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Evil shit made by the pharmaceutical company Roche. Taken regularly, it alters your skin's chemical composition, in order to eliminate acne. Apparently it's done wonders for people with extremely bad cases, and for most people it causes skin problems to completely disappear after five months. Which might make it worth the side effects, which include: How much would you expect to pay for a month's supply (sixty 40-mg capsules) of this wonderful stuff? $100? $150? This shit costs about $350/month. And if you're not one of the 95% who only need to take one set (five months) before you're cured, you get to pay $3500 over the course of the worst year of your fucking life.

And if you're really fucking unlucky, you'll still have acne a year after you've finished your treatment, and look in the mirror one day to see one of those giant lesion-looking zits sitting there on your face. The only kind of epidermal flaw the stuff actually kept off of me, and now I have one again. I thought this kind of thing was supposed to be gone when I hit 18 and my body stopped growing.

My little brother used accutane (WHICH CAN CAUSE LIVER FAILURE) and ended up in the hospital for 3 days and stopped using accutane. He came out of it with an extremely low tolerance for alchohol... but his skin was as smooth as a baby's bottom.

One of my room-mates in university was using this product, he showed me and my other roomies the warning pamphlet which contained a phrase that stands as the most disturbingly worded warning I have ever seen in a commercial product -

"If you are pregnant, and are considering taking this product, your doctor has a line drawing you should request to see."

No elaboration in the pamphlet, but I assume this was with regards to the birth defects. Kids, just say no.

Don't knock Accutane. It's meant for extremely bad cases of acne. I had acne so severe on my back through high school and college that I often suffered pain simply from sitting in chairs and lying down. I had to warn people not to slap me on the back or hug too hard. My shirts would get stained with blood where the large acne had bled. I tried soaps, creams, antibiotics and the like over the years and none of it worked. Finally last year I went to a dermatologist that prescribed Accutane. Yes, it is incredibly expensive. It was $490 for a 6-week supply, but fortunately my insurance covered it. I took it for six months. I had to go to my dermatologist for blood tests to make sure it wasn't doing strange things to me. The side effects I suffered was the complete loss of oil in my skin. My forearms, hands, face and nose became ridiculously dry. I had to constantly apply lotion to my skin (four or five times a day). My lips were extremely chapped and they bled. My nose was bone dry inside, and I had to shove moisturizing ointment inside it to keep it from bleeding and peeling.

I would do it all over again, too. The acne on my back is completely gone. My girl can give me a back massage now. My shirts don't get ruined anymore. I don't have to constantly shift positions in my chair so that it doesn't hurt. And no, Roche didn't pay me to say all this.

Ok, I took accutane for the full course (which is like, 6 or 8 months, I forget). It worked perfectly. I didn't have horrible acne, it was only on my face, actually. I guess I wasn't particularly at risk. After taking my initial blood test, the doctor said I had the cholesterol of "a Tibetian vegetarian guru", and needless to say, I didn't suffer much in the way of like, liver failure. I didn't, to my knowledge, become clinically depressed either.

Seriously, the FDA is not that negligent. If accutane had any sigificant chance of harming people (as in, greater than 0.001%) it would not still be on the market. It's been around since the 70s, and had it any serious short- or long-term side effects, it would've been yanked. Yes, there about 50 warnings on the package about women during pregnancy, but once it's gone, it's gone. No harm done. I haven't had any significant acne since I took it, several years ago. The only side effects I experience were dry lips and facial skin. For me, that was quite a fair price to pay for not having to deal with rather prominent facial acne.

A Clinical Perspective

About Accutane
Accutane is Roche's brand name (it is called Roaccutane in Europe) for isotretinoin, a chemical cousin of vitamin A. It is prescribed to treat severe, disfiguring cystic acne that has not cleared up in response to milder medications such as antibiotics. Accutane works on the oil glands within the skin, shrinking them and diminishing their output. It is taken by mouth for several months and then discontinued, with the effect lasting for a few months thereafter.

Possible Side Effects
Abnormal hair growth or loss, allergic reaction, bleeding gums, blood in urine, bowel inflammation and pain, bruising, changes in blood sugar, cholesterol levels, and skin pigmentation, chest pain, decreased night vision, decreased tolerance to contact lenses, a delay in wound healing, depression, difficulty sleeping, dizziness, drowsiness, dry or fragile skin, dry or cracked lips, dry mouth and nose, fatigue, flushing, headache, hearing problems, heartbeat irregularities, herpes, itching, joint pain, liver disorders, menstrual changes, nail disorders, nausea, nervousness, nosebleeds, peeling palms or soles, pinkeye, rash, skin infections, stomach and intenstinal discomfort, stroke, sudden drop in blood pressure, sweating, swelling due to fluid retention, tendon and ligament problems, urinary discomfort, vision problems, vomiting, weakness, and weight loss.


  • Accutane is a last resort. A doctor should eliminate all other possible methods for dealing with the acne before turning to Accutane.
  • The drug is known to cause severe birth defects, and women must watch a videotape and sign a consent form before taking it. They must also have two negative pregnancy tests before taking Accutane, and have monthly pregnancy tests while taking it. Two forms of birth control should be used while a woman is on Accutane.
  • Because Accutane affects the body's processing of fats and sugars, it should not be used by people with diabetes, high triglyceride or cholesterol levels, obesity, or alcoholism.
  • Accutane has been known to cause increased pressure inside the skull, particularly in individuals also taking tetracycline. Symptoms of this include headache, nausea, and visual disturbances; these should be reported to a doctor.
  • The drug has been recorded as having caused depression and other mental problems, including thoughts of suicide. This is still under investigation at this writing, following the kamikaze flight of a Florida teenager taking Accutane.
  • Persons taking Accutane should not donate blood or stay out in the sun too much. They should also avoid waxing for hair removal or any skin resurfacing treatments such as dermabrasion.
  • Because Accutane is related to vitamin A, individuals on the drug should not take vitamin A supplements - this would be equivalent to overdosing.
  • Symptoms of an Accutane overdose include abdominal pain, dizziness, dry or cracked lips, facial flushing, incoordination and clumsiness, headache, and vomiting.

Recommended Dosage
The recommended dosage range is 0.5 to 2 milligrams per 2.2 pounds of body weight, divided into two doses daily, for 15 to 20 weeks. Most doctors will start a patient at 0.5 to 1 milligram per 2.2 pounds per day.

The PDR Pocket Guide to Prescription Drugs, page 6.

So you're taking a scary medication with many 'possible' side effects that comes in a scary package with line drawings of possible birth defects and pictures of pregnant women with a big NO symbol over them. Read the information, learn the clinical facts about what you're putting into your body! But there's a few things that the packaging won't tell you, so here's just a smattering of information gathered from first and second-hand experience that might make your six months on Accutane go a little more smoothly.

Necessities for surviving a course on Accutane:

  • A prescription card
    The stuff doesn't come cheap folks. One of the writeups about the drug mentioned a cost of about $350/month. Yeah, you wish. For the doseage I'm currently on, it runs $600/month. That's $10 per pill. (Incidentally, when the doctor broke it down like that, I almost blurted out, "Oh, that's not so bad, I've paid $30 for a pill at a party before...") And if you're a female, the required two forms of birth control won't run cheap, either.
  • Lip Moisturizer
    And lots of it. Chapstick ain't gonna cut it, either, and forget about any of that sissy lip balm. You need hardcore stuff here. Aquaphor is my favorite, I've heard good things from fellow Accutane users about Carmex and Vaseline Intense Lip Therapy. I'm talking crates of the stuff...you'll be applying it every hour on the hour.
  • Speaking of Moisturizer...
    You'll want moisturizer for a place you would have never thought of before. And get all your minds out of the gutter, I'm talking about your nose. Nosebleeds are one of the most irritating side effects of taking this medication, and moisturizing nose sprays (nothing medicated here, just OTC saline spray) won't completely eliminate this, but they help quite a bit.
  • Sunscreen
    Sun sensitivity is a common side effect of most acne medications, so chances are if you're taking Accutane, you know the drill by now. Put on some sunscreen, you can get a tan when your course is up and your skin is perfect.

My final piece of advice involves those pictures of pregnant women printed on the back of every single Accutane pill in the package. They are there for a reason, I suppose, so that every time you take a pill, you are reminded not to get pregnant. Good advice, true, but this system also leaves tiny pictures of pregnant women scattered all over your floor from after you punch the pills out. If this annoys the hell out of you, just tear the packaging to pieces. Once you do this, your ten pills will be in foil and bubble packaging, like a normal drug. Which this isn't. But hey, it's (hopefully) only for six months.

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