Finished 30 days of accutane (10mg/day). Is there a wait time before continuing and should I increase my dosage?

Question

Male, 20, 121lbs, 5'11, . Been off accutane for around 2 weeks now and starting to get under-skin bumps around the hairline. Should I start taking accutane again? How long should the treatment last for me and is there a waiting time between short accutane courses or should I continue asap? Would a higher dosage be more suitable for me? Maybe moving on to 20mg?

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

J. Nicole Flandry Fussell, MD · Answer

In response to your concerns:
 Generally, goal dose is 120-150mg/kg. The treatment can be anywhere from 6-8 months, depending on how you tolerate the medication and weight. I would ask your provider to see what your ending "cumulative dose" was. It has been my experience as a dermatologist that some patients did not receive the appropriate dosing during their first course, and therefore need to repeat the medication. 
 I would recommend seeing a local provider for professional and appropriate care.

F. Victor Rueckl, MD (in memoriam) · Answer

Why did you only take it for 30 days? Accutane is about cumulative dosing. You need to get 8000-16000mg total into your system over a cumulative (daily) dose to be successful. Yes, you need more, and for a much longer time than 30 days! "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

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