My Son Has Been on Accutane for 8 Weeks His Acne Has Gotten Much Worse.

Question

I'm afraid that the accutane has mad him worse and he may scar from it. how long does it take to start to see improvement? and how do you know if your acne will leave scars?

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

Tobi B. Richman-Steinhardt, MD · Answer

I see you've asked this question, mom, about 2 months ago, and by now, hopefully your son is much better. However, your question is an important one that other people may benefit from. Yes, in the beginning, Accutane can flare up the acne a bit. Most people improve by the end of the second month. But there is another type of flare to consider: a severe form of acne, rarely encountered, called Acne Fulminans. On rare occasions, starting Accutane brings out this type. It can cause a lot of new cysts, fever, and even aching joints. If it happens, a dermatologist should evaluate the patient, possibly stop the Accutane, and prescribe a course of oral steroids. Hopefully, in your son's case, it was just a simple flare, and he's on his way to looking good!

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

I tell my patients that often their acne will get worse before it gets better, especially on Accutane. However, the long term effects of Accutane are the best from any acne medication, in my opinion, especially for certain types of acne. As long as patients don't pick and pop their acne, it should not cause scarring. I suggest your son stay on the medication, even if his skin looks worse right now, because it will get better and better soon.

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