Why is Accutane not working 4.5 months into treatment?

Question

I am a 21 year old male, weigh 155lbs and am 4.5 months into my accutane course. My back has 100% cleared up but my neck and chest are still breaking out in cystic pimples. What am I doing wrong? I eat healthy, exercise, shower and wash my face twice a day, I'm taking the pills with high fat meals. I'm getting pretty depressed because I feel like it will never work. My dosage so far has been month 1: 40mg per day, month 2: 60mg per day, month3: 70mg per day, month 4: 80mg per day, month 5: 80mg per day.

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

Morris Westfried, MD · Answer

You can safely take up to 2 mg per kilogram or 140 mg per day. I would ask doctor to increase dose to 120 mg per day and stay on until totally clear for one month.

Tracy Leong, MD · Answer

Thank you for your question. Depending on the severity of your acne, it make take a higher dose and longer course (or sometimes multiple courses) of isotretinoin to completely stop breakouts. In some patients, I have them take doses of up to 120 mg daily if the side effects are tolerated. It may be that you need a higher dosage.Isotretinoin is an amazing medication for treatment of severe, recalcitrant nodulocystic acne that works when most other medications do not. Don't lose hope, but keep in mind it may take a higher dose and longer course of the medication to get clear skin.I hope this answer is helpful! Best of luck.

Why is Accutane not working 4.5 months into treatment?

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Why is Accutane not working 4.5 months into treatment?

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Everything you need to know about Accutane

Our mission is to create a world where every investment in modern beauty is Worth It.