 3 times a day under instructions from the dermatologist. Like everything, it didn't work straight away and I saw results maybe a month or two after starting it. But once it worked, it cleared my face 100%. Only very occasionally did I need to worry about one pimple. Yes, the side effects are pretty heavy. Everything will dry out; your palms, eyes, nose, etc. My nose bled quite a bit at first. You go very pale & burn ridiculously easily. Otherwise, it was a God send. The only downside for me was coming off it. My dermatologist told me to slow down the dosage and it started to come back a little bit. However, a few months on and my skin was clear 99%. It's been a good year and a half since I came off Roaccutane. I'm now 24 and my skin is still a little acne prone but nothing like what it used to be. My back is completely cleared 100% of the time. Right now I have a few spots on my face but, hey, it could be a lot worse! I'm looking for a mild cleanser; I've used a product in Australia called Ultraceuticals which was fantastic at first but, again like everything, my face has become slowly immune to it. I'm considering the Clinique range as there seems to be nothing but bad reviews for Proactiv. Overall Roaccutane worked wonders for me, I'm so much more confident and happy than I was when I had acne. But the side effects ar
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January 6, 2011

Pros:

Clears up acne perfectly! I had better skin than most people who have never suffered from acne.

Cons:

Chapped lips (but it's not really a con as vasline easily solved the problem)

Amazing drug, which changed my life! Of course there are some scary side effects, however these only affect the minority and all drugs have lists of side effects. My friend used an over the counter cold remedy and she has an allergic reaction which made some of her hair fall out! I would also mention that everyone writing on this website is upset about their skin. The majority of people who find a cure for their skin do not search and write on acne websites. People in the UK with acne, get your doctor to recommend you to a dermatologist. It can take up to 10 months to get an appointment so do it sooner rather than later. They are are the acne experts. If your Dr. recommends accurtane go for it!
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January 5, 2011

Pros:

It works
No longer have oily skin
Nearly flawless skin

Cons:

Very dry skin
Headaches
Backaches

I did not have severe acne, probably closer to moderate . However, I have been dealing with acne for over three years and couldn't stand waking up in the morning and feeling crappy as soon as I looked in the mirror. I did find lots of success with minocycline for about 10 months, but it stopped working like so many other acne persciptions. I finally talked my dermatologist into allowing me to take claravis (isotretinoin). The first week I had headaches and what felt like pressure behind my eyes. This lasted about four days. The second week brought extremely dry skin. My ears, face and scalp were pealing lol- it was kind of gross. The second through late fourth week were hell for me. My face continued to break out with this annoying dry skin. In about the fifth week, things turned around. My face started clearing dramatically, but this was when I began to experience backaches in the mornings. The sixth and seventh week I had some breakouts, but not nearly as bad as the first month. Now, I'm in the ninth or tenth week and my face is not oily whatsoever and almost 100% clear. No new pimples, just healing old ones from a couple weeks ago. I 100% recommend this if things like benzoyl peroxide, clindamycin and different tetracyclines fail you. It's great waking up in the morning and feeling good about myself once again, no more worries:) Hopefully this helps with anyone trying to make the accutane decision, there are side effects but they were SO worth it for me! Good Luck!
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January 3, 2011

Pros:

Perfect Skin when it's over
Really Works!

Cons:

Chapped Lips
Red Face
Embarrassing Initial Breakout

Only answer to severe acne sufferers, nothing else works. Sadly my acne did come somewhat within 2 years. I fixed this with high doses of Vitamin A: 100,000 IU's daily for 5 months. Perfect now!
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January 2, 2011

Pros:

Gets rid of acne that is deep down in skin and acne that is already present. Removes acne that is stubborn and difficult. Leaves skin feeling beautiful! Builds confidence!

Cons:

More prone the sun/wind burn. Skin may get irritated and dry. I broke out with a mild and easy to treat staff infection.

Use this product if you have tried all the creams and washes on the shelf. You may have heard people complaining about dryness and the blood tests, but it really is worth it. It removes all acne, and only occasionally i break out with a zit here or there, but my dermatologist gave me a cream that removes it within a few days, and reduces its size over night! I am so confident!
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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