Dermatology Question

Dr. Rockoff:

I had a question concerning some advice about how to deal with my acne I have been recently fighting.  I am a 27 year old male, who has been recently breaking out worse around my mouth, nose, and on my shoulders.  I have done two courses of accutane in the past, one at age 17 and one at age 18, after the second course my acne was quite a bit better for about 4-5 years.  After that I started to break out around my mouth and nose again, and was put on minocycline and it worked pretty well for about 4 years, but then stopped working.  Over the next year, I was then given differin, then finacea, and then benzoyl peroxide, but none of them worked well and actually irritated my skin a bit.  I was just enquiring about your thoughts if doing a third course of accutane might be worth it, my acne is not severe but is usually persistant pustules and bothers me.  I also have been experience a large amount of clogged, dried oil in my pores on my face and alot of dryness and flakiness in the same areas, and even on my lips.  The dryness and flakiness that I am experiencing on my face makes me hesitant about taking more accutane, since my face and lips get really dry even from the most gentle cleansers such as cetaphil and even still after mositurizing.  I was thinking maybe a lower dose of accutane might work, but I don't know if that makes sense.  Do you think that accutane might be worth another try or what other options would you recommend possibly looking into next? Thanks alot

[Alan Rockoff, MD]

It is safe to use Accutane a third time, but the improvement you get from it may not last long.  I suggest that you speak with your dermatologist about other options, such as different oral antibiotics and other topicals, especially retinoids (vitamin A derivatives).  If these fail, then Accutane may be a consideration.

Take care.

Dr. Rockoff