Getting prescribed accurate for acne. Any suggestions?

I have been seeing a dermatologist for a year now.I've seen her three times and I'm not seeing any improvement. I've used every topical treatment there is as well as antibiotics. I want accutane but I feel it will be a struggle to get her to prescribe it to me. Every time I bring up taking something orally she prescribed me another topical cream. What's the big deal?

Doctor Answers 3

Isotretinoin and Prescibing

I prescribe this many time a day and have no problems with it.  I think its the best treatment that exists for acne, but I'm a cosmetic dermatologist who treats 100s of patients a month for scarring.  I suggest you see a cosmetic dermatologist who specializes in acne and acne scarring.  Best, Dr. Emer.

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews


Accutane (isotretinoin) is no longer made because, after multiple law suits, the original manufacturer stopped producing it. Other manufacturers picked up the ball and started producing it under several different names. Because of all of its side effects ( google "accutane side effects" so you can see the entire list), you should really consider oral antibiotics first. If your dermatologist refuses, I doubt she would ever prescribe isotretinoin. You should then consider seeing another dermatologist. The problem with oral antibiotics in women is that they can sometimes lead to vaginal yeast infections. However, if this does happen, it can be cleared up quickly with a quick dose of fluconazole(Diflucan).                             jlr

John Louis Ratz, MD
Lagrange Dermatologist


Accutane is an oral form of vitamin A. It reduces the amount of oil released by oil glands in your skin, and helps your skin renew itself more quickly. Accutane is used to treat severe nodular acne. It is usually given after other acne medicines or antibiotics have been tried without successful treatment of symptoms. Because it can cause severe, life-threatening birth defects, many doctors are hesistant to use it. Never use Accutane if you are pregnant or planning pregnancy. Women of child-bearing potential must agree in writing to use two specific forms of birth control and have regular pregnancy tests before, during, and after taking isotretinoin. Since their has been some links to depression, crohns disease, liver disease and other rare effects, many lawsuits have arisen in the USA which is another reason it is very difficult to give. Accutane is available only under a special program called iPLEDGE in the USA. Overall, in the right hands, it is a good medication and if used properly, it wll clear acne for life in 90-95% of cases. In your case, you will have to find a dermatologist who has experience with accutane and willing to precribe it for you. 

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 15 reviews

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