I have very oily skin with enlarged pores, blackheads, and moderate acne. I currently control the acne and blackheads with an antibacterial facewash (containing Triclosan), twice-daily application of a 2% BHA exfoliant (pH 3.2-3.6) and nightly application of 2.5% Benzoyl Peroxide. I am considering undergoing a course of low dose Accutane (0.15mg/kg/day) to reduce oil production and control my acne. Is continued usage of my BHA permissable for general exfoliation purposes?
Daily Chemical Exfoliation While on Accutane?
Doctor Answers 3
When on Accutane your skin is exfolaiting
Accutane, isotretinoin, is a retinoid. Retinoids are powerful exfoliating agents. When you are on Accutane, there will be no need to use any other exfoliating agent. In fact, the use of other agents may cause irriation. If you are on a low dose, it may be tolerable, but definately discuss this with your treating dermatologist. Also, reconsider the daily triclosan wash. Although there is no definitive human data at the moment, there are some safety concerns about using this agent. There are certainly other options with respect to treating acne.
Exfoliation while on low dose Accutane
I want to address your use of triclosan as an antibacterial wash first. Triclosan is a photosensitizing agent, so it will make your skin more sensitive to sunlight. In addition there are animal studies that show that it may have some effects on the endocrine system as well. I would not recommend using triclosan as a cleanser whether you take Accutane or not. Accutane also makes your skin more sun sensitive.
Generally, I don't recommend exfoliation while on Accutane however it does depend on how dry and irritated your skin gets during the course of treatment. If your skin is not dry, then very gentle exfoliation should be OK.
Your skin is more sensitive and more easily damaged while on Accutane, so if you do continue exfoliating, drop the frequency to twice a week at first, then increase as needed. I would also just use one product initially.
Low dose Accutane primarily works while you are on it, with relatively rapid recurrence after the course is done. Normally Accutane doses of 1.0-1.5 mg/kg/day as an average during the course of treatment are required to achieve a more long-lasting remission from acne.
That low dose should make gentle exfoliation safe
I always recommend you discuss these types of issues with your treating dermatologist, but in general, this low dose of Accutane should make gentle exfoliation with salicylic acid safe.