Accutane

Hi lianne--I can help (I've RX'd Accutane to many pts, w/ overall great results); a few Q's first:

-What degree was the acne just PRIOR to starting accutane (mild/moderate/severe/or extreme)?

-Are you on any other meds?

Please note that your well-thought out responses to these questions will

greatly assist me in narrowing down the possible diagnoses, so I can reply to you

with more accurate and helpful medical advice.

Thanks, --Dr. Steve, Your Online Family Doctor

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I am on minocycline, differin, clindomycin.

Personally, I'd classify my acne as moderate. They never go away, sometimes painful to touch, oily skin, just plain annoying.

But, taht is my personal opinion. In a photo taken 6 feet away, you probably couldn't see the acne. If you are standing nose to nose, it's 100% obvious. My acne is red. I wear make up to cover up the redness.

Hi lianne--good to hear from you again; thx for quick reply!

Here are the Answers:

1. Does the current case of acne typically get worse before it gets better?

A: YES: In my 12+ yrs RXing it, I'd say 60% of pts get worse, before getting better; PART of the reason is just natural progression of the dz (Acne vulgaris), esp. since it takes minimum 7-10 days for the drug to get to EFFECTIVE concentration in your blood; the rest is due to a 'drawing out' effect that it has on your skin pores (kind of like cleansing your bowels w/ a cathartic).

2. How long before seeing any improvements?

A: Typically, about 3-4 weeks (but can RANGE from 2 wks, up to 8 wks)

3. What typical side effects are there?

A: most common are: dry mouth & nose; cracking or inflamed lips; (I got both of these, when I took it about 17 yrs ago); dry eyes (this is why you shouldn't wear contacts); red eyes; general dry skin; vague muscle aches (episodic). These are the fairly common side effects. There are some more serious/dangerous side effects, which are included in this public link:

http://www.fda.gov/cder/drug/InfoSheets/patient/IsotretinoinPT.htm

(Don't be too scared by all that's listed here--most of the serious effects are quite uncommon; anywhere from <1% to about 5-6%). In general, I advise NOT to stay on it too long--perhaps about 5-7 months (at most), to get your face all CLEANED up (and pretty Images available only to Customers.



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"Shouldn't" wear contacts. CAN i, should I choose to? Cracked lips to the point of bleeding? Is this something chapstick can help with?

Once on accutane and I take it for 5-7 months, what is the rate at which my acne will reappear?

Once I finish 5-7mo on accutane, you suggest I go back on minocycline?

Another question... i know my skin on my face would be dry and flaky. Is it ok to do a microdermabrasion to get rid of the flakiness?

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