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Is Accutane Right For Me?

Jun02

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Dear Amy,
I’ve researched your archived articles regarding acne and found little feedback from Accutane users. I know you suggest the Philosophy line, which I’ve tried, it made my skin go crazy! I have moderate acne which has developed over the course of the last few years, and I am 33 years old. I recently decided to quit spending the endless dollars trying the various acne remedies (ex/ Proactiv, Philosophy, Neutrogena, and so on…), and finally visited a dermatologist. He’s supposed to be the most qualified physician around, he took less than 5 minutes looking at me before he stated that I needed to try Accutane, that was it- no other suggestion. I am fine with this if it gets the job done, I just don’t know much about it.
Once the nurse entered the room, I was flooded with information/warnings/counseling. This somewhat concerned me, though I understand there is a huge liability associated with the product and birth defects (which won’t be an issue for me, no babies anywhere in this future). I’ve since scoured the internet looking for some more information, but what I really want is some users feedback, not clinical studies/doctor recommendations/etc. The nurse told me “not to worry”, “lots of people use Accutane with little to no side effects”, “we see great results”, etc. Yet the pamphlets state things like “if you start to feel like you are going to take your own life, stop taking this medication…” ummm, ok. Anyways, if you could please let me know your thoughts on this product it would be greatly appreciated!
Thanks !!
-Stella

Well, I wish I HAD lots of thoughts about Accutane, but I’m afraid I know probably less than you do. I know all about the birth defects warning and…that’s about it. Obviously, it’s pretty powerful stuff and thoroughly works its way around your system if it’s capable of crossing the placenta enough to eff with fetal development, so I don’t blame you for being cautious. In fact, I commend you for it, since I think too many people just blindly accept what’s on the prescription pad without taking some time to really research the drug, especially in this day and age of pharmaceutical commercials and glossy magazine ads. (“Oh! Zelnorm! With all those commercials with the women showing off their tummies! That was cute, sign me up! Oh wait…never mind.”)
A little Googling of my own reveals that lots of people have posed the question on message boards and other answer services — here’s a thread at the makeuptalk forums and Yahoo Answers. There’s definitely a mix of first- and second- and even third-hand reports here, but it’s clear that the side effects are definitely not something you should take lightly or feel silly for worrying about. Here’s the FDA’s take on the downsides as well. Depression and other psychiatric problems are very much noted, as is liver damage.
Perhaps the best and most informative site I came across is the forum at acne.org. There’s an entire subforum dedicated to Accutane — treatment logs, polls, before-and-after photos, you name it. Spend a few hours here and I think you’ll get a sense of how often the scary-sounding side effects actually happen and whether the risk is worth it in your particular case.
Now. After just that teensy bit of research, here’s my big question: You identify yourself as having “moderate” acne. Accutane is intended for severe acne. Full stop. It is a last-resort type of treatment, and even the FDA considers it a “high-risk” drug. From the link I provided:

Accutane should be reserved for cases of “severe recalcitrant nodular acne,” according to the product’s labeling. This type of acne is resistant to standard acne treatment, including oral antibiotics, and is characterized by many nodules or cysts–inflammatory lesions filled with pus and lodged deep within the skin.

Does this sound like you, at all? If you aren’t sure, just do a Google Image Search for “accutane” or “severe recalcitrant nodular acne” and take a gander at the faces and bodies that come up.
Obviously, it doesn’t sound like you got your prescription from a doctor who operates out of a van down by the river or anything, and without seeing photos of your skin I couldn’t even begin to question his recommendation. (Oh, and there’s also the little thing about me NOT BEING A DOCTOR.) It certainly does sound frustrating, since you’ve tried just about everything I would recommend to someone emailing for advice. So in that regard, yeah, maybe you ARE ready for a last-resort treatment regimen, but I’m still having an issue with the whole “moderate acne” bit, because that runs counter to a lot of the general info and advice I’ve come across.
So. Obviously I hope some readers will chime in here with any Accutane experiences — good, bad, middling — but beyond that I’m just going to repeat the suggestion of the acne.org forums. Look at the “before” photos and ask yourself if your acne is in the same realm and if you really do, in fact, have any business messing with this stuff. Maybe get an account of your own and post a photo and see what the other Accutane users think. Or poke around the other areas of the site and see if there’s a regimen or product that you might want to try first. (The basic acne.org regimen can be done fairly inexpensively, and I know we’ve had many commenters sing the site’s praises before.)
And again, GOOD FOR YOU for being suspicious and cautious. Personally, what little I’ve read in the past couple hours while working on this column scared the crap out of me, so I don’t know what I’d do either. (But to be fair, the Internet is sooooo good at scaring the crap out of me, just in general.)

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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63 Responses to “Is Accutane Right For Me?”

  1. Robin Jun 02 at 9:51 am Reply Reply

    I used accutane about 15 years ago (… ugh) and it worked but I remember that my skin was irritated by the whole thing. I do not remember much else, as I am now over 30 and can’t remember much of anything ;)
    I’m glad Amy suggested Acne.org – the regimen is the only thing that has ever really worked for me. And it’s cheap!

  2. Heather Jun 02 at 10:14 am Reply Reply

    I took Acccutane twice, once when I was 22 and again at 25. My skin wasn’t as bad as the pictures you see on the forums, but the zits I did have were deep and painful and left scars. It was also bad enough that I had days I didn’t want to leave the house because I felt so ugly.
    That said, I tried EVERYTHING before I went on Accutane. My doc originally prescribed it for me when I was 19 and I chickened out and never got the prescription filled.
    The worst side effects for me were dry lips and I occasionally got rip roaring headaches. Towards the end of taking it I started to get high cholesterol which is why you have to get checked monthly while you’re on it. You shouldn’t drink and have to be super careful in the sun.
    I guess the point of this comment is that your situation sounds a lot like mine – moderately severe, frustrating skin and not a lot of options left. I read and freaked myself out and finally I took a moderate dose with a doctor I trusted.
    Compared to a lot of the medications out there, Accutane has been around for a long time and is well studied and documented. You have to make the decision that’s right for you though, if you feel the risk outweighs the benefit and you can live with your skin the way it is, then don’t take it.

  3. Jenni Jun 02 at 10:15 am Reply Reply

    I tend to agree with Amy on the “moderate acne probably doesn’t need to be treated with Accutane” assessment, but only you know what’s right for you. I have had a lot of frustration with doctors as of late who don’t take the time to listen or understand before diagnosing and treating my body. It sucks that in the current age of health care as it is, you really have to advocate for yourself and your own gut instincts. If the remedy your doctor prescribes doesn’t seem to fit the bill or just rubs you the wrong way, you absolutely should push your doctor for a more thorough explanation of WHY he or she believes accutane is the best solution for YOUR body and YOUR acne. Express your concerns over the severe side effects and the disparity between your “moderate” acne and the drug’s recommended use for “severe” acne. Research other less invasive or less “last-resorty” treatment options to try before taking the last resort of accutane. And if your doctor is a total jerk and won’t listen or respect your wishes for your body- GO FIND ANOTHER ONE! You deserve to be treated by someone who respects you and you take charge, do the research self. Doctors have a specialized skill set, but they are NOT the end all and be all! Don’t roll over to their expertise just because they are doctors because only YOU are an expert on your body.
    For my moderate acne, I had to push my doctor to allow me to try a topical antibiotic which she had prescribed for my brother but had not even mentioned as an option for me! And I am not kidding when I say that the pizza face that had plagued me for months through birth control and millions of other solutions disappeared in A SINGLE WEEK with that topical treatment.
    Sorry for the rant, but trust your instincts, do the research, advocate for yourself, find a doc who will listen and make the decision that’s YOU believe is best for YOU.
    Good luck!

  4. Amy Jun 02 at 10:17 am Reply Reply

    Take a look at the article linked to here (http://www.aafp.org/afp/20001015/1823.html) from the American Academy of Family Physicians (AAFP). It has pictures and does a run down of different treatments. I’ve never had many acne problems, but any acne I did have completely went away with Ortho-tricyclen. AAFP also has a handout on Accutane: http://www.aafp.org/afp/20001015/1835ph.html.

  5. Erin Jun 02 at 10:18 am Reply Reply

    I’ve been thinking about accutane too, but mostly because I’ve had acne since I was a teenager. I’m 28 and it really doesn’t seem to be getting any better. I’ve tried pretty much everything else my doctor can think of and while some things have made it a little better, nothing has worked completely.
    My family doctor used accutane when she was younger, as did my husband, my cousin and another friend and they all came out of it intact, none of them had any scary stories about it so that makes me feel better. I’ve been kind of nervous about it too (thanks, Internet), but I think when I’m done having kids it’s the road I’ll be taking.

  6. Christin Jun 02 at 10:31 am Reply Reply

    Stella – I took accutane when I was in my early twenties for my “moderate” acne after years of everything else not working, including proactive which I mega-hated. I loved the final outcome, and was mad at myself for not taking it earlier. I did have some skin peeling and sensitivity while taking it, and had to watch my diet so that my cholesterol didn’t rise. But it was so so so worth it, and my skin is still great almost a decade later.

  7. Ramona Jun 02 at 10:31 am Reply Reply

    Okay, so I did two rounds of Accutane in my teens. My acne was moderate, not like the pictures you see when you google, but it was persistant and resistant to other forms of doctor prescribed topical acne medications. Accutane was my last resort. And it was a life saver! Nothing else worked for me. Nothing.
    The only side effects I experienced were headaches when I took it on am empty stomach. Now that I am in my late twenties, I manage my acne with just birth control pills.
    All of this being said, ask your doctor about prescription strength topical treatments if you’re hesitant to try Accutane. You might try to give those a shot before you try Accutane.
    Accutane is a very studied drug too. Ask your doctor for medical journal readings…none of that scary, semi-scientifc Internet stuff…and then weight the pros and cons. Good luck!

  8. Jezer Jun 02 at 10:46 am Reply Reply

    I used Accutane in high school. I had tried everything that my dermotologist knew to try. I had moderate acne that just WOULD NOT stop. Accutane worked. One round, and my skin was near perfect, with just a random breakout every now and then.
    The side effects that I experienced were very dry skin, one bout of nasty fever blisters, some fatigue, and bone spurs in my heels. All of these went away after I was done with Accutane.
    Also, Accutane “brings out” all of the acne in your system, so you will have to endure a period of severely ugly skin. It doesn’t last long, and once that stops, you notice a much nicer complexion emerging.
    Accutane is harsh, it’s not pleasant, but it works.

  9. Marin Jun 02 at 10:59 am Reply Reply

    Oh, Accutane. How you saved me.
    Backstory: awful, AWFUL acne develops at about 11/12 years of age. I went through years of topical ointments, oral treatments, etc. Really, it was insane. My last resort was Accutane, which I was put on twice. In short: it works.
    My side effects were a slightly achy back once in a while, dry lips, and developing eczema on my arms. My cholesterol also skyrocketed, but fixed itself once I was off the medicine. I’m surprised that your doctor would put you on Accutane right off the bat, because most doctors prefer to put their patients through all the possible remedies before going on Accutane, which is a serious drug, but…he’s got a medical degree and I don’t. I’d just be very, very, very careful about birth control, and MAKE SURE YOU WEAR SUNSCREEN. My doctor tended to stay away from prescribing Accutane during the summer, because people FRY on it. Your skin is so dry that it has no natural oils to protect it, so take your normal sunscreen regime and double its effectiveness. Seriously.

  10. Kimmers Jun 02 at 11:00 am Reply Reply

    Ok, so I have taken Accutane. I actually took two successive courses of it, because the first was only semi-effective. This was when I was 16, and I’m now 24, so my little disclaimer is “things may have changed a little since then”. But here’s some of my experience with the drug.
    First, the possible side effects scared me to death. Everything from possible dryness of the eyes that could permanently prevent contact lens wearing (yikes!) to severe liver damage to possible suicidal tendencies. As far as the birth defects, my doctor had to sign a form swearing that I was on the pill AND using a backup method of birth control (at 16 I wasn’t having sex anyway, but I was on the pill). He also told me very frankly that if I did get pregnant while on Accutane, I would have to get an abortion. Period. My impression was that the birth defects were essentially a guarantee, and pretty horrific. But again, I wasn’t having sex, so I knew beyond a shadow of a doubt that I did not have to worry about that particular side effect.
    As to the others? Honestly… I think as with everything else, you just have to be careful. Part of taking Accutane means going for blood work every 2 weeks, at which time the function of all your internal organs are tested. Your liver isn’t going to fail overnight, so as long as you go for the testing you can feel pretty safely monitored. A pregancy test is also part of the bloodwork. When I took Accutane, I could not refill my prescription without proof of having completed the bloodwork.
    Keep an eye on how you feel emotionally. Tell your best friend or your boyfriend or your mom that you’ve started a new drug that has been known to cause suicidal tendencies. Ask them to be alert to any changes in your mood or behavior. If you or they notice a change, talk to your doctor. You can also be aware of some of the changes in your own body – do your eyes seem drier or more irritated than usual? Any strange pains or discomforts that are outside the norm? Just be aware of anything that feels a little off, and don’t be afraid to call your doctor even if the change seems minor.
    For me, the side effects were scary, but I was motivated enough to get past them. Like you, I’d already tried all the OTC stuff out there. I’d also tried prescription creams and pills, all of which accomplished nothing except to give me majorly dry, flaky (and still broken out!) skin. The only symptom I ever experienced while on the Accutane was super, crazy, coming off in scary flakes dry skin, and dry eyes. But I never had to stop wearing my contacts, and the eye dryness went away when I finished my course of treatment. The dry skin I treated with prescription moisturizers my dermatologist gave me. I’ll be honest – nothing, but nothing, is fixing that dry skin, and some days it was as embarassing as the acne used to be. There were days I went at my face with a toothbrush before school to get the flakes under control. And on the really irritated days there was sometimes blotchy, angry redness too. The bloodwork sucked and I was always a little afraid to hear the (always 100% fine) results.
    BUT.
    The stuff WORKED. I don’t want to seem overdramatic here because I will be the first to admnit that I did NOT have the kind of acne this drug is intended for. In no way was my acne “severe” in a textbook sense. I actually expected to get turned down when I asked to take it. But my doctor was fantastic. He said that no, I didn’t have pus filled nodules or deep, under the skin lesions. But was I self conscious to the point of panic? Yes. Was I unhappy with myself and constantly trying one failed remedy after another? Yes. Was I basically keeping Sephora in business in my quest to Cover That Shit Up? Hell yes. What defines “severe” to YOU is subjective. I think regardless of what a textbook might say, if you can read that list of possible side effects, if you can have a constant bruise in the crook of your arm from months of biweekly blood tests, if you can deal with the dryness and the flaking and the scary forms you have to sign every time you refill your prescription? You’ve probably made the right decision in considering Accutane.
    And here I am 8 years later and my skin is still fantastic. Do I ever break out? Sure. I will sometimes get ONE ISOLATED PIMPLE, never too angry, easily concealed, and almost always gone in a day or so. The vast majority of the time I would feel 100% comfortable with not one scrap of makeup on my face. (I am a girly girl, so I’ve usually got a full face on, but the point is that it’s a STYLE CHOICE not a necessity, and gone are the days when I would not so much as run outside to get my mail without my foundation firmly in place. When I backed out of group beach trips because I was a wreck at the thought of people seeing me without my makeup. When I slept at a friend’s house and woke up early to reapply my makeup before anyone else work up.)
    I say, if you feel comfortable with it, go for it. Make sure you are closely monitored by yourself and others. But I would reccomend nothing like I would this drug. I can say with absolute honesty that it changed my skin and my self confidence and my LIFE. Best of luck and please let us know how it goes.
    One other thing. No joke, when I took Accutane, the pills came in packs like most birth control does, where you pop the pill out through a foil backing? And the backing had this little cardboard pictures that would fall out when you popped the pill out. What were they pictures of? Tiny fetuses stamped with the big red circle with a line through it, to remind you of the potential birth defects. That FREAKED ME OUT so I sincerely hope they have since updated the packaging.

  11. Jenny Jun 02 at 11:07 am Reply Reply

    Just checking in to offer another opinion. My mom is a derm nurse and is very leary about Accutane. It’s some pretty strong stuff. I’d stay away from it if I was even thinking about having sex, but that’s just my opinion.
    Is there any reason why your doctor didn’t want you to try another oral antibotic? I had very good luck with a sulfa (sulfer?) drug, but was allergic to it. I also had good luck with arithomiscin (spelling, again) and amoxicillian. I would maybe suggest trying one of these first. One thing to remember on these drugs is that things will get worse before they get better as the bacteria gets ‘flushed’ from your system.

  12. Aimee Jun 02 at 11:25 am Reply Reply

    I took a course of Accutane in high school (about 15 years ago) and regret it. I, too, only had moderate acne, and besides the side effects, I was unhappy with the results. I got severely dry skin and lips, and tons of nosebleeds. I had to constantly apply neosporin or vaseline with a Q-tip up my nose. Accutane messes with your entire body because it’s basically shrinking your sabaceous glands. And I think they do warn you that the side effects can linger after you’re done taking the drug. I still have patches of dry skin, and I still get nosebleeds. Also, I don’t think it really worked that well. At age 29, I still have acne–I use the acne.org regimen generally, with topical benzoyl peroxide in the morning and topical 0.025% Retin-A in the evening. This seems to work to control breakouts, although I still get the occasional zit or two. I really suggest you try this regimen before jumping into a 5 month nightmare of dry skin, nosebleeds, and monthly bloodwork. Topical treatments can work just as well, and that way they’re more targeted to your face versus Accutane, which affects the skin covering your enitre body.

  13. Tamara Jun 02 at 11:25 am Reply Reply

    I, too, used Accutane in high school, after trying literally EVERYTHING (and I must say, antibiotics were a complete waste of time and messed up my digestive system for years). I had to stay completely out of the sun, my skin was crazy dry and I could only shampoo my hair every few days. Also, my skin seemed much more prone to scarring AFTER taking it. However, it worked, and for several years (all of college), my skin really cleared up.
    After that? Well, it is back (from 22 to now almost 30), but it is not the cystic stuff I had as a teenager, just persistent hormonal stuff that doesn’t go away with the Pill. I think if I could find a good asthetician and get regular salycylic peels and microdermabrasion (and maybe those light treatments) it would be better. I tend to think that Accutane would be a lot harsher and harder to deal with as a 30-something. I suspect the side effects would be much worse.

  14. Andrea Jun 02 at 11:29 am Reply Reply

    I took two courses of Accutane when I was in high school. Again, as others have said, this was after trying many other options. I think if you are classify in the amount of acne I had you would say it was moderate. However, it was of the not garden variety acne, it was the recalcitrant nodular acne. I think that is the part you need to pay attention to when you are thinking about taking Accutane. If you just have pimples, no, Accutane is over kill. If you have this particular type of acne, even if it isn’t a lot… you may need to use Accutane.
    For both courses I took Accutane along with Ortho-tricyclen.
    While I didn’t like taking it either time, it really did work. My worst side-effect was super chapped lips and if I did get sunburned (because of course I worked outside during this time), the peeling was bad and the healing was slow.

  15. RJStewart Jun 02 at 11:39 am Reply Reply

    My husband just started taking Accutane. He did this only after 2+ years of trying various VERY STRONG combinations of prescription topical ointments and antibiotics. When the heaviest-duty antibiotics that the dermatologist could prescribe for acne were not working on any consistent basis, he and his doctor decided to take the step towards Accutane. I’ve also had mild to moderate acne, and my dermatologists always started with antibiotics and prescription topicals first – a little tetracycline and a commonly used topical or two, and a little retinol or alpha-hydroxy acid cream. A few months of those has always done the trick, and I am usually antibiotic-free within a few months, and just use the topicals as needed, unless I have another bad cycle, which seems to happen every couple of years. I think it’s kind of odd that your doctor would suggest Accutane right off the bat, without even trying a regimen of the topicals and antibiotics that work well for most people. I’d get a second opinion from another doctor before committing to Accutane.

  16. Bonny Jun 02 at 11:49 am Reply Reply

    I used two rounds of accutane, one in my teens and another in my early twenties. I had moderate acne on my face, chest and back. I didn’t experience any crazy side effects, aside from severly dry skin (including my scalp and lips).
    For body lotion, curel worked best; for my face I used nothing but cetaphil cleanser and moisturizer for dry skin. I kept vaseline with me at all times for my lips, and I found I had to exfoliate them almost daily. I was only able to wash my hair weekly (I used to wash it every other day) and had to use a cortisone shampoo prescribed by my dermatologist. Once I finished the accutane cycles, my skin mostly returned to normal. I still have moderately dry skin, but most important my acne is completely gone. After treatment, glycolic acid peels helped clear away any remaining scars. I have not experienced any breakouts, other than the occasional pimple.

  17. Erin Jun 02 at 12:31 pm Reply Reply

    I also took two course of Accutane, once at 19, and again at 22 for fairly severe acne. Before the first course, I had done years of different treatments (topical & pills – mostly antibiotics) with limited success. And the Accutane just plain worked. I do still have the occasional breakout … I still have to wash my face IMMEDIATELY after working out or sweating a lot, but I use Neutrogena’s ance cream on them, and they’re gone in a day or two. And, for the most part, I’m happy I did it – my skin is just so much more manageable.
    BUT, the side effects are certainly not to be taken lightly. I don’t remember experiencing any of the emotional / physchological effects, but the physical ones were hard. As someone said above, taking Accutane definitely means things WILL get worse before they get better. Because the medicine is shrinking your oil glands, it also kind of ‘expels’ what’s clogged up already. I remember just barely touching my nose and having all the blackheads ccme out … kind of gross. Also, shrinking oil glands means the ones in your scalp too, so I got a really dry scalp & hair for those few months, and I still have pretty dry hair.
    The biggest side effect for me was the dry lips & skin. I literally carried vaseline everywhere I went for the 5 months, since I had to apply it like every half an hour … eventually I got a prescription lip cream to help with that, but still had to apply all the time. My skin was dry everywhere, I had to be really careful in the sun, and I did have some of the joint achiness as well. I had to go in once a month for a liver check & blood work, but never had issues with cholesterol.
    All in all, it’s not a pleasant course of medicine, but it works. For you, though, I’d push your doctor a bit harder to see if you can try som emore topical treatments first.

  18. Stella Jun 02 at 12:34 pm Reply Reply

    Thank you so much for all the advice!
    I am slowly checking out the message boards that you found, it appears that the ratings are 50/50 between pro’s and con’s. I have also checked out the acne.org and found that my skin is not that of the majority of the before pictures, I would still rate myself as moderate.
    I think my dermatologist took the Accutane route due to my stating that my skin appears to worsen with everything I try, also probably because I told him that I “can’t take it anymore and never want to leave my house”. And this puzzles me still: He stated that Accutane was the only product that is sometimes known to provide long term results. So I wonder how many people actually received clear skin for an extended period of time after the one round of usage?
    Another issue which I stated to the doctor was my dislike for the products out there that stain clothing, I have spent hundreds of dollars replacing all of the clothing/sheets/towels/etc. that were ruined after my experimenting with various topical items (ex/Proactiv)(Does the acne.org regimen stain clothing? Is it comparible to Proactiv?). Also, I informed him that I no longer use sunscreen (which I know is a huge no-no), but it breaks my skin out so bad now that it just adds to my wanting to hide in my house, also I wonder if Accutane helps with more than just acne? My skin tends to be a mess all around. In the summer it burns/peels/breaks out/blotches, I use samples of a topical ointment right now that makes my skin peel and break out. So yeah, I pretty much just give up on the thought of ever having normal skin again.
    Ramona’s explanation of her skin is similar to how I would explain mine, “persistant and resistant”. Even my arms look bad, they are somewhat tan with white spots which are dry and flaky…?
    Also, thanks Kimmers, your advice was just what I was looking for. Plus, am I the only one somewhat bothered with how much they are pushing the abortion issue here. I mean, we get it, but there is something so disturbing about how many times they said to me “you will get an abortion if you get pregnant” and the pic’s of fetuses in each pack?! I have to say that the extreme nature of this makes me somewhat dislike the manufacturer.
    Thanks again everyone!
    Love you Amalah!

  19. Stephanie Jun 02 at 12:36 pm Reply Reply

    I’m 25, just finished a course of accutane about 3 months ago. I had moderate to severe acne, my dermatologist had tried topical and antibiotics for about 2 years prior to trying the accutane. I love my skin now.
    I’m a bit surprised that your doctor is going right to accutane, but as other commentors have said, he is the one with the MD. I think the side effects do vary significantly from person to person, but it’s a personal decision that you have to make. I spent several months researching other people’s accutane experiences before I started my course, so I think you’re being wise to seek out as much info as you can as you consider it. Good luck!

  20. Jude Jun 02 at 12:58 pm Reply Reply

    My brother took Accutane almost 15 years ago but, we had both been seeing the dermatologist for 2 years before that course of treatment was offered to us. I looked at the side effects and balked and since my acne wasn’t nearly as severe as my brother’s I just continued to put up with it until a combination of growing out of it and ceasing the “must attack acne now” mindset of skincare took it’s natural course (I must say using a GENTLE cleanser was a life changing revelation for me). Anyway, my brother definitely had a more severe case and Accutane did work for him, but I would definitely put it in the last resort category because the treatment is rough. You look a lot worse in the beginning and (at least for my brother) when they say dry chapped lips it’s really an understatement… it was rough. But again, it worked and his acne was so bad for so long that even with the side effects heavily weighting the negative column, he still went for it. So, yeah, I guess my main concern is that this doctor prescribed this right out of the gate. I would definitely seek a second opinion. I also wish that dermatologists would do a lot more for patients in regards to actual skin care products and regimens before pulling out the prescription pad.

  21. Polly Jun 02 at 1:45 pm Reply Reply

    I had moderate but not severe acne in high school – enough to make me really self conscious -as if it’s not difficult enough to be a teenage girl! Our family dermatologist prescribed everything under the sun and nothing worked, and he presented accutane as an option but my mom wouldn’t let me take it – talk about teen agnst. The acne and low self esteem continued through college and finally when I was out of college with a job and my own insurance I saw another dermatologist who told me I was an excellent candidate for accutane. IT CHANGED MY LIFE. I had severely dry skin and lips as a side effect but I just coated on the cetaphil. I had a boyfriend – my now husband – and we used double and triple birth control and were somewhat paranoid the whole time but the end result was so worth it. My skin was clear for the first time in my life and I didn’t look in the mirror every morning to new pimples and the occasional cyst. After accutane, I actually got compliments on my skin. I didn’t have ANY acne at all for about ten years and about three years ago in my early 30′s I started to get flare ups again (but not nearly as bad as before the accutane.) My dermatologist suggested another round of accutane but in the last three years I’ve either been trying to get pregnant, been pregnant, or nursing so I’ve been using other prescription products instead. I use a topical gel called Klaron and a Benzaclyn product for spot treatments. When I’m not pregnant or nursing I occasionally take a pill called Solodyn if my skin is acting up. This seems to regulate things for awhile so I don’t have to take it every day (I’ve tried a lot of oral antibiotics for acne and this is the best one – NO side effects and seems to work quickly). Bottom line is that I wish I had taken Accutane in high school or college as opposed to waiting and I think it’s a miracle drug. I think people who don’t deal with acne every single day of their lives don’t understand how it makes you feel about your appearance. Just my two cents!
    Polly

  22. Megan Jun 02 at 2:21 pm Reply Reply

    I also took Accutane in college after many, many frustrating rounds of antibiotics (oh hay yeast infection !), prescription topicals, over-the-counter regimens (eff u, proactiv), and on and on. It did make me depressed, and it did work. I took Vitamen E capsules to ward off chapped lips, so that wasn’t an issue.
    The depression lifted after I stopped taking the medication. I should mention that I didn’t become suicidal while taking it; I just felt ‘down’ and kind of…sad. (Which, obviously, I mean…not ideal.) The cystic acne flared again about 5 years later, at which point I did another round. Again, it did make me depressed, and it did work – for a while.
    When my acne came back, I decided I couldn’t deal with another round of Accutane. My doctor tried giving me antibiotics, which didn’t work, and finally, thankfully, YES LORD YES, prescribed me Spironolactone. No one else I know has taken it, and I’m not sure why, because it worked beautifully for me. I always suspected my acne was hormone-related (I’ve never found a birth control I could tolerate because they make me feel crazyyy, maybe I’m just a particularly delicate flower), but. Anyway. Spironolactone worked. I took it in combo with Retin-A and haven’t had a problem since, haven’t dealt with any noticeable side effects, and, in short, am grateful. I no long take Spironolactone and use the Retin-A at night. Very easy, very reasonable, and very effective (for me).

  23. kaelak Jun 02 at 2:37 pm Reply Reply

    I used Accutane for “severe recalcitrant nodular acne” when I was 16/17 – my understnading was that it was for that condition and/or adult acne that didn’t respond to other, less aggressive, treatment. I am firmly in the “loved it” category – there was no risk of baby when I was that old, so i didn’t have to worry about the birth defects thing, and the only side effect that I had was severe drying of…well….everything. I used Eucerin (love!) and Vaseline my face and in my nose (dryer skin = bloody noses) and I was pretty good to go. One note – Accutane treatment was for several months, and it did not start to take effect until after I was finished with treatment, just as my dermatoligist said. I have have virtually flawless skin ever since (I’m almost 30 now).
    Good luck!

  24. Amanda Jun 02 at 2:41 pm Reply Reply

    I took Accutane when I was around 19 or 20 after a couple of years of trying topical and oral acne medication, in addition to using acne face wash and what not. I wouldn’t say I had severe acne, but I did have multiple kinds–whiteheads along with the kind of cystic type pimples that are big knots under the skin. So I too was very self conscious as others have said here. I think Accutane is the ONLY way to go, I’ve never broken out since, with the exception of a pimple here or there–but nothing cystic like before. Yes you do get very dry skin–my side effects were very dry lips, dry skin and dry nose (nose bleeds). I forged through by staying out of the sun, keeping tons of lip balm on hand and just dealing with it basically until I was done per Dr’s orders. I wouldn’t do it any other way, looking back, as I’ve had clear skin for close to 15 years now. Hope that helps!

  25. whitney Jun 02 at 2:45 pm Reply Reply

    I was on accutane for almost a year when I was 16. I also had what I would describe as “moderate” acne. Accutane was pushed because my mother was concerned I would develope severe acne in my late teens the way several of my family members had. Those ten months were miserable (weight gain, dry skin, couldn’t wear contacts, hair loss (minimal), bloating, and a slight bout of depression) but I’m ever grateful for it now. I’m 24 and alost NEVER get any form of pimple. I have no scarring from my time before or on accutane, my hair, which was way to thick to begin with, is fine now, and the problem of very oily skin/scalp that I had before is long gone. I would do it again if I had to relive, but I would be more open with my parents about the side effects I was having instead of holing myself up.

  26. acidspit Jun 02 at 2:46 pm Reply Reply

    You may want to read the comments from this particular post from Jezebel re: Accutane:
    http://jezebel.com/363735/how-i-conquered-my-cystic-acne-in-just-17-painful-steps

  27. Kate Jun 02 at 3:10 pm Reply Reply

    I’m chiming in as another satisfied Accutane user. I started Accutane when I was 22, after trying topical antibiotics, oral antibiotics, birth control pills, and everything else under the sun. My acne did not look as extreme as many of the pictures of severe acne on the internet, but it was constant – I had been broken out for ten years straight at that point. The first few months on Accutane were a little uncomfortable, and my face was simultaneously broken out and peeling (it was gross), the pills were expensive, and having to go in for blood work every few weeks was a pain in the butt. After the first few months, though, my face cleared up all at once and it was amazing. I felt really wonderuful, and not embarassed about my skin for the first time since puberty. Five years later, I still have dry skin, but nothing that good moisturizer can’t handle, and no other long-term side effects. It is definitely not the right option for everybody, but it worked really well for me and I felt it was worth all of the aggravation to finally have nice skin. I hope you find an option that works just as well for you – either Accutane or another treatment!

  28. Beth Jun 02 at 3:44 pm Reply Reply

    I was on Accutane as a teenager, after trying Retin-A, Benozyl Peroxide wash, etc. I took it for a few months, and went in for bloodwork while I was on it. Since I was a teenager, I forgot pills and eventually went off the medication because it was such a hassle. Also, I was already on antidepressants, so maybe this saved me from the scary side effects?
    I still had pretty bad breakouts in college, but more hormonal than the cystic acne I had as a teenager. After going on the pill at 22, my acne has cleared up significantly, and my breakouts are more controlled to the summer months (Thanks Chicago!) and my cycle.
    I also have a dermatologist who put me on Benzaclin, a gel you put on your face morning and at night to basically dry out the oil. That, the philosophy products, and a facial once every 10 weeks seems to do the trick.
    I’d agree that Accutane seems pretty aggressive for someone with moderate acne. I would try another dermo consult first.

  29. e.darcy Jun 02 at 3:55 pm Reply Reply

    I was put on Accutane for two years while in high school, I didn’t have bad acne, but the dermatologist told me that he was worried about scarring.
    it was dreadful, terrible… i still worry today about what side effects it could have caused to my insides since the effects are so horrible for pregnant women. (i don’t know if they still do it, but since i am a woman, i was paid to fill out their surveys of how it effected me)
    it left my face constantly chapped, red, raw. and after two years of taking the stuff?–it still didn’t go away. I’m left with skin that is still spotted, still have redness. the only thing that i have found to keep the inflammations at bay was the arbonne ‘intelligence’ kit.
    i would never wish accutane on anyone…but i hope that you find something that works-and if you do, please share with the rest of us!!!
    i’m having a particular ‘bad face’ day–that i think only people that have ever had acne can understand. like a ‘bad hair’ day–only you cant just cover it up with a baseball hat, and you want to crawl into bed so no one sees you… :(

  30. Catherine Jun 02 at 4:26 pm Reply Reply

    just to chime in — I cannot recommend Accutane enough. I’ve done it twice — once in 2002, once in 2005, and while my acne has not completely gone away (I had really terrible acne), it’s cleared up, and now I’d classify it as mild to moderate. While I was on Accutane, my skin was perfectly clear, and it remained clear for months afterward; I just have a really bad strain of acne and honestly, I’m going to be taking my third (and hopefully final) round of it beginning in July. For most people, though, it clears up your skin after one round.
    I didn’t have any of the side effects, although I definitely recommend sunscreen every day. I don’t think that taking it for moderate acne would be terrible — they just recommend it for the horrible cases only because if you get pregnant it will seriously harm the baby, and also because there’s a lot of hoops to jump through to get it — videos, paperwork, etc., because they’re paranoid about you getting pregnant on it. Also, you have to have your blood taken every month, so if you can’t handle needles, it’s probably not for you.
    I would recommend trying a few milder doctor-prescribed things first, just because Accutane can be a hassle (see: above). Minocycline and Yasmin (birth control) together have a good reputation, according to my dermatologist, for clearing up moderate cases of acne. Didn’t work for me, but again, I have some mutant strain of really aggressive acne (oh, goody). Retin-A is another commonly prescribed medication with a good success rate.
    Also, If you have really sensitive/dry skin, you want to use a pill instead of a topical because the topical can REALLY dry/irritate your skin (happened to me). Good luck, let us know how it goes!

  31. Sarah Jun 02 at 4:28 pm Reply Reply

    Another former Accutane user here (wow, there is a mini community of us on the Smackdown!). Like many of the other commenters, I was on Accutane in high school for moderate acne that was resistant to all other treatments. I did one course and then stayed on a “low dose” regimen for several years, taking just two pills a week. Part of the draw for me was the idea that the results would be definitive, that I could forget about my acne problems once the treatment was done. I loved the results while on Accutane–it’s the only thing that’s ever really worked for me–but years later I again have very oily skin and problems with breakouts on my face, chest, and back. At age 29. I’ve toyed with the idea of going back for another round just because I’m so incredibly sick of this lifelong battle with my skin, but I might want to have kids in the next few years so it’s really no longer an option for me. I’m glad to hear that others had permanent improvement; it just wasn’t the case for me.

  32. Deanna B Jun 02 at 4:35 pm Reply Reply

    I took Accutane when I was in high school for a couple of months. I had horrible acne that would not respond to anything else. I was on supposed to stay on Accutane for six months, but only lasted three. The first time I went to the beach while still on it, I wore a rash guard, pants, a hat, sat in the shade and the highest spf I could find and I still burned. Since I spend the majority of my time outside in the summer, me and accutane parted ways. The the side effects I dealt with were constantly chapped lips and bloody noses.

  33. Di Jun 02 at 4:48 pm Reply Reply

    I was on it for about 3,4 months 9 years ago. It was brutal, I hated being on it every second I was on it. It cleared up my skin beautifully for about 2 years. Derms have tried to put me on it since, and I refused. It gave me these little bumps on my arms, dried out my eyes like you would not believe, and made me despondant.It was the scariest thing I ever was on. Take the warnings seriously when you read them.

  34. Rachael Jun 02 at 5:17 pm Reply Reply

    My dermatologist had the same reaction that yours did when I went for my first appointment. The physician’s assistant that did the initial diagnosis put me on a much milder antibiotic (solodyn) and two topical creams (Tazorac and Benzaclin) for my moderate acne. Thank goodness she was the one I saw first, because when the dermatologist came in, he asked me if I wanted to be on Accutane. If I hadn’t known there were options, I probably wouldn’t have been so forceful in saying “No.” The antibiotic and creams have done wonders for my skin and I would encourage to ask what the milder options are.

  35. Jessica Jun 02 at 5:25 pm Reply Reply

    I’ve been really happy with the Alpha-Hydroxy line of products (available on http://www.drugstore.com). It’s by far the best for me at this point in my life.
    I’ve never tried accutane, but honestly, love the Alpha-Hydroxy line (I think I got the recommendation from acne.com or something).
    Good luck!

  36. heather Jun 02 at 5:32 pm Reply Reply

    I am on my last month of accutane. I am so thankful for it! I didn’t have severe acne, but moderate. It has worked wonders. The only side effect I have is dry lips. I use Aquphor all the time and that makes a big difference!
    I would do your research but also realize that not everyone reacts the same so the people who have tons of side effects arn’t the only users. I love it and am so excited to see how I do when I go off! GOOD LUCK in whatever you choose!

  37. AJMick Jun 02 at 7:23 pm Reply Reply

    Okay, I never took Accutane so I can’t weigh in on that stuff but I’ve fought acne for years and finally found a regimen that works. Philosophy doesn’t work for me – does absolutely horrible things to my skin – it works for Amalah, which is fantastic, but for me? OMG NO! Step away! Except for Purity to take off the makeup before cleansing. What I did find that works for me is the Dr Brandt line. Although, unlike Amalah, I cannot use Pores No More – it clogs my pores like crazy (it’s as if I have the opposite skin of Amalah). Anyway… what I do like? Poreless Cleanser, Moisture, Tone, Pore Effect, and Microdermabrasion. I also use the acne.org benzoyl peroxide (which does NOT stain/bleach fabric). Actually, I credit Dr B’s Microdermabrasion along with 2000 mg of flax oil a day (taken orally, via capsule, 1k am/pm) for really taking me over the edge to flawless skin. I am amazed. I can’t even begin to express how horrible my skin was before I figured out this regimen – it was so raw and almost swollen that it hurt to touch it. I would spend a good 10-15 mins a day trying in vain to cover the blemishes before going out in public only knowing that it still looked like crap. Now? I could go out w/out makeup and outside of the dark-ish circles under my eyes I wouldn’t be embarrassed.
    I wish you luck in your decision and I hope you figure out what works for you. I can completely relate to your situation as I was right there with you a few months ago. I would suggest getting a second a opinion at least before signing up for accutane, and if you do decide to shell out for any of the Dr B line be sure to buy from Sephora so you can return the product if you hate it. Before finding what works for me, I was ready to go to the dermatologist and do whatever they told me to do – the Dr B line was a last ditch effort and I was a little nauseous forking over big dollars AGAIN for unknown results. I’m so happy I took that chance. Best of luck to you!

  38. Lauren Jun 02 at 8:50 pm Reply Reply

    I took Accutane about nine years ago, when I was 26. I had a similar experience with the doctor as you. I went to a new dermatologist because I was tired of having adult acne. It wasn’t severe, but it was really ugly and annoying, for something I’d thought would be gone after I left my teens.
    Anyhow, the doc very quickly said, “so you’ve tried everything? Let’s do Accutane!” So I did it. I got a hat, wore sunscreen religiously, and didn’t get pregnant. Other than dry skin (and a bloody stool once, if I’m being totally honest), it was fine.
    Now, in the last year, I’ve started getting minor breakouts again. Mostly they’re timed with my cycle, and they’re not nearly as bad as they were before being treated, but you should know that even with everything you go through, it may not be a permanent solution.
    So, in the end, I do wish my dermatologist had been better about trying other options, but the Accutane did it’s job and I was indeed pimple-free for a very long time.

  39. shayna Jun 02 at 9:45 pm Reply Reply

    Now, to be fair – I *do* get severe, recalcitrant nodular acne. I literally fear the day I ever go off the Pill because it’s the only thing that keeps my skin in check without Accutane. But I have taken Accutane, at varying doses for varying lengths of time, at least 6 times. It is not fun, and I can’t believe the number of people who are willing to deal with the horror for (what looks to me like) fairly mild acne. However, having also done some serious academic study on the psychological effects of acne, I can’t really question anyone’s decisions on the subject. If you do decide to go the Accutane route, I’ve made some recommendations to friends in the past – thought I would share them here…
    Shayna’s exciting accutane tips!
    1: DO NOT LEAVE HOME WITHOUT CHAPSTICK. I am serious about this one. Put one in backpack, every purse, desk, nightstand, bathroom drawer, pocket, no kidding. You will get a new set of lips every 2 hours or so. Get one with sunscreen in it.
    2: Get a moisturizer for your face, something with sunscreen in it. Get something OUTRAGEOUSLY gentle, whether it’s a drugstore brand or something nicer. No dyes, no frangrances – basically, something that would be suitable for an allergy-ridden infant.
    3: Don’t use any face wash with any kind of scrub, peel, oil-fighting, or acne-killing words in its title. Doctors always recommend cetaphil. I think cetaphil is weird, but again, gennnnnnnnntle.
    4: Get moisturizing hair products. Also, get moisturizing body wash. Also, if you’re not accustomed to putting lotion on, like, everywhere in the summer, get used to it. Basically, if it has the word “moisturizing” in it, you want it. And wear sunscreen.
    5: No waxing, especially eyebrows.
    6: If you take any allergy pills, drink extra water, they get very drying.
    On the low doses, I never had too many problems with exciting tips 4-6, but your lips, face and hands will go fast even when you’re only taking a little bit.

  40. spookie Jun 02 at 10:29 pm Reply Reply

    Stella,
    Given what you’ve said about your general skin issues with your arms having dry flaky spots and the moderate acne, I would consult a normal doctor or another dermatologist to have a look at your skin without you saying anything that might sway their judgment.
    I’m not a doctor, but it sounds like you might have a generalized dermatitis issue – from what you said, your skin is not happy in general, not just on your face.
    Best of luck with whatever choice you make – I really hope you write back in the future and let us all know what options you chose!

  41. Janna Jun 02 at 10:30 pm Reply Reply

    I’ve done 2 courses of Accutane – one when I was 16, and one when I was 21. I would say my acne was moderate in number – I never had more than 4 or 5 zits at once – but I think it was characteristically more like severe acne – if I pushed on them, I’d feel soreness and a cyst under the skin. Not sure if that makes any sense. Anyway, I tried just about every treatment in the book before going on Accutane, and it did work, at least somewhat well for me. I had fewer pimples during and after the treatment, but a few years after my first course, it returned to what it was before (hence the second course). The only side effect I had was chapped lips and slightly increased cholesterol.
    That said, my Accutane experience was pretty positive. However! Like I said, it didn’t completely get rid of it. But what did was a combination of Duac (I believe it’s newer) and Differin. I don’t even have to use those 2 things every day, and my skin is completely clear. So, it might be worth asking your doctor about that as one last option. Good luck!

  42. Mintea Jun 02 at 10:32 pm Reply Reply

    I’m currently on Accutane and I have to say that the stuff works. I had very active oil glands and my face was superbly oily,resulting in big, painful zits that wouldn’t go away no matter what I tried. I did the whole antibiotics and topical treatment thing but it didn’t work.
    I’m in my third month of treatment and the oil production has gone down considerable and I actually have normal skin now.
    There are side effects of course, like very dry lips and eyes. I have the blues more often and the cholesterol level went up too.
    I’ve got a few more months before I can get off the meds and I can’t wait.
    Good luck with your choice.

  43. Lori Jun 03 at 7:09 am Reply Reply

    My teenage son went from BabyFace to PizzaFace practically overnight. The dermatologist tried antibiotics and Retin A first for two months, then threw up his hands and prescribed Accutane.
    It didn’t make one bit of difference after three months. And every morning kvetching about the dryness. Every month kvetching about the liver function tests. Two years later, he still has skin issues.
    How I wish I could put him on birth control pills.

  44. lula Jun 03 at 12:52 pm Reply Reply

    You might want to consider seeing a naturopathic doctor. They are the primary care doctor to the natural medicine world.
    Just something to consider… I don’t have terrible acne, but did get my share of zits as a teenager. I’ve been extremely annoyed to have to deal with adult acne into my 30s…deep cyst-like acne that leaves scars. I went to a naturopathic physician who suggested a few things that might help (eg drinking more water) and at the end of her spiel said “well, you can always try giving up wheat”. It took me a while, but I was finally so frustrated that I tried it. …Within a couple of days I noticed everything drying up with an outbreak along my neck behind my ears that suddenly appeared and eventually cleared (I’m told it was they way my body released the toxins). My skin became glowingly normal… Sometimes I’ll go back to wheat – a slice of pizza or pasta – and if I eat it more than a couple of days in a row I’ll start with the acne again… It was like magic… A solution for my skin with no damage to my body or wallet.
    Not eating wheat is hard – I find that I’m okay with spelt (a more ancient form of wheat that hasn’t been hybridized too much) so at least there are some bread and pasta products that I can eat freely.

  45. Becky Jun 03 at 1:10 pm Reply Reply

    I used Accutane in college and would highly recommend it.
    However, I do find it odd that a dermatologist would recommend it straight off. Most experts I spoke to said Accutane was reserved for severe acne — or for resistant acne, as in my case. I never looked like most of the pictures you’ll see online – but my acne did not respond to anything — birth control pills, doxycycline, monocycline, Retin-A, sulfa drugs, creams, pills, etc.
    Even if you’ve tried over-the-counter stuff before, most dermatologists would want to try out a few other options before resorting to Accutane. In some respects, I wish I could have skipped all those failed attempts to go straight to Accutane, but I also respect my doctors attempts to exhaust all options. I would definitely follow up and ask why he/she thinks Accutane is necessary in your case — but if it came down to it, I wouldn’t hesitate to recommend it.

  46. ekh Jun 03 at 1:11 pm Reply Reply

    Just thought I’d add another data point. I had pretty good skin as a teenager, but things started to downhill when I hit my 20′s. My acne was probably moderate rather than severe, but I was really unhappy with my skin. I tried topical benzoyl peroxide (which I believe is the active ingredient in most of the Proactiv products), oral antibiotics, Retin-A, topical antibiotics, and nothing really seemed to make a difference. I went to a new dermatologist, who explained to me that, in her experience, Accutane was the only treatment that would be guaranteed to work for stubborn acne like mine. She explained that, for some people, a single 6-month course of Accutane can clear up acne for good. She did caution me that, in her experience, Accutane had less of a long-term effect for women suffering from adult acne.
    I did my first round of Accutane when I was 22. I had virtually no problems while I was on Accutane. I switched to Cetaphil cleanser and moisturizer and had to increase my lip balm usage, but other than slightly dry lips I had no side effects. And my skin cleared up amazingly–I finally felt like I had great skin, which was truly a revelation. After I went off of the drug, the good skin lasted for about a year. But gradually my skin got oilier and the zits came back.
    I did a second round of Accutane when I was 24. Again, virtually no side effects and my skin was perfect while I was on the drug. Again, about a year afterwards the acne came back (although it was probably a little milder than before). I started using topical Retin-A, which was moderately effective. Recently my skin seemed to be getting worse, so I went back to the dermatologist. I’m now using Benzaclin, which is a combination of benzoyl peroxide and clindamycin (a topical antibiotic). It is working much better than the Retin-A did, and I have virtually stopped breaking out.
    Sorry for the novel, but thought my experience might be helpful. To summarize: Accutane worked for me, but didn’t provide the long-term benefits I had hoped for.

  47. Stella Jun 03 at 2:24 pm Reply Reply

    Wow, so much information, and exactly what I was hoping for!
    Thank you everyone for your personal experiences and suggestions!
    I’m still undecided but feel better prepared to talk with my dermatologist at my next appointment.
    I’ll keep you posted-
    Lula,
    you’ve raised an interesting point, oddly my good friend was just informed that she was also having reactions due to wheat consumption. I find this so very unusual. Thank you for the info.!

  48. R Jun 04 at 11:53 am Reply Reply

    I had a similar experience to many other commenters. I had moderate acne, but after trying oral antibiotics and topical prescriptions for three years without any change in my acne, my doctor prescribed Accutane. It made my skin really, really, really dry for about 6-8 weeks, and that’s about it. I don’t have acne anymore.

  49. Steph Jun 04 at 3:09 pm Reply Reply

    I completely, 100% second Lula’s recommendation of seeing a naturopathic doctor. I had moderate to severe acne for about 10 years before I went to one this year. I was off wheat, dairy, sugar, red meat, alcohol, coffee and a bunch of other random stuff for 3 months. It was SO HARD but it was SO WORTH IT. Not only is my skin is completely clear (took about 2 1/2 months of being off all that stuff) it looks AMAZING. It GLOWS. I smile every time I look in the mirror. Plus I generally feel way better. It sounds impossible, but as I started feeling and looking better, it was easier. Now I can eat all of that again in moderation. So it isn’t a lifetime commitment to eating rice and beans. :)

  50. K Jun 04 at 4:03 pm Reply Reply

    I’m 30, and have been dealing with mild-to-moderate acne for about the last ten years. I’ve tried Retin-A and a number of oral antibiotics (including erythromycin and doxycycline), with so-so results. About six months ago, I wanted something better and also wanted to go off the doxycycline (I had been on it for two years, and was worried about birth defects also – I believe all the acne antibiotics carry some risk of birth defects, though none as bad as Accutane), so I asked my dermatologist for something different. Like your doctor, his first recommendation was also Accutane! But I instead asked for a prescription for Tazorac, which my sister had been using and loved. It’s 6 months later and my skin is 80% better – just very small occassional breakouts now, and hardly ever the big red angry ones that made me embarrassed to be out in public. I’d ask your doctor to try a less intense topical first (for me, Tazorac was worlds better than Retin-A or Differin, but everyone is different). One last tip if you do try Tazorac – ask for very specific instructions on using it; it’s very harsh and your skin will turn very pink and dry if you don’t acclimate your skin to it properly. I put it on for 5 minutes the first day, 10 minutes the next, 30 minutes the day after that, etc. After a few weeks I could wear it overnight with no problem, but it takes a little getting used to.

  51. Stephanie Jun 04 at 4:48 pm Reply Reply

    I am a medical student who just finished a dermatology rotation on which I saw LOTS of patients on Accutane. At first, I was shocked at how many people were on it, especially ones without “severe” acne. However, the multiple doctors/physician assistants that I worked with stated that, while liver enzymes do have to be checked every month (NOT every 2 weeks), they rarely see a rise that causes discontinuation of the medication. You almost assuredly will have dry lips, sometimes hands…all treatable with some chapstick in every bag you own, to be used liberally. In regard to the “please tell us if you feel like killing yourself or others” scary-type warning, it was created because of ONE senator’s 17 year old son’s suicide in the 1980′s, when Accutane was new. (See, been around for awhile!) What happened was this idiot senator left town with FULL KNOWLEDGE that his 17 and 19 year old sons were throwing an alcohol fueled party. It just so happened that before said party, the 17 year old’s girlfriend dumped him. He got loaded and killed himself. I don’t know his baseline depression, but basically this senator went on a crusade against Accutane (likely to numb his guilt, I would bet) saying that this was the ONLY reason that his son EVER would have done this. No thought to the approved binge drinking or teenage relationship angst.
    That’s all to say, all the dermatologists I worked with also said that was crap. None of their patients have changes in mood (though some of them suspect that that warning gives the mouthy 15 year olds license to say “sorry mom, I was yelling at you because of the Accutane”. Other than that, no changes that they note. Nonetheless, the senator got the laws passed, so that question will be one that you get every month.
    Hope some of this helped. I say go for it.

  52. aka Alice Jun 04 at 4:53 pm Reply Reply

    One more story..a little different than some of the others. I’m 45. I’ve done 2 1/2 rounds of Accutane. Once in my mid 20s. Once when I was 38 and I started a cycle when I was 40 but I didn’t finish.
    I have had moderate, but persistent acne (clearly) seen I was a teenager. I get some of the deep cystic nodules, usually once a month. Enough so that I either had one, or was recovering from one. By the time I used Accutane the first time I’d tried every over the counter option available (at that time) and every prescription option as well (tetracycline, Retin A, Cleocin, etc…you name it, I’d used it)
    Here’s the deal for me. Accutane worked…for awhile, but there were side effects. I had to stop the cycle when I was in my 20′s because my cholesterol and triglycerides went through the roof…probably because I continued to eat and drink whatever I darn well pleased (hey, I was in my 20s…the time I life that I claim to be my second adolescence). In any event, I could tell that event starting Accutane had a miraculous effect on my skin…but the effect wore off.
    Again, by my late 30′s, I was just tired of always having to cover up my skin…so I went back to a dermatologist. Had one that made me go through some other treatments before seeing that they didn’t work, and started doing Accutane again. Again, miracle. It worked, for awhile (about 2 years), then the cysts started again…So back on Accutane again! But by then, the law had changed, and I just couldn’t get to the doctor’s office every two weeks to get blood work done, so I stopped after about two months. The dry lips were the worst. One time I was in the sun for a few hours and my lips got so sunburned that they bled.
    Now I’m 45…and again dealing with breakouts again. (will it ever end? Will I be old, gray, wrinkled, and still dealing with acne?)
    Currently, I follow the regimen outlined on Acne.org AND I use Minocycline…which seems to deal with the cysts far better than doing nothing, but I still get breakouts. I’m not sure I’d go back to using Accutane again though.

  53. Stella Jun 05 at 8:23 am Reply Reply

    Thank you Stephanie, I feel so much better hearing a bit more about the depression warning. That was one of my big concerns, though I’m generally a happy person and am surrounded with loved one’s that I’m sure will point out any changes in my personality should they occur.
    Also, it helps hearing that so many others have had the same battle (misery loves company?), I don’t feel so vain now for thinking I can’t leave my house on a bad skin day.
    Thanks everyone & thanks Amalah! (…& congrats on the new baby boy!)

  54. Robin Jun 05 at 10:32 am Reply Reply

    I was on Accutane in high school (1995) after trying all other available treatments with my dermatologist for the 4-5 years before. My acne was never AWFUL but definitely bad enough to interfere with my self-image (always hard as a teenager.) In my case I went on it more for the persistance of my acne rather than the severity (although it was bad.)
    Like others have said, the acne definitely gets worse before it gets better. It brings out all of these big cyst like pimples and makes your skin really sensitive. It makes you look like you have a mild sunburn all the time with various degrees of peeling. Lips get peely,red and look like you have cold-sores even if you don’t. In school you could always tell which kids were on Accutane by looking at them. I never had any mood related side effects. The skin-related side effects went away soon after stopping the medication and I had “perfect skin” for several years.
    Now, I am 28 and have what I would call “very normal” skin. It’s definitely not perfect but I feel like Accutane erased my tendency toward acne and now I just have occasional, mild breakouts like most people.
    It’s really good that you are aware of the severity of the potential fetal side effects in addition to the side effects to yourself. I would make sure you are using a VERY effective form of birth control if you do decide to go on it.
    It looks like there is a lot of good personal experience information here, good luck making your decision!

  55. Lori Jun 05 at 11:50 am Reply Reply

    GET A SECOND OPINION! For someone with moderate acne, I am surprised that your doctor prescribed Accutane as a first resort instead of a last resort where it belongs. Tetracycline is typically one of the first options prescribed because it it works well and doesn’t have the intense side effects as Accutane. I am very surprised and shocked that it was prescribed first before other less risky treatments. I used Accutane as a last resort. It is not the type of drug that a good doctor would prescribe so cavalierly.

  56. Kimba Jun 05 at 12:04 pm Reply Reply

    So I actually have used Accutane before, when I was in high school. I had moderate acne, something that severely bothered me for many years, ate away at my already low self-conscious, and pretty much just made me down right miserable. After years of visiting the dermatologist, trying this, that, that one over there, and this one right here, I finally begged my mom to suggest Accutane, a drug my cousin had just tried that had worked a real live modern day miracle on her skin. So we did, and went through all the blood tests (they make you take them every month to be sure you’re not pregnant) and I went through it, one program, on a lower dosage and POOF. Never had a problem since. Sure, I have the occasional little monster that shows up, but honestly, I can’t tell you how happy I was with it. I’m not saying it’s right for everyone, and there are definitely precautions you should take (ie do not get pregnant!), I just know that it worked and made such a difference in my self esteem. So. There’s that. :) Good luck!

  57. Liz Jun 06 at 1:04 pm Reply Reply

    Stella~
    My doctor urged me to try Accutane when I was a teen and had moderate to severe acne, but I decided against it because of all the possible side effects. I had tried all the topical creams and even some of the ‘cillin’ drugs that are supposed to kill bacteria or fungus or whatever and none of that worked.
    My step sister who also had horrible acne when she was younger suggested that I try this brand called Erno Lazlo and it actually ended up working!! My face cleared up very quickly and now I only get the occassional pimple. It’s kind of expensive, but I found that the results were well worth it, it can be bought at Nordstroms or online through their website. I would recommend going to the counter and asking the specialist there to help point you in the right direction.
    Whatever you decide I hope that it works well for you!

  58. Cathy Jun 07 at 2:44 pm Reply Reply

    Just wanted to chime in -
    I used Accutane in college – it works, yes, but the depression can be very real – it does happen. I actually had to stop taking it because my depression was so severe. It completely changed my personality; I didn’t want to get out of bed, didn’t want to go to class, etc. It also made my lips so dry that they bled regularly and made my skin peel.
    But, it can work and does work for some. I have had acne my entire life – I am 30 this year – and the only thing that made it finally go away was Fresh Umbrian Clay Face Treatment. If you decide to try other options first, I highly recommend the stuff.
    Good luck!

  59. Carm Jun 13 at 2:54 am Reply Reply

    I’m on Accutane (20mg per day) now. I didn’t have the typical acne you’ll see on the photos, but that’s because as you get older the less severe your acne has to be for you to be eligible for Accutane. People expect 13 year olds to have bad acne, so doctors are reluctant to treat it. When you’re 33 it gets a bit more serious.
    Anyway, I’ve been on it for about 7 weeks. I’ve noticed a definite improvement in my skin, and my self confidence is much improved.
    However, my lips are so dry and cracked it looks like they’re misfigured and somebody’s burnt around my mouth but I do pick them. Chapstick and Blisteze are your friend.
    My nails are splitting merely from folding towels (and splitting right in the centre too, where it takes ages to grow out) — but I started taking multivitamins and my nails seem to have improved.
    Personally, I would recommend it.

  60. My name is Amanda Nourse and i would like to show you my personal experience with Accutane.
    I have taken for 6 days. I am 27 years old. My dermatoglogist put me back on Accutane partially because Klaron, Rentin A, & Doxycyclin were NOT working….I have been on Accutane before about 7 years ago so not too concerned about the side effects. With my previous run on this medicine I didn’t have the severe back aches. I will say I did have tons of issues registering with the IPledge website…all too confusing all to combersome! Didn’t have to do that 7 years ago. Since this is my 2nd go round I can say that for me there were no depression issues because my skin looks awesome …tons of compliments. As with all things once I stop so will the side effects. This medication is obviously for those with severe acne so you should certainly weigh the pros vs. the cons…for me I didn’t think twice…
    Side Effects :
    I’ve been on Acutane for 6 days now & I will say my back is aching terribly & my lips are DRY!
    I hope this information will be useful to others,
    Amanda Nourse

  61. woolisoycle Feb 03 at 6:19 am Reply Reply

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  62. chels Mar 16 at 4:38 pm Reply Reply

    Im 16 and I have acne, I wouldnt say it is super severe but it bothers me tonnes! I hate looking in the mirror and i like to stay in my room so i dont have to face people. I want to be prescribed accutane, because there are sooo many success stories, but I don’t know if my doctor will prescribe it to me.. how old do you need to be and what should i ask my doctor? I am going there tomorrow to ask him for something to help my skin. I feel how i look really impacts what I do, where I go, and my mental health.

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