roaccutane

my acne was not helped by Dianette or anti-biotics and finally aged 22 -  two years ago - I took the plunge and had roaccutane with very good results. However, the acne has now returned with vigour. I have polycystic ovary syndrome but have periods. I now have been taking yasmin, a very light contraceptive pill, plus spironolactone, but 4 months in my skin is just as bad
Question - should I consider a further course of the rather powerful Ruaccutane - I have heard that one can only have 2 courses in your lifetime and also that it takes 6 months off your life expectancy!)
Thanks
Mary (aged 24)

[Alan Rockoff, MD]

It is not true that you can only take 2 courses of Roaccutane (Accutane in the US) per lifetime, and it is most certainly not true that it takes 6 months off your life expectancy.  My only hesitation about your taking this drug again is that the condition may return once again in a couple of years, and you can't keep taking it over and over.  You therefore ought to talk with your doctor about options--antibiotics, for instance--that may not have worked for you in the past but may do so now.  If they fail, though, you can and shouod consider another course of the Roaccutane.

Best.

Dr. Rockoff

[mary333]

Dear Dr Rockoff
Thanks for your advice - presumably it is inadvisable to take Accutane over and over because it is a very powerful drug? Do you have experience of patietns who have had sustained improvement from two episodes of Accutane, and not needed to keep on repeated it?
Mary

[loiloi]

I have taken Roaccutane twice. 20% of patients require a second course. My dermatologist says she will prescribe up to 3 courses.
As Dr. Rockoff says, because Roaccutane changes the skin, treatments which previously proved ineffective may now work.
Have you taken Dianette with oxytetracycline?
Have you tried a topical retinoid like Differin?
A second course of Roaccutane will give you a holiday from your acne and could lead to long term remission from acne. However, as your acne is caused by an underlying condition it is possible you will relapse again.
Loiloi xx