Acne is a very common skin condition that I help manage for dozens of patients daily. Not only can it bother patients physically with pain and scarring from cysts, but a large part of its effects can also be psychological, affecting self-confidence and even contributing to depression and anxiety.
My Experience with Acne
Now I know, you’re all saying, Dr. Massie what would a guy with a perfect face like yours know about acne and low self-confidence? Well, I’ll let you in on a little secret. Back in high school, probably 8-9 years ago (don’t question those numbers), before being the dashing gentleman-about-town you all know, I struggled with acne myself.
Throughout most of high school, I tried countless treatments for my moderate acne vulgaris. None were successful enough for me to get any of the dates I wanted though! But keep in mind I also wore tear-away track pants and Portuguese soccer jerseys almost every day, despite having no Portuguese heritage, so there might have been multiple factors contributing to that…
That being said, I was lucky enough to manage my acne and avoid scarring with topical treatments, occasional antibiotics, and good skincare. However, in some cases, these treatments aren’t enough. That’s where we look to Isotretinoin, better known as Accutane, and more recently Epuris and Clarus.
How does Accutane work?
Whenever I bring the idea of Accutane up with a patient, I am always curious to see their reactions. There is so much information and misinformation out there that I find it’s rare for a patient to have an open mind. It’s unfortunate, because sometimes patients who could benefit from it are too scared to try without even being able to say why.
Isotretinoin is a retinoid and thus a Vitamin A derivative. It works by shrinking sebaceous glands and decreasing sebum production, a product that feeds the bacteria that worsens acne. It helps to unclog pores, decrease oil production, and limit inflammation, thus tackling all causes of acne with just one medication.
Finding the Right Dosage
I have parents often come in nervous about putting their child on medication because of their own experiences, so it is important to realize how much things have changed. Years ago, the consensus was that a high-dose treatment plan would get the best results. However, recent studies have shown that management can be just as successful with far more reasonable doses that cause fewer side effects. This is typically taken daily once with food but unlike before you no longer need to eat a 72 oz steak and a Denny’s Grand Slam with each pill!
Side Effects of Accutane
As with all medication, there is always a chance of experiencing mild side effects. Most patients can expect dry skin and dry lips. Usually, this is mild enough to manage with an oil-free moisturizer and some Vaseline for the lips. Less commonly, patients can develop nose bleeds, dry eyes, joint pains, and abdominal discomfort. Throughout the process we also monitor for symptoms of depression, though most research has found that there is no evidence of the medication impacting one’s mood.
Before getting started as well as at certain checkpoints during the process, all patients will need to get some bloodwork done. In most cases, patients spend approximately six months on the medication during which we meet every month to monitor progress and make any necessary adjustments.
Female patients will need to practice two forms of contraception as the medication is not safe for developing fetuses. Rest assured, if you do not have birth control already, we can find the best option together and have it prescribed for you at our clinic.
Isotretinoin has a very high success rate for treating acne and one of the greatest benefits is that its results typically continue once we have completed the course. It is the only medication I have that can permanently alter the course of acne for the better. Regardless of what you’ve heard about it, if you have acne that is not responding to other treatments, you can only benefit from coming by my dermatology clinic in Calgary to discuss other options!