Acutane Advice

[Coop1313]

My son has severe acne and nothing has worked. The acne is a big factor contributing to his social anxiety with feeds his depression. He’s been doing better, generally speaking, and wanted to try Acutane to clear up his face. He says he’s ready to get back into his life but only if his face clears up. He started on it about 5 weeks age on a small dose and it was increased last week. The issue is that it is significantly worse now. We know that is part of the process but he’s not sure how much longer he can take his face looking worse plus it really hurts. Has anyone been in this situation? I just told him to stick with it because some people take longer to get the results. Any help would be greatly appreciated.

[greenyartist]

Hey,

I'm so sorry that your son has to go through this. I've struggled with acne for so much of my life and especially during my highschool years. I used to skip school just so that nobody would have to see me. It's awful and I can sympathize with your son. When i really struggled with it I know that I would get stuck in a cycle of getting a bad breakout and then getting horrible anxiety and then touching and scratching my face as a response to the anxiety. Then I would just break out more from touching and messing with my face. Something that helped me was taking note of the times that I was touching my face and would find something else to do with my hands. I kept a ring on my thumb to twirl when i got anxious but I know a couple of friends find that figet toys work too.

Other than that, I changed my diet up and did go on meds to help with my acne. It gets better and someday he won't feel like this. Just keep encouraging his confidence!

[Coop1313 in reply to greenyartist]

How did you change your diet? Did you cut anything specifically out??

[greenyartist in reply to Coop1313]

Yes!

I was a heavy soda/pop drinker and cut that wayyyyy back to decrease my sugar intake. I also cut dairy out (besides the occasional ice cream) and decreased my red meat intake.

I think that the sugar decrease was the most helpful thing!

[Coop1313 in reply to greenyartist]

I’ve been trying to get him to do the exact same thing but he can’t give up sugar! He did recently give up red meat for the most part. He doesn’t eat much dairy. I try to remind him that this too shall pass. He’s been through so much the past 6 years. But I have to remind myself what it must be like for him the minute he wakes up. My heart breaks for him everyday. I have learned tho that the best thing I can do for him is live my life.

[greenyartist in reply to Coop1313]

Yes its very true! I know it's hard but don't let him see you carrying his burden too! You don't want him to feel guilty for making you sad. Remind him of the things he can be proud of and feel good about that aren't related to his skin and appearance. He's going to grow up with a strong back becuase of all the things he has been through!

[Coop1313 in reply to greenyartist]

A neighbor introduced him to art and he has really taken to it. In fact, he set up a spare room to have a place of his own to do it. It gives him a sense of worth which he hasn’t had in a long long time. He’s planning on making a piece for a breast cancer awareness auction in October.

[greenyartist in reply to Coop1313]

That is incredible! Not only to pick up a new hobby/skill but also immedietly putting it towards a selfless cause! You both should be proud! He's on the right track for sure!

[Hidden]

Hi Coop - Had acne during my teens with pustules. I had treatment including hormone and light treatment. One possible cause of acne is zinc deficiency. If you take a zinc and vitamin C supplement it may help with the skin. The condition might be due to hormones. Vitamin F which is found in evening primrose and starflower oil may help with prostaglandins and might help. The actuane may be too strong,. If you are in the US Neutrogena have a special range of skin preparations to help with acne with a special light mask. You might find vitamin E in coconut oilskin preparations helpful for the skin. To build your immune system a couple of teaspoons of coconut oil on a biscuit a day may help prevent bacterial infections and even viruses. Cutting out chocolate and confectionery might help as well as cutting out sugar and too high fats. Vitamin D deficiency may contribute to skin disorders, and also to depression. You can get vitamin d drops from Superdrug trebling the dose for children's drops. Cod liver oil gels eg seven seas is odourless and has no unpleasant taste high in vitamin D. The B group of vitamins is also important for skin care especially B12. Multi vitamin supplements may help. Seeing a private consultant might help though it is expensive. Anne French cleansing milk is cooling and cleans away dirt. It is gentle on the skin. Olive oil soap eg palm olive or Dove might be helpful. Hope you can find advice from your pharmacy.

[Coop1313 in reply to Hidden]

Thank you so much for the information. If you had to pick 2 of the items you mentioned, which ones would it be? Although he is struggling right now with the actuane, he is committed to keep going for now. I can’t overload him with ideas. Again, thanks so much for your suggestions.

[Hidden in reply to Coop1313]

Two recommended from my suggestions from Dermatological research are to take zinc supplement with vitamins c. Neutrogena products such as "Spot on for Acne" cost seven dollars dollars. As you are taking the medication prescribed no doubt it will be fine but you might go on a blog ,to find out if it gets worse before it gets better.

Another suggestion for teenage acne is real silver colloidal silver from Vitogene.com/blog/colloidal silver

Collodial silver liquid can be useful internally. Silverlab.com have good website explaining its uses for hormonal acne. Your are lucky to be in the US.

Guess the actuane will show improvement but the topical application of either Neutrogena or colloidal silver may be beneficial. The psychology of skin problems is important so feedback about the prescription will be helpful from info from users.

[Dolphin14]

Dermatologists and aestheticians now have a wide range of procedures and facial treatments that help acne.

Perhaps you can see what's available in your area

[Figgins42]

Hi! Yes! I took Accutane for approximately 6 months! It will work for him! It's a miracle drug! I couldn't get to school, I hated myself, my life. I hid all the time. I had acne for 7 years and after going to multiple doctors and having a plethora of treatments and medications and agonizing over my appearance, I finally found a Doctor willing to prescribe Accutane to me. Within a few weeks, my skin cleared up. Not only that, I had a beautiful glow that everyone remarked on. Your son is going to be so happy when he starts to see results! I don't know why they didn't put him on the same dose from the beginning. From what I recall, I took the same dosage out of a blister pack every day for 6 months. Be patient! Don't be scared! I'm middle age now and I took it when I was 18. Medicine has gotten even better since, so I'm sure it's even safer now. Tell him to stay the course with it and drink tons of water! I promise he will be a changed young man! Good luck! Any questions please ask!

[gleason9guy]

Encourage him that this is something that can get better and that you're willing to help him. Accutane, as I recall, didn't work over night. It takes awhile to alter one's body chemistry. And they should be watching his lipids very closely during this process. I will say that the time I spent on this drug was well worth it. If he is patient and let the drug do it's job, he should see a marked improvement. Try to keep the skin surface clean and dry without a lot of the normal picking at the skin. It will eventually start to dry up and not nearly be as much of a problem.

[ScrapQueenJenn]

I have taken it three times. I have never had the purge (it gets worse before it gets better) but there is a Facebook group for people needing support while taking Accutane and it is mentioned a lot there. It is normal. I used it as a teen in high school and it worked fantastically on my cystic acne. After having children my body changed and it returned though not near as bad as in my teenage years. The 2nd time I took it the doctor didn't see anything so he stopped me too soon and it returned again. Hence the third time. Anyway, tell him to just keep swimming. It will get better. It will just take some more time. It will all be worth it in the end, I promise!

[metalminded]

Hello Coop1313,

I was on acutane two years ago, at 48. I had a kidney transplant that resulted in a form of acne that was all over my face and parts of my body, caused by the large dose of Prednisone I was on.

I was on a low dose for around 6 months or so. Acutane is not the most comfortable medication to be on, a lot of side effects. I had the same issue though, I thought it wasn't working and was very upset. When my dermatologist took me off, my face was almost completely clear. My body still has some, but my face looks great, which is what everyone sees and that is their first impression.

Tell him to keep taking the medication as directed it should work. I hope you have a really good dermatologist too. That can make all the difference! (I'm in the US, Illinois).

Good luck! Feel free to reach out if you, or he, has any questions.

[Lilly5]

Please look at this link from Harvard: health.harvard.edu/mind-and...

[Lilly5 in reply to Lilly5]

I don't know why but when I clicked on the link it told me to subscribe or log in. Let me see if I can do a copy paste here:

Questions & Answers: Does Accutane cause depression?

Updated: April 16, 2019Published: March, 2014

Q. Does the acne drug, isotretinoin (Accutane), cause depression and suicide, or are psychiatric risks from the Accutane side effects exaggerated?

A. The debate about the safety of isotretinoin (Accutane) parallels the debate about the safety of antidepressant drugs — huge benefits versus what some think are serious risks.

A chemical derivative of vitamin A (retinol), isotretinoin is a wonder drug for the treatment of severe acne. It cuts the output of the sebaceous glands, source of the oils that contribute to acne lesions. It changes the cells that line hair follicles, so they become less likely to block the follicle openings and permit a lesion to develop. And it reduces inflammation (redness and pain). For those with the most severe form of acne, about 90% improve substantially during the 20-week course of treatment. If acne returns, it is usually mild enough to be treated by more conservative methods.

Accutane side effects are serious.. It dries the skin and nasal passages, and it can cause peeling skin, thinning hair, and brittle nails. Joint pain, high blood lipid levels, weakened night vision, headache, and liver inflammation can also occur. Accutane so dangerous to a fetus that, to receive a prescription, women must understand the dangers, have two negative pregnancy tests, and use two forms of effective contraception to avoid becoming pregnant.

Then there is the issue of Accutane's neuropsychiatric side effects. High doses of vitamin A can cause headache, depression, fatigue, irritability, aggression, even personality change and psychosis — a syndrome called hypervitaminosis A. So it's no surprise that there are concerns about Accutane side effects.

Clinical trials have been reassuring. For example, researchers in St. Louis previously reported a study in which they treated 101 teens and preteens for acne over four months, half of them with isotretinoin. They found no difference in depressive symptoms between the two groups, and no suicidal thoughts in patients who took isotretinoin.

Suicide, thankfully, is rare, so it would not be expected to occur in a study this small. In large surveys, though, it is also hard to find increased depression or suicide risk. One review found that suicide reports to the FDA following isotretinoin use are one-fifth the number expected by looking at rates in the general population. Other surveys of thousands of patients have found no increase in depression, suicide, or antidepressant drug use in patients taking isotretinoin. But critics point out that depression and suicide are probably under-reported and that some of the authors of these reports had links to the drug's manufacturer, Hoffmann-La Roche.

Individual case reports do link Accutane to depression — especially patients who say they became depressed for the first time after taking isotretinoin, recovered when they stopped, and became depressed again after restarting. Also, when compared to other drugs, isotretinoin has a relatively high frequency of FDA case reports of depression and suicide.

And there is scientific evidence that Accutane acts on the brain. Using brain scans, researchers at Emory University showed this year that the drug reduces activity in the orbitofrontal cortex; so does depression. Patients whose orbitofrontal activity slowed the most were not more likely to become depressed, but they were more likely to have headaches. And another recent report suggests a connection between headache and depressive symptoms in isotretinoin users.

Patients taking isotretinoin should let their physicians know about any depressive symptoms, self-destructive thoughts, or other mood changes, and maybe about headaches as well. But depressed persons need not avoid isotretinoin. Severe acne itself often lowers mood and damages self-esteem, so effective treatment can improve emotional health. As long as they stay informed and attentive, patients and physicians should be able to negotiate this medical treatment safely.