The Truth about Accutane! (Dermatologist discusses accutane) | SwoleMD Skincare

I am a dermatologist and I want to tell you the truth about Accutane. Is Accutane safe? People so often worry about Accutane (isotretinoin) side effects. I will give you Accutane tips for dry lips, which is by far the most common side effect from Accutane. In the video I discuss Accutane before & after and what expectations you should have. The video address Accutane hair loss and regrowth. In this video we also look into Accutane and pregnancy and Accutane and depression. While ultimately you and your dermatologist decide on dosing and how to take isotretinoin, today I discuss how to take Accutane properly. I don't get into the idea of Accutane purge but I will say it is rare and most of the time is not a problem.

Chapters:
0:00 | Introduction
1:24 | Side Effects
2:55 | Why Accutane is Hard to Get
4:54 | Helpful Information
5:52 | Men vs Women on Accutane
6:41 | Skincare Routine while on Accutane
9:00 | Outro

Always taking skin questions in the comments!

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#skincare #acne #accutane

Thanks for watching the video The Truth about Accutane! | SwoleMD Skincare

[SwoleMDSkincare]

Since the video sparked some interesting commentary here is a bit more information.

I will never say that serious side effects don't happen, as this is the case with ANY medication. Here are some sources supporting the long term safety of isotretinoin. I wanted to go ahead and get these posted so any people considering Accutane could look at them. I think you will find these studies go along with what I described in the video.



Isotretinoin Exposure and Risk of Inflammatory Bowel Disease
1078 pts from 1995-2011 and 2006-2011, Mayo clinic
Study did not show increased risk of IBD with prior isotretinoin use (if anything the risk decreased.) Despite this we still counsel our patients and screen for IBD before starting the medication.




Laboratory Monitoring During Isotretinoin Therapy for Acne A Systematic Review and Meta-analysis
61 studies, 1574 patients, date from 1960-2013

Basically says we over monitor blood tests because the medication because while lab abnormalities are common they often self resolve and are not harmful. Despite these studies many dermatologist still check monthly labs.





Psychiatric Adverse Events in Patients Taking Isotretinoin as Reported in a Food and Drug Administration Database From 1997 to 2017


Anxiety and depression is higher in those with acne, you must consider this when looking at the data. Rate of completed suicide in patients taking isotretinoin may be lower than that of the general US population. On top of this our Accutane patients we see monthly providing a great opportunity to screen them for symptoms.




Isotretinoin effects on bone

Just a comment on this paper and to answer some questions about growth plate closure and such. Often times issues with isotretinoin and growth plate closure have occurred in children. Children being treat with isotretinoin for life threating cancers, these cancers often occur in young children around the age of 5. This is not an age range that we use isotretinoin in, so the growth plate closure is usually a moot point. Always has to be considered in younger patients with acne though.






Risk of new-onset inflammatory bowel disease among patients with acne vulgaris exposed to isotretinoin

There was no significant difference in the odds of developing IBD at 1 year between isotretinoin-exposed and unexposed patients with AV (adjusted odds ratio, 1.40; 95% CI, 0.95-2.05). With that said patients who are getting frequent checks with their dermatologist may be diagnosed sooner (than someone not coming in for checks.)



Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis


Review of 31 studies, Isotretinoin isn’t associated with increased risk of depression but it actually tends to decrease depressive symptoms.


Isotretinoin: controversies, facts, and recommendations
Describes that when reviewing data there is weak evidence for increase depression, suicidality, or inflammatory bowel disease. Transient lab abnormalities are mild and not even worth stopping the medication.




Long-term safety of isotretinoin as a treatment for acne vulgaris
Study of 720 patients, mean follow up of r5 years, but up to 12 in some patients. OF note most patients had a HIGHER dose than we typically give patients. 7.2% of patients did report mucocutaneous and some muscular symptoms, but the important thing is they were all mild. (dry eye, join aches, eczema flare up) There were no serious long term side effects.

 


Isotretinoin for acne vulgaris—10 years later; a safe and successful treatment
Follow up on average of 9 years with 88 patients, some up to 10 years.
Patients were questioned about and examined for cutaneous and systemic adverse effects of isotretinoin. This include mucocutaneous and musculoskeletal problems as well as infections. No long term clinical side effects were identified in any of the patients, and labs were taken from 28 and no biochemical abnormalities were noted.




Roaccutane treatment guidelines: results of an international survey
1000 patients, from several countries, Mucocutaneous side-effects occur frequently but are manageable while severe systemic side-effects are rarely problematic (2%). Essentially supporting that Accutane should also be used in more mild cases if scaring or psychological stress if caused by the acne.

[phamtomblue]

As usual, most dermatologist just discusses the common "temporary" side effects but never mentions the serious side effects associated with the drug. Is the drug effective at clearing acne? Absolutely, but is it worth gambling your health? I'll admit that it works for the majority, but there's a sizable group of people who have been injured by this drug. This is a fact and not some anecdotal story to cause fear mongering. I say this because I've taken Accutane in the past and am experiencing the side effects after years of cessation. Accutane gave me dry eyes (MGD), osteopenia and chronic neck pain.What bothers me is that most dermatologist will downplay the side effects and mention that you'll be monitored closely with blood works to give you a some sense of assurance. They are oblivious to the fact that it could take years for the side effects to pop up for the patients to notice thus giving the dermatologist the false idea that they've never or rarely encountered patients who had long-lasting effects. Patients don't go back to their derma for dry eye, neither for IBS nor muscle pain. I went back to my derma after 5 years of not seeing her after the accutane course and told her about my condition and that people who have side effects from accutane aren't rare. I'll leave this tidbit, I've been to two nationally ranked eye centers at John hopkins (wilmer eye) and U Penn (Scheie). They have a questionnaire for new patients and would you like to know what's one of the first question? It asks patients of past isotretinoin use. It's very telling about the safety and supposed rarity of long term side effects when Jon hopkins and Upenn hospital has it on the top of their questionnaire.

[SamanthaRod]

Did an accutane treatment in 2019 and all I can say is I am SO sad I waited until my 20s were almost over to get flawed skin. I don't regret it at all, HOWEVER, I did experience telogen effluvium and lost so much of my hair 😥. I went from thick curly hair to dry, thin, limp hair. I keep a very healthy diet, take supplements that dermatologist recommended and make sure to be very gentle with my hair and it's finally growing back. I wish the cost of clear skin wasn't losing my hair... I wish I had known this could happen. It's so sad/frustrating to get rid of one insecurity, my acne, only to trade it for another one, super thin hair.

Wishing everyone who goes through accutane health and success, and I hope you all are able to keep your hair ❤

[ZooChronicles]

Can I ask what’s the difference between the hydrating cleanser you recommend and the normal Cerave hydrating cleanser?

[arjunkhandelwal]

Can accutane cause type 1 or type 2 diabetes? There are many studies on pubmed which states that accutane can cause both type 1 and type 2 diabetes..please reply

[trwilli]

Hi Doctor, my dermatologist recommended Accutane for treating Grover’s disease. Is Accutane effective in treating this?

[sanasammers]

will it cause like any sort of weight gain or make you have more belly fat because i feel like i’ve been getting more fat

[lindaluna]

Accutane was initially intended as a chemotherapy drug. They stumbled across it working for severe acne. So now it's prescribed to our teenage kids.

After taking it and experiencing years of muscle pain, joint pain, chronic fatigue, IBS, nose bleeds, B12 deficiency, magnesium deficiency, low testosterone levels, excessive dry eyes (MGD), you don't go back to your dermatologist. So that's why this Doctor says he doesn't know of any of those cases. You'll spend years going to many different doctors in various departments, that don't know how one area of the body links to the other.

This is literally poison for your body!! Start with your diet and try to cut out dairy and grains as much as possible, to determine whether you might have food sensitivities.

[eshank]

Do I need a sunscreen if I am not going out in sun at all during my Accutane/Isotretinoin cycle period. Kindly suggest. Thanks!

[wibabaraanita]

Can I use forever aloe Vera gel and my cetaphil oil cleanser also dr Rachel vitamin c face serum while on accutane

[CCameron]

Hello, I have some questions:

1. If I get severe migraines frequently, is this safe to take? I have heard of brain swelling. Although it's rare, does it put me at a higher risk?
2. Is this medication safe to take on the keto diet?
3. I already have very dry eyes. How much worse do you think it would make it?
4. The doctor I saw put me on spironolactone and doxycycline. Is it safer?

-I have recently seen a dermatologist and have told him everything above. He wanted to put me on accutane, but I am reluctant due to the issues I've been having. I am asking these questions for a second opinion and would appreciate your feedback!

Thanks,
Courtney😊

[ZedEdo-tp]

Please sir at over 40 it is safe even at 10 mg a weel will it affect eye i got mild acne and very oily skin merci😊😊😊😊😊😊😊😊

[jessylibert]

I'm almost a week on accutane for hormonal acne, currently 24 years old. How does it come that in Belgium they give lower dosages from 10mg to 30mg dependant on each case over a long time period and in the USA they give sometimes 80mg or more like that is very concerning to me. Could you explain this briefly please. By the way a very informative video. I have no side effects so far but I allready have slight dry lips year round so I'm pretty used to using vaseline each night on my lips. Also could it be a problem for me because I have allready atopic skin on some parts of my body

[-o_o]

Hey Dr MD, I just recently found your channel as I was looking for accutane videos that maybe tell the reasons why acne relapses after stopping it for some time but could not find any.
I was hoping if you could state some reasons?
I even took a second course but it was ineffective at treating my acne unlike my first time on it.
My acne is back and I am feeling down.
My dermatologist suggested I do yellow laser but it is still not as effective at treating my acne compared to accutane.
I would like to hear your opinion on this.🥺

[nomoreshiny]

Doctor, could you possibly provide some feedback?

Five months ago, my derm prescribed accutane. I barely had any acne to start with, but she said to use it. I always had normal skin (not too oily, not too dry — I was right in the middle).

I started 60mg per day (30mg day, 30mg night), taking it for 7 weeks (I am 185 lbs). I quit after 7 weeks bc I noticed SEVERE dryness on my entire forehead: wrinkles, fine lines, dry visible pores.

I’ve now been off Accutane for 3 months & the dryness remains. It’s like my forehead was stripped of 100% of its oil.

It corresponds directly with the accutane making my whole forehead super red & pulsing while on it.

It’s like crepe paper, like HUNDREDS mini horizontal fine lines that look like “crinkled saran wrap”. When I try to pull my skin up to see if all the crinkled skin flattens out, it doesn’t, all the lines just turn vertical. :, ( It looks so fragile in this way & to the touch.

I also get nosebleeds still, 3 months later! Ugh.

The doctor that prescribed me it says none of this is due to accutane, which is just crazy. Before accutane, my whole life (37 years), my forehead had oil & no texture whatsoever. I also never got a single nosebleed my entire life. So frustrating to hear my prescribing derm say these effects are not due to accutane.

So I’m asking around, and would like to know if you think this texture will go away & my sebum will return. I’m distraught. I’m heartbroken. I really am.

Thank you for your time & consideration.

[topshot]

I started taking acne when i turned 16, and i just finished with 6 months and did 40mg twice a day. Will this stunt my growth

[jaquielopez]

Hey Dr. MD I got off accutane 5 months ago and still experiencing hair loss. What should I do to better my condition. Should I try minoxidil?

[freebird]

What is the right dose for me in mg (90kg) with mild acne?

[AndrewZambetti]

Can accutane or anti hormonal medicine hurt hormone levels permanently

[Etreavj]

I have eye floaters already... can it make the case worse?