Spironolactone & Accutane going on 4 months now and still breaking out? (Photo)

It is pretty unusual to not be dry from isotretinoin at 80 mg/day.  The biggest reason why this would occur is because of poor absorption.  Isotretinoin, is a derivative of Vitamin A, and vitamin A is fat soluble, which means that if you aren't taking the medication at the same time as a meal with fat in it, you won't absorb it properly... and you won't get dried out.  When my sons took it, they would take it after dinner with their dessert, usually a bowl of ice cream.There is one version of isotretinon, called Absorica, where the fatty meal isn't as important for its absorption.  In my experience I use this particular brand when I'm dealing with thin young women who aren't probably eating as much fat as the average individual.That being said, even a course of Accutane won't guarantee that you won't be stuck with spironolactone to control hormonal acne for more years to come.   In my 20 years of experience with treating acne, the mostly likely patient to re-break out after a full course of Accutane is the female with hormonal acne.  I wish you the best, Marla Klein MD

Accutane needs to be used for 5 months and reach a cumulative dose of 150 mg per kilogram. If you weigh 110 pounds or 50 kilograms you should receive 2250 mg total over the course of treatment. At 80 mg per day you are receiving 2400 mg per month and this will almost always work. Another option would be to subsidize 5 mg of prednisone for the aldactone while you are on accutane .