Accutane or spironolactone for 47 year old female?

General information about Accutane (Isotretinoin) and Spironolactone, both medications are used for treating severe acne that doesn't respond to other treatments.

Accutane is a powerful drug that can cause significant side effects including dry skin, eye irritation, and in some cases, mood changes. It has also been associated with increased cholesterol levels. Accutane is typically used when other treatments have failed and it's usually taken for a course of 15-20 weeks.

Spironolactone is a medication that was initially used to treat high blood pressure and heart failure, but is now often used off-label for acne, particularly in women. It can cause high potassium levels, especially at higher doses.

In your case, it seems you have already been on Spironolactone for years and it has stopped working. The suggestion to increase the dose to 200 mg is something that should be discussed with your dermatologist and possibly a cardiologist, considering your slightly high potassium levels.

If your dermatologist is recommending Accutane, they have likely considered your overall health and believe that the benefits of taking this medication may outweigh the potential risks. It's important to have a thorough discussion with your dermatologist about the potential side effects and risks of each medication, and how they could interact with your existing health status.

In conclusion, both medications have potential side effects and risks, and the decision to take either should be made with your healthcare provider, taking into account your personal medical history, health status, and the severity of your acne.