Even if Accutane is prescribed in the middle of the recommended dose range, some patients still do not respond well. In these cases, the prescriber may need to increase the dose toward the upper limit of the dose range in order to achieve more effective results.
Oral dapsone could be an adequate and safe drug in severe acne, and it might also be a promising and hopeful alternative treatment for nodulocystic acne when isotretinoin fails.
Accutane "cures" about half of those people who take it so that they never need to do anything else for acne. In the first few weeks of treatment, about one in five patients gets a little worse, and one in 500 patients gets much worse. The rest either get much better, or better for a while.
This is usually due to purging, in which the isotretinoin pushes out dead skin cells and debris. Because your skin can become red and dry, the medication sometimes makes acne look more inflamed and obvious. My reaction was probably a combination of purging and irritation, but it eventually cleared up.
Answer: Accutane breakout
Continue on your regimen. Accutane doesn't simply stop working. Your pores are still changing and al that is coming out was going to continue giving you acne in the future so Accutane is just making it all come up and out. Stick with your regimen and keep going.
Stress and hormonal changes
For patients experiencing significant stress, even Accutane is not a cure-all for acne. This is because stress can induce breakouts through a series of bodily effects that can make acne more resistant to any treatment, even Accutane.
So Accutane is a medicine that's been around since 1980, and it's a pill that patients take for five to six months and it works a hundred percent of the time to clear up 100% of the acne. And for 85% of people it's permanent. They never have acne again, it's the only acne medicine that works that way.
Accutane treatment has a high average success rate of around 85% for patients who complete the entire 6-month course. For patients with severe or cystic acne, a 6-month course of Accutane offers the best treatment to alleviate the symptoms of severe acne by slowing down the growth of skin cells that can clog pores.
Most people on a typical course of the drug of 0.8 mg/kg for a 16- to 20-week course could do three treatment courses over their lifetime if necessary. Many doctors will use the approximate 0.8 mg/kg as an average treatment dose but will not hesitate to increase the dose in order to get the desired results.
Answer: Breakouts are normal during accutane
Breakouts may still occur, but pimples are less deep and go away faster. Sometimes, patients continue to get occasional new pimples after 4 or 5 months of therapy. Rest assured, your skin may continue to improve for several months after completing the medication.
Each person's response to isotretinoin treatment is different, but most people begin to see the desired results within 2-3 months after starting to take the medication.
Isotretinoin (Accutane)
The most effective treatment for hormonal pattern acne is isotretinoin, often known by its original brand name of Accutane. Accutane works by “shrinking” or deactivating the oil gland in acne-prone pores thereby preventing the overactivity of the oil glands that is necessary for acne to develop.
Answer: Second Accutane course
There are a quite a few patients that need a second, or even a third course of Accutane if they have very stubborn acne, so that would be a perfectly fine option for you if you think you need it. I might recommend increasing the dose if you did well and tolerated 20mg daily.
Isotretinoin-Free Options
Topical retinoid medications indicated for the treatment of acne include Retin-A (tretinoin), Tazorac (tazarotene), and Differin (adapalene). As with isotretinoin, retinoid medications require a prescription.
I usually recommend to my patients that they stay on a topical medication (like Differin or Retin-A) to help the skin stay acne free post Accutane. If your acne returns, which does occasionally happen, your doctor may want to look into other possible causes if he/she has not already so.
Treatment with isotretinoin often results in prolonged clearance of acne, which can be permanent for some patients. A course of treatment generally lasts about 4 to 5 months. It can run shorter or longer.
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.
Relapse rates in patients with acne after treatment with oral isotretinoin vary between 10% and 60% depending on the dosage regimen used, the length of follow-up, and the characteristics of the study population.
Isotretinoin is a powerful drug that's used to treat the most severe cases of acne. Your doctor may recommend this drug if you have severe acne that doesn't get better with other medications, including antibiotics. The drug is derived from vitamin A.
How Effective Is It? Accutane is the single most effective drug for treating severe acne that hasn't responded to other treatments. About 50% of people who take it experience cleared skin to the point that they never need to treat acne again. Most people take this drug for four to six months.
What does hormonal acne look like? Whiteheads, blackheads, papules, pustules, cysts and nodules are all common hormonal acne symptoms. Normally, whiteheads and blackheads do not cause pain, inflammation or swelling, but if they do, then they are most likely forming into cysts and pustules.
How Accutane Works. Put simply, Accutane permanently shrinks your oil glands. Because people with acne produce more sebum than necessary, the elimination of the excess causes your skin to stay clear because your pores no longer get clogged.
The hair loss is likely temporary, and your hair should start growing back when you stop taking the medication. You can also take certain steps to prevent or limit hair loss caused by isotretinoin. Preventive steps can include avoiding the sun, increasing your folate intake, moisturizing, and adjusting your dosage.
Worsening acne is a temporary side effect: When you start taking isotretinoin, acne can worsen for 1-2 months before it begins to clear. This happens with many other acne treatments.
Accutane can also increase your cholesterol and triglycerides, so fatty meats, high-fat dairy (like butter or cream), and starchy foods should be limited. Fresh fruits and vegetables, along with whole grains, are usually a good choice.