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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5
37.1%
4
34.1%
3
15.3%
2
7.3%
1
6.2%

Used Isotretinoin (Accutane®)? Rate It:

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January 6, 2010

Pros:

got rid of my acne

Cons:

was the worst 6 months of my life, dry eyes (couldn't wear contacts while on it/a few months after, though I can now), felt lethargic, lost appetite, couldn't go out in the sun, would get red after 10 minutes (not really an issue for me since I am pale and never made sunbathing a hobby but for some people I'm sure it would be a big deal). Back aches, dry lips (manageable with vaseline applied continuously)

My acne severity is listed for what it was pre-accutane. now i would consider it to be very light, yes I do get pimples occasionally, but its been a little over 2 years since I took accutane and my acne is both a million times less and more manageable when I do get it, ie actually goes away when I use topical treatments. I was miserable while on it, but ultimately its the only thing that worked for me and if my acne came back I would use it again. only use it if you have tried EVERYTHING else.
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January 4, 2010

Pros:

Completely cleared my back and chest acne. Gave my skin a nice shine. Unclogged pores on my nose that had been there since i was 13.

Cons:

mildly dry lips

Accutane is the best product out on the market and is worth getting.
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January 1, 2010

Pros:

Less Breakouts.

Cons:

dry face, dry lips, Leg acheness, ITCHING, contact irratation, high blood pressure.

I've only been on this product not quite a month yet so i cant really say how good its working. I have noticed i am getting less breakouts but my acne is really red. Im guessing its the dryness. Im only on 40mg so im hoping they will up my mg when i go back to the derm in a couple weeks. Im hoping accutane will clear my acne and make it so it never comes back again. Its very embarressing. It does give you very bad chapped lips and very dry skin especially around ur mouth area. Its usually driest when i first wake up in the mornings. Another thing ive noticed is my arms are really red and bumpy from them being dry and itching them like crazy. I also have to wear glasses because accutane tends to dry my eyes out making my contacts irratate me. It'll all be worth it if accutane is the miracle acne medication they say it is. If your as desperate as me and want your acne gone try it like i am :]
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December 30, 2009

Pros:

It works.
The ultimate exfoliator!
For some reason it's cleared up my dry skin related eczema on my back instead of making it worse!

Cons:

Initial breakout (thankfully it was mostly on my scalp and I have hair to cover it up)
Dry lips (tolerable with frequent lip balm app)
Dry face
Would've been very expensive had it not been for my insurance ($1300/month!!! but with my copay it's only $10)

Here's my story- I don't know what hit me but at age 33 I had my first acne outbreak and my face and forehead were covered with dreadful cystic acne. I tried all the OTC stuff first like benzoyl peroxide, salicylic acid and sulphur. The salicylic acid wash followed by BP cream irritated my skin so much I developed periorbital cellulitis and had to be on Augmentin and Bactrim. Bactrim made the acne stop but it left a bunch of unsightly hyperpigmented spots. As soon as the antibiotics were over my acne came back. Then I wrote myself a script (I'm an MD) for topical clindamycin. Nothing. I didn't want to wait another few months with topical retinoids because I knew it'd take that long even to see if they'd work and my face was still pimple central. And I wasn't thrilled about the prospects of being on a tetracycline class antibiotic for years. So I went to a dermatologist; he didn't fool around and immediately recommended isotretinoin. With my medical background, I went in already knowing all the worst case scenario badness like hypertriglyceridemia related pancreatitis, inflammatory bowel disease, DISH, pseudotumor cerebri, etc. But both my derm and I knew adult onset acne tends to be recalcitrant and my options were running out. So I bit the bullet and went on it. I'm on 20mg twice daily. I'm skinny so actually it's somewhere btw the recommended 0.5-1mg/kg/day regimen. The drug made my face peel like crazy and I had some initial new pimples in the weirdest spots (on my scalp!), but after that all the acne on my face just arrested and is now starting to fade away. I was so amazed. I never got depressed. In fact, I'm ecastatic because I finally found something that worked. I haven't developed any liver or lipids issues. Dry lips and face are minute nuisance compared with the benefits (in my case anyways). So far I'm very encouraged by the results.
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December 28, 2009

Pros:

still waiting

Cons:

very expensive and still waiting

im on my 6th week on accutane and my skin has never looked as bad. ive started to get spots in places where i would never get them before i went on this. i asked my derm about this and apperantly you gotta wait 3 months to see improvement and the reason my skin is getting so worse is that the acctune is causing all the bacteria to draw out of my body. my acne has never been worse as it is now! a lot of people including me will think that this gets to work straight away but this is far from true. with some people it does but with others you have to let it get worse before better which can be very frustarating. like i said 6th week skin has never looked worse and im still waiting
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December 24, 2009

Pros:

Cleared my skin within the 2 months. I only have a couple pimples left but nothing like before. I can't remember the last time my skin looked this good. Monthly tests to ensure your body is handling the meds.Price is cheap compared to all the other creams and potions I have used in the past.

Cons:

Dry lips, dry scalp, achy joints, hair thinning a little. Cholesterol jumped up to moderately high but has not increased since the first month.

This medicine has been wonderful.This was my last resort due to all other treatments failed. I would recommend it to anyone who hasn't had success with other treatments. No doubt this is a medicine with serious risks so make sure you educate yourself and decide if it is right for you. Although I have suffered for many years I am still glad I tried other treatments first. I think this med is only for last resort due to its possible side effects. Many complain about the monthly blood tests but that was the only way I would take Accutane. I don't want to sacrifice my health for clear skin.
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December 23, 2009

Pros:

Easy to take, gets rid of oily skin (and hair), and most of all, it gets rid of acne!

Cons:

I got really bad eczema while on Accutane (my derm prescribed me some cream for that), some minor aches and pains, and nosebleeds. Also, Accutane left pretty bad scarring on my skin, in texture (indented scars, which I had never gotten before), and hyperpigmentation. Blood tests monthly.

Accutane changed my life. I had pretty severe acne that would cluster in groups on my face, as well as extremely oily skin. It was a really difficult time for me, so humiliating. I tried so many different things (including topical and oral antibiotics), and nothing worked for me. I felt hopeless until I got Accutane. It really started to work around month 3-4, after that my skin stayed clear until the end. I've been off it for a month and my skin is still clear, although it's oily again because I'm on Retin-A now. Although my skin is oily and I do still have a lot of red marks left, I'd gladly take this over acne anyday. Accutane saved my life!
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December 20, 2009

Pros:

Skin is not oily anymore. Acne was completely gone after about 2 to 3 months. (I'm on my last month now, and my skin is looking great)

Cons:

Besides the chapped lips that seem to be almost mandatory, I suffered from having rashy arms/hands, minor depression, slight erectile dysfunction lately (lets hope that'll go away!) and apparent worsening of eye sight (which is temporary apparently)

I would definitely recommend this product. Side effects aside, it works wonders getting rid of your acne and helps you get more self-esteem!
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December 19, 2009

Pros:

It makes your acne go away while you're on it. Make sure you have a doctor that discusses this med in depth w/you. Ask a lot of questions, bleeding when you go to the bathroom isn't normal. Your triglicerides should always be monotored monthly.

Cons:

My acne came back about 3 months after stopping this product. I did three courses @ 40 mg. Caused a lot of headaches, back, neck pain. Dry skin, skarring, hair fell out. Do not take Tetracyclines(birth control or antibiotic)while on this med.

My doctor was not monotoring this medication well, and other physicians are not aware of the counterindications of this drug. You should never have surgery on this drug. If you have headaches you should stop the medication altogether. I had a c-spine epidural while I was on this medication (also do not take any corticosteroids--read the fine print) to make the pain go away in my neck (common side effect) which no doctor knew was from Isotretinoin. I developed an epidural hematoma, and went paralyzed. I then had to have c-spine hematoma evacuation and a lamenectomy at 3 levels. I had trouble with clotting the entire time I was on this medication but I was also prescribed tetracyclines by doctors that don't know how to pick up a PDR. Because of the steroids and medications they gave me for my back and the ammount of accutane I was on, I then had an acute adrenal crisis & almost died. This drug is a cancer tumor chemotherapy, only use if you absolutely must.Try organic/hormone free diet
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December 19, 2009

Pros:

mostly cleared up my acne for a year.

Cons:

I still always had at least one pimple after accutane use, When I started on it my acne got MUCH worse than it was before,now about a year and a half later my skin is getting bad again even though I am still continuing on retin-A,really dry skin/lips

It works for some people really well and sort of worked for me. Get it if you want your skin to clear up enough that you are willing to risk it for all that money; however, I definitely wouldn't have gone on it if my parents did not have insurance to cover it.
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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