Accutane - The miracle drug?

[Darted]

Accutane!

I've heard that accutane is used to treat acne all over the body and it's very effective in every case.

I'd like to discuss accutane and your opinions on this drug. I know it's a very powerful drug and it does have very dangerous and harsh side effects. With a monthly follow-up, do you suggest this treatment for back acne?

This drug is usually the 'last resort' to an acne treatment due it's side-effects and high price. I was offered this treatment by a dermatologist, without prior treatments of any kind. What should I do?

 

[ljjustboy]

hello,

I was treated with roaccutane (a market name for accutane in Europe) a few years ago and it worked really well for me. Before roaccutane I tryed like a million commercial products and none worked. Than I went to see a dermatologist, who at first prescribed an antibiotic treatment with broad spectrum antibiotics. That did help a little bit, however when I stopped with the pills all was back as it was before. Also antibiotic had a negative impact on my health in general, because it affects the digestion process.

That's when my dermatologist advised me to try roaccutane. I was on roaccutane for about two months and my skin improved dramatically, I literally didn't have any acne at all at the end. Even when I stopped taking the pills at the end of the treatment, the results stayed, I do get some acne from time to time, but it's much, much better then before. From what my dermatologist said, roaccutane influences the skin pores in a way that makes them produce less oil, which is exactly what my problem had been all along, the skin on my face was really oily all the time, and by washing it with different face washes it only made thing worse.

However, there are some things to consider, when taking roaccutane:
- my dermatologist said I can only take this treatment during late autumn and winter, because the drug makes your eyes and skin temporary much more sensitive to the sun. I also had to wear quality UV blocking dark sunglasses when I was outside, not to damage my eyes.
- your skin can get really dry during the treatment, and for some time you may actually feel like it made your skin worse, however it is only temporary, as your skin is responding to the drug, it took about a month for me to see the first results, but after that it got much better very soon. It didn't actually much happen to me, as I had really oily skin before, all it did have was very dry lips, I had to use Blistex like every half hour
- there are some serious side affect that are linked to the drug, however have not been proven. I haven't experienced any myself, but have read some posts on forums, that made me think twice before taking the treatment. For instance if a woman takes the drug, she mustn't get pregnant for at least one year after ending the treatment or her baby might have brth defects. You can read more on that here: Isotretinoin - Wikipedia, the free encyclopedia
- it's very expensive

I would say that you should do it if your condition is so severe that it makes you feel uncomfortable in everyday life. I had severe acnes on my face not on the back and my face was making me feel nobody wants to even look at me. If it happened to me again, I would take the treatment again. But if it only happens to you occasionally and not in a severe form, than I do not think it is worth the risk.

 

[marqau]

Accutane = Isotretinoin.

I am taking it for acne rosacea that is a side effect of another pill I have to take (I had a kidney transplant.)

The usual protocol is:
1. try benzyl peroxide (like proactive) - didn't work for me at all (made it worse).
2. try doxycycline (mild anti-biotic) - worked for me very well but interfered with one of my other pills so had to stop it.
3. Isotretinoin (Roaccutane / Accutane) - works amazingly.

You need to have your Cholesterol checked as Isotretinoin can push it up. You also need to be careful about your lips and eye-lids as they can dry out. Also use sunscreen.

I'm assuming you are a guy. Isotretinoin is a disaster if there is a chance of pregnancy as it will cause bad birth defects. Basically it is not worth the risk for females who may get pregnant to take it at all.

Except for the dry lips, I have not noticed any bad side effects and my skin is really good now. I only take 10mg every second day. In Australia (where I am), it can only be prescribed by a specialist dermatologist with authority and only after going through the protocol above. There will be further restrictions if you are female.

Isotretinoin shrinks the oils glands and that effect is usually permanent so you only have to take it for 8 to 12 months (or less) and you should be cured.

Its funny that you didn't try doxycycline first but I think for guys, Accutane is an effective and permanent cure so why mess around and waste time. Think about the risks of side effects and get off it as soon as you can.

 

[OPHELIA_HARDIN]

Accutane is a wonder drug -- just wish it had come on the market sooner because I suffered from terrible cystic acne. Run, don't walk and get a prescription right away.

Usual dosing is much higher and therefor more expensive than needed. Might want to mention this to your doctor.

See:

Low-dose isotretinoin in the treatment of... [J Am Acad Dermatol. 2006] - PubMed - NCBI

or google:

low dose isotretinoin - Google Search

Buy some Chapstick, because you're going to need it! Best of luck.

 

[RaKroma]

I will repeat what I have been saying for years now based on my personal experience with treating acne, following other acne suffers' experiences and discussing treatment options with several dermatologists (who no longer prescribe Accutane.) I believe all other options should be exhausted before people jump on Accutane. When Accutane fails to work on some people (and it does not work for everyone), that's not the end to acne treatment!! they switch to laser based treatments that are safer and have worked well on those patients. Current alternatives to Accutane is Levulan-photodynamic treatment and the newer Isolaz laser treatment.. There are also other light/laser treatments on the market. Is it really worth treating acne with Accutane when permanent liver damage or the more common IBS/Crohn's disease can develop?
Roche the original maker of Accutane stopped producing the drug. I can't remember when was the last time a pharmaceutical corp voluntarily stopped producing a "miracle drug" that had to be profitable? They were drowned by Accutane related lawsuit payouts and couldn't justify it. As for generics, the 2009 FDA recall showed that not all generics are created equal.

 

[KaraBulut]

Most of the information in the thread is accurate. Accutane works but unfortunately the effects of oral isotretinoin aren't limited to just the oil glands. It affects every system of the body.

There are plenty of people who took the drug who swear by it. It worked miracles on their acne when the usual regimen of peroxides, hydroxy acids, topical retinoids and antibiotics didn't resolve the problem.

The first problem reported was elevated liver enzymes and possible liver damage. Then it was determined that Accutane resulted in severe birth effects and patients were required to use two forms of birth control while on the drug. Then there was some evidence that the drug could cause temporary psychological changes including depression. Then there were questions about Crohn's disease, alopecia, anemia, osteoporosis, arthritis, eye damage, etc.

This drug was designed as a last option for people whose skin was being scarred by acne. It was a drug of last resort. Unfortunately, it was over-prescribed and inappropriately prescribed in many cases.

 

[evanrick]

ive been on accutane 3 times and it has the potential to be very dangerous. i would only use it if it was a last resort as some studies show it can fuck with brain development or cause liver failure, either way, you die from it.

accutane is very much a double edged sword, it gave me some hope that my life wouldnt be taken away by acne, but it may have been the accutane that did that in the end. more research is needed and i wouldn't give up on acctane, the drug is a miracle if there ever was one in medicine.

ill never know if it was accutane that caused my mental problems - since i was already primed for that, however it is very effective, just realize the risks cannot be understated if you have a family history.

say you get accutane but 5 years later or 5 months later you get major depression and hang yourself, not a very safe drug in the long run is it?

i would much rather see someone suffer acne than depression, because acne is treatable without using accutane.

there are much safer things you can do to treat acne like ultraviolet radiation, antibiotics and salicylic acid, topical retinoids etc. so think of those options first before thinking about accutane.

now if you are perfectly healthy otherwise and have no family history of depression and the acne is terrible then only after trying other things would i say try accutane.

 

[LebGuy]

Ahhhh accutane. Pretty much saved my life. I was that kid in school with the spotted shiny face. Spotted from the acne, shiny from all the crappy topicals and washes prescribed. I had zero confidence and zero ability to make conversation. I was basically a recluse my entire middle school/high school days. Blah blah....<insert more sad things here>....

I finally went to my dermatologist and told him he needs to do something or else I'm done coming for the worthless doxycycline and Retin-A. He suggested 2 things: accutane or laser treatments. Hell no to the laser treatments and the ridiculous price tag! Treatments are on going and extremely expensive. Accutane it was. Worked perfectly. After month 2 I saw 90% improvement. The only side effect I noticed was the dryness of my skin and lips. The monthly blood tests aren't bad, and always came up good.I took it for 6 months and it worked wonders. Today I'm completely clear. I might get 1 or two zits a month...but no more. It was definitely worth the risk.

Also for those in the US, get it from Walmart....much cheaper than all the other pharmacies lol

 

[cocksucker4use]

Accutane is marketed only with a Risk Evaluation and Mitigation Strategy (REMS), an FDA mandated plan whereby the manufacturer supports monitoring patients, training physicians and other staff, as well as establishing a registry of patients taking the drug. Like everyone here advises, it should be used only as a last resort, after multiple therapies have failed. That said, it is within the scope of your phyician's prescribing authority to start you on it. (He saw your back, we didn't). Someone above mentioined laser therapy. Check it out, as it may eliminate or minimize scarring, as well. As advised above, if the drug is not covered by your insurance, shop around. Cosco, Target, Walmart, etc. It can make a huge difference, like 30% or more.

 

[dj1035]

my cousin died from severe liver damage caused by accutane...i personally wouldnt recommend it.

 

[breathe]

I took it and it worked wonderfully after just a few months and I've been clear since (3 years ago+) but it's left me with joint pain and stiffness more than I ever had before, as well as having less energy most days now. Your call my friend.

 

[Rosary]

Knowledge as a 3rd year pharmacy student:

Mild to moderate acne is generally treated with topical preparations. Benzoyl peroxide is usually the preferred drug choice. Low strength is initiated and gradually increased. If acne does not subside after 2 months, topical antibacterial should be considered. Azelaic aicd is an alternative to benzoyl peroxide. Patients generally prefer azelaic acid due to lesser local irritation.

In accordance to British National Formulary, topical antibacterial is no more effective than topical benzoyl peroxide. It is best reserved for patients who wish to avoid oral anterbacterial and who cannot tolerate them. Moreover, it could cause antibacterial resistance upon prolong used.

Systemic treatments(oral preparations) should only be sought after when topical treatment fails. Oral antibacterials and oral retinoids (accutane) are treatments available for severe acne. For oral antibacterials, tetracycline is usually given for acne in does of 500mg twice daily. If no improvement is seen after first 3 months of treatment, another oral antibacterial should be used. Maximum improvement is seen after 4-6 months but in severe case, treatment may be needed for 2 years or longer. Get consultation from professionals before initiating antibacterial treatments. Concomitant use of different topical and systemic antibacterials is undesirable due to development of bacterial resistance.

If all else fail, oral retinoid could be used. Oral retinoid is a toxic drug and should only be prescribed under supervision of specialist. It is given for at least 16 weeks and repeat courses are not normally required. Due to the mechanism of the drugs, it could associated with depression, increased plasma triglycerides and cholesterol. Although highly unrelevant in this board, it should be noted that this drug is teratogenic. Oral retinoid should be avoided in liver impaired patients. Patients under treatment of oral retinoid should not donate blood during treatment and 1 month afterwards. Caution should be taken on the amount of vitamin A taken as well. Wear sunblock if possible as patients under oral retinoid is advised not to exposed to strong sunlight.

In short, accutane which is an oral retinoid is indeed an effective anti-acne medication but think in this way, would you eradicate a house full of termites by burning the house down or would you go for the a much milder alternative first before resort for a deadlier option. Bad metaphor I know but I couldn't think of a better example at the moment.

Hopefully my wall text educates you even in the slightest.

-JY

 

[mbamike]

I was prescribed Accutane when I was in the Navy. Cleared my acne up really well. This was many, many years ago. I did not notice any problems other than I had to stay out of the sun while taking it.

 

[nafhoosier]

I took Accutane for about six months.

To be honest, they were some of the most physically painful of my life.

-My lips were horribly dry, all the time. There was no solution. I had to constantly chap them or else they'd bleed.
-My cholesterol went up significantly and for the first time in my life I was diagnosed with high cholesterol and high blood pressure. I felt like an old man and had symptoms of diabetes.
-I got horrible infections in my cuticles on my fingers that forced me to take antibiotics and soak them daily. My skin on my fingers would crack and bleed, sometimes uncontrollably.
-My eyes dried out and I needed drops.
-I lost much of my sexual inhibitions.

Beyond that, my acne has never been better since. I don't have it anymore. But there's a reason why the drug is being considered to be banned. It causes severe side affects and I don't know if it was all worth it.

I'm glad my treatment is over!

 

[syoBsUtsuJ]

I am neither an advocate for, nor an antagonist against Accutane. I can and will only share my personal experience:

After changing my diet, using a plethora of topical solutions and innumerable antibiotic pills my dermatologist finally prescribed me accutane for my cystic acne when I was 14. I was told that my face would probably get worse before it got better ... and WORSE it did get! My doc didn't even hesitate to prescribe another month's worth of treatment and my pimples just kept multiplying and even "merging" in a couple of cases ... ouchie! I was two weeks into my 3rd month of treatment (and after 6 weekly visits to the dermatologist for direct supervision) when I quit abruptly. My face was just getting way too bad. Now I don't know if I should credit the accutane or my abrupt cessation thereof, but my face cleared up almost immediately within a week of quitting said accutane treatments.

A year later I went in for dermabrasion ... a very traumatic and then depressing procedure, but well worth the woe(s) after 6+ weeks. It almost entirely got rid of my pocky complexion, and now I can honestly say that I am happy. Sure, I still get adult acne from time-to-time (a zit or pimple here or there), but nothing like personal torment I endured in my early teens.

 

[maxpowr9]

Ah, Accutane. This really is a last resort drug and a good doctor would not go for the stuff unless you truly had exhausted all other options. I took it as a teen and this drug literally fucks up your entire body with some of the changes being PERMANENT!!! I still have chapped lips. It destroys the oils in your epidermis leading to dry skin and paper cuts can be common and quite bloody too. I still have pretty dry skin as a side effect. Even got so bad for me that I got nose bleeds a lot. There is also the very high chance it will send you into a depression without any real causation (eg. traumatic events) as it will be chemically induced.

Yes, my acne is permanently gone (don't even get white heads anywhere on my body) but those few months put your body through hell. If you do go on the drug, you have to be legit prepared to do so.

 

[shaychboi88]

Accutane is marketed only with a Risk Evaluation and Mitigation Strategy (REMS), an FDA mandated plan whereby the manufacturer supports monitoring patients, training physicians and other staff, as well as establishing a registry of patients taking the drug. Like everyone here advises, it should be used only as a last resort, after multiple therapies have failed. That said, it is within the scope of your phyician's prescribing authority to start you on it. (He saw your back, we didn't). Someone above mentioined laser therapy. Check it out, as it may eliminate or minimize scarring, as well. As advised above, if the drug is not covered by your insurance, shop around. Cosco, Target, Walmart, etc. It can make a huge difference, like 30% or more.

I highly recommend the program (free!) developed by the dude who does acne.org funded only by the products that he's formulated but which you don't need to buy in order to follow the "regimen" that he came up with (by accident when he was at his wit's end, nothing had worked for him).

I'd be so worried about the psychiatric effects; I believe there was a Congressman from Michigan who's son committed suicide and that started investigations that eventually let to the warnings that now accompany the "drug facts" for Accutane.

 

[CowboyBob]

Never use accutane. My sister used it 20 years ago and she's paying for it now. It can cause ulcerative colotis, crohne's disease and other diseases of the digestive tract that will show up years and even decades after you stop using it.

Last year she was at the Mayo Clinic's Methodist Hospital and had her large intestine removed. The doctor said this was because of her accutane use. She wishes she has never used it.

 

[Telstra]

Never use accutane. My sister used it 20 years ago and she's paying for it now. It can cause ulcerative colotis, crohne's disease and other diseases of the digestive tract that will show up years and even decades after you stop using it.

Last year she was at the Mayo Clinic's Methodist Hospital and had her large intestine removed. The doctor said this was because of her accutane use. She wishes she has never used it.

How can people live without intestine ....