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Dermatology  (Expert Forum)
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accutane cystic flareups
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
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MedHelp Member's Question

accutane cystic flareups

by dobze, Jan 09, 2006 12:00AM
My son has been using accutane for 11 weeks now.  The top half of his face forehead, nose and top of cheeks has cleared up very well but he keeps getting a large cyst or two every couple of days which start out as very large bumps then explode into large scabs which take a while to heal.These are on the lower half of his face near his mouth and chin. We are wondering when these will literally stop bursting forth. He did not have this type of cystic acne before he started accutane but he did have enough acne to warrant the accutane. He started out on 40mg. per day for the first month and has been on 70mgs. a day since then. He is 135lbs. Also is he taking too much accutane for his weight? Could this be causing the flareups? Your input would be most appreciated. Thanks
Doctor's Answer

by Alan Rockoff, MD, Jan 10, 2006 12:00AM
The dose is fine.  Sometimes there is mild worsening at the start of treatment, or else the acne is just doing its thing, and the Accutane hasn't taken hold yet, which takes 3 months and sometimes more.  It sounds as though your son is on the right track.  Completing the course would produce uniformly good results.



Take care.



Dr. Rockoff
Member Comments (5)

by SweetSumrRain, Jan 11, 2006 12:00AM
To: dobze
Hi!  I did a 6 month treatment of accutane less than a year ago.  I suffered from severe cystic acne from my teenage years right into adulthood.  I took 40 milligrams once a day alternating with 80 milligrams every other day.  When I started the treatment, my acne grew increasingly worse in the beginning but started to get significantly clearer around the end of month 2.  My dermatologist told me that it is completely normal to have a major acne flare-up in the beginning but to not get discouraged and continue with the treatment.  By the end of month three, my skin was totally clear and blemish free!  Your son should expect some extreme dryness and flaking of his skin as well as really dry hair. My lips also became very chapped and wearing contact lenses was at times uncomfortable.  Despite the risks that may occur with Accutane, I believe this was a miracle drug for me!  I had lab work done every month to test my liver and never had any problems or complications.  I have read some very negative things about Accutane and it's possible risk and side effects but I believe that all drugs have their pros and cons.  My self esteem was very low because of my severe acne problem.  Accutane was the only medication that ever made any improvement for me and trust me, I tried everything!



I hope your son has the same positive effects that I did.  I know what it's like to suffer from acne.  Let him know that I have been acne free for months long after my treatment with accutane.  I use the Proactive system for cleansing on a daily basis and my skin is beautiful for the first time in my life!



Best Wishes,

Summer

by rook_pup, Jan 12, 2006 12:00AM
I been on everything since I was a teenager (now 35). I have been on Accutane  a few times. It worked fine, then the acne would come back once I was off it.



Have you tried changing his diet? My nephew was getting pretty bad acne and we took him off of sodas, and fast food and started him on proactive and his cleared up. I was still breaking out too, at 33 until I started using that proactive stuff. Don't knot why it works so well and other stuff does not. But, you might want to try it.



Good luck!

by beautifulface, Jan 27, 2006 12:00AM
I took a course of Accutane when I was 23.  I'm 27 now and am currently battling the worst, weirdest mess of acne ever.  It's a mix of open and closed comedones and pustule yuck and those red underneath-the-skin things that never go away.  Luckily for me, I can say that this is the worst post-Accutane situation I've developed, and up until a few months ago, I had just gone back and forth between relatively clear skin to mild breakouts.  My main reason for posting here is to mention that Accutane does not work for many types of conditions.  I just yesterday saw a new dermatologist who told me that my current condition might have been brought on by a series of microdermabrasion treatments I had done last fall, when my skin looked very good, apart from blocked pores  here and there, so beware of that, too.  The doc just informed me that he thinks I might suffer from a combined affliction of both normal acne and rosacea in certain parts of my face.  He's put me on antibiotic (doxycycline), Differin, and some other cream I haven't picked up from the pharmacy yet that is only for my chin, which is the worst part of my face (I think that is where he suspects rosacea might be in play).  Anyway, maybe this is too far off the topic of the original post.  I apologize, but it's my first post and it's so hard to stay focused!

by Rainbow Nation, Jan 31, 2006 12:00AM
Hello.  Being a woman at 31, having acne is really the last thing you thought you were going to have to deal with!  I've been on Roaacutane twice in the last 3 years, and voila:  it's back!  This morning I actually made an appointment with another dermatologist as I do not want to do another course of Roaccutane.  My situation is however very similar to a lot of women:  I have PCOS!  This is a 'condition' which many woman at childbearing age encounter.  There has not been a huge amount of study done about this condition, however, more and more women are being diagnosed with PCOS when complaining about the symptoms such as irregular menstral cycles, obesity, acne, diabeties and the list goes on....

As this is not a condition which has enjoyed the research it needs to date, please discuss this with your doctor.  The internet has a HUGE amount of information avaiable about PCOS which you could look up and get to understand.  I've lost over 30kgs in 3 years as a restult of knowing about it, so that I can make SUBTLE changes to my lifestyle in accordance to my condition. By definition I should be overweigt, insulin resistant, ongoing problem with acne and so on; I still have a battle with my acne, however, and I am infertile (because of PCOS and a hormonal imbalance over and above the imbalance PCOS causes), other than that, I've never looked beter!  PLEASE, before your self image is effected, research PCOS, chat with your doctor, get as much knowledge about this as you can.  If you don't have PCOS, you'll have studied the condition for someone you know who might have.  Wish me luck for my appointment, I'm going to beat this thing!  :-)
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