How do you qualify for a second round of Accutane as I want to ask about doing it again but I don’t know if I can or not?

Question

I've been on accutane before and it cleared my skin perfectly. But i started breaking out again about six months after stopping and i want to go on it again because i get cysts and scars. I don’t know how to ask my dermatologist because it isn’t as bad as before and i feel like it’s not severe enough for me to take it again.

Jason Emer, MD · Answer

talk to your physician I frequently do second rounds of accutane if needed. start at home peels and dermarolling 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 skin care 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 microneelding RF like intensif or fractora 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 tyou go to an expert who combines skin care, lasers, microneedling, PRP, and facials while on oral medications for acne.  Best, Dr. Emer.

Viktoryia Kazlouskaya, MD · Answer

I don` t know your sex, but if you are female you may try Spironolactone instead of Accutane. Hormonal acne relapses after accutane more often, and Spironolactone can be used after. It has very good safety profile and can be used for a long time. In general younger patients and men relapse more frequently.
If you want repeat accutane, and to answer your question correctly one needs to know more about the dosage that was used and if you have reached so-called cumulative (maximum recommended dose for a course). Some studies recommend actually treating few more months after remission is achieved to prevent recurrence. I use accutane for about 20 years and in my experience, indeed, longer duration of treatment gives best results. So, maybe you can even take it right now. Never afraid to ask your physician!!!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question. There is no set criteria indicating when a second course of isotretinoin therapy is recommended because it depends on each person and how severe there acne is and what other treatments were tried and failed. I highly recommend you consult with a board certified dermatologist regarding your acne and inquiring about treatment options that are appropriate for you, including another round of isotretinoin.  Take care and good luck.

How do you qualify for a second round of Accutane as I want to ask about doing it again but I don’t know if I can or not?

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