Occasional Breakout While on Accutane

Question

Is it normal to still have the occasional breakout when I have been on Accutane for 2 1/2 months?  It happened once but I believe it happened because I was approaching my menstrual cycle. I'm just wondering whether this means that the drug isn't working.  Most of the time though, my skin is clear.

Melissa Chiang, MD, FAAD · Answer

It sounds like the medication is working if your skin is mostly clear. Accutane patients tend to see an improvement within 2 months of starting therapy. Breakouts may still occur, but pimples are less deep and go away faster. Sometimes, patients continue to get occasional new pimples after 4 or 5 months of therapy. Rest assured, your skin may continue to improve for several months after completing the medication. For patients with substantial breakouts, I would consider an extended course of accutane. Good luck.

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

Dina D. Strachan, MD · Answer

It is not unusual to continue to get breakouts while you are on Accutane. Remember, you will be on this drug for 5-6 months. It continues to work for a month after you stop taking it. 2 1/2 months into it you are not seeing its full effect. In my experience, some patients respond quickly and others don't respond until the last months of therapy. Be patient!

Don Mehrabi, MD · Answer

Thank you for your question.
It is very common to continue getting acne or an occasional breakout while on Accutane treatment. Accutane treatment courses generally last 6-7 months, and the truly beneficial effects are noted in the 3rd and 4th months. In regards to doses, Accutane is based on body weight and you may want to check with your physician to see if he is giving you approximately 1mg/kg body weight.  Also, you may want to try Yaz as your birth control to see if that helps minimize your breakouts.
Hope this helps!

Bryan K. Chen, MD · Answer

It is certainly common to have occasional acne while on Accutane.  It is also common to have occasional acne after a full course of accutane.  The most important factor that determines long-term success with Accutane is probably the cumulative dose of the medication taken for the entire course (should be between 120-150 mg per kg body weight). 
After your course of accutane, if you continue to develop acne around the time of your periods, you may benefit from "hormonal" treatments including oral contraceptives and/or spironolactone.
Good luck.

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