Serious Accutane advice needed...

[garyjr2889]

ok, im 18 and have had acne for a little over 5 years, almost severe although its got a little better, about three months ago i started accutane 40mg, a day and did not have a good experience with it at all. the worst side affects were the chronic back and joint pain... and also i had confusion a lot and ringing in my ears and couldnt concentrate. so i totally stopped it after 2 months. my face is still doing a little bit better from what it was before accutane but i still want it completely clear. and i read all about lasers but they seem WAY to expensive and it makes no sense to fight a problem from the outside in. Now these are the problems, i play guitar A LOT meaning joint pain doesnt help me at all, i work at a hospital so i run constantly and my back kills me when i was on this stuff. so these are the questions I need answered... if i go back on accutane, will the joint pain subside in any way? and once im off of it will it completely go away too? because i understand that accutane is a derivative of vitamin A which is fat soluable meaning it can stay in your system for years.... i also read that people still had back pain for like 10 yrs after taking it. and also it can cause a lot of other bad bone probelms that blood tests can't read.. So basically im asking how long the side effects will last during and after the treatment... mainly the joint/back pain and if it's worth risking it??

[loiloi]

As with any decision, the expected benefits need to outweigh the potential side effects. If your back pain has gone since you stopped treatment this should reassure you that you just have to put up with the side effects for 4 months, not forever. Bone calcification would be an issue with long term use, but not with one or two 4 month courses. Accutane does receive some negative press, but this needs to be balanced against the fact that it has helped a lot of people. Please trust Dr. Rockoff. You can also speak to me by going into the acne forum. I have taken acutane twice. Loiloi

[garyjr2889]

well i really want to go back on it but am scared. i mean i just read all this stuff on how it can affect gene expression, cause brain damage and be permanent. now what im considering, just ride this out because maybe its just hormones peaking and i might just grow out of it? cause neither of my parents have had bad acne at ALL ever, and none of my relatives so maybe it will fade with time? or risk bein totally screwed up for life? please help me out im sooo confused. i need someone to talk to. my email is ***@**** also.. thanks so much

[garyjr2889]

well i really want to go back on it but am scared. i mean i just read all this stuff on how it can affect gene expression, cause brain damage and be permanent. now what im considering, just ride this out because maybe its just hormones peaking and i might just grow out of it? cause neither of my parents have had bad acne at ALL ever, and none of my relatives so maybe it will fade with time? or risk bein totally screwed up for life? please help me out im sooo confused. i need someone to talk to. my email is ***@**** also.. thanks so much

[loiloi]

It is a shame you had to stop after two months as a four month course often leads to a long remission. As Dr Rockoff says, it is the total amount you take that matters, eg 12 weeks of 40mg works the same as 24 weeks of 20mg. Side effects are dose related so you should consider his point 2 above. Muscle pain and not hearing as well as you used to are listed as rare side effects of accutane. It stays in your body for two weeks so i would see a physio about your back ache. Loiloi

[Alan Rockoff, MD]

In prescribing Accutane for over 25 years, I haven't had a single patient who had to stop the drug because of muscle pain.  Because finishing the course of this drug is almost surely the best option open to you--lasers don't work very well and the results don;t last--I think you should look into the following:
1. Is it possible that the back pain was caused by or aggravated by something else besides Accutane?
2. Is it possible for you to take a smaller dose of Accutane, perhaps for a longer time, to mitigate the symptoms?
3.  Perhaps you take anti-inflammatory medications like Advil to make any pain you do have more tolerable.

You should discuss these questions with your dermatologist.

Best.

Dr. Rockoff