Accutane.

"I micro dose Accutane so I currently take two pills a week each one's 40 milligrams which has really been great. [...] Accutane is the brand name of isotretinoin a retinoid given by mouth to treat acne. It works because it is a comedolytic meaning it dissolves blackheads and whiteheads and it also is sebum suppressive it reduces the output of oil."

"Accutane, branded name for isotretinoin, an oral retinoid, that quite literally was one of the most game-changing inventions in dermatology. [...] Before Accutane, if you had acne, nodular acne, scarring was the outcome. You were going to likely have scarring in some capacity. [...] When isotretinoin came on the scene, it completely changed that because it's really the only medication that can, being the key word here, cure the acne. It can shrink those abnormally dilated and enlarged and active sebaceous glands that are driving the sebum. It has so many benefits for acne and it keeps people from having disfiguring scarring acne, completely has changed lives. There are side effects with isotretinoin for sure, and it should be administered by your health care provider, a board certified dermatologist."

"Accutane is a retinoid given by mouth to treat acne and while it's very effective for many people for treating acne it is not at all safe during pregnancy it causes severe fetal malformations that are not compatible with life."

"This patient's a candidate for Accutane. They've got a lot of acne and they're at risk of scarring. They really need a treatment plan to go ahead and prevent future scarring from really bad acne. Accutane can be a great option in those circumstances."

"I might actually just put a patient on Accutane and really try to dry up those oil glands so that they're not getting this recurrently because topical medications like retinol are although effective can only go so far if you have this many forming on the skin you might need to treat it from the inside and Accutane can be a really good option and because there's not a ton of inflammation it's not inflammatory cystic acne a course of Accutane is probably going to take a little longer but ultimately it would give you a really good result."

"I had a bigger one on my cheek a couple of weeks ago. I took Accutane when I started to feel that deep one coming up, and it knocked it down, perfectly."

"Accutane is the ultimate acne treatment, and it far and away exceeds the results from topical acne treatments and oral antibiotics because once you stop taking it, the acne does not tend to come back in most patients. I took it myself for about four months as a resident and had a pretty durable response just from that, and I've been happy ever since. It's an oral pill, a synthetic form of vitamin A, that shrinks the oil glands and normalizes how skin cells mature so they stop plugging up your pores. The downsides are dry skin, cracked lips, and easy sunburn, plus rarer risks like joint pain, elevated liver enzymes or triglycerides, and very rarely pseudotumor cerebri. It's expensive too, at least $150 a month if you're paying cash, plus blood draws and monthly visits for about six months, and anyone who could get pregnant has to go through the iPledge program with monthly pregnancy tests because it causes severe birth defects. Still, for severe cystic acne at risk of scarring, or acne that's really hurting someone's quality of life, it's usually the first treatment I'll recommend."

"For the most severe cases of acne that are especially at risk of causing scarring, Accutane is typically going to be the go-to. It's a great option, it is curative to the acne, and it has a high cure rate. It's not a perfect pill, a lot of people think they're going to go on Accutane and their acne is gone forever, but it's a great option to use after we've tried less intensive things."

"I've been prescribing Accutane for ten years, and the evidence just doesn't support that it causes depression. In fact many patients' moods improve once their severe acne clears, and in my own practice I've only had one patient develop depression on it, and they were able to restart and finish the course later without a problem. As for the medication itself, it's a potent oral retinoid that drastically reduces oil production, fights the bacteria that causes acne, and calms inflammation, which is why it's considered the gold standard for treating stubborn, severe cystic acne, including acne that scars. A fifteen to twenty week course can lead to an eighty to ninety percent improvement. But there are real side effects: dry skin and chapped lips are almost impossible to avoid, some people get dry eyes or mild nosebleeds, we sometimes monitor labs for elevated lipids or liver enzyme changes, and there are teratogenic risks, so anyone who can get pregnant has to follow strict contraception and testing rules. Rarely it can cause pseudotumor cerebri, and about ten to fifteen percent of people get achy joints or low back pain that resolves once they stop. I took it myself and haven't had any long-term negative effects, and most people don't either, though twenty to thirty percent will see some acne relapse down the line. The bottom line is Accutane works wonders for severe acne, but it comes with the potential for side effects and strict guidelines for use, and while relapses are possible, many people do get long-lasting relief."

"I treat acne every day and I prescribe Accutane almost every day to my patients, and I've taken it personally, my wife has also taken it, and a lot of my staff members have taken it. The side effects are almost a given: dry lips and dry skin during any course of Accutane, and about 10 to 15 percent of my patients develop joint pain, though it's never persisted beyond a course and never limited their daily activities. Nosebleeds can happen too because the nasal passages get dry. On depression, when we look at the actual data, the rates of depression in patients who take Accutane are really no different from patients who don't, and I would not say suicidal thoughts are common on Accutane. In almost 12 years of prescribing it and screening every patient every single month, I've only had one patient develop new onset depression or suicidal ideation, and they stopped, got treatment, and later restarted and finished the course with a great result. Many of my patients actually get happier on it because clearing their acne restores their confidence. It's appropriate if you have severe cystic scarring acne, or moderate acne that topicals can't control, and sometimes even for persistent mild acne when other options aren't covered by insurance. It's not a good fit for everyone though: uncontrolled mental health issues like bipolar depression, heavy alcohol use, or genetic triglyceride problems can rule someone out. It is not a toxic drug that should be banned from the market, and it's also not a drug that's appropriate for everybody with a pimple, but in the right patient, with a good relationship with your dermatologist to determine candidacy, it is something I think is a very good drug, and I absolutely love that we have a medication that can help people regain their confidence."

"Accutane is essentially a synthetic form of vitamin A, and when you take it by mouth it helps shrink down the size of your oil glands, but it comes with a number of potential side effects. I believe those can be managed quite well under the care of a dermatologist, but some people do suffer throughout their course of Accutane and others experience long-term side effects. I prescribe Accutane in my clinic every day, and it's a fair number of people who end up dealing with side effects like skin and eye dryness, chapped lips, GI upset, headaches, joint pain, and muscle aches, though we don't lose that many patients to the side effects because we're careful about setting expectations and helping them get through it. It also gets patients started more slowly, since they don't really see a lot of improvement until they've been on it for about two months. Still, I think Accutane can be a good drug."