accutane on chin, scars

Dr. Rockoff,
I have a few questions for you.
#1) I am a 25 year old male. I had been getting painful cystic acne on my chin, and also postules on my chin area for the last six years. The condition worsened, then got better, on and off. Finally, I decided to try Accutane. I am on it now. Why do I only get cysts and acne on the chin? Have you ever seen this in any other male patients? I know it is common along the jawline for women. I had my hormones tested, and everything was normal. Can it be dental, glandualar? I am confused and concerned. I only get pimples on my chin. The rest is clear. I mean, does Accutane work, as in shrinking the sebaceous gland, no matter what the cause is?

#2) I weigh 134 pounds. What dosage of Accutane would give me the best shot at remission from acne? I am on 40 mgs now, week 7, I think my derm wants me to be on 60 eventually. Is this the amount you would have me on, if I were your patient?

#3) I still get pimples, on Accutane. They are taking longer to fade. I am worried that the Accutane will cause them to scar. Can't the Accutane have a negative effect on the cortisone or something? Will the Accutane cause scars, will these marks fade?

I want to explain that I went on Accutane because the cysts I would get, and the constant acne, they were painful, deep, and did not respond to any treatments. I had to get them injected constantly, and that too would leave marks for a while. However, I never used any topical retinoid for any extended period of time.

Thanks Dr. Rockoff.

[Alan Rockoff, MD]

It sounds as though Accutane is a good choice for you.  In truth, since oil glands are on the face, chest, and back, it's hard to explain why some people have more problems on their forehead, others on their chin, etc.  It isn't usually because of pressure (chin straps), local factors (shampoo), or other things people use to try to correlate the location with.  But in the end it doesn't matter, since you're likely to get better anyway.

60 milligrams is right for you, when the doctor thinks you're ready.  Accutane doesn't delay healing; by stopping you from getting new marks, it lets the old ones finally fade, but it takes several months.

Take care.

Dr. Rockoff

[beautifulface]

I'm a woman, so you're right that our hormonal situations might make us very different, but I just wanted to let you know that my dermatologist thinks my constant chin issues may be rosacea (with the rest of the stuff I deal with in other areas of my face being traditional acne).  The chin stuff just never seems to go away fully, and constantly flares up.  I just started oral and topical antibiotics and will be putting yet a different cream on my chin area as soon as I pick it up from the pharmacy.  Oh, I should mention that I went on Accutane at age 23 (am now 27), with really only the chin problem just like you.  Since getting off Accutane I have had more issues with constant clogged pores on my forehead.  I hope you don't suffer the same fate, but maybe if you do, you might check out the rosacea possibility.