Is Accutane appropriate for my condition?

Question

I’m a 43 year old woman who gets 3-4 cysts a year since I started Spironolactone 4 years ago. Spiro seems to be failing now and my dermatologist feels we have exhausted every type of topical and antibiotic options. She is encouraging Accutane. I am terrified of the purge process, but she feels my purge will only last about three weeks. All of my cysts have left pitted scars even though I leave them completely alone. I’m afraid of scarring. Also, I get permanent atrophy from steroids. Suggestion?

Raffy Karamanoukian, MD, FACS · Answer

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Viktoryia Kazlouskaya, MD · Answer

Accutane is excellent when used correctly. There are ways to deal with purge - start slow or add steroids at the beginning of the treatment. You may also use procedures for scar resurfacing during treatment with Accutane (we did not recommend this in the past but recent studies showed it is safe and may help quicker). Good luck!

Is Accutane appropriate for my condition?

Answers (2)