Treatment of hyperpigmentation while being on Accutane? (Photo)

Question

I’ve been struggling with acne since I was 10. I’ve taken multiple courses of accutane and I now decided to stay on a low dose regime (20 mg/week). It works great. I realized that I have bad hyperpigmentation. I don’t want to stop accutane as I really was depressed by my acne. I think the hyperpigmentation comes from not using sun protection. What options do I have to treat it while staying on accutane? Is laser an option as my dosage is only so low? Thanks for your help

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

Jason Emer, MD · Answer

​Hyperpigmentation of any kind needs a combination approach of peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly,; lasers like Clear + Brilliant, Aerolase or Laser Genesis; radiofrequency like Venus Viva; and constant skin care and sun protection. Bimonthly facials with SilkPeel DermalInfusion are essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. Hypopigmentation will need more of an evaluation and possibly additional lasers to get improvement. I suggest a formal consultation with an expert in lasers and peels. Best, Dr. Emer.​

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

I do believe the dose is low enough for either of these treatments.  However see your Dermatologist and have this option discussion.

Best of luck!

Treatment of hyperpigmentation while being on Accutane? (Photo)

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