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Avatar universal

Accutane and Severe Wrinkles

Hi,

I am 47 years old and on accutane for almost 6 months (40 mg then 60 for past month).  I have noticed for the past month DEEP, large wrinkles under my eyes (running into top of cheeks).  Is this a drying effect from accutane?  I have read alot about accutane but have not seen wrinkles as a side effect. As a matter of fact, isn't accutane suppose to rid one of wrinkles along with acne?

I am taking this for a cyst problem on my back, not my face.  But my face now has some acne and these wrinkles look like I have aged 20 years in the past month.  I asked my dermotologist and she said not to worry- it will go back to normal after treatment is done.  Can these wrinkles really go away?  Are they reversible?  I am scared stiff!   I can't believe how this has changed my face.

Please someone advise!  Need another professionals advise or someone who has experienced this?

thanks,

Jayson
16 Responses
309783 tn?1271958229
Hi Jayson, i have taken accutane twice and hope i can reassure you. Accutane does cause drying of the face and lips. Your face may become particularly dry if your excess oil problem is isolated to your back. Make sure you use a good moisturiser and lip balm. Elizabeth Arden 8 hour cream is good for lips. For your face i would recommend a cleanser and moisturiser by Lutsine, either the one for dry skin or the one for spot-prone skin which has become dry due to acne treatment. Your dermatologist is right, these are superficial dryness lines not permanent wrinkles, as you say retinoids are used for smoothing skin. Side effects should stop within a month of completing your course. How much longer do you have on the accutane? If you cannot tolerate your recommended dose ask your dermatologist about going back to 40mg. You don't say how heavy you are but the usual dose of accuatne is 0.5 to 1mg x your body weight in kilograms per day for 16 to 24 weeks. Your total dose should be 120-150mg x your body weight in kilograms. Accutane can have some unpleasant side effects which is why it is reserved for the most persistant severe acne which has not responded to other treatments. This has to be balanced against the fact that it is your best hope of acheiving long term remission from acne. Keep in touch, Loiloi x
Avatar universal
Hi Loiloi,
Thank you for your reply.  To help answer your questions, I weigh 135 lbs.  It worries me so much about the lines under my eyes because they are so deep and long (down to my cheek).  There is also some puffiness.  I took my contact lens out to see if that helps (even though they were not causing me discomfort at all).   I have been super moisturizing with the thick eucerin paste -- in the AM and heavy before bedtime.  Alot under my eyes.  I almost feel like I am "over moisturizing" because the lines seem so thick.  I pray and hope you are right about them being temporary..... I've always had nice skin on my face and I swear I feel like I look 20 years older.   I was tempted to start using "firming" cream under the eyes but afraid it might be counteractive.  I am now taking 20mg in the AM and 40mg in the PM (hoping the split would help) but so far no difference.  I am in my 6th month, and the accutane has helped the cyst issue on my back to some degree, but a few still keep popping up.  They are large cebasious type cysts.  But only a few come back, mainly around my monthly cycle time.  But I havent had to have any "lanced" like I was doing before.

Do you think Eucerin paste (heavy duty) is good for under my eyes?  Sorry to be so repetitive, but these wrinkles are making me depressed.

Thanks again,
Jayson
309783 tn?1271958229
Hi. 135lb is 61kg so 60mg per day is the highest dose you can take. Dividing the dose is definately advisable. Eucerin is a good brand because it is for sensitive skin.  How much longer do you have to go on accutane?  If you cannot tolerate your maximum dose discuss lowering it with your dermatologist. A dose in excess of 30mg per day will be more than 0.5mg/bodyweight in kg/per day. Don't worry if all your spots haven't gone by the end of the course, improvement may be seen for up to 8 weeks afterwards. My face was very red when i took accutane and my lips were very dry but these side effects were gone within two weeks of finishing the course. Medicines affect everyone differently, but I have not heard of anyone who developed permanent wrinkles due to accutane, and think these are temporary dryness lines. Keep moisturizing and drink plenty of water. Loiloi xx
Avatar universal
Thank you Loiloi.   I appreciate someone taking the time to review with me.  My last dose (finish of 6 months) is suppose to be in 2 weeks.  However my doctor told me we might have to stay on longer since the cysts on my back are not totally gone.  And today I just got big pimple on my nose!    How can these grow with all this medication in my body?

Blah blah, I feel like a big complainer :(
309783 tn?1271958229
Accutane dries up the sebaceous glands and i found this meant that pimples would come to the surface quicker, like the medication was forcing them out of my skin. Most people only need one course of accutane but some people, myself included, need two or three. I know it's difficult but accutane is your best hope of a long term remission from acne. Whenever i felt disheartened, i reminded myself how much i hated spots and why i was doing this. I also bought a money box to put a pound (or dollar!) in each day to buy myself something nice at the end of my course. Loiloi xx
PS: You say your acne flares up with your monthly cycle, what contraceptive pill are you taking? If you are not already using an anti-androgen pill switch to Diane35 or Yasmin which provide birth control and clear acne. Avoid progestogen only mini-pills and the Depo shot as these can make acne worse.
Avatar universal
Hi Loiloi,

I don't take contraceptive pills because I am over 40 and smoke.  The wrinkles around my eyes seem to get deep on some days and look less severe on others.  The weird thing is --- I stopped moisturizing under my eyes for 2 nights and it looked better!  How weird was that?  Then I had to moisturize because it was way to dry.

I have also been losing much hair (I would say about 25%) because you can see my scalp in certain areas.  The hair itself is very very dry, and I use conditioner every day, but the hair remains dry and falls out/thinning.  I've read some of the other posts about hair loss and I hope it grows back full again.  I am finishing my 6 month treatment and gonna ask my doctor if I should use the vitaman A gel on the cysts rather than more accutane.  Do you know if this works good too?

Thanks,

Jayson

Avatar universal
Hi Loiloi,

I finally decided to stop taking the accutane 4 days ago.  The strangest thing -- two days after stopping, I broke out with a psoriasis breakout on both my arms (elbow to wrists).  I always had "one spot on one elbow" -- it never spread or caused issues -- I used cortizone cream a few times a year and it vanished.  now BOTH arms are covered.

Have you or anyone heard of psoriasis breakouts due to Accutane?  And oddly enough, when I stopped?   My eyes are still severely (loose skin and deep wrinkes).  I pray this goes away.  Do you know how long after you stop taking accutane that these side effects go away?  Like wrinkles, hair loss, chapped lips, etc.

thanks!

Jayson
309783 tn?1271958229
Hi. The chapped lips should stop soon after stopping treatment. I actually experienced an excess of hair rather than a loss whilst on accutane and this side effect ceased 4 weeks after stopping accutane.
Accutane can cause rashes, sensitized skin and hives so i would get a doctor to look at your arms as oral antihistamines and hydracortisone cream may be indicated.
I have used topical Differin which dermatologists have found to be the most effective acne gel, it is a retinoid. Loiloi xx
Avatar universal
Reading your responses to Jayson warms my heart and put a smile on my face.  Its refreshing to know that people so thoughtful and caring are out there.  Jayson, I hope you find relief some time soon as I hear accutane is rough stuff.

Myself, I am supposed to start my course in three weeks.  I am using a topical tretnoin at the moment so I feel like I'm getting a crash course on what's to come.  Some time to find a good moisturizer and cleanser.  I plan on visiting this site more as I get into taking it.

Good luck to all!!  I'll take Loiloi's advice of reassuring myself as to why I started this all in the first place, to stick in there and I'll definitely get a money box for my reward in hopefully 6 months.

Avatar universal
I had accutane in the 1980's. I had a total of 3 rounds because the first didnt last long.  Back then I was in my mid to late teens.
I am now in my late 40's and I have SEVERE wrinkles around my mouth, eyes and laugh lines.  How can anyone survive a life of severe dehydration?  I have been on depression meds since back then too.
Even my arms have wrinkles!!
Does anyone have any Idea how to get my body hydrated and keep it that way?  I make sure and drink my alloted amount of water each day.
So, now what??

carriegirl1
Avatar universal
Hi CarrieGirl,

    I just read your post about having severely dry skin. This could be due to not getting enough of the healthy Omega 3 Fats into your diet.
You can get these by incorporating more Avocadoes, Flaxseeds, (I love to grind flaxseeds in a mini blender and eat them that way, because it has a delicious nutty taste, or I add them into my smoothies). You can also supplement with Fish Oil pills, and Flaxseed Oil. Try to incorporate more Wild Alaskan Salmon into your diet, and nuts, such as walnuts and almonds if you are not allergic to nuts. I love eating raw pumkin seeds that I get from Trader Joe's. I also supplement with the Flaxseed oil, fish oil pills, and sometimes I also take evening primrose oil. I also try to incorporate alot of olive oil into my diet. The best way is to not cook with it, as that damages the oil, but to instead just use it as is, as a salad dressing with lemon juice and spices, etc. You may even have a hormonal balance that may be causing your skin to be on the dryer side, such as an underactive Thyroid Gland. But if not, or even if you do, your health along with your skin, with still greatly benefit from incorporating more Omega 3 fats into your diet, such as by supplementing with flaxseed oil, and/or fish oil pills. If you do this, you will be hydrating your body from the inside out,and your dry skin may just be a sign that you are not getting enough of the Omega 3 fats that your body desperatly needed on a daily basis.
Avatar universal
Hi rose294,

I am about 35 years old male and got 6 months treatment of accutane around 10 years ago. I have deep wrinkles around my eyes, nose/cheek area. They look worse when smiling!
And guess what, I am a health nut and I exercise 4 times a week and take balanced nutrition (minimum junk food, balanced carbs, protein, fat, fiber diet) and also take a daily multi-vitamin and omega 3 fish oil (3 capsules a day to give about 1000mg  recommended dose) and I regularly use Flaxseed oil and olive oil in my diet. I also eat walnuts a few times a week.
Guess what, all this doesn't do anything for the wrinkles. I still have deep wrinkles at age 35.
So please don't give people the misinformation. These don't make much difference. I do have a great lean/muscular body but poor/dry skin (except that my acne is much less severe now).
Avatar universal
hi i took roaccutane for only 4 months and i am 50 years old.my chin is really wrinkled now and i think i look years older now people always said i looked young before. i have been off it for 6 months and they havent gone i am like you really down about it,
Avatar universal
I am male, 29 y/o, and took two rounds of Accutane at 16 and 22 years old, and I have always felt that it was responsible for severe premature ageing. Today at age 29 I am at my wits end over heavy wrinkles on my eyes and forehead. I look like I am 40 and have spent my entire life under the sun. I can't imagine how old I will look at 35, 40, 50... These wrinkles have been permanent since my last round of Accutane at age 22 and get worse year by year. No amount of supplements or healthy diet has made any difference. Furthermore, all my mucous membranes are chronically dry (eyes, nose, mouth). Advice on the subject is usually condescending and fails to address the problem (e.g. drink more water, take oil supplements, etc.). Of course one tries everything possible! One consolation is that the effects are only superficial and I am not in pain or discomfort as some people are. I wonder if anyone who has experienced severe dry skin and wrinkles due to Accutane has found a solution. Of course it is impossible to prove that it was the cause. Even plastic surgery, botox, fillers, etc. could be an option, to only know that they would actually help.
Avatar universal
Hi,
I feel the same as you, I took isotretinoin Actavis 30 mg for about six months, and after three months I noticed that I had received ugly looking nasolabial folds, the skin on my face had like dropped down. I stopped taking the pills a year ago, but there's no change, the folds look still bad, I felt that I aged about ten years in three months, and it has caused me a lot of stress and bad feelings. The doctor denied everything. Now I have some new acne on my face, and really regret that I started the medication, because it doesn't heal acne for a long time. I'm now 51 years old. The wrinkles around my eyes got also deeper. My nose is still dry inside and the skin is so much thinner and gets easily red. I wish I had investigated the issue before starting the medication, since one cannot trust the dermatologists that they would inform you that medication could damage one's skin badly.
Avatar universal
I sincerely wish that I would have researched further into the side effects which weren't the "normal".  I turned 42 in April.  I completed a 6 month Accutane roller coaster ride in December.  My acne has been wonderful since I completed my last dose.  About 2 months ago I began to notice wrinkles - not LINES but WRINKLES around my mouth and chin. I have never smoked.  I only drink maybe 2 - 3 times a year socially.  I don't take any medications on a regular basis.  I do drink Coke and Dr Pepper which I know aren't great for me, but that is as harmful as I honestly abuse my body.  I wear sunscreen every day on my face, and I was extremely careful of being in direct sun when I was taking Accutane.   The lines on my chin are moving toward my jaw areas.  It is as though I have aged 10 years in about 1 week.  The dryness has also returned to my lips as if I were on the medication, however not as severe.  It is certainly disappointing, saddening and depressing.  My grandmother had beautiful skin at 87 when she died.  She had a few LINES around her eyes.  She wore powder and tinted lip balm only.  I was hoping to inherit her lovely skin and was doing great in my opinion - except for adult onset acne caused by pregnancy.  I think I would have fought the "eventually disappear hopefully" acne which was painful in comparison to the deep wrinkles which I am plagued with now!!!!  I have spoken to a family member (age 47) who was romantically involved for several years with a plastic surgeon.  She discouraged me from spending money on worthless OTC moisturizers, cremes, oils, retinoids, etc because they will not fix the problem.  She recommended a laser treatment, Fraxel.  I haven't even done any research on it yet, but I plan to very soon.  She had a treatment and looks about 30 - fabulous in my opinion.  She said it causes collagen to be stimulated and regenerated  - or something similar to that.  Currently I can't seem to find anything with a lot of information regarding the wrinkles caused by the drug, but I will keep looking.  If I find anything of interest, I will post here again for every one to be aware.  Good luck to all of you!

Tara :)
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