Desperate about acne

My daughter started to have noticeable acne when she was 17 yrs old: her skin was clear before.
Since then, she has tried without any significant improvement oral antibiotics, topical antibiotics, she is on the contraceptive pill and she is using, although not on a regular basis, Retin A on her face. Now the acne has spread on the chest and she is distrought. I am scared about putting her on Accutane because is a controversial drug and my daughter is prone to depression.
She has never done a test to measure her hormones nor a culture to establish the nature of her pimples. She will be 20 yrs old in three months and she is totally self conscious. What do you recommend? Thank you.

[Alan Rockoff, MD]

There may be other antibiotics her doctor may want to try.  If they fail, she should strongly consider going on Accutane.  Accutane is not a controversial drug; it is a spectacular, life-changing drug that's been in regular use for almost 24 years.  It rarely (if ever) causes depression.  It causes tremendous happiness when people miserable over their severe acne finally clear up.  If you doctor recommends it, don't let the alarmist publicity scare you off.  Properly used, it's a safe and pretty-easy-to-take drug, and it's effectiveness is reliably remarkable.

Best.

Dr. Rockoff

[Neuron]

I would be careful with accutane.

I took it in 1996 and while it worked well and cleared up my back and chest acne I began having acne on the front of my neck that is cleared up now but lasted for eight years and left scars. Before the accutane I had never had a pimple on my neck but primarily had acne on the T-zone region and upper back and chest.

In addition, my eyes appear to be permanently dryer due to it.

For some reason the accutane triggered the acne to invade my neck. Acne in my case was stubborn as I have been suffering from it for 30 years.

The best drug I found until my acne faded naturally was minocycline; I took it for years with no apparent problems.
It is for maintenance only and does not cure the condition.

[philrx]

I took tetracycline (same class as minocycline) for my acne, and it made my teeth discolored (yellow).  
Personally, I think Accutane is amazing - yes it has side effects, but what drug doesn't?
The dermatologist can only offer a suggestion (prescription) and you can decide whether to take the drug or not.

[AliW]

I was a freshman in college when I went on Accutane and what a difference it made in my skin!  I actually took two courses of it in my lifetime.  They were 3 years apart.  Oral antibiotics never seemed to work and retin A just burned my skin.  Your daughter may be depressed because of her skin and self consciousness.  It made a huge difference for me.  I am 35 years old now, and take the birth control pill to keep my still not so perfect skin under control.  The breakouts on my back and chest never came back.  I highly reccomend it for her skin and self esteem.