Is Accutane overkill for treating my moderate sebaceous hyperplasia on the sides of my face?

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

I would probably go ahead and work closely with your dermatologist to try a low dose of accutane . You are somewhat limited in your options due to the post inflammatory hyperpigmentation. Have you tried some light hyfercation with your dermatologist? You might have some good improvement with that sort of treatment, since the heat doesn't go very deep like a laser might. You could always have a few lesions treated with different settings on the hyfercator and then decide what is a good level for you to pursue. As far as the risk of bowel and liver effects from accutane, as long as you have regular labs and watch for symptoms, a low reasonable dose and course of accutane should not have any bearing on your IBS or liver. Another thing you might try is some microneedling, with or without radiofrequency energy. You shouldn't have to live with the bumps if they are a very big concern to you. Best of luck!