Roaccutane: Poison or saving grace?

(This is a blog post for a friend of mine. She would really appreciate your advice / input)

Holy Moly but Google can be a bitch!   My 15 year old son has mild to moderate acne which I have left up till now but it is getting worse rather quickly.    I was afraid of making him self-conscious so left it trying to get him to wash his face and drink water etc.   I have now taken him to the dermatologist as I don’t want him to get bad scarring and I am also concerned about self-esteem issues. 

So far no scarring and no real esteem problems although he does say he feels ugly.  The dermatologist says it is typical teenage acne that will simply get worse in time as his oil glands over produce.  I am hoping he doesn’t ever have those dreadful painful cysts and we can sort it out before then.   My son doesn’t want to do the anti-biotic route as he wants the acne gone now.  I understand this but I am sitting with that script for the drug and I have serious reservations about him taking it based on the many horror stories I have read on the net.  The side-effects sound horrendous!

So what to do?  I know the drug is very effective and he would love a clear skin of course.   He has had the blood test saying he can tolerate the drug.  He would take it for 4 weeks and then do another blood test to see if he is tolerating it.   If he is he does 5 months of it.  My other concern is he is ADD and on Concerta.  He was diagnosed at age 9 and putting him on Ritalin was incredibly hard for me.  I feel back at that place but this time the meds seem even more terrifying!

I can’t leave it.  I remain haunted by a work colleague who lost her 16 year old nephew who hung himself in desperation after feeling so hideous from acne.  Fortunately my son doesn’t suffer from depression or anxiety and apart from the ADD, is a very happy normal kid.  Shit and crap, what do I do?    Help!

 

Comments

[Lisa]

My son had HORRIBLE cystic acne, and was put on a course of Augmentin (2 10-day courses) and now takes a daily dose of doxycycline (50mg). I know for him, the antibiotics took less than a week to show that they were working. You could literally watch the acne go away. It was amazing. (He also uses two topical medications, one in the am and on in the pm, but nothing worked like the antibiotic.)

It's hard to find a dermatologist to prescribe Accutane here in the US. Ours wouldn't even consider it. I would try the antibiotics first.

[teki]

@Lisa-hasn't Accutaine been pulled of the market? Seems I keep hearing about lawsuits concerning it.

I had moderate adult onset acne (not cystic) and used oral antibiotics and a couple of really great topicals. I'm with Lisa, I'd try that first.

[Megan]

Well. Roaccutane is definitely one of the best acne meds available. I've been on it 3 times and it's not the medication that makes you depressed, it's the way you look and feel when you have acne. My mom actually went to Switzerland to meet the founders of the drug as she had such severe adult acne and she has been on it more times than me. In her words "it saved her life". So if there is treatment available , and you have the means of providing it to your child and do not, you are doing more harm than good.

[Rachel]

I agree with Megan. Not sure about the above and being pulled off the market but I took Accutane back in about 1994 after about 8 years of pretty severe teenage acne. I feel like it basically changed my whole life, yes it is a pretty strong drug but thinking back on the pain that acne caused me all those years...well worth it. Such a formative time in a person's life, if you can make this time easier on any child my opinion is to go for it. I'll always be grateful.

[thalia]

I took accutane it was a total miracle for me. Acne gone forever, i just wish they would have let me take it as a teenager, i ended up taking it in my 20s after suffering for years.

Only side effect I had was very dry lips - doctor suggested a lipsalve they use for cows udders which was brilliant but I had to put it on about every 5 mins! And my hair dried out and went curly, which was actually a rather nice side effect!

I think as always the negative cases make a great story so they are over reported. I've heard nothing about it being taken off the market.

[Alice]

I don't know much about the drug, but perhaps cutting back dairy products might help with the acne?

There are a lot of studies showing dairy allergies and its' correlation to dairy intake. Perhaps this would be an area to look into before taking the drug?

[kari]

I have three friends who say Accutane changed their life for the better. I know it's just more anecdata, and maybe not even what you are looking for, but if your son reads the side effects and is okay with the possibility, and everyone is on the lookout for the side effects, then I say go for it. Everyone deserves the change to not feel ugly.

[Sara]

I would say that at 15, he's old enough to make the choice for himself.

[Katherine]

I took my 15 year old son to the doctor for bad acne last month. He started having issues last spring, but at that point HE wasn't willing to do much about it - wouldn't even wash his face other than in the shower every other day. It cleared up in the summer and early fall, then came back again late fall. Over Christmas break, he decided it was bad enough that he was willing to take Ned's and use creams. The dr said she would not prescribe accutane without trying other things first. My son is on doxycycline 150 mg a day and creams morning and night. It is not an instant fix, but it is looking better 3 weeks into the regime. The dr said he would be on the antibiotic for 2-3 months and then probably just the creams. Only if this doesn't work, would she consider accutane.

I had drs discuss accutane with me as a teen/ young adult several times, but I didn't want to take it. I'm still, at 45, on a low dose of antibiotic (minocycline) daily to keep my acne under control.

My son feels like no one would want to go out with him, the way he looks. I don't think he is depressed, but discouraged. He does have many friends who enjoy his company, just not a girlfriend.

[Lynn]

Accutane saved my face. It's a serious drug but I had a serious problem -- horrible cystic acne. I wish I had taken it a few years earlier, in fact. You and he should be aware that serious side effects are possible and decide if they are worth dramatically improving the acne. It was worth it for me -- my acne was going to scar my face for the rest of my life. I had tried every other topical and internal med including antibiotics first. Be aware that your acne gets worse on it before it gets better (but it gets SO much better!)

[Michelle]

Hi Tertia and friend.
My stepson had very bad acne and I was loathe to put him on Roaccutane for the very reasons you mention. We visited a very good dermatologist who explained that Roaccutane was a very good drug to use but it was only effective with certain types of acne. He said SA doctors were too hasty to hand it out and get results. One of the side effects of taking Roaccutane with the wrong acne resulted in the pimples making like a volcano and then creating scars like craters.
My stepson is very tall and greww very quickly. He said that his type of acne was from the Human growth hormone being too abundant. He put my stepson on a very mild anti biotic called Tetralycil. He was on this for over 2 years and it made a huge difference in conjunction with weekly treatments of Red/blue light treatment at the dermatologist and another teatment called Cautry(SP)These were alternating treatments using different UV lights and the cautry was like cauterising the zits.
He prescribed a diet free of nuts or soya based products, no melted /saturated fats(pizza and chips) and only hormone(hormone indused acne) free milk in moderation. At least 2 litres of water a day.
Not sure your friend can get her son to stick to the diet bit as we all know how teenagers operate but it defnitely does help.
I would get a second opinion on the type of acne he has and whether or not Roaccutane is the right treatment or not. I personally would opt for the less extreme route.
Best of luck and let us know the outcome of his treatment.

[Angel]

Does the dermatologist know he's on Concerta?

[BiancaW]

I cannot help you at all, my son is only 7, so not there yet. I just wanted to say that I totally understand your stress about making the decision. I had to go through it with Ritalin last year and I stressed myself into oblivion. I did what you are doing, tried to get as many "real life" stories, as opposed to Google Hype - well done. Good luck with making the decision.

[L]

I had terrible acne all through my teenage years and into my twenties. I tried everything for it besides accutane and I mean everything, from normal things like proactiv, retin A, benzoyl peroxide, etc. to weird stuff like snail slime and urine on my face. None of it worked. Then recently for unrelated reasons I took an IgG food sensitivity test and found that I was sensitive to a whole list of foods. As soon as I cut these foods out of my diet my acne vanished. My skin is now clearer than it has been since I was eight years old apart from the acne scars left over. I don't know if this is necessarily causing your friend's son's acne but I would recommend trying the test to anyone who is desperate for a cure. Who knows, it could work naturally without having to use any intensive medication!

[Lorette]

Roaccutane is the BEST option! My 13year old daughter was on a 6 month course, strictly controlled by the dermatologist (e.g. blood work every month etc). Her skin is now, one year after completing the treatment, 120%. Only complained about dryness of lips and eyes during treatment. (Dermatologist gave little gift pack with ointments that helped a lot). Her self esteem went through the roof - even ache on her upper arms cleared up. I would recommend the treatment to every person who has acne! Did not interfere with any other medication but I think communication with relevant dr's are crucial. So glad we did it!

[Karishma]

Do it. Do it do it do it. I can't even say it enough. This is no jail sentence - the dose can be adjusted or the Accutane stopped if the side effects get bad enough, and honestly with proper self-care, it shouldn't be an issue. Stock up on Aquaphor. I took a horrendously high dose of Accutane for 7 months - 120mg, the absolute, absolute maximum allowed for my weight, because my dermatologist was very aggressive. I didn't have a single problem with it, my skin wasn't even that dry, all I got was some chapped lips. (Most girls my size are put on literally half the dose, but my derm went for maximum efficacy.) Literally, my ONLY regret was that I didn't do it five years before I finally started it. Yes, the monthly appointments/blood tests/whatever are a pain, but I cannot even begin to explain how utterly life changing it is. I don't even remember what it's like to have a pimple, and for a girl whose cheeks used to be (I'm not even exaggerating) a sheet of congealed bruises and congealed blood - sometimes I'd walk around with blood on my cheek from a broken zit without realizing it - I'd say just DO IT.

[Retha Burger]

Please don't listen to all the horror-mongers out there. Two of my children have been on Roaccutane with fabulous results. My son took it when he was 16 - after going the whole antibiotic route which didn't work at all. At that time (mid-90s) the medical aid wouldn't pay if you hadn't exhausted all the other options and the monthly cost was about R1500 - it's much cheaper today. He is 32 now and he has never had another pimple anywhere on his body. My daughter had to take it twice - they say this often happens with girls. The skin clears up and then 6 months later the problems start again. But now a year after she finished the second course her skin is still beautiful. They do dry up, eyes, lips, etc, but if you buy a big enough supply of lip-ice and eyedrops there is no problem. My son's dermatologist gave him a course of cortisone tablets to take for the first week just to help with the adjustment.
You are being a responsible parent to consider all the angles, but if your child is well-adjusted and has a supportive parent I cannot see what the dangers are.

[Trish]

I suffered from acne my whole teenage/adult life and tried EVERYTHING from antibiotics, Dianne, topical treatments, diet etc and then did Roaccutane in my 30s 2 weeks after my last child was born. BEST decision ever! Acne gone forever and only side effects were dry lips and hair (bonus as I had oily hair before)I wish wish wish I had done the Roaccutane as a teenager as I think my confidence levels would be completely different now.

[anon]

My hubby used it...best thing he ever did. Never had acne again. He just wished he did it earlier since he now has terrible scarring from having acne his whole life. He did have the side effects of dry skin and chapped lips but as long as he used sunscreen, he was fine.

[Anna]

I'm glad it's "only" typical acne. A friend of mine had it as a teenager and had TERRIBLE acne. As an older teenager (18 or so), it resolved and you'd never know he had a problem. He has such a clear complexion!

Alternatively, I had another friend who had a viral form of acne which left him dreadfully scarred.

People have given great advice about Roaccutane. (I have no experience with it). I wish your son the very best! :)

[Lara]

Do you have access to Proactiv skincare? It's been around for 20 years, my dermatologist here in California created it. It really works and quite quickly too. Please consider trying it if you can get it where you live and resort to the prescription drug as a last resort. www.proactiv.com I used to have to order it online but now they sell it at the shopping malls here in the U.S. Good luck!

[Suzi in Vegas]

I would support the comment on Proactive (there are knock offs that work as well.) It worked VERY well on my moderate acne.

If he does not have cycstic acne, I am surprised you got Accutane. That is a POWERFUL drug. My little brother did two courses of it over several years... he said he'd rather have the acne than do it a third time. Made him sick, depressed, and so dry, he got nosebleeds, couldn't wear contacts, etc... but it did clear up his really bad cystic acne.

I would recommend the antibiotics for a few weeks first. Give it a try before you move to such a strong drug for acne that's just "mild to moderate." You would be surprised how quickly antibiotics can work. Even when I am on them for a sinus infection, my face clears up with in a day or two.

Good luck to you, and to your son.

[Kell]

My nephew is 16 and also suffers from cystic acne. My sister, a doctor, took him to a dermatologist and after all other treatments didn't work, he got an rx for accutane. It is a very powerful drug but in some cases the benefits out weight the risks. If he were my son, I would only use accutane as a drug of last resort. Antibiotics work for most people and you won't know until you try.

[Andria]

I took Roaccutane as a teenager and, although it worked very well for my skin, I know believe it precipitated a major depressive episode for me. My psychiatrist has confirmed that Roaccutane can have that effect on the developing teenage brain if a teenager has any predisposition to depression (i.e. family history or major life events). You need to go and see your son's psychiatrist for their opinion before you start the Roaccutane. Many dermatologists are unaware that both Roaccutane and cortizone can affect depression. Please get my email address from Tertia if you'd like to be in touch with me.

[M]

I took Accutane as a 30 yr old after trying multiple cleaners, washes, acid washes, etc. It was hard to deal with the dry dry hair, skin, etc...but results were good- never had that kind of clear skin, not even as a child. I SO wish I had done this earlier in my life, before my pores were trashed and I was stuck with the scars I have now...

[H]

I suffered from mild acne as a teenager and occassional acne as an adult up until my first pregnancy (pregnancy cured it for good!! Which makes me believe acne is 100% hormonal and no water/diet will cure it).

I used Roaccutane for two years or so while in my teenage years and I'll say the psychological benefits of better skin FAR outways the fisiological negatives. I remember covering up mirrors and refusing to look at myself in public bathrooms as I told myself that I look ugly, horrible etc. I was too embarassed to talk to my parents about it, so it really consumed my life! I hated myself, I hated life (well I guess all teenagers do!).

As a teenager he will be hormonal, struggling to cope with normal everyday life. You don't want the added stress of acne (which leads to social alienation and withdrawal). Acne is the silent school bully. I had no side effects or long term problems from Roaccutane, had been off it for 8 years when I fell pregnant and had no issues with my pregnancies. (I know it's detrimental to pregnancy), but since he won't fall pregnant, he should just remember that when starting a family one day, it needs to be out of his system.

Totally worth it!

[Patricia]

I and at least 10 family memebers and friends took accutane in our late teens and had AMAZING results. The side effects were minimal and mostly related to dry lips and hair. The people who post on line are the few that have those side effects and "anger". You can always go right off if the side effects start up it's not that scary.

[Lindsay]

Haven't read other posts BUT I was on it! AMAZING! So, so, so effective but DON'T do it in summer, you HAVE to stay out of the sun! It is rough though, peeling skin, dry, dry, dry lips and eyes but I use Elizabeth Ardens 8 hour cream for my lips - worked brilliantly, only thing that helped the dryness! Eye drops worked for the eyes. If my daughter had the same problem I wouldn't hesistate if the Dr thought it was the right option! Not sure about the other meds though! So happy I did it but at times it was quite hectic. Good luck. x

[Jan]

Hi Tertia,
I had severe cystic acne and took two course of Accutane in the mid-1980s (in my early 30s). It was a miracle, as other posters say. The deep pimples literally erupted and peeled up off my face, leaving clear, smooth skin. (Think of the cells lining a pore as shingles on a roof. They are warped and crooked for those of us with cystic acne, so stuff gets clogged. Accutane, and topically administered retinol or related A vitamin products, make the "shingles" line up and properly extract sebum. Accutane also helps dry up the oil secretions.) The side effects I experienced were temporary night vision problems, some headaches and joint pain, and very dry skin and lips. Yes, there are some concerns about side effects and we still don't know much about long term damage -- I have some night vision problems now, but don't know if that's the result of Accutane or normal aging (I am 58 now) -- but it was really a matter of being able to function and continue in society and the working world. Acne is such a curse -- no one wants to look at you, deal with you, hire you. I would say give it a try. Yes, do it in winter and stay out of the sun!

[Nadine Lundwall]

I highly recommend Roaccutane!!. I am now 31 years old, but when I was 24 I hit a really stressful time in my life. My husband and I got married and 2 months later he was relocated to JHB, we had to move there asap. We were under major financial pressure and I was a mess. My skin suddenly got so bad (I had never had any kind of acne before) and it was brought on by extreme stress. I had such low self confidence and was trying to find a job!!. I saw a dermatologist and he recommended Roaccutane. I went on it and 3-4 months later my skin had never looked so good. Now in my early thirties people comment on how nice my skin looks - if they only knew!! Good luck!

[jan]

Deefinitely do the treatment.
Both of my kids had severe acne and this was a wonder drug. The last thing kids need is low self-esteem from having acne. The Dr. will monitor him and make sure all is well. Do not hesitate.

[mash]

I had acne into my late twenties, I wish I had taken the roaccutane sooner. It's great. And I'm a real hippie, I never touch medicine for anything, it's been about 10 years since I've so much as taken a dispirin! (OK apart from some seriously hectic fertility medication).

[mash]

One more thing - in the interim you can make a big impact by using a clean towel every day (i.e. you only use the towel to dry your face once before washing it), and also clean pillow cases every day. Nothing touches your face that isn't disinfected, that means you clean your cell phone every day, sunglasses, etc. Be incredibly careful what touches your face, including your hands. The oil must react with bacteria to make the pimples, and there's bacteria around all the time, but you can minimise it.

[Allison]

My husband had a very serious case of cystic acne as a teen, and he did a course of Accutane at the age of 15 or so, but not before he had significant scarring which remains to this day. I know that he considers Accutane as the drug that "saved" him, in a matter of speaking.

He did another round of Accutane at the age of 30 because the acne was rearing its head again. He was closely monitored through the entire course of treatment -- for good reason! Its side effects are quite serious. His health now is fine. Of course, he was not on any other drugs at the time of treatment.

It's true that it is a serious drug, but acne is seriously debilitating to the self-esteem. My husband is very handsome, but still, at the age of 45, worries that when people look at him, they're looking at his scars and not at "him."

P.S. We have three sons, and we are on the lookout for any signs of acne, because my husband is adamant that they will not experience the grief -- and scarring -- that he experienced.

[Lyn Ploos van Amstel]

Hi there - I am one of those who almost never use any kind of prescription medicine if I can avoid it, for myself or my kids. (my husband is my polar opposite in this regards, so combined parental decisions in this field become tricky). My son was where your friend's son is two years ago. He and I tried everything else first to avoid Roaccutane but nothing made any significant difference to his skin. Finally we made the big decision and it was miraculous how everything turned around for him. He went from being a grumpy, moody, self-conscious teenager who never wanted to go anywhere, to his normal sunny, happy self, with a beautiful clear unscarred skin in about three months. I think under the proper supervision of a competent medical practitioner, whom you trust, these drugs can make the world of difference. Wishing your friend's family well.

[R Mathias]

I took Roaccutane as a teenager and have to say I wouldn't recommend it. I don't have definitive proof that everything I experienced was due to the drug but in hindsight I do think it had an effect. It did help the acne but not permanently and not totally. Following taking it I suffered from several severe bouts of tonsillitis, resulting in me having a week off school every month for 6 months. This added to existing academic stresses and I became depressed. I successfully dealt with it through counselling and it may have happened anyway but I feel the drug was a contributing factor. Research I did later showed that it can damage the lining of the throat and I think this perhaps led to the illnesses. Obviously it was a complex problem and different people respond differently to various drugs. I would just be aware of the side effects and watch your son carefully if you do decide to take it.

[Meg]

I'm not sure if Roaccutane now is the same as Accutane was in the late 90s, but I had a horrible experience with it. Granted, I was on a dose too high for my size, but it immediately caused extreme fatigue, stiff joints, and severe depression. It was the worst-case senario. For me, it was not worth it, at all. My dermatologist said an antibiotic wasn't working after a few weeks and insisted on Accutane, saying the side effects were very rare. However, I now know that the side effects for teenage girls are NOT as rare as they thought. Hopefully they've improved the drug since then, but I urge your son to think carefully about any alternatives, especially since he is already dealing with ADD.

[Juanita]

Like the blog, appreciate the share!

[Alison]

A bit late on this, I have two friends who took it back in the 80's, so it things may have changed - one had a good experience, the other developed the terrible, raised, keloids all over his chest, back and face. It was very hard on him. All best