Low dose Accutane and hair loss

Question

I have taken 2 courses of accutane- both with 30mg for 2 months, then 60mg for 6 months. The second course was mainly to address oily skin, but it came back. I want to do 20mg weekly indefinitely for my oily skin. The only issue I had during both courses was hair thinning at 60mg daily towards the last 4 months. Is this a cumulative effect or a higher dose effect? If I do 20mg weekly for my oily skin, will I experience hair thinning? Please help!

Jason Emer, MD · Answer

You seem to be on too low of a dose. Start lasers in office, dermarolling, and peels like AERIFY at home now (see link).

All of my Accutane/isotretinoin/acne patients do our Accutane protocol from emeragecosmetics.com (where we do free skincare consults daily) and peels like aerify/cosmelan/enlighten.
Acne requires a combination approach to get long-term improvement.  For all patients on isotretinoin, we require them to be on skincare such as vitamin C (Skinceuticals Phloretin CF, EmerageSkin AOX-C), glycolic cream (Jan Marini bioclear, EmerageSkin enzymatic polish), kojic acid serums (Skinceuticals phytoplus), and hyaluronic acid serum (IS clinical hydra cool serum, Skinceuticals B5, EmerageSkin hyla B) in the morning and retinols  (reve skin 1.0 and sente biocomplete serum) and salicylic acid (reveskin acne purifying enhancer), growth factors and peptides (anetageMD, EmerageSkin Re-Fit Face/Eye) night.   
All of our patients get clear+brilliant non-ablative laser along with a microsecond YAG laser such as aerolase or laser genesis and microneedling with PRP or microneedling RF like intensif or fractora or pixel8 monthly to help improve breakouts, speed the healing process, and improve scarring and facial redness while on the isotretinoin/Accutane.  LED light therapy, cosmelan/enlighten/AERIFY peels, salt facial, or dermalinfusion can be done as well to speed up the improvement. I suggest you go to an expert who combines skincare, lasers, microneedling, PRP, and facials while on oral medications for acne.  Best, Dr. Emer.

Viktoryia Kazlouskaya, MD · Answer

The correct answer may be more complex. Yes, hair loss IS dose-dependent, and you have a higher chance to keep your hair with the lower dose. But it still can happen. However, you mentioned hair thinning, so I would be sure you have no underlying androgenetic alopecia, that may be a separate issue, so you can get treated for it together with taking Accutane. Get your hair examined by a specialist!Also, taking medicine for just oily skin is a bit questionable practice. I had a few patients who were taking it for skin texture and very mild acne for a very very long time (a few years), and even 10mg was enough. However, you need to be monitored regularly. Once in a while with blood tests and pregnancy tests if appropriate (sorry, not sure what is your sex). There are other options now to suppress oily glands, you may try photodynamic therapy or Aviclear, regular laser procedures for skin texture are also safer than being on Accutane forever. I hope this helps....all the best.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question. In general, Accutane is not meant to be used long term as there are numerous side effects even with a low dose. There are topical medications that are effective for oily skin and safe to use long term. I highly recommend you consult with a board certified dermatologist regarding appropriate treatment that best suits your needs.

Low dose Accutane and hair loss

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Low dose Accutane and hair loss

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Everything you need to know about Accutane

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