Accutane dosage information

[Jason11]

Great forum by the way. My question is this. I am a 26 year old male weighing 140lbs. I had a relatively minor acne in high school that was controlled with antibiotics. I went the next 8-9 years with minor breakouts that was controlled with topicals and antibiotics but my acne was never a major issue. If you asked people around me, they would say I have good skin. However, over the last year, I have been getting a cyst on my face once a month and a cyst or two on my back. I have been getting cortisone injections for these and use antibitoics sporadically. I noticed that one of the cysts left me with a small scar a few months ago, so I panicked and went on accutane. I have seen four dermatologists over the last year and they all say I am a borderline candidate. One of them thought I should do low dose therapy (20mg a day) but the dermatogloist my insurance covers think I should do a normal course (120mg/kg total dose). I have been on accutane for a week (at 20mg/day)and my face is almost completely clear..occasional white heads here and there but my skin looks good. However, I don't really like being on this drug and want to get off of it as soon as possible. I don't have any major side effects but don't like the dry lips and feel a little achy.
       1) Can I stay on the low dose form if I see results or should I go for the full dose?
       2) What is the shortest amount of time that I can stay on the medication and still see some benefit?
       3) I have read that some doctors take their patients off the drug early if they have responded early. I know that a total dose of 120-150mg/kg is used for long term remission...but what if the patient has mild disease..like I had...Clear skin with the occasional cyst?
       4) If I stopped this drug after 2-3 months on 20mg/day would the therapy have been a complete waste of time?

This is all strange for me because I have never had bad acne...I can usually cover it up and most people comment that I have nice skin..its just, I got nervous when I saw a small scar left from a prior cyst..and didn't want to worry about it going forward. Any advice you can offer about my particular situation will be much appreciated.

[jimgreen]

Hi,
  I am an 18 year old who has suffered from acne sicne middle school.  I have tried everything excecpt accutane.  I started accutane on 8-12-05.  It is now October.  I have experienced chapped lips and dry face.  The acne seems to stay the same.  I weigh (165 lbs) and am pretty tall and very active.  Although i workout oftern, I still shower at least 3 times a day and clean my face with clearisil.  I live and south georgia where its very humid.  I take (40) mg a day only ONCE.  my appointment is friday.  Should i try to get an increase to 80 mg since it hasn't gotton better or worse~thank God!

          Thank You,
          Patrick

P.S. I look foward to recieving e-mails from any Dr. or patient, mom, dad, etc. ~ anyone that has been though this before.   my address is ***@****

[Alan Rockoff, MD]

I agree that you're a borderline candidate.  Still, as long as you're taking it, I think you should take the full course at the full dose, because that will give you the best chance of staying clear long-term.  It's not such an intense treatment even at the full dose.  The fact that you cleared up so fast doesn't mean the acne's gone.

Best.

Dr. Rockoff