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Accutane Only Cures Deep (Cystic) Acne - Seattle, WA

One of my friends took Accutane as soon as he got...

One of my friends took Accutane as soon as he got his first pimple, because his lawyer father wanted his son on the strongest treatment available.  It certainly seemed to work for my friend.

My parents are both doctors, so they felt it was best to start with less powerful acne treatments and see if those would work.  (Doctors are the only parents that triage their children out of treatment.)  Somehow, it took them 4 years after my friend started taking Accutane to figure out that the less powerful treatments weren't working.

At 13, I started taking doxycycline, an antibiotic that is supposed to kill the bacteria that lives in clogged pores.  It was partially effective, although I found out the hard way that you need to always take doxcycline with food, or the capsules will get stuck to the stomach lining and cause an ulcer.

I also used Retin-A on my face to reduce clogged pores.  While that reduced the amount of acne on my face, I got deep cystic acne on my back and chest -- the kind where white cysts form under the skin after the acne heals.  Retin-A didn't seem to help that, and it would require a lot of Retin-A to treat my face, upper back.

At 17, my parents sent me to a local Dermatologist for an Accutane consultation, and she put me on Accutane.  Taking Accutane entails monthly blood draws to see if Accutane is causing problems with liver functions.  I was also taking a recently-FDA approved allergy medication, and the combination elevated my liver functions above normal levels enough for my doctor to stop Accutane after about 4 months, which was a little on the short side of a normal course.  That short course of Accutane didn't cure my cystic acne, so I went back on Accutane for a full 6 month course once my liver functions went back to normal.  That time I was only taking Accutane, and my liver functions remained within the normal range. 

Accutane has some nasty side effects - initially, it does make acne worse, and by reducing oil production it causes dry skin and in my experience, stiffer joints.  It only partially reduced the shallower acne I had on my face, but it did seem to cure the deep cystic acne I had previously.

In hindsight, I wish I had started Accutane like my friend did at 13 -- it would have prevented 4 years of cystic acne.  10 years after taking Accutane, I've learned to use a 2% salicylic acid astringent to treat the whiteheads and blackheads that Accutane didn't cure. 

Seattle Dermatologic Surgeon

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i'm almost 65 and took accutane in my 40s, but much of the damage was done, i did notice a change in skin tone to be baby softness, although some scarring and leftover cyst cavities still remain. Eldest at the time 18yo son took accutane when it was apparent he was also experiencing similar acne, it worked perfectly without residual affect, number 2 son at 16yo was given, what i later found out was a 'generic' Accutane which DIDN'T work AND for both, the course was only 3 months, not six as indicated by Dr Brandith's caregiving program. As we speak, #2 son is having cyst help due to dermie being on vaca, only one on the island. Mahalo for this page.
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I started accutane when I was 18 (I am 20 now) and stayed on it for 6 months and my skin was fabulously clear!! The sad part is that this clearness only lasted 6 months and then my acne came all the way back. It really really sucks going from having low-self esteem due to skin and then to 6 months of high self esteem due to clear skin and then back to low self esteem. I feel like a totally different person because now I am not as outgoing as I was when I had that glorious 6 months of clarity. But I am glad it worked for someone.

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Yes, it is okay to use T/Sal on you face and hair while on accutane, just make certain to wash it off within 5 minutes and moisturize your skin immediately after showering.  Salicylic acid is a mild acid and is a better choice than traditional soaps or shampoos.  So replace other soaps or cleansers with T/Sal -- don't use both. 

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I have been on accutane 40mg for 2.5 months now. For the first month and a bit my acne cleared, but now its flared up again terribly and all over my upper back. Do you think I should stick with it? Three doctors (not my derm.) told me to stop it as im experiencing terrible side effects.
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I had to stop Accutane for a few months because my liver functions were out of the normal range (and no, I wasn't drinking at all).  You might ask your Derm about at least reducing the dose for a while.

Also, I recommend Neutrogenia T/Sal shampoo (make certain it is the one with 3% saliyclic acid, not Coal Tar) as a shampoo and body soap.  I recently discovered it and is has helped unblock pores and clear up my skin.  If I had known about it when I was a teenager, it's possible I wouldn't have needed Accutane at all. The directions say to leave it on for a few minutes, so I turn off the shower, apply it everywhere, wait 5 minutes, and then rise it off the with lukewarm water.  Colder water (75 F) is key because hot water will strip out all of the oil in your skin and your body will respond by trying to create more oil.  After the shower, follow with a non-irritating moisturizer like CeraVe or Vanicream.  Accutane dries out your skin so you need a moisturizer so your skin isn't always stressed by the dryness.  And if you're going outside, get a moisturizer with SPF.

Salicylic acid takes weeks for it to fully clear out your pores, so you need to use T/Sal every time you shower.  T/Sal has worked wonders for me.

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Are you saying you are using the T/Sal on your face or your hair? Is it ok to use T/Sal on your hair while taking accutane?
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It's like they say, "cobbler's children go barefoot."  Doctors like to avoid the most aggressive treatment, especially for their own children.  Considering the side effects that made the manufacturer pull the branded version of Accutane off the market, I can see why.  I just wish I had been more diligent about using the Neutrogenia Salicyclic Acid cleanser that I had even as a teenager.  It really only works as a preventative (unclogs the pores slowly), and I was using it once it was too late.  Now the alcohol base is too harsh for my skin, so I have to use other acid creams (like Finacea) to keep my pores clear.

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Wow -- your experience sounds almost identical to mine! Right down to the fact that my dad is also a doctor and put me on everything except Accutane until we realized nothing else would work. Had the same back issues, and Accutane has kept me clear for the past 5 years! 

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