Post-accutane acne

[aboulton]

Dear Dr Rockoff,

I'm looking for some advice/reassurance. I have been off accutane for a little over a year, during which time I have had at most one zit at any one time which would disappear relatively quickly. In the last few days, however, I have had two zits appear simultaneously, and I'm slightly worried. I've been using benzoyl peroxide religiously for the past several months, so now I'm questioning whether the positive effect of the accutane may be over. What would you recommend I do? I have some residual scarring from my previous acne, and pigmentation has only recently evened out, so I'm fairly anxious that the situation doesn't develop further. Is it in any way normal to have a couple zits at a time even after a 'succesful' course of accutane? And if not, what would a dermatologist consider for someone in my situation -- assuming that the acne doesn't progress massively beyond the current level. (ps I'm 23 years old and had been suffering from acne for over 5 years, with minor success with benzoyl peroxide and no improvement from antibiotics or topical retinoids.)

Thanks so much.

[DrCrocker2B]

Be worried. I never had acne until I turned 26. It got so bad that after trying all the usual topical medications and a few oral broad-spectrums, I started accutane. I took it for over 1 year. It worked, but about 2 years later the acne returned slowly. Today, it is as bad as it ever was, but now I have acne,severe dry skin patches, premature wrinkles, and age spots. I wish I had skipped the synthetic vitamin A and just used fish oil and other supplements. I recently found some help with taking organic cod liver oil (Carlson's) which is naturally high in vitamin A. I also see improvement now that I take plenty of zinc and vitamin C. Egg yolk applied topically (also high in A) is supposed to work. I hope this helps you.

[Alan Rockoff, MD]

If all you have over a year after finishing Accutane is a coupe of pimples now and then, you're unlikely to have to do anything more than apply a topical anti-acne cream.  Once you're through a course of Accutane, the skin often does break out a bit, but responds to simple treatments that never worked for you before.  Ask a doctor to look you over and prescribe such a cream.  No need to be worried.

Take care.

Dr. Rockoff