Multiple Accutane Courses

I have taken three courses of Accutane, and am now 25 years old.  It works great, but each time the benefits slowly wear off.  I expect this to happen again.  I called Roche to inquire about the risks of a 4th course.  They said no more than two courses are recommended because the side-effects on the bones are not known.  Seems suspicious that this is the one side-effect that evokes some concern and yet it is "unknown."

After my most recent course I developed a bothersome eye-floater that has persisted for two years.  I think this might be attributed to the Accutane because it showed up just as I completed the 8 month course, and I have read other complaints about eye floaters and Accutane.   Other than that, the side-effects have been well worth enduring.

Why is Roche concerned about bone changes more than the other side-effects after multiple courses?  And is it reasonable to attribute the eye floater to the Accutane?

[Alan Rockoff, MD]

Isotretinoin (Accutane) is sometimes used long-term for such conditions as ichthyosis, a congenital problem which causes severe, widespread scaling.  A few such cases have shown bone changes, but it isn't known how much Accutane taken for how long may cause them.  This isn't an issue for one or two courses of 5-6 months, but whether repeated courses can be a problem isn't known.  I'd hesitate to prescribe another course for you just on  grounds of efficacy.  If the acne has come back after three courses, it is indeed likely to do the same again, and since you're 25, and the acne could go on for some time before you grow out of it, that may not be a good enough result to make the unspecified risk worth taking.  Ask your doctor about conventional alternatives or photodynamic therapy using aminolevulinic acid and light sources such as a laser or intense pulsed light, as an alternative option.

Best.

Dr. Rockoff

[David H]

Thanks Dr. Rockoff.  The results of Accutane are so pleasing that I would be willing to accept some risk in taking yet another course...it's just very tough to assess that risk.  Much of the available information is vague.

What are your thoughts on accutane causing eye floaters?

[Alan Rockoff, MD]

I'm not aware of the association.  If it happens, it must be rare.

Dr. Rockoff

[bman0425]

hi my name is blake burman im 16 and have had acne since i was 13 when i was fourteen my brother went on accutane and it worked wonderfully my mum then told me to go on it aswell and worked wonderfully until i stopped a six months corse 4 months later it came back. I then went back on it and again for 4 months and came back just after 2 months. I am now i am back on it and am affraid that it will come back again i dont know what to turn to and need advice please if anyone knows something helpfull please let me know ***@****

[bman0425]

hi my name is blake burman im 16 and have had acne since i was 13 when i was fourteen my brother went on accutane and it worked wonderfully my mum then told me to go on it aswell and worked wonderfully until i stopped a six months corse 4 months later it came back. I then went back on it and again for 4 months and came back just after 2 months. I am now i am back on it and am affraid that it will come back again i dont know what to turn to and need advice please if anyone knows something helpfull please let me know ***@****

[bman0425]

safdasd

[hutch13]

A related discussion, going for #2 was started.

[Davejoe]

A related discussion, Why are most doctors scared of multiple courses of Accutane? was started.