Accutane for Acne Treatment
Find out if Accutane is the right option for your acne treatment
Dr. Michele Green is an internationally known specialist in acne scars removal and prevention in NYC. Accutane is an important medication in dermatology and an essential medicine in acne treatment and acne scar prevention. Accutane® has been considered the “last resort” when all other drugs or treatments have been ineffective for nodular acne or cystic acne. Its primary indication has always been for treating severe acne. However, Accutane has now been embraced by the American Academy of Dermatology to expand its recommendations to more than just nodulocystic acne, to chronic or recalcitrant acne papules and pustules. Many patients benefit from this medication, as it can prevent acne scarring in most individuals.
Accutane is the brand name for an oral medication called Isotretinoin, also known as 13-cis-retinoic acid. Since Accutane is a retinoid, it means that it is related to Vitamin A. It is an amazing treatment for acne patients when no other topical or oral medications, photodynamic therapy, lasers, or chemical peels have been effective in permanently curing acne. The newly expanded guidelines by the AAD will encourage more dermatologists and other healthcare providers to prescribe Accutane sooner and prevent needless physical and emotional acne scarring. While there has been controversy over Accutane over the past two decades, it remains the only treatment to “cure” severe cystic acne and prevent acne scarring.
Inflamed and irritated acne that goes left untreated has the potential to create permanent acne scars that can be even more difficult to treat than the acne lesions themselves. To best manage an acne breakout and prevent the development of acne scars, it is vital to meet with a board-certified dermatologist, like Dr. Michele Green in NYC, who can accurately and effectively treat your acne. Dr. Green is an expert in the field of cosmetic dermatology, with over 25 years of experience treating some of the most discerning men and women in the world. Dr. Green takes the time to thoroughly understand the unique concerns, needs, and goals of her patients to deliver phenomenal, long-lasting results. During a consultation with Dr. Green, a personalized treatment plan will be established that is tailored to suit your skin type, tone, and condition. The result will be a clear, smooth, beautiful complexion, leaving you looking and feeling like the absolute best version of yourself.
23 year old woman treated for acne with Accutane – 3 months
What is Accutane?
Accutane is the trade name for isotretinoin, an oral medication commonly prescribed to treat acne. Brand names of isotretinoin include Absorica, Amnesteem, Claravis, Myorisan, and Zenatane. Accutane is a vitamin A derivative and belongs to a class of drugs called retinoids. It is a naturally occurring product and, therefore, easily processed and excreted from the body. In high concentrations, it is extremely effective in treating acne. Its potency is very effective in clearing all types of acne breakouts, such as whiteheads, blackheads, cysts, and nodules. A buildup of sebum, and bacteria causes acne and debris in the pores which can get clogged, inflamed or infected.
Accutane treats acne by decreasing sebum or oil production by the sebaceous glands and destroying acne-causing bacteria. Accutane is a life-changing medication that can treat moderate to severe acne that has failed to respond to other treatments such as topical and oral antibiotics, topical tretinoin, and over-the-counter acne products such as salicylic acid, glycolic acid, and benzoyl peroxide. In the past, Accutane used to be considered a “last resort” treatment option when all other treatments had failed. However, Accutane is now a very commonly prescribed medication to treat all types and severity of acne and prevent future acne breakouts and new acne scars from forming.
How does Isotretinoin work as an acne treatment?
The exact mechanism of isotretinoin is not entirely known. Still, it is believed that its mechanism of action induces apoptosis, or programmed cell death, in certain body cells such as the sebaceous glands. By inducing cell death of sebaceous glands, and reducing oil gland production, the inflammation, and bacteria that live in the follicle are reduced. This process allows the skin to heal and blocks the formation of new acne lesions.
In addition to apoptosis, isotretinoin reduces sebum production and has an antimicrobial effect on certain bacteria that live in acne vulgaris. Accutane also reduces the size of the sebaceous glands themselves. Isotretinoin also increases the rate of skin cell turnover. This medication makes the dead skin cells that are sloughed off less “sticky” therefore, less inclined to form comedones (blackheads and whiteheads). These various mechanisms of action work in unison to create a more permanent “cure” for cystic acne.
How does Accutane treat severe acne?
Accutane provides patients with a clear, healthy, blemish-free complexion. Not only does Accutane help manage acne vulgaris breakouts by reducing oil production and killing acne-causing bacteria, but it also plays a role in preventing acne scars from forming. Accutane effectively combats all types of breakouts, whether it be cysts, nodules, pustules, pimples, whiteheads, or blackheads.
What is Accutane used for?
Accutane treats all types of acne that are persistent against other treatments, such as oral and topical antibiotics. Accutane, also known as isotretinoin, is an oral medication that decreases sebum production. Acne is caused by a buildup of sebum, bacteria, dirt, and debris that clogs the pores and causes an infection and inflammation. Accutane not only helps treat current acne breakouts but also prevents future breakouts and new acne scars from forming. Many patients report that their acne was permanently cured after completing their course of Accutane, or at the very least, acne-free for many years after.
What is the treatment process for Accutane?
The first part of the treatment process entails scheduling a consultation with Dr. Michele Green in her private New York City office. You will discuss your current skin condition and assess if Accutane is the best course of medication for you. A thorough review of all past medical history is performed, including any hormonal changes or family history of acne or other skin issues. While Accutane used to be relegated to simply treating only severe acne cases, its usage has expanded to treat much milder, chronic, or recalcitrant cases of acne.
The complete course of Accutane is typically five months, and patients must sign up for the iPLEDGE program to receive their medication directly from the pharmacy. Patients with cystic or recalcitrant acne first need to consult with Dr. Green to see if Accutane is the best course of treatment for them. Dr. Green will conduct a thorough review of your medical and surgical history, medication history, and past acne treatment to see if you are a good candidate for Accutane. Dr. Green will order a complete metabolic profile and other blood tests, including hormonal tests, to ensure that there are no liver abnormalities, hormonal irregularities, or anemia. Women are required to have two negative pregnancy tests before they are allowed to begin treatment. In addition, women are asked to use birth control, or abstain from sex, during these five months. Since Accutane can cause permanent birth defects in a fetus of pregnant women, female patients are advised to use two different forms of birth control while taking Accutane (i.e., birth control pills and male latex condoms).
The dosage of Accutane is based on the weight of the patient. The dosage is generally between one to two milligrams per kilogram per day, based on weight, and may be taken once or twice a day with food. Many patients notice immediate improvement within the very first month while taking Accutane. A very small subset of patients notices an increase in acne breakouts during this first month. Gradually, over the five months, the dosage is increased to ensure that there are no new acne breakouts. The maximum dosage given for Accutane is 2 mg/kg of body weight per day. Over 95% of patients respond to Accutane and suffer no further acne breakouts after completing their five-month course of medication. All generic versions of isotretinoin use the same dosing calculations.
Male treated for acne with Accutane – 6 months
Of the 5% of patients who do not clear after five months, 50% of these patients are completely clear after the second course of Accutane. There is a small percentage of patients who require a small maintenance dosage of Accutane to keep their skin clear of acne breakouts. 95% of patients clear completely from their course of Accutane and only have occasional pimples afterward.
While on Accutane, monthly blood tests are required to monitor liver enzymes, white blood cell count (WBC), and red blood cell (RBC) counts. Women are required to have monthly negative pregnancy tests via blood tests or urine tests. Accutane is controlled through the government-run iPLEDGE program. All blood tests and birth control methods must be documented and updated monthly in the iPLEDGE® system to prescribe Accutane for each patient.
The cost of Accutane depends on several factors. The cost of the prescription medication varies depending on which pharmacy you use to obtain the medication. In addition, monthly blood tests and examinations may be covered by your health insurance, but it is important to consult your policy to determine benefits and eligibility.
Does Accutane work to treat severe acne?
Yes! Accutane is extremely effective in treating all types of acne. It has a high success rate of nearly 90% on average for those who complete the 5-month course. About 50% of people who take Accutane report not needing to treat acne again afterward. Of the 5% of patients who do not clear after 5 months, 50% of these patients are completely clear after the second course of Accutane. Accutane will not only treat the existing acne breakouts, but it will also prevent acne scars, which are difficult to get rid of, from forming in the first place. When Accutane is prescribed by an experienced dermatologist like Dr. Michele Green and it is taken as directed, it is an amazing medication to treat or completely get rid of acne breakouts.
How long do you take Accutane to treat acne?
Generally, a course of Accutane is five months but can range from four to six months depending on the individual’s progress. Some patients require a second course of Accutane, which will be an additional four to six months. Some healthcare professionals may prescribe a low-dose, low-frequency regimen for Accutane as an “off-label” treatment. This means that the FDA has not studied the risks associated with taking Accutane at a low dosage for a long time. Therefore, the use of long-term, low-dose use of isotretinoin is typically not recommended.
What are the most common side effects of Accutane (Isotretinoin) therapy?
- Dry skin, peeling skin
- Dry lips (cheilitis)
- Dry Eyes
- Skin peeling
- Sun sensitivity (sunscreen use is important while on Accutane)
- Joint pain
- Gastrointestinal (GI) side effects
- Mood changes
- Night vision changes
- Hair thinning
- Allergic reactions
- Potential acne flare-up
17 year old treated for acne with Accutane
How to treat or prevent some of the common side effects of Accutane?
The most common side effect of Accutane is dry skin, and Dr. Green will encourage you to use moisturizers or cortisone creams if the dryness is severe. Lip dryness, which has been associated with isotretinoin use, can also be treated with emollients. Some patients suffer from dry eyes, and it daily use of saline eye drops helps correct this problem. Your skin will be very sensitive to the sun, so strict sun avoidance and tanning machines are also imperative. Daily sunscreen use of SPF 50 or higher and proper sun protection are essential while taking isotretinoin and being outdoors.
What are the potential laboratory abnormalities from Accutane?
- Increased sedimentation rate (ESR)
What are the potential nervous system side effects of Accutane?
- Benign intracranial hypertension
- Blurred Vision
What are the Gastrointestinal (GI) side effects of Accutane?
- Inflammatory bowel disease
- Ulcerative colitis
- Inflammation of the pancreas or Pancreatitis
- Stomach pain
- Increased cholesterol and triglyceride levels
- Elevated liver function
- Yellowing of your eyes or skin from jaundice
- Severe diarrhea or rectal bleeding
Mental Health Side Effects of Accutane
- Increased anxiety
- Suicidal thoughts
- Other mental health problems
Musculoskeletal Side effects of Isotretinoin
- Myalgia (muscular pain)
- Arthralgia (joint pain)
- Premature epiphyseal closure of the growth plate
- Hyperostosis changes (excessive bone growth)
Teratogenicity and Accutane
Accutane is a teratogen that causes serious side effects, specifically severe birth defects if the medication is taken during pregnancy or for a short time before conception. Isotretinoin is classified by the FDA as a Category X medication and is strictly contraindicated during pregnancy. Taking Isotretinoin while pregnant can harm the unborn baby and cause birth defects, including hearing and visual impairment, missing or malformed earlobes, abnormalities in brain function, and facial dysmorphism. It is also advised not to breastfeed while taking Accutane. Since Accutane may pass during breastfeeding, you should discontinue doing so while on this medication.
Drug interactions with Isotretinoin
It is advised to discontinue Tetracycline antibiotics, Doxycycline, or Minocycline while taking Isotretinoin (Accutane), as this can contribute to the development of benign intracranial hypertension. Symptoms of this syndrome are a headache behind the eyes, ringing in the ears, and vision disturbances.
It is also important to discontinue phenytoin (Dilantin) while taking Isotretinoin, as this can cause bone loss and weakening of bones. It is very important to completely read your medication guide while taking Accutane.
32 year old treated with Accutane – 6 months
Is Accutane dangerous?
No. Accutane is not dangerous if prescribed and taken correctly. The most common, mild side effects include dry lips, dry eyes, and dry nose that are temporary and alleviated by Vaseline or Aquaphor. However, Accutane can cause serious birth defects, miscarriage, premature birth, or stillbirth if the person becomes pregnant while taking it, which is why there is a strict protocol in place to prevent pregnancy in anyone taking Accutane. Additionally, Accutane, when ingested, is filtered by the liver, so it is important to avoid alcohol consumption to prevent any damage to the liver. (The liver also processes alcohol). The dosage of Accutane will be monitored by the prescriber, like Dr. Michele Green, and carefully monitored to ensure that there is no increased risk of Vitamin A toxicity or unwanted side effects.
How long does it take to clear acne with Accutane?
Typically, a full treatment course of prescribed Accutane takes 20 weeks or roughly five months. Most patients will start to see an improvement in their acne breakout within one to two months of beginning the treatment, though patients should be advised to continue treatment for the duration of the prescribed length of time. At the end of the 20-week treatment period, 95% of patients see their acne fully cleared. However, some patients may require an additional 4-6 months of Accutane treatment to achieve the best results. When you have finished your initial five-month treatment period, you should return for a check-up appointment with Dr. Green. She will examine the treatment area and recommend whether treatment should be continued.
How long does Accutane acne treatment last?
Accutane acne treatment is a long-lasting or permanent treatment option for patients suffering from severe acne breakouts. Following the 16-20 week treatment course, 95% of patients will see a full reduction of acne nodules on the treatment area, and for the remaining 5%, most require only to continue the treatment for another 16-20 weeks. Studies have found that younger recipients of Accutane acne treatment are more likely to have a relapse in acne breakouts than older patients. If a relapse of acne should occur, patients may return to their healthcare provider to receive another round of Accutane treatment.
Can Accutane make you tired?
Although it is not a common side effect, Accutane does have the potential to cause feelings of tiredness and fatigue. If you experience increased feelings of tiredness while taking Accutane, alert your provider, who can make any necessary adjustments to your prescription.
Does Accutane cause hair loss?
Hair thinning and hair loss are potential side effects that can occur when taking Accutane. In part, these effects develop because Accutane decreases the size of sebaceous glands in the skin, including the scalp. This can be very drying to both skin and hair. This can cause the hair to become brittle and make it more susceptible to breakage. However, this type of hair breakage can be mitigated by using deep conditioners and gentle shampoos.
Hair loss that results from taking Accutane is only temporary and should fully resolve on its own once Accutane treatment is concluded. If your hair is slow to grow back after finishing your prescription for Accutane, let Dr. Green know. Topical hair treatment serums, topical minoxidil (Rogaine), oral supplements like Nutrafol, and in-office procedures like Platelet-Rich-Plasma (PRP) injections may help to speed up the regrowth process. Dr. Green will be able to evaluate your hair condition and recommend the best combination of treatments for your situation.
Does Accutane cause weight gain?
No! Weight gain is not one of the potential side effects of taking Accutane. Additionally, Accutane does not cause weight loss. Weight changes have not been linked to Accutane.
Does Accutane get rid of blackheads?
Accutane was a treatment reserved for severe cystic and nodular forms of acne. However, its use has been expanded for the treatment of all kinds of recalcitrant acne that have not been able to be effectively resolved with other oral or topical medications. Accutane combats different causes of acne, including clogged pores, acne-causing bacteria, excess oil production, and skin inflammation. These qualities of Accutane make it an effective treatment for all types of acne, including blackheads and whiteheads.
Skincare while taking Accutane
Accutane causes the skin to be more photosensitive and also commonly causes dryness. It’s imperative that while on Accutane, a rich, non-comedogenic moisturizer and broad-spectrum SPF are both used. These two skincare products will help to nourish the skin and replenish moisture as well as negate the negative effects of the sun’s harmful UV rays, respectively. While some well-known acne-fighting ingredients include retinoids, alpha hydroxy acids, benzoyl peroxide, and salicylic acid, these ingredients can be far too irritating for patients who are taking Accutane. While on Accutane, one should avoid using skincare products that contain these ingredients. Instead, individuals taking Accutane should stick to a skincare regimen that is gentle yet effective to keep their skin looking and feeling healthy and well-moisturized without exacerbating any acne or dryness.
Non-comedogenic products containing gentle and hydrating ingredients should be included in the skincare routine of someone who is acne-prone and taking Accutane. There are many different products available for treating acne, and it can be a challenge to find what works best for you. Knowing your skin type is the first and most important step in determining which products and ingredients will benefit you most. For acne-prone skin, it’s generally recommended to use a gentle cleanser twice daily without intense scrubbing. Scrubbing skin too aggressively can exacerbate skin irritation and worsen inflammation. Cleansers that are meant to treat acne usually work by gently exfoliating the skin, sloughing off dead skin cells, and reducing the presence of bacteria and oil that are causing acne. Dr. Green has carefully formulated the Gentle Cleanser from her MGSkinLabs, Inc. line to give patients a way to retain skin moisture while effectively cleansing the skin. This cleanser is perfect for daily use and gentle enough for those who are very dry and sensitive, as one may be while taking Accutane.
Applying a lightweight, oil-free, non-comedogenic moisturizer is essential for patients who are taking Accutane. Accutane reduces the amount of oil produced in the skin, which contributes to the moisturization of the skin. It’s always important to keep the skin hydrated to maintain skin health, especially so when using a drying medication such as Accutane. The Ultimately Sheer Hydrating Lotion from Dr. Green’s MGSKINLABs is designed for sensitive and acne-prone skin, making it the perfect moisturizer for patients on Accutane. The lotion is enriched with aloe and rosewater and never leaves behind a greasy feel as some hydrating lotions do.
Using a broad-spectrum SPF while treating acne with Accutane is a non-negotiable skincare step. Accutane can make the skin extra sensitive to sunlight, potentially worsening the appearance of the acne, exacerbating the breakout, and resulting in dark marks where there are acne lesions. Dr. Green recommends a physical sunscreen incorporating ingredients such as zinc oxide or titanium dioxide that sit atop the skin and act as a physical barrier against the sun’s rays. Dr. Green’s SPF 50 Advanced Formula Broad Spectrum Sunscreen is a great option for sun protection, especially when on Accutane. To ensure proper coverage, apply 15 minutes before sun exposure and reapply after swimming, with excessive perspiration, or anytime after towel drying. Also, sunscreen should be reapplied every 1.5-2 hours for best sun protection while exposed to direct sunlight.
Can you drink alcohol on Accutane?
Since Accutane is absorbed and metabolized in the liver, it is not advisable to drink alcohol during your entire course of treatment. Drinking alcohol can elevate your liver enzymes, and this interaction could potentially damage your liver. Drinking alcohol while taking Accutane can cause possible side effects of permanent liver damage. It is liver metabolism that makes taking certain medications, which get absorbed by the liver, not advisable taking Accutane.
Female, Acne treatment with Accutane, 3 months
What procedures should you avoid on Accutane?
Accutane is a photosensitizing medication, so it is best to use a high SPF daily and avoid the sun while on Accutane. Since Accutane delays wound healing, you should avoid cosmetic procedures such as dermabrasion, exfoliation, plastic surgery, chemical peels, laser treatment for acne scars or tattoo removal, laser hair removal, or waxing. Since the effects of Accutane can stay in your system after the course of medication is complete, you should avoid ablative laser treatments, such as the Fraxel® laser, for at least one year from the completion date of the medication.
When planning any acne scar treatment after the course of Accutane is completed, it is imperative to consult an acne scar expert, like Dr. Green, to determine the best laser treatment and waiting time necessary after the course of Accutane is completed. Generally, dermal injections of Restylane®, Sculptra®, or Juvederm® can be done while a patient is still on Accutane. Radiofrequency lasers (RF), such as Vivace and eMatrix® laser, must wait at least six months after completing Accutane therapy. Microneedling® with PRP.
When does Accutane start working as an acne treatment?
Most patients notice an immediate improvement in their skin in just the first month of taking Accutane. Over the next five months of treatment, the dose of Accutane is gradually increased to ensure that there are no new breakouts. The maximum dosage of Accutane prescribed is 2 milligrams per kilogram of body weight per day. Over 95% of patients respond well to Accutane treatment and suffer no further acne breakouts after completing their five-month course of medication. All generic versions of isotretinoin use the same dosing calculations. Of the 5% of patients who do not clear after five months, 50% of these patients are completely clear after the second course of Accutane.
28 year old female, acne treatment with Accutane – 1 month
Is Accutane safe to treat acne?
Although there are many potential side effects, Accutane is an entirely safe medication. Isotretinoin needs strict monitoring under a doctor’s supervision for potential side effects. A controlled dosage needs to be followed by prescribers, as a dosage that is too high can result in toxicity resembling vitamin A toxicity.
There have been several FDA warnings about the risk of buying Accutane over the internet. Since Accutane is a complex medication with numerous side effects, you should never initiate treatment on your own without the medical advice and guidance of a board-certified physician like Dr. Michele Green in NYC. An experienced dermatologist must monitor you for possible adverse effects and administer the appropriate dosage to avoid serious health problems.
Is Accutane safe for everyone?
Accutane is a treatment that is safe for most patients to undergo. The biggest exception is that Accutane is not safe for patients who are pregnant or breastfeeding, as Accutane can lead to serious birth defects and developmental abnormalities in babies. For that reason, the FDA requires female patients who are capable of becoming pregnant to take a monthly pregnancy test while on Accutane. Accutane should also be avoided for patients who are taking the following medications, as the drug interactions can be dangerous: Tetracycline antibiotics, Doxycycline, Minocycline, and Phenytoin. Further, alcohol consumption should be avoided while taking Accutane. Studies have shown that Accutane is fully safe to be consumed at full dosage for patients with the following conditions: Crohn’s Disease, Diabetes Mellitus, epilepsy, Spina Bifida, and Ulcerative colitis. Patients with the following conditions are unlikely to experience any adverse effects of Accutane related to their condition so long as the dosage is smaller, to begin with: Chronic Renal Failure, Renal dialysis, Immunosuppression, manic depressive psychosis, motor neuron disease, and multiple sclerosis. During your initial consultation with Dr. Green, be sure to disclose any medical history to ensure that it is safe for you to begin Accutane treatment.
What is the iPLEDGE Program for Accutane?
The iPLEDGE Program was initially initiated in 2005 and encompassed all FDA-approved isotretinoin. iPLEDGE is regulated by the gov U.S. food and drug administration. The goal of the program is to prevent birth defects and ensure proper monitoring and prescribing of Isotretinoin. There is a centralized system for physicians, pharmacists, and patients to manage the medication and minimize any potential risks.
Women of childbearing potential who participate in the iPLEDGE program to take Isotretinoin therapy for recalcitrant cystic acne must have two documented negative pregnancy tests before the medication can be prescribed. They must also sign an agreement to use two forms of contraception or maintain abstinence during the period they are taking Isotretinoin. Birth control pills are considered an excellent method of pregnancy prevention while on Accutane. The combination birth control pill is recommended since it contains both estrogen and progesterone, not the mini-pill. Monthly negative pregnancy blood tests are required for all women to continue with Isotretinoin for the entire period they are on the medication.
Monitoring of liver enzymes and a complete blood count are necessary both before the start of Isotretinoin treatment and at monthly intervals. It is important to complete these monthly liver function blood tests, and blood chemistry, including triglycerides, to ensure that you have any unwanted side effects from Accutane. Women must have a negative pregnancy test completed monthly while taking Accutane.
Why was Accutane discontinued?
In 2002, the original makers of Accutane, Roche Pharmaceuticals, discontinued the manufacture of Accutane when the patent expired. They discontinued manufacturing Accutane for business reasons: the influx of numerous cheaper generic medications now available and the cost of defending personal injury lawsuits brought by some people who took the medication. Accutane is now available again in pharmacies with a prescription from a physician. Accutane is also available in the United States through the generic version (isotretinoin) or other brand names such as Absorica, Amnesteem, Claravis, Myorisan, and Zenatane.
What brands of Isotretinoin are currently available?
As of 2017, the following brand names are available for Isotretinoin in the United States:
These newer generic medications should be taken with food, especially with high-fat meals. It is important to take the drug with a high-fat meal to ensure its absorption and to make sure that you are receiving the correct dosing of Isotretinoin. The brand Absorica uses technology that incorporates fats in the actual capsule to make sure that the correct dosage of medication is delivered to the patient. Twice daily dosage may be better than a once-a-day dosage to help with continued absorption of Isotretinoin.
Accutane is the only “cure’” that currently exists for recalcitrant acne. While it is a “miracle” drug for many patients, it has many possible side effects. A board-certified dermatologist must be monitoring you during this treatment. Dr. Michele Green has been prescribing Accutane for over two decades with excellent treatment results and the prevention of acne scarring.
Does insurance cover Accutane?
Your health insurance may cover the cost of Accutane. Before starting Accutane, it is important to consult your health insurance provider regarding your policy to determine complete benefits and eligibility.
How much is Accutane?
The price of Accutane varies depending on your insurance coverage. It is highly advised to contact your health insurance company before starting Accutane to determine whether Accutane is covered under your specific plan and if there are any out-of-pocket costs associated with the medication.
Does Accutane heal acne scars?
Acne scars are formed when the pores become clogged with bacteria, dead skin cells, and sebum, and the bacteria start to multiply and cause inflammation. The inflammation causes trauma to the surrounding tissue, breaking down the skin and destroying collagen. The inflammation stimulates the skin to begin its healing process by producing more collagen. Collagen is the protein responsible for the skin’s structure. When too little collagen is formed, you will see depressed acne scars (atrophic scars) characterized by pits that form in the skin. When too much collagen is formed, you may have raised acne scars in the form of keloids or hypertrophic scars.
In general, acne that causes acne scars tends to be cystic because it is infected and more inflamed than whiteheads or blackheads. Accutane works by minimizing the oil glands in the skin and directing the growth of new skin to prevent the buildup of these clogged pores. These positive effects can also help to combat the development of acne scars by reducing the amount of inflammation and the severity of the acne breakouts. Accutane helps to eliminate any existing acne and prevent new acne breakouts from forming, allowing the skin to heal.
After completing Accutane therapy, once your acne breakouts are under control, residual acne scarring may be visible. While one may be eager to start treating these acne scars immediately, it is important to wait the prescribed amount of time upon completing the course of Accutane. Cosmetic procedures such as dermabrasion, exfoliation, plastic surgery, lasers, laser tattoo removal, laser hair removal, and waxing should be avoided during treatment and for several months afterward. Since the effects of Accutane can stay in your system after the course of medication is completed, you should avoid ablative laser treatments, such as Fraxel, for at least one year from the date of completion of the medication. To establish a plan for treating your acne and residual acne scars, schedule a consultation with an expert, like Dr. Michele Green in New York.
Can you treat acne scars while on Accutane?
Accutane works well to treat active acne breakouts, which serves to prevent the formation of acne scars. Suppose you have acne scars that have formed previously and would like to eliminate them. In that case, it is safest to wait until after the Accutane treatment has been fully completed before beginning treatment for acne scars. Some of the most effective acne scar treatments include chemical peels, dermal fillers, the eMatrix laser, the Fraxel laser, and the VBeam laser. While on Accutane, however, the only acne scar treatments that are safe to perform would be the VBeam laser treatment and dermal filler treatment. For chemical peels and the eMatrix laser, patients should wait for six months before receiving this treatment, whereas for the Fraxel laser, patients should wait for one year.
How to treat acne scars while on Accutane
Acne scar prevention is one of the major benefits of Accutane treatment. However, some patients wish to eliminate the appearance of acne scars that have formed before while on Accutane. As the active acne breakout begins to fade while on Accutane treatment, previously formed acne scars may become more noticeable on the skin. Two acne scar treatments can be performed while a patient is currently taking Accutane: VBeam laser treatment and dermal fillers. The VBeam laser is a gentle laser that is ideal for patients with sensitive skin that works to decrease the discoloration and redness of acne scars and can also help decrease the prevalence of P. Acnes bacteria responsible for active acne breakouts. The VBeam laser treatment works best when performed in a series of five treatments spaced approximately four weeks apart. Dermal fillers, such as Restylane, Sculptra, and Juvederm, can also be used while a patient is taking Accutane, and are best for filling in the depressions of atrophic acne scars. Atrophic, or depressed, acne scars form as a result of an insufficient amount of collagen during the healing process, which leaves intents in the surface of the skin. Dermal fillers can be injected into these depressions to fill in the lost volume for smoother skin.
How to get Accutane for acne treatment
Accutane is available by prescription only. To get Accutane, the first step is having a consultation with a board-certified dermatologist like Dr. Green. With Dr. Green, you will discuss your current skin condition, and she will assess if Accutane is the best course of treatment for you. A thorough review of all past medical history is performed, including any hormonal changes, family history of acne, and your previous methods of acne treatment. A complete metabolic profile, among other blood tests, is then sent to the laboratory to ensure that there are no liver abnormalities, hormonal irregularities, or anemia. Women are required to have two negative pregnancy tests before they are allowed to begin treatment. In addition, women are asked to use birth control, or abstain from sex, during these five months. Since Accutane can cause permanent birth defects in a fetus of pregnant women, female patients are advised to use two different forms of birth control while taking Accutane.
Participation in an online program called iPLEDGE is required to receive an Accutane prescription. All patients must be registered with iPLEDGE to get their prescriptions from the pharmacy. Dr. Green will provide you with an identification number that you will use to access the iPLEDGE program and fill your prescription. Additionally, before you start taking the medication, you must sign an informed consent sheet acknowledging that you understand the risks associated with taking isotretinoin.
A follow-up visit with Dr. Green is required once a month while you are taking Accutane so that your progress may be evaluated and your condition, including any side effects you may be experiencing, may be discussed. During each monthly visit, a set of blood tests are sent to the lab, including a pregnancy test if you are a woman who can become pregnant.
Is Accutane worth it?
Yes! Accutane is worth it. Most patients who have taken Accutane only have one regret: not taking it sooner! Dealing with acne can be exhausting as you try the countless over-the-product acne products, even trying various topical and oral antibiotics prescribed by a physician to no avail. Acne can cause self-esteem issues and even lead to depression, and it, unfortunately, does not end there for most people. Even if your acne is under control and you don’t get any more breakouts, you may deal with stubborn acne scars that are permanent and hard to get rid of. For this reason, it is highly recommended to start Accutane as soon as possible to avoid acne scar formation if you are experiencing severe cystic acne.
Accutane – 6 months before and after
Is Accutane a good acne treatment?
Accutane is a highly effective acne treatment that can be used to cure even the most severe cases of cystic acne, as well as for moderate cases of any type of acne vulgaris. The oral medication works over 16-20 weeks to eliminate the active acne breakout found anywhere on the body and prevent the formation of acne scars. Accutane is a good option for any patient with acne that does not respond to usual methods of breakout reduction, including other oral medications, chemical peels, laser treatment, or photodynamic therapy. If you are struggling with stubborn acne, schedule a consultation appointment with Dr. Green to determine if Accutane is the best treatment option for you.
Is Accutane good for everyone?
Accutane works to eliminate acne breakout, and 95% of patients who take Accutane experience a complete reduction in acne within the first round of treatment. For patients who do not see a complete reduction within the first five months of treatment, Accutane treatment can be continued for another four to six months to achieve the best results. Less than 1% of all patients who receive Accutane require more than 12 months of therapy to achieve optimal results. Some patients should not begin Accutane treatment in the first place, specifically patients who are pregnant, breastfeeding, or wish to become pregnant in the next five months or patients who are currently taking tetracycline antibiotics, doxycycline, minocycline, or phenytoin. Should serious side effects occur, such as suicidal thoughts, severe gastrointestinal distress, excessive bone growth, joint pain, blurred vision, or other musculoskeletal issues, discuss with your healthcare provider about ceasing treatment.
What are some side effects of Accutane?
Accutane acne treatment results in some common side effects that can be fairly easily dealt with. As Accutane works to decrease sebum production, the treatment can lead to dry lips, which can be seen in 90% of patients, dry skin, which can be seen in 80% of patients, nosebleeds, which occur for 80% of patients, and dry eyes, which can occur for 40% of patients. Some patients may experience joint and muscle pain (15%), temporary hair thinning (10%), and sun sensitivity (5%). Dr. Green recommends the regular use of a moisturizer, eye drops, and sunscreen to combat these common side effects of Accutane treatment. There is also the potential for nervous system side effects, such as drowsiness, dizziness, and headaches, gastrointestinal side effects, such as nausea, stomach pain, pancreas inflammation, increased cholesterol, and elevated liver function, as well as mental health side effects, such as depression, anxiety, and suicidal thoughts. If the side effects of treatment become unmanageable, be sure to consult with Dr. Green.
How do I get Accutane prescribed?
Accutane acne treatment is a powerful treatment option that is prescription only, as the dosage has to be precisely measured for each patient’s body mass. Further, the iPLEDGE program for taking Accutane requires monthly pregnancy tests for those capable of becoming pregnant and blood tests. To get a prescription and set up the iPLEDGE program, you must start with an initial consultation with a board-certified dermatologist, such as Dr. Green. Together, you and Dr. Green will review your medical history as well as any medications that you are presently taking to determine if you are a good candidate to begin Accutane treatment. If Accutane would be beneficial for your situation, Dr. Green will then write you a prescription for the medication.
Who can prescribe Accutane to treat severe acne?
Accutane is not available over the counter, meaning that patients will have to receive a prescription to begin Accutane treatment. An experienced board-certified dermatologist, such as Dr. Michele Green in NYC, should only write accutane prescriptions. To begin your acne treatment process, start by scheduling a consultation with expert dermatologist Dr. Green.
Is Accutane the best acne treatment?
Accutane is one of the most effective acne treatments due to its ability to address all of the major factors that lead to acne breakouts at once. To start, Accutane can reduce the body’s production of naturally occurring oil called sebum, which can clog the pores and lead to the formation of acne. Further, Accutane influences the creation of comedones or the whiteheads or blackheads that form when the pore is clogged with sebum, dead skin cells, and other debris. By influencing the composition of the skin’s surface, Accutane creates an environment that is unsuitable for the formation of the bacteria known as P. acnes, which is responsible for the inflammation that can accompany acne vulgaris. The suppression of acne bacteria, reduction of sebum production, and reduction of comedones make Accutane one of the most effective acne treatments available.
Does Accutane cure acne permanently?
Accutane is a permanent or long-lasting solution for the most severe and persistent forms of acne. For 95% of all patients taking Accutane, five months is long enough to eliminate all active acne breakouts on the skin’s surface for a long time. Various demographic factors may contribute to whether or not a patient will experience a future acne breakout in the treatment area. For example, studies have found that younger patients are at a higher risk of relapse than older patients. Additionally, men with acne on their back and chest are more likely to experience a future acne breakout following Accutane treatment than women with mostly facial acne. If acne does return post-treatment, patients can return to Dr. Green’s office for another round of Accutane treatment or potentially for a longer-term, low-dose course.
Will Accutane get rid of acne forever?
Accutane acne treatment is the most effective treatment for eliminating stubborn, severe, persistent acne breakouts for anyone over the age of 12. Most patients will see their acne improve permanently following the Accutane treatment. If acne persists, Dr. Green may prescribe an additional round of treatment for optimal results.
How do I get started with Accutane for acne treatment today?
Acne is one of the most common medical skin conditions, with the American Academy of Dermatology reporting that over 50 million Americans are affected by some type of acne annually. Although common, active acne breakouts and the acne scars that may be left behind can induce feelings of self-consciousness and negatively impact one’s self-esteem and quality of life. There are many different types of acne, various underlying causes, and an abundance of acne treatment options, making it feel impossible to achieve clear skin when you’re attempting a DIY approach. If you are suffering from acne and scarring, and want a permanent solution, schedule a consultation with board-certified dermatologist Dr. Michele Green in her boutique New York City dermatology office. Dr. Green will conduct a thorough physical assessment and medical history to customize the best treatment protocol that is safe and effective for your skin.
Dr. Green is an internationally renowned expert in the field of dermatology with over two and a half decades of experience, providing her patients from around the globe with the best non-invasive treatment options, including for acne and acne scars. Castle Connolly, Super Doctors, The New York Times, and New York Magazine consistently identify Dr. Green as one of New York City’s best dermatologists for her dedication to her patients and expertise. Dr. Green takes a holistic approach to treatment, customizing the treatment plans for each patient to incorporate a unique combination of in-office procedures, specially formulated skincare products, and any necessary prescription medications that are best suited to addressing their specific skin concerns and achieving their aesthetic goals. To schedule a consultation with Dr. Green and get started with your acne treatment, please call 212-535-3088 or contact us online today.