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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January 11, 2011

Pros:

Clears up skin very quickly

Cons:

Dries out skin, lips, and eyes severely
Acne came back after a few months
Very serious side effects
Expensive even with healthcare

Even as a last resort I would not use accutane, it is better to live with the acne than what can arise from taking this drug. Depression is the one most people worry about when taking this, but there are others. Inflammatory Bowel Disease is one of the most severe problems as it is a life-long, debilitating disease. This product is far too risky to consider. After my acne returned from being gone for a few months I decided to try to fix it on my own and I have it under control. Cutting sugary and greasy foods out of my diet, and a baking soda mask twice a day to keep skin clean has almost completely cleared my skin, it takes more of a commitment than accutane but it is so much safer. Strongly oppose risking this medicne.
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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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December 14, 2010

Pros:

Medium-term acne reduction

Cons:

I had pretty much every con there is for it - dry skin, dry peeling (and bleeding) lips, bleeding nose, bleeding gums, dry eyes, sties, raised blood cholesterol levels, depression, hair loss, terrible photosensitivity, aching muscles and organs.

I have been on 3 rounds of Accutane in my time, starting from when I was 11, the last when I was 18 (I'm now 28). Each treatment worked, for up to a couple of years after, but the acne always came back in the end. During the first treatment I had to go on steroids to stop my face from collapsing. My recommendation is that if you really want a short term solution, and you are willing to put your body through hell and possibly cause permanent damage to your organs, go for it, but life is long, and Accutane doesn't get rid of acne permanently.
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December 10, 2010

Pros:

helps with acne a little bit

Cons:

dries out your skin like you won't believe, requires blood tests, enhances depression, dangerous for your body, didn't help all that much with acne.

I was on this for 5 months and it barely helped my acne. All it left me with was dried skin and lips so cracked they bled constantly. My doctor finally pulled me off of it since it wasn't doing much good and my blood tests were showing enhanced liver levels that could have been dangerous. This is so dangerous to take!
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November 29, 2010

Pros:

Worked while I was taking it

Cons:

Suicidal thoughts and instability
Other mental distress
Profuse nose (any anywhere) bleeds
Monthly blood tests
Side effects - just read the booklet
Acne came back 1 week after finishing it

I have mixed feelings because it did save me from terrible scarring at my most vulnerable time - but at what cost? I had acute cystic scarring acne starting at age 12. I started Accutane about 13 and had to sign a contract, that my parent also had to sign, saying that I would not get pregnant because of the terrible birth defects. They said normally a girl would be required to be on birth control, but I was so young - that was just the beginning of mental stress. I could only take it for 6 months at a time with a 6 month break in between, but they said that I should be able to take it once and be cured for life. I had terrible internal feelings that I didn't really understand, but the first round wasn't THAT bad. It dried out my sinuses, so I would have nose bleeds in the middle of the night. I started acting out too. My acne was perfectly clear while I was on it though. One week after I stopped, the acne came right back so I had to spent the next 6 months dealing with the acne again. I was really wary about trying it for a second time ("just one more time"), but I was young and my parent and doctor said I should so I did. Big mistake. Sure, the acne was clear, but I was as unstable as ever. I felt like "I love my life, my friends, and my pets, everything is great" but then have this uncontrollable urge to stab myself or down a bottle of pills. It was like I didn't WANT to kill myself, but there was something inside of me saying "do it, do it." The nose bleeds got so bad that once in the shower I just saw blood streaming down my body and when I turned to the side it splattered across the shower wall. Then there was the time that blood just started oozing out of my ear in Biology class. I had a friend who took it and told me he had liver damage from it. Again, a week after I stopped a second time the acne came back. I refused to take it a third time and instead used 3 separate prescriptions to avoid 1 tiny Accutane pill a day.
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October 29, 2010

Pros:

made my skin less oily and there was a decreased in acne severity while taking it but just lasted for 3 months

Cons:

initial breakout, i mean the gross type
high possibility of scarring. i got teribble scarring from this
redness of the face

i don't think this would help anyone who are suffering from oily skin like me. it is not safe and does not targeting the root cause of sebaceous glands' oil secretion. androgen is the major cause of it. i am taking 100 mg spironolactone once a day for a week now and there is already a decreased in sebum secretion.
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October 10, 2010

Pros:

None!

Cons:

It's a poison, literally! Could cause depression, liver damage, permanent thinning of the skin, colitis, irritable bowel syndrome, hair loss, blood problems, basically every side affect known to man and these could develop months, even years after you stop treatment.

You have to be either stupid or extremely vain to take Accutane. This drug is a poison, and what a lot of people don't know is, Accutane was developed in the early 80s as a cancer medicine because it kills cells. Its purpose is too stop the sebaceous glands from producing oil, which is not even natural. When my doctor gave me the pamphlet explaining Accutane, I couldn't help but notice that the patient's skin in the after photos ten years later looked horrible! My doctor treated me like I was crazy because I did not want to take Accutane. The truth is, they just want an easy way to treat acne and don't take into account the potential harm it can inflict on the human body. Just look at the PSAs on TV and notice how the drug companies who make Accutane are being sewed by hundreds of people who took it. In the long run, you have to ask yourself a really crucial question. Would you rather have dry, chapped, crappy looking skin without acne, or would you rather be a human being and bear the zits?
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October 6, 2010

Pros:

none. it didn't work for clearing acne

Cons:

very dry lips, excema patches throughout body, and a little bit of the "hazy brain"
Though, I could have just seen that symptom because I had heard about it.

My Accutane treatment was 6 months, 20mg, to 40mg, to 60 mg, to 80 mg, to 90 mg for the last two months. Accutane did not work - my acne was entirely due to hormone fluctuations, and taking birth control has now cured me of my acne. The doctor I obtained the accutane from did very little to review my medical history, beyond finding out what acne drugs I had taken up until the moment of my considering Accutane. Very much like a one-trick pony, she immediately recommended Accutane, saying that she does it all the time. While I can't entirely blame her, as I came to her with ten past years of failed acne treatments, all on the traditional "route" of increasingly potent anti-biotics and topicals, it amazes me that no medical professional looked at the whole picture of my health to try and see what could be causing my acne. Accutane was a huge hassle, and it took my own initiative of asking my general practitioner to prescribe Yaz for my acne to go away. Now I have a dermatologist who is completely against Accutane, and I agree. While I see that it has been beneficial for many people, I view it as a very dangerous drug, and I am disappointed that I decided to take it, albeit my exasperation in the ten years of failed acne drugs led me to that decision. My advice is to consider all external factors, both your environment and physical problems that may not seem like they relate to your acne, before resorting to Accutane. Get multiple opinions from different doctors, and consider that there may be future ramifications, even once you are off the drug. (although I have not experienced any) Now I am left with greater scarring from the acne I had while on Accutane, and I also have to wait a year before taking steps against the residual scars.
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September 20, 2010

Pros:

No pros to report.

Cons:

Massive Side Effects.
Didn't change my acne.

NEVER TRY THIS! I got this on prescription about 20 years ago (without any warning about the side effects from my doctor). After a few weeks it killed ALL my joints. Every joint in my whole body was hurting and making strange noises. I then stopped Accutane but I still have severe problems with my joints. Now, I soon will have to get knee implants.. So, my advice is clear: never try Accutane, it's not worth it.
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September 16, 2010

Pros:

Can clear your skin temporarily, sometimes permanently.

Cons:

Side effects are horrible and can kill you or severely impact your life.

TAKING THIS DRUG WAS THE WORST DECISION IN MY ENTIRE LIFE. Five years after taking the drug I still suffer from many debilitating side effects. Sjogren's syndrome, severe headaches, fatigue, neurological problems, muscle problems. I have not been the same since taking the drug and I probably never will be. Most people do not know that Accutane is a CHEMOTHERAPY drug that was originally designed to indiscriminately kill cells in your body with the hope of killing cancer. Simply put, it is poisonous. Even if you do not experience side effects immediately, long term problems can occur years later due to the heinous damage this drug can do to your body. I cried tears of joy when I got the Accutane prescription from my doctor, but now I feel like crying tears of anguish daily at the mistake I made in taking this garbage. I am in my mid twenties and I feel like my life is over. Seriously, just look up the long term side effects on google. Most people will probably not listen to me, but do not say that I did not warn you.
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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