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  • Accutane for full body acne... how long?

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    Old 09-19-2001, 03:07 PM   #1
    boozecans
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    Accutane for full body acne... how long?

    I've been on accutane for about 50 days now, and my face is completely clear (my face wasn't too bad in the first place, but its definitely better, like spotless). But the main reason i started accutane was for my back, shoulders, and chest (they are REALLY bad, about 15 cysts and countless smaller red marks). I haven't seen any improvement whatsoever in these areas, i've still been getting like 5 cysts a month. Does someone with experience know how long my chest, back, and shoulders are going to take to clear? Your help is appreciated. Thanks.

     
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    Old 09-19-2001, 03:56 PM   #2
    u2mad25
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    Re: Accutane for full body acne... how long?

    Boozecans,

    I understand the frustration and I was in the same situation as you are now. I'm a 28 year old male who started Accutane 1st week of June (20 mgs/day for 2 weeks, then 40 mgs for almost 2 months, couldn't tolerate that dose for long, back to 20/day which is where I am at now). I mainly decided to take Accutane for my body acne (chest, shoulders, back had some cysts cysts and generally looked awful). Like you, my face sometimes broke out but my body was worse.

    I have to say, Accutane has been the best thing for it, and I was really scared of the drug. But even at this low dose, my body acne has cleared almost totally *knock on wood*. The red marks suck though. I have about 1 more month to go and despite the fact that I don't feel so great while on it (some aches, dryness, mood changes), I am toughing it out for a bit longer. The doc says that there is a chance that it could return but perhaps not as bad and it is very encouraging that I cleared in a low dose, so I may be in the clear for good!

    What I can suggest to you:

    1. Talk to your doc about dosage to see if you need to up or play with it a bit, although my personal belief is that the body needs only small doses over a period of time to really feel the effect.
    2. Patience. 50 days is not enough time. The 3rd and 4th month should see real improvement. I'd be surprised if you didn't and would then suggest maybe trying more hormonal approaches like Saw Palmetto, other herbs, etc.
    3. Lots of water, vit e 400iu a day are a must. Take B-Complex too to balance out your vits (since Accutane is really just mega Vitamin A essentially).

    Keep us posted on your results! Hope I helped.

     
    Old 09-19-2001, 08:29 PM   #3
    boozecans
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    Re: Accutane for full body acne... how long?

    Thanks for your words of encouragement man, you just made my night!

     
    Old 09-20-2001, 05:40 AM   #4
    agaddy
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    Re: Accutane for full body acne... how long?

    Boozecans-
    what dosage are you taking? In the literature that comes with the pills it says (also on the Roche website) that reoccurrance of acne is significantly reduced if you take a slightly higher dose than normal. For instance, I weigh 115 and am on 80mg/day. My derm i head of the derm department at Mount Sinai Medical School/Hospital, So i trust him.

    Also- my husband had body and face acne about 11 years ago and he took 2 courses of accutane. Now his skin is perfect on his face and he only occasionally gets a cyst on his back- none on his chest or shoulders. He experienced this clearing slowly over a couple of years. When I met him he was 20 and had 3-4 cysts on his back at all times, now he is 26. Good luck.

     
    Old 09-20-2001, 08:02 AM   #5
    u2mad25
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    Re: Accutane for full body acne... how long?

    Agaddy-

    You are right that higher the dose of Accutane, the greater likelihood that acne will not return, perhaps ever (although there are a few cases where it does it return regardless of dose). In that case, the cause could be more hormonal and other approaches (for women, BC pills and for men, saw palmetto or even B5 since that synthesizes hormones) should be really helpful.

    I do have fears that since I am at a low dose for my weight (150lbs) that it may return when I'm done in a month. But I could not tolerate a higher dose than 40mg/day. I had headaches, dizziness, I couldn't do anything. My body rejected it, I think. The low dose (20mg/day) has cleared me and I am more optimistic that despite what the literature, I will remain so.

    By the way, Roche is testing and perhaps soon will make available a new "version" of Accutane...it's a micro-nized version (think Retin-a micro). Clinical studies have shown that at the lowest dose, this new version is just as effective as higher doses with less side affects. Here's a summary of the article:

    Fewer, Lower Doses Of Micronized Isotretinoin Effective For Nodular Acne

    A DGReview of :"A randomized trial of the efficacy of a new micronized formulation versus a standard formulation of isotretinoin in patients with severe recalcitrant nodular acne"

    Journal of the American Academy of Dermatology

    08/17/2001
    By James Adams

    Isotretinoin in its micronized formulation can be administered less often and in lower doses for treatment of severe recalcitrant nodular acne.

    It can still achieve clinically equivalent results to the administration of standard formulation isotretinoin.

    Investigators from 18 different institutions, including University of Iowa Healthcare in Iowa City, Iowa, and Roche Laboratories, Inc. in Nutley, New Jersey, United States, conducted a double-blind, double-dummy study with 600 patients with severe recalcitrant nodular acne.

    Half of the patients received 0.4 milligrams/kilogram of micronized isotretinoin in a single dose without food. The other half received two divided doses of standard isotretinoin with food for a total daily dose of 1.0 milligrams/kilogram.

    The investigators monitored acne lesion counts for a 20-week period.

    Results showed that the two patient groups had equal reductions in the total number of nodules. A similar number of patients from each group exhibited 90 percent clearance of nodules.

    "Once-daily use of the micronized and more bioavailable formulation of isotretinoin under fasted conditions is clinically equivalent to the standard twice-daily formulation under fed conditions in the treatment of severe recalcitrant nodular acne," the investigators conclude.

    J Am Acad Dermatol 2001; 45: 187-195 "A randomized trial of the efficacy of a new micronized formulation versus a standard formulation of isotretinoin in patients with severe recalcitrant nodular acne"

     
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