Can I go on Accutane for the third time?

Question

What should I do if I have been on Accutane twice (together for more than 1.5 years) and I still have severe acne? I am female and I weigh 60kg. I have been on accutane for 1 year (20mg/day) and then the acne come back. Than, after half a year, I get back on accutane for 6 months (30mg/day), and very severe acne came back again immediately. Now I don't know what to do. I would like to take Accutane for the third time(this time a higher dose) and I want to know if that is even possible? Can I go on Accutane for the third time?

Amy Y. Paul, DO, FAAD · Answer

You can definitely repeat your accutane course, and may need to take a higher dose.  Some patients have very resistant acne and can tolerate a higher dose just fine.  I would estimate your total dose with your two previous courses to be lower than what you need.  If you follow the ipledge guidelines and have labs done periodically, you should be able to tolerate a higher dose, and I have found many of my patients do better on a third course because they are prepared for the dryness and need for strict sun protection.  Since you are a female, you might want to check with your dermatologist about maybe also adding spironolactone to your regimen, which will help with hormone management and the acne.  Best of luck!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Thank you for your question. Accutane (isotretinoin) dosing is based on an individual's weight, which is 1 mg per kilogram for a minimum of 4 months. But for severe acne, treatment may need to be increased. I highly recommend you consult with your dermatologist regarding any questions or concerns you have about treatment. Take care and good luck.

F. Victor Rueckl, MD (in memoriam) · Answer

For severe acne, you need to be on a higher cumulative dose. 20mg daily for one year is 7300 total mg, which is LESS than the very lowest level we recommend for MILD acne. 30mg daily for 6 months is 5475mg which again, still less. For severe acne you need more than 12000mg cumulative. Sometimes even up to 16000mg total. Your dosing is just not appropriate to treat your severe acne. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Can I go on Accutane for the third time?

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Can I go on Accutane for the third time?

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Everything you need to know about Accutane

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