Acne Community
Too much Accutane?
About This Community:

This patient support community is for discussions relating to acne and foods, scars, adult acne, blackheads, rosacea, and pimples.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Too much Accutane?

I took Accutane for 6 months 2 years ago.  My acne was very mild but my dermatologist put me on 40mg per day in the first two months and 80 mg per day for the following 4 months. I was 165lbs at the time.  My acne was completely clear after the first week.  My experience on the drug was not pleasant and i feel completely irresponsible of the dermatologist considering my response to the treatment and the mildness of my acne. During my course, the corners of my mouth were completely cracked about an inch on both sides and my skin was peeling excessively.  To this day, my skin is still dry and flaky, my lips are still chapped, my eyes still burn, and my scalp is still extremely dry.  Sorry for this being so long, heres my question.  Do you think my dermatologist was wrong with his dosage and duration considering i was completely clear after one week and being that my condition was extremely mild? I feel like i was terribly mistreated and i feel awful about it.
Related Discussions
23 Comments Post a Comment
Blank
309783_tn?1271961829
Hi. The usual dose for Accutane is 1mg X kg patients bodyweight/per day. 165lbs is about 75kg so the standard dose for a patient this weight would be 75mg. However, 5mg tablets are not available in all countries and it would be normal to prescribe 80mg to a patient weighing 75mg. Side effects are generally dose-related, but 5mg would not make a big difference.
Accutane has many potential side effects but this must be balanced against the fact it is the most effective acne treatment available. These side effects are described in great detail in the literature enclosed with the tablets. Were you given this?
It is licenced for severe acne, but may also be used for milder acne which is persistant, leaving scars or causing distress to the patient.
Accutane works by shrinking the sebaceous (oil) glands. These grow back very slowly, by which time the patient has nearly always outgrown their tendancy to acne. This is why your skin is still dry. I highly recommend either Cetaphil or La Roche-Posay products for skin fragilised by acne treatments. For dry lips I find Elizabeth Arden 8 hour cream much better than Vaseline.
Although your skin was clear after one week, Accutane must be taken for  16-24 weeks to lead to a permanent remission from acne. If you had stopped taking it before then, your acne would certainly have returned.
Best Wishes, Eloise.
Blank
Avatar_n_tn
Thank you for responding to my message. You are very kind.

I am getting very skeptical now that my oil will ever come back. I have been off accutane for almost 3 years and there is no oil ever on the surface of my skin. Pre-accutane, my skin was extremely oily.  I know you say the oil glands slowly come back, but they haven't comeback at all in 3 years.
Two questions...
1)  How do you the oil glands slowly grow back to the normal levels before accutane, did somebody inform you of this? just curious
2) Do you think its possible that they won't come back? I am very upset about this because i feel like i need some sebum on the surface of my skin to feel comfortable. Thank you so much and i hope to hear from you soon
Blank
Avatar_n_tn
Thank you for responding to my message. You are very kind.

I am getting very skeptical now that my oil will ever come back. I have been off accutane for almost 3 years and there is no oil ever on the surface of my skin. Pre-accutane, my skin was extremely oily.  I know you say the oil glands slowly come back, but they haven't comeback at all in 3 years.
Two questions...
1)  How do you the oil glands slowly grow back to the normal levels before accutane, did somebody inform you of this? just curious
2) Do you think its possible that they won't come back? I am very upset about this because i feel like i need some sebum on the surface of my skin to feel comfortable. Thank you so much and i hope to hear from you soon
Blank
309783_tn?1271961829
I am an expert on Acneic skin with lots of experience with Accutane.
Accutane shrinks the sebaceous glands but this effect is temporary. They grow back very slowly by which time the patient has nearly always outgrown their tendancy for acne. This is why the remission from acne is usually complete and long lasting.
You are right that a small amount of sebum is beneficial for skin, but at the moment you are going to have to use good products for fragilised skin. I recommend La Roche-Posay's Physiological cleanser for very dry skin followed by their Hydreane Riche moisturizing cream for sensitive skin. You can order these products online if there is not a stockist near you. Use Elizabeth Arden's 8 hour cream on your lips, its much better than other lip treatments I have tried.
I understand your frustration but I often hear from patients for whom the sebaceous glands have grown back too quickly and their acne has returned. It was not possible for your dermatologist to predict how a medicine you had not used before would affect you.
Best wishes. Eloise.
Blank
Avatar_n_tn
Thank you once again.  But if you had to say, would you say that my sebaceous glands are still growing in size, or is it possible that they have permanently been shrunk? And how long would you guess that it is going to take for skin to start have oil on the surface again? 1, 5, 10 years? Because I have ran out of patience here, i am starting to look into ways i can stimulate my sebaceous glands to produce more sebum.
Blank
Avatar_n_tn
Hi!
Ive been on Accutane a few times during the years and I had not the worst type of acne but still bad. My skin got clear in about a week to. I was also put on 40 mg a day initially. I then lowered the dose myself because I was afraid of the side effects and didnt want the dry skin. The dose that was fine for me was actually as low as 30 mg a week!!! That´s quite a differance!! So i don´t see why your doctor would increase your dose to as high as 80 mg a day. Sounds a little risky to me. Why take more than you need of a drug that can have such severe consequenses?
I can´t explain why you still have dry skin. Ive just heard it normally takes about a year for the medicine to be completely out of your system. For me, that´s about the time that my skin have been fine without the pills and then Ive had to take another cure.
Have you asked your doctor about this?
/Jenna
Blank
Avatar_n_tn
Hi, thanks for the respnse.  I did ask my dermatologist and he said this was a normal course.  Did you say that your acne has come back and you;ve had to take another course? Maybe this means that you didn't take enought the first time.
Blank
309783_tn?1271961829
Hi Noah, it is really difficult for me to answer your question as patients respond differently to medication. Accutane does not permanently stop sebum production. It's effect is semi-permanent/ temporary in the long term. The medication is no longer in your body after 5 weeks of finishing the course. However, sebum production is diminished enough that 80% of patients never need another course of Accutane. There is not a way to stimulate the sebaceous glands internally. You will have to apply moisturizing products to the skin whilst the dryness persists.
I cannot accurately give you a time scale, as we have heard from other members -some relapsed after just 8 weeks whilst others are free from acne indefinately.
Eloise.
Blank
Avatar_n_tn
Thanks for responding once again. However, i respectfully disagree with you saying that there is no way to stimulate the sebaceous glands internally. I have read that these medications can increase sebaceous glands..
1. testosterone given to prepubertal males
2. Progesterones with androgenic properties such as medroxyprogesterone, levonorgestrel, Phenothiazines
Blank
309783_tn?1271961829
I meant there is not a way to stimulate the sebaceous glands without risking a relapse of acne, which presumably you don't want. Both testosterone and progesterones are major factors in acne. Patients who take these medications (for birth control, sex change etc) often experience acne.
Eloise.
Blank
1096290_tn?1257311676
When it comes to acne, skip the drugs. First and foremost drink lots of purified water and stay away from or limit the use of carbonated beverages and alcohol. Many of us with acne problems continue to drinks all of these sodas or drinks that contain a lot of acid, colors, etc. Soda can really mess up the face. Leave all sodas and other drinks on the market alone and stick to only purified water. Try these waters - Poland Springs, Volvic, Penta (expensive), Smart Water, or Dasani. These waters have all been thoroughly purified so as not to contain any contaminants. What they say really is true water does wonders to the body! Second drink some type of green tea (at least 1 to 2 times a day). Green tea contains many antioxidants that will help in decreasing your acne problems. Try purchasing the Celestial Seasonings Green Tea and if you’re not a teetotaler try drinking one of the sugar free green tea products put out by Lipton.
Blank
309783_tn?1271961829
Noah- Have you tried the Oilatum range for chronically dry skin, eczema, dermatitis etc?
Hallie- Noah is not trying to clear acne, he is suffering intolerably dry skin after Isotretinoin treatment.
Eloise.
Blank
Avatar_n_tn
No i have not tried that. Thanks. Additionally, i actually have read that sebaceous glands have nothing to do with having dry or not dry skin.  I have read that sebaceous glands do nothing but clog pores and contribute to acne. So obviously the sebaceous glands are not what i need to solve the dry skin. I have been told the reason that my skin is still dry 3 years post-accutane is because of this excerpt below, please tell me what you think about this since you are very knowlegeable on accutane and it's effects, once again thank you so much for trying to alleviate my problems, you are a very kind person...

"Accutane causes dryness but its not due to stopping sebum production. Retinoids are known to break down the skin barrier and thin the stratum corneum. It could also have an effect on the intra cellular matrix lipids(this is not sebum by the way)."




Blank
Avatar_m_tn
The Roaccutane or Isotrenoin treatment are the greatest disaster for the skin and doctors that continue to prescribe it are CRIMINALS. I had self-inflicted acne) as I put on a deteriorated cream and in a month the flawless mixed skin became swollen with pimples). For me it was similar, the doctor prescribed more than was necessary but even in the 'necessary' dosage this treatment has very long-term (I tend to think quasi-permanent after 8 years when the skin has remained in the same awful condition) damaging effects to the skin. I came to look more than 10 years older and it's like a painless but incurable disease. Acne sufferers must understand acne doesn't heal very quickly at all, they shouldn't get near that Roaccutane and Isotrenoin which are DEFINITELY not the treatment unless one wants to age prematurely and that there are so many (as I have discovered) treatments for acne (even common cosmetic butters such as shea, mango, avocado that heal acne slowly by regulating sebum production without suppressing the sebaceous glands). You should't insist on promoting these products which are extremely detrimental to the skin if you care in the least about the skin health of other people. Researchers should focus on discovering an antidote to Roaccutane because they are responsible for the immense suffering that the drug is causing so many people and on something that restores the size of sebaceous glands rather than continue not to listen to victims of the drug.
Blank
Avatar_m_tn
The Roaccutane ages the face because it deforms the skin (it shrinks the skin particularly in the chin area where the decreased sebaceous glands are most numerous - which is why the face appears 'shrunk', the skin is pulled downwards, the area between the nose and the corners of the mouth is stretched (this is even painful and itchy), thus creating the aged appearance). I have tried all possible creams during the past years, don't smoke, and these suggestions concerning hydration, moisturizing or diet are irrelevant.
Blank
Avatar_m_tn
I would be really interested to know if a treatment has been found for the restoration of the size of the sebaceous glands (permanently as the long-term efficacy of the hearsay internal treatment with hormones like testosterone is questionable and the treatment itself seems risky for the hormonal balance). The skin 'healed' with the Roaccutane drug looks old and dead in shape and texture (no more translucent, but parchment, dried-fruit-like skin). This treatment while eliminating acne succeeds in destroying completely the appearance of a person's face, one's outward image and self-esteem.
Blank
Avatar_m_tn
I completly agree with safire3. Ive been off of accutane for 5 years now and still suffer. At just age 24 my skin is lifeless, premature aging, verry dry and red in complection.
Im interested if anyone has any experience in solving these issues?
Blank
Avatar_m_tn
Hey Noah
I too suffer the same problems.. It's been. About 10 years for me.. It's gotten better but is still a bit of a battle.. Clear skin though!! Not as moist as I would like though.. Are those testosterone pills over or under the counter? Is it safe to take ?
Blank
Avatar_m_tn
I also want to restore my sebum oils. I took about 40 mg of accutane for a month to two months before stopping. After 4 years, my face is really dry and I have exfoliative chelitis from taking accutane. If anyone have any leads to restoring the sebum glands, please let me know.
Blank
Avatar_f_tn
My son has had a similar problem for quite a while.
However it was not because of any previous treatment or medication. Hope you can solve this some way or the other.
All the best to you!
Blank
Avatar_m_tn
It's been more than 2 years since i finished my accutane treatment. My acne cleared but I now suffer from papulopustular rosacea instead. I now have a permanently dry skin, eyes,  and my skin is getting worse and worse because of the rosacea and dryness (this means spider veins!) Please if you have mild acne don't take this drug! How I wish I could turn back time and how I blame myself for being so naive!
Blank
Avatar_m_tn
I would kill to have that problem (dry skin)
I took accutane twice and relapsed not even 2 weeks after each treament
My acne (inflamatory) was mild before accutane but extremely persistent and got worse after each treatment
To this day my acne is still worse than it was before accutane

While on the drug...the only side effect i had was dry lips..and even that was very mild

This drug did absolutely nothing for me

Ive never ever had dry skin .... Not even while i was on this drug

The only severe side effect i had while on this drug was extreme sweating
And to this day almost 10 years after my last treatment it hasnt gone away
I still sweat profusely


Again... I would kill for dry skin
Blank
6030644_tn?1378489639
Hello, I am currently on 40mg a day Accutane (self-prescribed) But I do want to tell you how to get back some oil onto your body. I have recently gotten into natural oil that don't cause breakouts. Jojoba oil, almond oil, grapeseed oil. I personally use Jojoba oil with lavender and tea tree oil on my face. For you I would consider mixing Coconut oil aloe vera lavender and even some jojoba oil along with vitamin E should give you the moisture from the outside perspective. I like to kinda slather mine on there and then let it absorb, Also works great with makeup and gives you a youthful glow. This is a no fail of getting moisture back into and onto you skin :) Plus Raw honey as a scrub/mask gives you a glow and moisture. I would definetly recommend aloe vera. look up the benefits from using it. Along side with it might want to try some natural supplements to moisturize from the inward out. Like some omega-3 oils, fish oil (talk to someone about the fishy after smell/taste they should be able to recommend something) as well as VItamin E. This should dramatically help. nature is always the best way to balance out skin and its natural PH. God bless and I HOPE this helps. All these things listed are relatively cheap too :)
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Acne Community Resources
RSS Expert Activity
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank