I’m due to start Accutane. When should I come off Dianette?

Question

I’ve been on dianette for 2 0years but I still get cystic acne. Everytime I come off dianette my acne gets much much worse so I go back on it. I’m due to start accutane next month and I want to know if it’s better to come off dianette while I am on accutane. There is no chance I can get pregnant so I don’t need it for contraception. I am concerned that even if accutane completely clears my skin the acne will just come back as soon as I stop the dianette. I am 40 in a few months.

Anna Chacon, MD, FAAD · Answer

The relationship between hormone-based therapies like Dianette (a combination of an estrogen and an anti-androgen) and isotretinoin (Accutane) can be complex. Accutane is a powerful medication used to treat severe acne, while Dianette is often used to manage hormonal acne.
If you have been on Dianette for 20 years and still experience cystic acne, and your acne worsens when you stop Dianette, it suggests that your acne might be hormonal in nature. Accutane can be very effective for severe acne, but it may not fully address acne that is mainly driven by hormonal imbalances.
Continuing Dianette while on Accutane is generally considered safe, and it might help to manage any hormonal component to your acne while the Accutane addresses the more severe, cystic acne. However, this should be discussed with your healthcare provider.
If you are concerned about your acne returning after stopping Dianette, it might be worth discussing other hormonal management strategies with your healthcare provider.
Since you mentioned that there's no chance of getting pregnant, it's important to note that Accutane is known to cause serious birth defects and should not be taken by individuals who might become pregnant.
Remember, it's crucial to have these conversations with your healthcare provider, who can provide the most appropriate advice based on your individual circumstances.

I’m due to start Accutane. When should I come off Dianette?

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I’m due to start Accutane. When should I come off Dianette?

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