Accutane Progess

I'm 22 years old.  I have been on Accutane for 16 weeks (roughly 4 months), and my progess is decent.  The first two months I was on 40/mg per day, and the following two months I have been on 60/mg a day.  Just recently (in the past month), I have gotten about 3 inflamed pimples (one on forehead, and two on face).  (1)Is it normal to be getting pimples this far into treatment? My derm said that my course will probably be 6 months.  Also, I have noticed that when I get a larger whitehead than normal, the pimple will get rid of the whitehead, and then turn into a harder bump after a few days.  (2)Is this normal?  Before I started my course of Accutane I was on several antibiotics and topicals over a period of time with moderate success.  I would say I have/had moderate acne before treatment.  My Dermatologist said that I shouldn't binge drink.  (3Is it still okay to have a few drinks every once in a while?--3)Does alcohol kill or limit the effectiveness of the drug? I am of Indian decent with my family having a lighter skin tone than most indians.  It seems as though after all the topical treatments (retin-A, differin, benzaclin) my face has maybe become slightly lighter than the rest of body's skin.  (4)Any comments regarding this?  (5)Finally, does accutane make the face slightly red/pink at times?

Best regards.

[Alan Rockoff, MD]

1.  Yes, people break out at times 4 or even 5 months into therapy.  Still, the drug is likely to work.
2. Yes--normal variation.
3.  Doctors recommend limiting alcohol because of a mild risk of liver problems with Accutane.  Your doctor is checking your liver, I'm sure, as part of routine follow-up.  Moderate alcohol intake seems reasonable.
4.  Retin-A can lighten the skin a bit, but not permanently.
5. Yes.

Best.

Dr. Rockoff