Hannah* is currently a college student who struggled with both acne and rosacea. Her dermatologist suggested the use of the medication isotretinoin, which is a prescription medication used to treat severe, cystic acne that is resistant to other treatments. She shares her experience going on isotretinoin as a treatment for her skin problems.
How did you decide on isotretinoin for treatment of your acne?
“I had a lot of mixed feelings about using isotretinoin. I started getting regular teenage acne when I hit puberty, but my skin always seemed a lot worse than my peers. I went to see my dermatologist and he said my redness was due to rosacea and that the small bumpy acne all over my forehead and cheeks was different from regular teenage acne.
So then started my journey by trying what felt like every single medication and combination of topical treatments in the world. I had tried everything from antibiotics, topicals, and cleansers from the time I was in 6th grade up until the end of junior year of high school.
I asked my doctor what I should do next, and he suggested isotretinoin. Although isotretinoin also had the side effects of liver damage, pregnancy defects, and some very rare instances of depression or suicidal thoughts, the research I gathered by talking to dermatologists and those who had taken isotretinoin reassured me of its effectiveness.
I then went on a 6-month course of a brand of isotretinoin called “Absorbica.” Before my process of getting my first month’s prescription, I was handed an iPledge booklet, which explained all the side effects and precautions I had to take when taking isotretinoin.”
What was it like being on isotretinoin?
“Every month, I had to get a pregnancy blood test. This did become a hassle at times especially when I had a busy schedule. Once my test results arrived at my dermatologist, I would have to schedule an appointment to review my test results and see how I was doing in general. After, I would have to go online and answer questions that tested my understanding of using the drug. Then, finally, I was able to pick up my prescription at the pharmacy for that month. It was a very long and time-consuming process. It was also time sensitive so it was essential to stay organized, book appointments in advance, and stay on top of everything.”
Did you see any results?
“By my 3rd month of taking Absorbica, my skin was almost completely clear. After the full 6 months, my skin was nearly flawless. Even the acne on my back and chest was gone. Unfortunately, this only lasted for about 3 months before my acne came back; however, it was much improved than from when I started, and it was only my face that started to get those many tiny bumps (but less “dense” than before).
By this time, I was entering my senior year of high school and I wanted to have clear skin before I graduated. My dermatologist told me it was not uncommon to have a second course of isotretinoin. My mom was hesitant because she read the side effects, and she was worried. My first round wasn’t too bad, and my liver wasn’t having any problems so I decided to take a second course for another 6 months.”
Where there any problems you encountered?
“Some of the side effects I experienced included chapped lips, dry skin, and sometimes dry eyes. My dermatologist was also monitoring my white blood cells because apparently, they did lower at one point during the course of treatment.
My acne was fully gone within 2 or 3 months after using the medication, but I still had the drying side effects. When my course was finished, I was entering the second quarter of my first year of college. My acne (those pesky small bumps) started to come back again, but always less “dense” as before. After having clear skin for so long (twice), having it come back even though it was better was still so difficult and I felt distraught about it.”
How do you currently feel about your skin?
“I was glad that I was able to have clear skin throughout most of my senior year of high school and first quarter of college. I felt that it really boosted my confidence and made meeting new people and making new impressions easier. I’ve grown a lot since the start of college and I’ve come to accept my skin for what it is and that I and anyone else with skin difficulties are beautiful. My confidence now comes from within and even though my acne is not entirely gone, I am proud of who I am as a person and the care that I still have for my skin.”
Do you recommend that others with similar skin conditions use isotretinoin?
“To those who are considering taking isotretinoin, I believe that after talking to your dermatologist and doing your own research, if you are leaning towards taking isotretinoin, it is not a “bad decision.” I don’t regret taking it at all. Although it was difficult to regress, it is good to be aware that your acne may not be all clear for the rest of your life. In some cases, it is mostly gone and in some cases, you may need to take a second course if you choose. My advice is to explore all of your options such as birth control, spironolactone, or other treatment options before committing. Even now, my acne actually responds better to all of the medications I had tried before going on my first course and maintaining my skin is actually much easier than before isotretinoin.”
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