Retin-A didn’t work for acne. Going to go on Accutane, but am incredibly worried about permanent loss of libido or sex drive.

Question

Hello, I’m an 18 year old male and I’ve struggled with cystic acne for 6+ years. I’m seeing a dermatologist in the next month, but thought I’d ask this question to get other opinions. I think I’m going to go on accutane because my brother had incredible success with it, but I’m incredibly worried about permanent loss of libido or sex drive, I feel like I’d be suicidal if this were to happen. From everything you’ve experienced is this a common or somewhat common issue? Thank you for your time

Jason Emer, MD · Answer

Thank you for your question, acne scars need a combination approach for long-term improvement. Everyone has a unique pattern of acne scarring, and most people have various types of scars, so we create a tailored treatment plan for each patient. We often use:- Injectable fillers like Bellafill and Sculptra (with or without subcision) for atrophic, indented scars. - Subcision for depressed, tethered scars. - Vascular lasers like Yellow laser, Aerolase, excel V, or IPL for redness or thick acne scars. - Lasers such as Fraxel, Erbium, CO2 or fractional radiofrequency (Venus Viva, Skinfinity, Intensif microneedling RF) for textural issues and superficial scarring. - TCA CROSS and punch excision for deep ice pick scars and narrow box car scars. 
All lasers are combined with microneedling/PRP to improve the results and accelerate your healing time. Keep in mind that a personalized combination treatment by an expert physician will give you the improvement you're looking for. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  I would not expect accutane or generic isotretinoin to have any effect at all on your libido or sex drive.   It is not a hormone in any way, and is basically just a special form of vitamin A that makes your skin very dry and helps clear up acne very well.  Women have to take birth control or be using 2 forms of birth control while on it so a fetus in the womb does not get exposed to the medication, but other than that, it has no bearing on sexual function or hormones.  Talk to your dermatologist about your concerns, and they will help you feel more comfortable with the medication. I hope you have wonderful success and clearance of your acne

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hello and thank you for your question. Common side effects of isotretinoin (or Accutane) include dryness of the skin, fatigue, and muscle pain. Less common side effects include hair loss and headaches. Accutane is an effective treatment for nodular, cystic acne. Thus, I recommend a consultation by a board certified dermatologist for evaluation of your skin and discussion of appropriate treatment. Best of luck.

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