What is Accutane?
(All About Accutane)

(by: Good Looking Pharmacist w/ Good Looking Loser)

Although this article is written by a registered pharmacist, it is not medical advice nor a suitable replacement for medical advice from a trained physician.
The following is subject to our Medical Disclaimer and is for connivence purposes only.
You are encouraged to verify this information with your doctor or dermatologist and obtain a prescription before using this compound. 

Forward by Good Looking Loser

I like covering scam-filled industries and and telling you what actually works. Cosmetics, especially skin care products- are some of the very worst.

Case in point- Proactiv.

Proactiv is arguably the most purchased, well-known and advertised skin care product in the world.

Over 200 million dollars is spent annually on promoting the product, often with airbrushed, photoshopped pictures of celebrities that have never had chronic hormonal acne. There is not a single ingredient in their formula that addresses any the hormonal or derma pathways that cause acne to flourish. It is one of the lowest rated products of all-time at consumer affairs (1.1 over 275+ ratings). Even mainstream doctors criticize the formula and warn buyers that it's main ingredient, benzoyl peroxide can cause tumors to grow.

Yet it remains the popular skin care product in the world.

Like Joseph Goebells, Adolf Hilter's Propaganda Minister of Nazi Germany, said-

If you repeat a lie long enough, it will become truth.

Certainly Proactiv followed the Third Reich's example to market their own products.

Instead of using white SS thugs, however, Proactiv stations unintelligent, highly aggressive, rude foreigners (YOU KNOW THE TYPE I'M TALKING ABOUT) at mall kiosks for $6/hour to shamelessly and verbally assault potential passing customers.

The over-the-counter treatments are less expensive but usually not much better if you suffer from persistent, reoccurring acne.

Whether you know much about it or not - you've probably heard of Accutane.

With good reason, in an industry filled with scams - Accutane is a Godsend for so many people.

People are often dissuaded from trying it because they heard will "kill them," from other people who haven't tried it.

Just like EVERY prescription medication - it will work for the majority and not work (and produce side effects) for a smaller minority.

Lets get to the bottom of things and sort through the propaganda using some first-hand experience and our resident pharmacist.

Erik's Accutane vs. Acne Experience

(Good Looking Loser w/ ErikTheGreat)

I, Chris, am not genetically prone to acne. I never got much as a teenager. Nor did I get it when I was taking 2 grams of testosterone on a weekly basis back in college.

Anytime anything on this blog is not from my first-hand experience, I make sure to let you know. I have never used Accutane.

I did consult my friend Erik (he posts in the forum sometimes) for his experience with this compound, he has used it for 3 "cycles" as overseen by his doctor.

Once when he was 17 years old, once during the summer between sophomore and junior year of college and once during the middle of a steroid cycle and into post-cycle.

All three times he experienced excellent results - what he estimates to be a 90% reduction in acne.

Erik didn't have extreme acne, other than during the tail-end of the steroid cycle that had consisted of 500mg of testosterone for 14 weeks and 30mg of Dianabol for the first 5 weeks. Two compounds notorious for causing lasting breakouts that can result in scars if not treated.

The estimated 90% reduction in his persistent, slightly above-average acne led to a nearly totally clean face that would last for several years. This is further notable because Erik is a professional hockey player, wearing the same sweaty equipment 5 or 6 days a week.

While some peoples faces are wiped clean, 90% is still significant.

I don't want to sound like a commercial, but it's definitely true- if you have persistent or extreme acne that has not significantly benefitted from commercial over-the-counter treatments and lifestyle/diet/hygiene changes - you might wanted to consider asking your dermatologist about Accutane.

This one is the real deal for a lot of people and the near complete solution to clear(er) skin.

Although Erik is our personal resource for this, we must know 10+ girls off the top of our heads that use or have used Accutane. It's quite popular and effective for females that often experience massive breakout before, during and after their period.

Not Erik, but representative of a 90% reduction in acne.

What is Accutane?

Accutane, sometimes referred to by its generic name isotretinoin, is a synthetic version of Vitamin A, used primarily in the treatment of cystic acne, or acne vulgaris.

It is found naturally in small amounts in the body, but this is too insignificant a quantity to cause an improvement of acne symptoms. It works by helping the skin to repair itself easier, reducing scarring and leaving skin more supple. While you may be thinking that acne doesn’t necessary warrant the use of Accutane, as much as 80% of teenagers, and bodybuilders will experience acne bad enough to seek help. Coupled with the fact that steroid using bodybuilders will have supra-physiological levels of hormones, it can be expected that acne will be much worse than the average person.

Uses of Accutane

As mentioned previously, the primary use of acne is in treating cystic acne, better known as acne vulgaris. However, there are other uses of Accutane including;

• • It is occasionally used as an adjuvant to other acne treatments, such as oral antibiotics or even benzoyl peroxide.

• • Acne Rosacea

• • Certain forms of brain cancer

• • Experimentally genital warts, though side effects may be a bit on the harsher side.

• • Treatment of Hidradenitis suppurativa- this is a disorder that affects areas with a high concentration of sweat glands, such as under the arms, and manifests itself as clusters of abscesses that occur over and over again, or as cysts.

• • Treatment for acne induced via medications, steroidals, birth control, etc.

How Does Accutane Work?

Interestingly, Accutane has been shown to work via multiple mechanisms, exerting a multi-faceted reach. These mechanisms include;

• • Promoting Cell Death- Accutane accelerates a process known as apoptosis; better known as cell death. It promotes death of multiple cell types, but most importantly being the cells of the sebaceous glands[i].

• • Accutane can change expression of genes important in skin health- by either decreasing or increasing the expression of particular genes, Accutane is able to modify the rate of skin development as well as sebaceous glands

• • Accelerates production of neutrophil-gelatinase-associated lipocalin (NGAL) in the skin, which reduces sebum production, as well as exerting anti-microbial effects.

• • Inhibition of metalloprotease MMP-9 (gelatinase) in sebum, which is known to have an important role in the development of acne.

Dosing Information

Speak to your dermatologist for advice how YOU specifically should take Accutane. The amount of acne you have and how you respond to your initial doses will determine how much you should take (and continue to take).

Usually a patient starts on a low dose such as ~40mg  (or two 20mg dosages taken twice a day) for 2 to 4 weeks and then uses a maintenance dose that generally higher than their starting dose.

This is a common dosing protocol-

When taking Accutane, it is advisable to take it after a eating a high fat meal, to increase its absorption. Accutane is highly lipophilic, meaning that is unable to enter blood without an appropriate vehicle. The dosage of Accutane required varies significantly from person to person, and depends largely on the severity of the acne and relative body mass of the patient.

Since many of the times Accutane therapy is initiated it is because of severe acne, a standard dose of 0.50- 1mg per kg of bodyweight daily[ii], split in two doses is recommended.

This treatment may last up to 6 months, and clears quite a few cases up completely. If following initial 4-week dose, acne is still present, a second dose may be initiated 8 weeks later, albeit at a higher dose. Bodybuilders may require this higher dose, but it becomes extremely important to monitor liver values if it is used, since Accutane by itself is highly hepatotoxic. Women who use Accutane may use lower doses, since the amount of testosterone flowing through their body is lesser than men.

Low dose protocols may be just as effective, produce less side effects and can save money.

For example, the 2006 "Journal of American Academic Dermatology" documents that just taking 20mg of Accutane on a daily basis for 6 months-

"... was found to be effective in the treatment of moderate acne, with a low incidence of severe side effects and at a lower cost than higher doses."

How Often Will I Need to Take Accutane?

Well, luckily, for many users, acne will disappear completely after the first go (as many of 40% of users report this). Though its only 40%, this is a massive number considering that they were considered incurable prior to initiating therapy.

A further 40%, though not cured, have their acne significantly improved, and will probably be cured with one subsequent course of treatment.

The final 20% may experience relapses as bad as the original episodes, but, as a major plus, each subsequent course of treatment is more and more likely to bring about a cure.

This is a very good trade, considering the toxicity of the drug. You will not be required to use it for life, and are very likely to cure your acne altogether (since 8/ 10 users attain this) by the end of a second cycle.

Acne sufferers stand a lot to gain (or acne to lose) if they follow through with the treatment and not irresponsibly "forget" to take it.

(for some reason a lot of kids "forget" to take Accutane and wonder why it failed them - if you resemble this description, please stop reading my blog forever)

What to Expect When Using Accutane

When using Accutane, initially you may experience worse acne in the first 4 weeks.

This is in response to the sebaceous glands producing more sebum, before they are inhibited. Not to worry though, as this only lasts a short period before the true power of Accutane kicks in. Some people claim that Accutane causes depression; however, it may just be exaggerated after they’ve already had it.

Since it's a very powerful compound, you may experience some bothersome side effects, listed below.

How Pimples Occur and Disappear

Side Effects From Accutane

The main concern when using Accutane is its hepatotoxicity (liver toxicity), especially as the dose for the medication increases. Doctors will give their patients a liver panel (especially GGT) every 4 to 6 weeks to make sure everything is okay. It should be noted that numerous prescription drugs also affect liver values, Accutane is not unique in this facet.

That is why you SHOULD NOT be consuming large amounts of alcohol or using oral steroids.

Obviously some people do both and don't die - we're just telling you not to. You should drink a lot of water, up to a gallon a day. Diet soda, coffee or French fries do not count as water.

There are other common common adverse effects that are associated with its use. These may include, in order of frequency-

Common Side Effects

• • Dry Lips (92% of Users)

• • Dry Skin (57% of Users)

• • Dry Nose (30% of Users)

Less Common Side Effects

• • Rash (can include eczema)

• • Inflammation of the lips (Cheilitis)

• • Hair Loss or Alopecia (this is possible but not more than any other prescription drug, any hair that lost will likely return because it is the result of "shedding" and not miniaturization)

A lot of these side effects dissipate after your body gets used to the compound.

If you are having lingering extreme side effects (significant depression, mood swings, headaches, fatigue) beyond the bothersome ones listed here, call you doctor - you will probably have to discontinue Accutane.

Accutane and Bodybuilding

As with the rest of the information in the article, this is not medical advice.

This is just a fictional guess to shed light on how and why bodybuilders prone to acne use Accutane.

Bodybuilders need to use it in a very particular way to control their acne, while maintaining muscle mass. Accutane has been shown to decrease growth hormone and IGF-1 levels, after just 3 months therapy. This may be bad for natural athletes, especially since those two hormones are some of the most anabolic in the body. Anecdotal evidence from users also reported that testosterone levels become suppressed, although more evidence for that claim is needed.

Steroid users that experience brutal acne from a cycle can use one of two approaches;

• • If the acne is largely steroid induced, a low dose of about 10mg daily should suffice. Though all the acne may not be removed, it is likely to control it to a great extent

• • If you had acne issues throughout your life, you may need to use a larger dose. However, certain considerations have to be made, such as the potency of the steroid on the liver, since Accutane also is quite liver toxic. Injectable cycles should not be a problem, but you need to closely watch your liver values when you use the drugs concomitantly.

Megadosing Vitamin A Instead of Using Accutane?

Since Accutane is quite similar to large dose of Vitamin A, a lot of people are curious if they can just use megadose Vitamin A instead.

First off, Vitamin A (like Accutane) is fat-soluble can be quite hepatoxic to your liver. You cannot just pop Vitamin A caplets at will, like you could do with Vitamin C or Vitamin B12. If you were under the notion that doing this sort of thing would be productive - stop thinking about it.

Despite the similarities, you need to take a toxic dose of Vitamin A to equal the effects of Accutane.

If you have a low-moderate case of acne, It might be worth speaking to your doctor about incorporating a large(r) but safe dose of Vitamin A into your diet. Many of the mechanisms between the two compounds are similar. But don't expect it to work miracle or be "just as good" as Accutane.

In short, Accutane's active molecule is significantly more bioavailable (able to be used by your body) than Vitamin A. You'd have a near toxic dose of Vitamin A to replicate the effectiveness of Accutane. This isn't something you are going to want to try.

Although Vitamin A isn't usually a total solution for acne, adding it to your diet can only help.

How Can I Get Accutane?

Currently, Accutane is reasonably controlled in its sale, requiring supervision by a Dermatologist for prescription and dispensation.

Due to some of the rarer side effects, like birth defects, patients need to be thoroughly analyzed before using the drug. Pregnant men or women should not take Accutane. Like many prescription drugs, it has also been implicated in cases of suicide, making Dermatologists reluctant to prescribe it if you have a history of psychological issues or if you are a reckless, irresponsible idiot.

Accutane Tips (Do's and Don'ts)

(w/ ErikTheGreat and Blake)

Like I said, Erik has used Accutane 3 times and Blake (resident hot girl) has used it once, here's their personal tips for you-

DO NOT

• • DO NOT Drink.
    
    Mixing alcohol and Accutane can cause enzymes to raise very quickly. In theory, you can blow out your liver in a single night.
    
    (everyone always gives the advice "don't mix ___ with alcohol, it's dangerous." In this case, it actually is a significant risk.

• • DO NOT Take oral steroids.
    
    Same deal, it's bad for your liver and could cost you big time.

• • DO NOT Take vitamin A.
    
    Other than vitamin A from food, you don't even want to take a multivitamin. We've discuss how both vitamin A and Accutane are similar and how they can be toxic in high doses.

• • DO NOT Use over the counter acne treatments, especially benzoyl peroxide (Proactiv and other shitty treatments).
    
    Your skin will be super sensitive and might be very dry. Using over the counter treatments will cause imflammation and can harm your skin.Only moisturizers are acceptable. Check with your doctor if you have any questions about a specific product.

• • DO NOT Take other vitamins to try and speed up the process.
    
    These probably won't harm you but they won't do a damn thing. Only vitamin E and fish oil may be acceptable, ask your doctor.

• • DO NOT Eat a lot of junk food.
    
    It's bad for you and encourages acne.

• • DO NOT Ignore persistent physical or psychological side effects.
    
    To some extent, your should get used to the Accutane in the first 4 weeks. If things seem to get worse, tell you doctor immediately.

• • DO NOT Go tanning.
    
    Limit your sunlight exposure as much as possible.

DO

• • DO Moisturize your skin and lips.
    
    Your skin will probably get dry, most people's does. A basic moisturizer will do. Consider put a little humidifer in your room as humidity is generally better than any topical product.

• • DO Use a mild cleanser.
    
    Don't wash your face more than 2 times a day though.

• • DO Take your Accutane with a meal that has fat.
    
    This isn't a green light to eat junk food, as we've already mentioned.

• • DO Drink a lot of water.
    
    Have at least 12 oz. when you take Accutane and close to a gallon of water a day.

• • DO make a calendar.
    
    You should know when you started Accutane, when you finish Accutane and when you doctor has told you to change doses.

Further Resources

• • Acne.org: How it Works, Side Effects & Reviews 

• • Good Looking Loser: Skin Care