Prolonged Roaccutane use- is it harmful?

Hello. I am a 23 years old female and I can't remember the last time I had clear skin. My dad had pimples so it must be genetic, and I've tried all sorts of treatments before I discovered Roaccutane which have worked on me like a miracle for the last 3~4 years. I've not yet experienced noticeable side-effects nor am I planning on getting pregnant any time soon.
However, many of the doctors I've spoken to recently are encouraging I stop using the successful drug. I agree with them that I have taken it for a long time but they were never of very high dosage (from 2 pills a day to one in 2~3 days).
So why are they saying I should stop? Are there long term side-effects I should know about?
The thing is, although many have said I should stop, noone has yet clearly explained why. I'm hoping I could get some useful info through this post. Thank you all for reading.

[loiloi]

Hi.
The reason doctors are saying you should stop is that Accutane usually results in a long term remission from acne after taking it for 16-24 weeks. Therefore, there is no reason to continue using it after this time. It works by shrinking the sebaceous glands which produce oil on the skin which leads to spots. Sebaceous glands grow back very slowly so most patients are free from acne indefinately after one course. By the time the sebaceous glands have grown back (which usually takes years rather than months) the patient has virtually always outgrown their tendancy for acne. It is not like antibiotics or anti-androgens which stop working when you stop taking them, and therefore have to be used for as long as your tendency for acne persists.
Accutane is licenced to be used for 16-24 weeks. Occasionally patients need a second or third course if their acne does come back. But it is not licenced to be used in the way you describe. Have you been obtaining your Accutane from a dermatologist or buying it online?
As well as the high risk of malformation in exposed pregnancies (you should use 2 forms of contraception whilst on this drug) Accutane can cause liver damage and raised cholesterol. Have you been having your liver function and cholesterol levels checked regularly?
The good news is your acne is unlikely to return when you stop taking Accutane (80% of patients experience a long term remission from acne after one course lasting 16-24 weeks). Also, having taken Accutane, if you do get spots again standard treatments which may have previously failed are likely to help (such as antibiotics, topical retinoids or anti-androgen contraceptive pills such as Yaz or Yasmin) because your sebaceous glands have been made smaller by the Accutane.
Hope this information is helpful.
Best Wishes, Eloise.

[inquiry_girl]

Dear Eloise,
Thank you so much for your helpful reply. I plan to get my liver and cholestrol levels checked and since you say that other forms of treatment should be affective I am hoping to try those out as soon as possible.
I have another question though, which is, could I start on Diane 35 straight away next week? (I tend to get really oily and start breaking out once I stop accutane for a few weeks and I would like to avoid this situation if possible). Or, since I've been taking one pill a day so far, should stop my treatment more gradually(could you tell me the recommended time frame and number of pills per day appropriate for getting off accutane?)
I've gotten all my pills over the years through my dermatologists and I wish they'd been more informative about the treatments, as they've been giving them to me like vitamins. I'm loving these forums. Thanks for reading and I look forward to your reply.
Best,
inquiry_girl

[loiloi]

Hi.
There is no need to gradually wean off Accutane, you can just stop taking it.
If you are changing from another brand of pill to Diane35, start Diane35 straight after the last pill in the packet of your old brand, without having a break.
If you are not currently on the pill, take Diane35 on the first day of your period and you will be protected against pregnancy straight away. If you start it on any other day you will need to use a condom for the first 7 days, this is all explained in the instruction leaflet.
If you are sexually active, follow these instructions carefully as Accutane will stay in your system for 5 weeks and is very dangerous to an unborn baby.
Eloise.

[inquiry_girl]

Dear Eloise,

Thanks again. I'm not sexually active at the moment but hopefully soon XP and when the time comes I'll make sure to be careful. Concerning accutane I'll be trying out your suggestions. Hope you have a lovely week.

Sincerely,
Inquiry_girl