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Dermatology (Expert Forum)
Accutane and seborrhea dermatitus on scalp
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.
Accutane and seborrhea dermatitus on scalp
by momv630, Mar 24, 2004 12:00AM
My son (13 yrs. old) started on Accutane 1 month ago. While it has completely cleared up his cystic acne he started to get a very bad case of seborrhea dermatitis on his head along with some loss of hair. He suddenly got this extremely bad case of dandruff with an itching inflamed scalp. The derm gave him selenium sulfide shampoo 2.5% and some betamethasone lotion for his scalp. This helps but it just keeps on coming back. The itching gets so bad that he just can’t take it. The derm just said to stop the Accutane and come and see him in a week.
My questions… 1) Will the acne come back now since he was only on it for 1 month? 2) Since seborrhea is a side effect of Accutane (listed as a side effect on the patient material) and too much selenium sulfide shampoo can cause inflammation, itching and loss of hair (also a listed side effect). What is one to do if they both cause the same problem?
I don't want the acne to come back but this seborrhea problem is really bad.
Thank you
My questions… 1) Will the acne come back now since he was only on it for 1 month? 2) Since seborrhea is a side effect of Accutane (listed as a side effect on the patient material) and too much selenium sulfide shampoo can cause inflammation, itching and loss of hair (also a listed side effect). What is one to do if they both cause the same problem?
I don't want the acne to come back but this seborrhea problem is really bad.
Thank you
Doctor's Answer
by Alan Rockoff, MD, Mar 25, 2004 12:00AM
, Mar 25, 2004 12:00AM
I am very skeptical that the seborrhea is a side-effect of Accutane, not have seen it once in 21 years of using Accutane. I am also perplexed by the statement that selenium sulfide can cause hair loss-after all, you can get Selsun Blue over the counter. Many statements written in package inserts are more alarming than facts would justify.
Stopping Accutane after one month makes it very likely that the treatment will fail. Since I assume that your son's case is severe enough to warrant this drug, I urge you to give serious consideration to working with your dermatologist to treat the seborrhea (there are lots of medications other than Selenium), and to complete the course of acne treatment. I have never had to stop this drug because of seborrhea, not even once.
Good luck.
Dr. Rockoff
Stopping Accutane after one month makes it very likely that the treatment will fail. Since I assume that your son's case is severe enough to warrant this drug, I urge you to give serious consideration to working with your dermatologist to treat the seborrhea (there are lots of medications other than Selenium), and to complete the course of acne treatment. I have never had to stop this drug because of seborrhea, not even once.
Good luck.
Dr. Rockoff
Dr. Rockoff
From Roche labs. Look under "Adverse reactions-Skin and Appendages" ...
http://www.rocheusa.com/products/accutane/pi.pdf
Good luck.
Dr. Rockoff
My son stopped the Accutane and within 3 days all the itching and dandruff stopped. Now a few cysts look like they are coming back now. I sent an email to Roche labs and asked them if a 13 yr. old with 2-3 cysts on his nose only should be on Accutane. Within 5 minutes the Roche nurse called me at my home and said "Accutane is not recommended for ages 12-17 and especially for kids who have just a few cysts". The accutane did clear up the problem but that phone call convinced me not to put him on it again. Yes, I will try to find "something" to help, I don't know what, but until then I think I could sleep alittle better knowing he's not on such a stong drug.
Thanks for your input Dr.
I believe accutane is a drug that should only be used in extreme cases of acne. All other methods should be tested first.
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