My accutane course

Hi,

Im a 35 year old male from the Netherlands and i'm on Roaccutane (branded) since november 2007. My weight is 99kg and i'm using 50 mg a day. I still have 10 days to go. Since i started i never had acne again, but i do have the side effects like feeling tired, very dry lips and moody sometimes. Doctors in Europe prescripe lower dosage than doctors in the US. In the Netherlands 0.5 mg per kg is normal. My question is: what are the chances that the acne will return on my age? Im afraid it will come back. Like i said i will be finished in 10 days and at that time i will almost have the minimum dosage of 120mg/per kg. I calculated that i still need 1 more week to reach that, after that 10 days. Is that necessarry you think?

King regards,
Tom

[loiloi]

Hi. The usual dose for Roaccutane is 0.5 mg per kg bodyweight per day. It is only increased to 1mg per kg bodyweight per day if necessary ie your acne has not responded to the starting dose. 7 months is quite a long course, courses usually last between 16 and 24 weeks. One more week of Roaccutane would not make any difference so don't worry. Roaccutane usually results in a long term remission from acne. 80% of patients only need one course. 20% of patients require a second course and of those 25% require a third.
You should have a check up with your dermatologist about 8 weeks after finishing your medicine. If you relapse you may be offered further treatment. Also, having taken Roaccutane you may find that if they are necessary, topical or oral treatments which were previously ineffective will work.
The maximum total dose in any one course should be between 120 and 150mg per kg bodyweight per day.
Eloise x

[tom_24nl]

Hi Eloise,

Ok thanks for your reply. Does age make any difference, i mean i can image that when you are 20 or something a relapse is more likely to occur than when you are 35 like me.....i also heard that for women the chance is even bigger? Thanks again.

Tom

[loiloi]

Hi. Yes, the chance of relapse decreases with age. Females are more likely to relapse as their acne often has a hormonal cause. Eloise x

[tom_24nl]

Hi Eloise,

Thanks again for your answer. I have 2 more questions :-). You say that 20% need a second course. Those 20%, are that people who took the maximum dose of 120-150 mg/kg? My second question: is is true that your skin will improve after the accutane course...now my skin is very thin etc? Thanks again.

Tom

[loiloi]

Yes. when given at the recommended dose accutane results in 80% of patients experiencing a long term remission from acne after just one course.  No other treatment can match these statistics, and accutane is considered the "gold star" treatment for acne.
Side effects such as thin, sensitized or flushed skin will improve within 2-4 weeks of stopping the medication.
Don't worry about the possibility of your acne coming back. Your dermatologist will evaluate you at your follow up appointment and will advise you as necessary. Enjoy the holiday from acne that accutane has without doubt given you :) Eloise x

[tom_24nl]

Hi Eloise,

Yes i hope so....i had mild acne but at 35 i was sick of it :-). I hope i will never get it back!!! Thanks for all your answers and you enjoy your holiday also.

Tom.

[tom_24nl]

Hi Eloise,

A few months ago i asked you some questions about accutane. I stopped taking accutane 2 months ago. It worked great for me,  but now i see a few blackheads. They are minor, but it's freaking me out! I dont have oily skin and no breakouts. Should i worry? Im a male, 35. Thanks again.

[loiloi]

Now that your skin is no longer sensitized from the Roaccutane it is possible to use a topical preparation for these blackheads such as Differin (0.1% adapalen). Even if this did not work for you before, it will now because Roaccutane has changed your skin.
Roaccutane works by shrinking the sebaceous glands so they cannot produce oil and subsequent spots. They return to their normal size very slowly so most patients are free from acne indefinately.
Have you been discharged by the dermatologist or do you have another check-up? Another course of Roaccutane can be prescribed, if you do have a definate relapse, with at least 8 weeks inbetween courses.
Don't worry though, most people with 'normal' skin have a few blackheads :)
Eloise.

[tom_24nl]

Hi Eloise,

Thanks for your answer. My first check-up is next october, so 4 months after my course. Ok a few blackheads is not a problem, you are right......no in dont have a topical preparation but i can ask for it if it get's worse. My skin is not oily so that's a good sign i guess. Before my accutane course i had very oily skin. I can live with some blackheads! Thanks again.
Tom