Do Hormonal Treatments Work when Accutane Has Not?

I had Accutane two years back for six months. My face remained clear for a year and then the acne came back. Lately, it has worsened. I have been taking hormonal medications for two weeks now, but there hasn't really been much improvement. My question is, do oral contraceptives actually work where Accutane has not? Should I remain hopeful?

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2 Doctor Answers | Asked by shehreen in bangladesh

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Get a work-up

When Accutane does not work, a female patient needs to be worked up for hormonal problems. Polycystic Ovary Syndrome (PCO) is a common problem. I have also diagnosed a very rare adrenal carcinoma in a severe, recalcitrant acne patient. The only way I make these diagnoses is with lab work. If all is OK, or you do have PCO, I would suggest you and your dermatologist discuss the use of oral contraceptives and spironolactone along with Tazorac topically. Good luck!

Repeat Accutane

If you had a good response to Accutane, but it recurred after a year you might return to your dermatologist. You probably need a higher dose. While the initial improvement with Accuante occurs with even low-dose therpy, a permanent cure is usually obtained only with a dose commensurate with your weight. Yes, hormone theapy may help when Accutane does not. This is especially true in cases of hormone imbalance. It would be wise to have blood test to determine your honrmone levels. Do... more