How long should I need to take Roaccutane?

I'm a 23 year old female, weighing around 57 kilos. I'm on 20mg of Roaccutane daily, taken in two separate doses (am/pm). How long will I need to be on roaccutane for? If I increase my dosage can I take a shorter course? My acne is not exactly severe, but it is persistent and it doesn't respond to other treatment. I'm asking because I've only been taking the drug for 4 days but already my skin is dry and itchy and cracking and I've suffered from eczema around my eyes all my life.

Doctor Answers 1

Accutane

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. As it dries out oil glands, patients experience severe dryness of their skin and mucous membranes including eyes and nose and mouth. 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.

The course of accutane is usually 4-6 months in dose ranges from 20-60 mg/day. The goal is to reach a 120-150 mg/kg dosage over the single 4-6 month course. The typical dose ranges from 0.5-1 mg/kg/day. This gives you a 90-95% success rate of clearing acne for lifetime. When starting accutane, you can get a flare of symptoms and you will start seeing results usually after 6-8 weeks. There is a 5-10% recurrence rate of  acne on accutane and courses can be repeated 2-3 times if needed after a 4-6 weeks break on the medication.

Overall, in the right hands, it is a great medication and if used properly, it will clear acne for life in 90-95% of cases. For the best results, please consult a board certified dermatologist with experience with severe acne.


Calgary Dermatologist
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.