Accutane?

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DD23 just met with her dermatologist. Her dermatologist is suggesting Accutane for her adult acne. This dermatologist owns a laser center and has worked in the field for 30+ years. She is great about recommending unconventional treatments and being upfront/honest about the benefits of various treatments. DD has had acne most of her teen/adult life. Not horrible acne, but she usually has 6-10 spots on a good day and can have 20-30 at any one time. They are generally small, but sometimes cystic. I work in pharmacy, and an very, very educated on topicals and most oral meds (she has tried/failed most of them including naturopathic ones), this post is specifically about Accutane or other Isotretinoin meds. We are aware of the BCP needs, complicated filling process, and depression risks.

If you or your child took Accutane for average acne, that just didn't really seem to resolve on its own in adulthood, what was your experience? Side effects, how many months, long term benefits? Her husband had horrible, cystic acne that was almost debilitating. He took Accutane and had terrible side effects from it, but it did work. Most of our patients in the pharm, had similar side effects.....but the ones who didn't have significant side effects, don't necessarily stand out in my memory! haha He isn't super positive about her trying it, based on his experience. But he will let her do what she wants (even though that means a second form of BCP while on it ). 

Any experiences out there?

 

[lewelma]

My dad was in the human trials for accutane in the 1980s. He was 40 and had pretty bad acne his while life. I don't remember much (I was 12), but I do remember the before which was pretty bad and the after where he basically has no acne at all. Definitely worth it for him. 

[Tenaj]

My oldest was on Accutane when he was 17.  He has basically made me promise to never put any of the other kids on it.  He didn't realize that what he was feeling was depression until he was off of it.  He refers to that year as "the dark time".  We had discussed this issue, his doctor had discussed the issue and we all still missed it.

[MEmama]

DS was on it for 9 months last year. Only by the very end was it starting to help— by no means was his skin clear, but it was getting a little better. He stopped because he was moving overseas so wouldn’t be able to jump through the hoops, and because it had already taken so.long. 
 

He did struggle with depression last year and had some frightening mental health concerns. It’s impossible for us to figure out if it was the Accutane or navigating covid during his senior year (public high school, but he opted for entirely online so it was very lonely in addition to the added stressors). 
 

His skin is still bad, but I won’t put him back on Accutane. I do think it helped with some of the cystic acne; I feel like if he cared enough to actually follow a basic skincare routine now he could probably clear the rest up with decent over the counter products. His skin looks much worse than it ought to be at nearly 19, but until he can be bothered to care I guess it won’t get better.

Edited January 4, 2022 by MEmama

[regentrude]

My DC took isotretinoin as a teen after many years of unsuccessful courses of topical and oral antibiotics. Only side effect was dry skin. Dc took it for several months. Great success. 

I very much regret not having done it sooner (I was concerned about side effects and mental health). 

Edited January 4, 2022 by regentrude

[marbel]

One kid took it for a long time; did not report or exhibit any depression or other mental/emotional struggles. It worked, though several years later there are still some breakouts but he doesn't take the time/effort to control the remaining acne (doesn't wash hair enough, touches face, etc). 

Second kid is on it  now at age 22. Beautiful results so far, no emotional issues that we can determine - actually, it's better due to the fact the acne is going away. 

[Beth S]

We chose not to use Accutane, for rather severe acne, b/c of the possible side effects.
We took one son to the dermatologist for years.
Two of our sons ended up having great success with Acne.org products.

[Hannah]

DD22 has just come off it after 9 months and her skin is clear for the first time in years - she tried every other remedy before Accutane. 

Her side effects were nose bleeds for which she had to use nasal spray and very dry lips.  No depression or other mental health issues.  She does horse riding and made sure to wear UV protective clothing and a special sun visor around her riding helmet. 

[TarynB]

I took it in my late 20s, after either temporary or limited success with other derm treatments since my early teens. My worst side effect was dry lips - I just carried chapstick in my pocket and reapplied it frequently. I ended up doing two courses of about 6 months each, with about a 6 or 7 month break in between. The first course improved my acne probably about 80% and the second course pretty much eliminated it. My derm said two courses is common, especially in adult women (hormonal acne). I have a family history of depression so I was concerned about that but never had any problems.

My son took it too, ended up with pretty much exactly the same experience as me. He was about 16 when he started, took two courses. Been over two years since he stopped the treatment and has good skin now.

Edited January 4, 2022 by TarynB

[saraha]

Ds21 tried everything, did accutane, stomach issues as side effect, a year and a half from being done now. His face was really clear for the first year or so, now he has some break through acne but not to level it was pre-accutane. He doesn’t like the break through acne but also doesn’t want to go back to dermatologist

[popmom]

7 hours ago, regentrude said:

My DC took isotretinoin as a teen after many years of unsuccessful courses of topical and oral antibiotics. Only side effect was dry skin. Dc took it for several months. Great success. 

I very much regret not having done it sooner (I was concerned about side effects and mental health). 

This was my experience. I was in my 20s when I took it. My only side effect was very dry skin. It really helped me. I also wished at the time that I had tried it earlier. 

[CTVKath]

I was on Accutane twice. First time was in my teens and I took it for 6 months. The only side effect was dry skin and chapped lips. My acne gradually returned and I did a second 6-month regime in my mid-20s. Only side effects were dry skin and chapped lips. I've never had an issue since and I'm in my 50s.

[rebcoola]

Accutane worked wonders for me. ODd is supposed to be starting it the I pledge program for Females has been a huge pain in the a$$. 

[Corraleno]

DS was on it for 9 or 10 months at 18. He had really dry flaky skin and severely chapped lips — his lips were swollen, cracked, and bleeding, even using special medicated lip balm from the dermatologist. And his skin looked really horrible for the first few months — way worse than before he started taking it. He also had depression, although he is prone to that anyway, so it's hard to sort out how much the Accutane may have exacerbated it. They did have to reduce the dose at one point when the blood tests for liver function became concerning. His skin definitely improved but after a year or so the acne came back, not as bad as it was before Accutane, but not clear either. He did not want to go through another course of it, and he now uses Curology and his skin is much better than it was a year after his Accutane treatment. 

One thing I would ask the dermatologist about is whether they would consider using a lower dose for a longer period. What actually matters isn't the daily dose but the total cumulative dose, which is calculated based on body weight. So it's just as effective to do a lower dose over a longer period of time, which will minimize the side effects, but dermatologists tend to prescribe the highest doses that can be tolerated (starting low and then escalating) to get the fastest results and be done sooner. If I had to do it over again, though, I would have insisted on sticking with a lower dose for longer.