Accutane

Hi

I used accutane 3 years ago but the acne has since returned, albeit in a less severe form.
However, I have been diagnosed with hemochromatosis in the intervening period.

My derm is considering putting me back on accutane to clear up the acne.

1) Is it possible to have hemochromatosis and take accutane? My doctor takes blood every 6 months to keep my iron levels low.

2) I will most likely be going on a low dose course of accutane. Does this make it less likely that I will have a severe flare up of acne during the treatment? On my previous course, it flared up at 50mg but was non-existent when I took 20mg. This time around, my derm won't be putting me on a dosage higher than 30mg. I would be interested in your opinion on this. Is a lower dose=less side effects?

Thanks a lot, I appreciate your help.

[Bharat Chawda, MD]

Dear Shaned1,

Accutane is  a wonderful drug for Acne when used with proper precautions. Before taking it one should have a normal liver function test, lipid profile and blood cell counts. I hope you have had these tests. If not, please discuss them with your doctor. Now to answer your questions:

1) Hemochromatosis treatment should not interfere with your Accutane regimen provided your liver functions & blood counts remain normal all the time.

2) Low dose Accutane would be enough to control moderate acne. The important thing is not just the daily dose, but the overall cumulative dose, which depends on the treatment duration. It is approximately 120 mg per kg body weight. So for a person weighing 60 kg, treatment has to be continued till the cumulative dose reaches 7200 mg. Your doctor can decide your treatment duration depending on the cumulative dose appropriate for you.

The lower dose of isotretinoin does not necessarily mean less side effect. Side effects and precautions still remain the same.

Hope that this information helps and hope that you will get better soon.

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Best Regards.
Dr. Bharat Chawda