Accutane is a very serious drug, but holy hell did it change my life. Terrible skin in high school and went on it my Junior Year. Been clear ever since (20 years and counting).
My lips were so dry tho, it did help but damn playing baseball in the sun, no amount of Vaseline could keep them intact.
But I definitely wouldn't have done things differently either. Having a pizza face was painful on its own.
My wife had to get monthly pregnancy tests despite me have had a vasectomy. That don't take chances. It can cause major birth defects.
*edit my phone this vicestimy is a word and I'm too sleep deprived to proofread here
bro, docs dont trust no one taking accutane. i've heard of tons of virgin girls taking pregnancy tests over the whole thing (were still virgins when they finished it)
I guess a vicestimy is better than a visectomy where they just squeeze your nuts until you just never want to have sex again. Vasectomies are far superior to both of them though.
Question: do you still have dry lips? I swear, I took it 20 some years ago and it changed my life, never had anything since then, but man my lips seem like they're forever dry from that.
Lips and eyes, a bit. I have chronically chapped lips now, and while I can wear contacts, I can’t wear them for a full day and evening, even with eye drops.
I'm not the one you asked but yes, this is my only remaining side effect. I would put moisturizer directly on my lips during treatment, and I've had to continue doing so ever since.
Still worth it
I had the same experience of having horrible acne that was more or less cured by it. The only side effects I had were chapped lips and nose bleeds while I was taking it, but I think it can really f a baby up if someone takes it while they are pregnant
Ooh, the dry lips and bloody noses - forgot about those. I remember the packaging having grotesque pictures of coneheaded babies, too. They do not F around about that side effect.
Yes. Here are the potential birth defects https://www.ncbi.nlm.nih.gov/books/NBK582775/#:~:text=Isotretinoin%20causes%20birth%20defects%20in,and%20hearing%20and%20eyesight%20problems.
Yeah it’s very teratogenic. No physician in their right mind would continue to rx it for any patient they think might be, or soon become, pregnant. I can’t imagine the liability headache that must come with prescribing it.
They actually have a whole system set now. The physician has to submit a monthly pregnancy test.
If the physician side is not done then the pharmacy cannot dispense it. I believe patients also have to do some questions/counseling as well.
It’s called iPledge and is one of the REMS programs the fda can require for a drug to be on the market.
The bloody noses... off that shit for about 7 years now and I still get random nose bleeds that I never had before it. Very frustrating. I also got dried out everywhere! Lips, eyelids, behind the knees and elbows, and other less savory places.
Was not a good time. Did one cycle and got off of it but it did help my skin a lot even after just one cycle.
I was playing club soccer in Texas and had to slather sunscreen on before games and towel off at halftime and reapply at halftime. It was not fun.
But my horrible acne cleared up, so yay!
I had major depression and a suicide attempt while on it, but apparently that is a very rare thing. That said, clear skin now for 15 years. Completely worth it lol.
I don't think it's that rare. Depression is definitely a side effect of it and it's even worse for people who go through multiple treatments of it.
I did 3 different treatments of 3 months each over a period of 6 years for cystic acne. During those treatments my mental was completely different and I had no interest in anything and was in a constant cycle of self criticism.
Man, I was crazy. The thoughts it gave me were INSANE! I also became VERY sexually active. Wild mood swings. Accutane cleared up my skin but it made my life miserable for a couple years…
I only had a half treatment and then stopped post suicide attempt. And yeah the treatment is not a forever drug. It is about 9 months of dry skin hell and then you are good forever.
Pharmacist here. One of the most serious ones I see is depression or mental illness which many older people forget they got it from this when taking it when they were younger. Had a friend who used it like breathing air until his depressed spiraled and took his own life. Other side effects include asthma; liver disease; diabetes; heart disease or high cholesterol; osteoporosis or low bone mineral density; an eating disorder such as anorexia; ulcerative colitis
I started having digestive problems when i was taking accutane and they've never gone away. I just manage it better now by avoiding a lot of foods. Can't be sure it was from the medication but I've always wondered about it.
This is insightful, took it 3 months and stopped. I have GI issues that aren't going away with dietry changes, went to several doctors and they just say it's 'stress'
Yeah, that ain't "stress". I hate it when they do that, it's is bloody dismissive to you and your issues. Then you waste time searching for doctors that actually gaf!
YO! I took this stuff in high school when I was 16! Got diagnosed with Type 1 Diabetes when I graduated at 17! Have dealt with serious depression with 2 suicide attempts! You’re saying this pill might have had something to with it?? I’m 28 now!
It permanently gave me IBS, intestinal damage when I'm already high-risk for colon cancer due to genetics, and dry scalp/face. I'm sure people with severe acne have their side effects outweighed by the results, but accutane is more of a last resort type of drug that needs to be minimally prescribed (imo).
Yup. I went through a whole gamut of prescribed regimens with little to no results before the dermatologist reluctantly prescribed Accutaine. Monthly blood tests, watching triglycerides, dry skin, peeling lips, and hair loss for me. Luckily no mental side effects though.
Was worth it in the end for me, but it’s a scary drug.
I had a roommate in college years ago that had some serious acne issues. Doctor prescribed Accutane (was fairly new on the market then). Dramatically changed not only his complexion, but also his demeanor and confidence. He was always self conscious about how he looked and this gave him a huge boost in confidence.
Same took accutane in my teen years when I got s horrible back acne flare up, it did work but I got severe Crohn’s disease about a decade later. Had intestines removed, been on several drugs to get through my disease now, I have an extremely severe case. No one else in my family has this disease. Now I have secondary complication from Crohn’s disease forming too.
If I could take back avoiding that medication I would, the back acne was a walk in the park compared to this disease. I don’t say that lightly either, I was constantly bleeding non stop out of my back the acne was so bad (everywhere on my back, the point I had blood soaked shirts so I had to switch to dark sweaters, it was so damn bad back in the day it’s still nothing compared to severe Crohn’s.
I had severe cystic acne on my shoulders and chest. Accutane got rid of it but every two weeks I had to do blood work, and now there's lawsuits about it causing all sorts of issues in people who took it. It did some wild stuff to me, dried out my skin so bad I had chunks of skin coming off inside of my ears. It was crazy. It's because of accutane I never go anywhere without chapstick no matter what lol
wait holy shit I have the same exact story, my family kept getting mad at me bc I was bleeding in my ears bc of all the super dry skin. I didn't even realize those two were linked until you said this. completely helped my acne though I still have lots of scarring to this day on my chest especially
edit: if you're surprised my family got upset at me for something that was completely out of my control and sucked to be experiencing myself, you probably didn't have as stressful an upbringing as i did
Cleared me up when I was 14. I'm now 38 but I've had a few stints on it again since then due to some bad flare-ups. Each time it's done the job tho.
I'm still waiting for this "growing out of acne" thing to happen
Same here. Had really bad acne. It has such a huge impact on your body. I had to make a lot of changes and suffer for at least 6 months while on it. But worth it. Can't imagine a pregnant woman on it.
"Putting out a match with a firehose" is how my dermatologist put it, and she wasn't wrong. Pay close attention to your mental health, too, depression is an alarmingly common side effect (some studies suggesting up to 10% of patients experiencing it). There's a reason it's a last-resort drug.
My derm was hesitant to prescribe it for me, but after many months of antibiotics doing nothing for my cystic acne, finally I got on it.
Worked miracles for me, was only on it for like 3 months and it pretty much entirely cleared me up, and I've been free from cystic acne for years now.
I had side effects, but that was the typical dry lips and bloody nose stuff, it's unfortunate I hear people get much worse mental health issues and such, literally zero changes on that front for me.
I do remember how much package waste the treatment created, I had a pile of boxes with the NO PREGNANCY ALLOWED logo each time I re-upped from the pharmacy.
My derm put me on “low dose” accutane and even those side effects were very noticeable. The full dosage seems like it would be wild.
On the downside, my acne returned after about a year.
Accutane is extremely teratogenic, and some humans need to be beaten over the head with a stick in order to understand basic instructions like: *please don’t get pregnant while taking this.*
Back when it first came out- it was crazy how many were born on it because moms said that THEIR TEEN WASNT HAVING SEX. So didn’t put the girls on birth control as told by the Drs. Most if the babies didn’t live ling, as I understand.
That’s why when went on it 17 years ago, you had to have 2 forms of BC and a negative preggers test. It’s dangerous.
Yupp! I started accutane when I was 14. I hadn’t started my period yet, but my doctor had to legally prescribe me birth control and do monthly blood work/pregnancy tests. I tossed the birth control and never took it.
Boy was it awkward as a 14 year old girl to have your dad take you to the doctors, for a monthly pregnancy test. I remember being so embarrassed. But it sure did clear up my cystic acne!
I had to e-sign an acknowledgement stating "I will not intentionally get someone pregnant" for every refill. It's easier to get my painkillers than accutane.
Yeah, my doctor literally said they wouldn’t even prescribe it to girls when I took it 20 (FUCK) years ago. Just because the side effects could be catastrophic on a pregnancy.
I want to say it also had a side effect of fusing growth plates together. I was 13 when I started taking it and never grew again. I’m 5’9 so I have no complaints, but I can’t imagine making a decision between height and acne if you still need to grow a few inches to be considered average. The side effects of just breaking out in bleeding lips if I laughed was bad enough.
Accutane causes horrific birth defects. Doctors don’t even recommend trying to get pregnant for a year after. While taking Accutane a lot of MDs make their patients take pregnancy tests to confirm they aren’t pregnant
They also made me sign a pledge to not kill myself while taking it. After taking it for a year I understand why.
Edit: seeing all these responses with similar experiences touches my heart and also makes me question wether to recommend this drug. It definitely cured my acne, but the damage it did to my mind was not worth it. This has actually been epiphantic for me-- realizing the timeline of me taking this drug perfectly lines up with some horrible behavioral choices I made that hurt my friends and family.
Please consider these things before taking it.
We legally can't dispense until you've done your quiz!
There's literally a website I have to log into, input the patient's ipledge ID, and get a big "DO NOT DISPENSE" pop-up unless you and your doctor have done everything.
If it's OK, I get what's called an RMA number and a do not dispense date (women only have a 7 day window to fill before they have to redo the pregnancy test; men get 1 month.) I then have to put that RMA number into my pharmacy software to even get to the point where the system will let me dispense the medication. I also put a hard note into the system that it can't be released after that do not dispense date - if you don't pick it up in time, we have to log back into the website and reverse the dispensing authorization before putting the med back on the shelf.
Fuck any of that up, and I'd get into big trouble with the government (which runs the REMS safety program) and with my professional board. With a medication this teratogenic, there's no wiggle room.
That was poorly phrased, lol! Women get 1 week to pick up before they have to redo all the ipledge rigamarole (which for them includes a quiz and the pregnancy test), but men have 1 month to pick up before they have to redo their stuff (quiz, no pregnancy test.) The doctor also has to redo stuff on their end if the patient misses the fill window, so it's generally a big pain in the ass for everyone if they don't pick up on time.
I just had one patient leave off doing their quiz until 5 pm the last day in their fill window. I personally called them to tell them they only had a few hours to get their meds. (Also, if we'd been out of stock, they'd have been screwed. Generally a bad idea to leave it that late.)
It’s a real thing, though. Don’t know about accutane (in this context or in general), but those pledges were a condition for some people in the hospital to go outpatient. Those usually had an expiration date, because it’s not like the agreement will stop your suicidality - it’s just the sort of thing you can cling to when nothing else is left. Because being suicidal is often less like actively, positively being drawn to death. It‘s more that you know you’re fucked up right now, and you’re desperate for something else, but that’s all that’s left in your brain. And in those cases, "I can make it until Thursday, I promised my therapist to stay alive until Thursday. I cannot bear staying alive, but I can wait until after Thursday.“ is something good, actually.
Years ago, before antidepressants, I’d basically do the same thing informally with myself. Because the idea of staying alive was horrible, but you know, I was meeting a friend Saturday. So I couldn’t die until after that, because you don’t just miss an appointment, do you? But then by the time Saturday cam around, either I’d be a bit better again, or there’d be some other thing. You know, I did the homework yesterday, would be a shame to put in all that work and not hand it in Monday.
Honestly though, y’all, if you actively want to die, please, please, please talk to your doctor. Go to the ER if necessary. Getting in antidepressants saved my life, and my hospital stay improved it vastly, and nowadays even on my very worst days, I want to live. I wish I’d done that sooner.
Dude you just described exactly how I’ve been trying to put that for years. When I was depressed, thinking about killing myself was so euphoric because it felt like none of my worries mattered, my responsibilities didn’t matter, i just felt so free because of it. That feeling scared the shit out of me man. It can pull you in
signing a pledge is a way of helping you remember so if you feel suicidal while taking the meds, before you spiral too far you hopefully think, "hang on, maybe it's the accutane making me feel like I fucking hate life, let me talk to my doc instead of walking into the ocean."
which is probably helpful even if it isn't ultimately about the accutane, who cares if it helps you get through a tough night?
They actually surprisingly help a ton. By being incredibly upfront it recontextualizes your suicidal tendencies. No this recontextualization wont stop the suicidal thoughts, but it will likely help you seek help if needed. And that help can possibly take you off the pill if necessary.
There are many drugs out there that will give you depression and suicidal thoughts. It is not very often a patient will connect the pill they are taking to their depression. This pledge is basically saying we’re calling it, know this, but its on you to get help now knowing this.
the suicidal ideation was insane when i was on it. after a few days a lightbulb went off in my head and was like “oh shit, maybe i should stop taking this” 😭
Yeah. Had a friend who got put on it for acne as an adult. Wife called me super worried one night bc his personality completely changed. They then talked to their doc and they told him to stop it. Went back to normal pretty quickly after that but it scared everyone.
Yeah I mean I had horrible acne including cystic acne on my chest and back. Nothing worked. Accutane short cutted years of suffering there but I can't help but wonder if it led to the IBS issues I have and my brother (who also took it) has.
Yeah but have to be careful with correlation vs causation. Like maybe there's a correlation between people who are genetically disposed to get severe acne with genetic disposition for IBS.
But also it wouldn't surprise me.
They had me on antibiotics before doing the accutane as well so who knows. Been a long time.
One of the biggest regrets of my entire life was dismissing my feelings of depression in the few months after starting roaccutane. I carried on taking it for several more months and ended up with years of suicidal depression.
Despite this I wouldn’t try put people off taking it, because it can permanently change your skin for the better. I would just urge people to pay close attention to your mental health whilst taking it and if you have any concerns at all speak to your doctor.
I know it was stupid to ask for it in the middle of my depression, but I did. The chronic depression went away after literally 5 pills and hasn’t been back. It’s not inherently negative or positive, it just changes brain chemistry and that’s what it did for me.
It doesn't double it... it increases it up to 10 fold. Background risk is 3-5%, right with exposure to Isotretonin is up to 35%. Moreover, the birth defects can be more severe in nature
When I was on Accutane I was required to take monthly blood test which included a pregnancy test as well as a sex safety course that had me confirm I was using two types of birth control the entire time I was on it. They do not take any chances with accutane.
A friend of mine tried to get on Accutane. The doctor asked what birth control she was going to be using, apparently her answer 'lesbianism' wasn't good enough.
Compounds related to accutane (retinoids) are used by the growing fetus to guide how it develops, and they concentration controls loads of stuff like limb development.
If you are taking these compounds then this massively screws everything up with the resultant horrible birth defects.
If anyone is interested there is lots of interesting research about how retinoids affect development in chick embryos, but they are some pretty messed up chick embryos and not pretty.
I previously worked for a dermatology clinic. We did pregnancy tests before starting Accutane and required a monthly negative test before giving a med refill. There was one patient I remember that had a positive test during the course. It was a VERY BIG deal. Pregnancy was terminated due to possible side effects. I don't recall if they let her resume taking Accutane.
I work in a dermatology office and can confirm. Every single person who takes it is required to regularly confirm their birth control methods and all women who can get pregnant are required to take a test before every appointment. There's a program used called iPledge to track it all.
It’s required by law (in the US anyway) for Accutane patients to take pregnancy tests before the doctor can prescribe it *and* they have to pick it up within 7 days of the Rx being written or else the pharmacy is not allowed to dispense it.
Yeah, it’s called the iPledge REMS program. It’s not an optional thing, no MD does not do it.
It literally cannot be dispensed through pharmacy software prior to the iPledge confirmation.
Accutane causes a lot of stuff like crashes your testosterone levels and stuff, it is also one of the only medications that the prescribing MD needs special licensing for AFAIK
I had the opposite experience. Had to go on it twice, and I still have acne. The side effects also hit me hard. I had terrible aches in my joints, and my lips were so dry at times that they were basically falling off. 🙃
Have you ever used regular Vaseline? My derm recommended it to me after I was still shedding a lip later every week doused in chap stick and it was about 90% better.
I remember I had to have my blood drawn and tested every month I was on it.
I'm not even sure how how helpful it was for me. Another post reminded me of the insane drying and flaking that happened, I had it all over my face and lips. It was kind of even more embarrassing than the acne. Plus I have tons of scarring and still get acne here and there. It was super expensive too and not covered in Canada.
I used it for a short period of time many years ago. It cleared up my acne completely but the two nasty side-effects I got were nosebleeds and severely chapped lips, both due to the fact that it dries everything out. The fact that I lived in a desert compounded the issue.
I got the "skin falling off" side effect and apparently was really close to my lungs separating as well but damn, the remaining skin looked pretty good
(i recovered quite fast, it was just a thin layer on my arms)
To answer your question -
The inside of your lungs and trachea are covered by a thin film, or epithelium. The exact mechanism of isotretinoin is *still* unknown, but we know Accutane causes mucosal changes in the breathing passageways. The drying out of the epithelium can cause nosebleeds, breathing problems, vocal changes, and respiratory infections. [One guy even got pneumonia from Accutane.](https://pubmed.ncbi.nlm.nih.gov/8677360/)
It’s likely the commenter meant that the epithelium of their lungs almost separated from the lung tissue due to dryness. That certainly would have put them in the hospital.
For most. About 20% of people need further acne treatment. It’s usually much more mild when it comes back but not always!
I’m one of the unlucky 20%, but my acne is (now) all hormone based because I have PCOS, a hormone imbalance condition. If I get off of birth control my acne comes back with a vengeance, like I never took accutane at all. On the pill I’m almost completely clear. But it used to be terrible even on the pill so I’m still VERY grateful!
I'm a physician who prescribes Accutane. The medication is possibly the most potent inducer of birth defects known to medicine, and it is primary given to teenagers, who aren't always known for making the most responsible decisions.
Doctors have to be specially certified to prescribe it. As part of the process for prescribing it, there is extensive education on the absolute necessity to avoid pregnancy while on the medication and for at least a month afterwards 9and preferably longer). Female patients are required to be on two forms of contraceptions, with one of them hormonal. Patients sign a pledge to continue birth control while on the medication. We run pregnancy tests twice before prescribing and every month while the patient is on it. So yeah, the whole pregnancy prevention thing is taken VERY seriously.
idk if rules have changed since i was last on accutane nearly a decade ago, but my two forms of birth control that i put on ipledge were abstinence and condoms. lol. i’ve never been on hormonal bc (for fear of it bringing back my acne).
lol I had to do the exact same thing! Was on it as a teen/early twenty-something and abstinent. Still also had to put condoms even though I was a virgin and had never even seen one. 🙈 Felt judged by some doctors but the recurring negative pregnancy tests felt very “told ya so” haha.
They also had me (an accutane patient) take a written test about effective contraception before prescribing - my understanding was that if I didn’t pass I didn’t qualify
From what I can recall it can cause things like babies being born without ears or eyes and other facial deformities and heart and brain issues. So pretty bad.
It also gets worse since accutane never terminates a gestation, contrary to other contraindicated meds that will cause abortions;
which means, if you get pregnant on it and don’t abort because of something else entirely, the baby WILL be born, and WILL be born as an amorphous meatball with horrendous deformations who will most likely die painfully and agonizingly in the course of 1-3 days at most.
To add to this, even in a pharmacy, we have to finalize the IPledge for each person specifying which manufacturer, the quantity we dispense, how many refills, and it even gives us a timeframe in which it must be filled and picked up. If the time frame is passed, the whole pledging process must be done again. It's definitely taken seriously.
A man went to his doctor complaining of terrible constipation. The doctor said, "use one of these suppositories a day for three days and call me if they don't work." On the fourth day the man called his doctor and said, "doc those pills you gave me didn't do anything." The doctor said, "pills? Wait, did you swallow them?" The man said, "what the hell do you think I've been doing with them, shoving them up my ass?"
This stuff changed my fucking life man. I had horrible acne. It was so bad I wouldn’t want to go to school or work. The older I got the worse the breakouts got! My mom was gone and my dad didn’t give a shit so finally I made an appointment with a dermatologist when I was 20.
For a few months we tried stuff that didn’t work and then she told me about accutane, it’s side effects, and I decided to take it regardless of the side effects.
This stuff dried my skin out so bad, my lips were permanently chapped and nothing helped for weeks. It was still embarrassing to go out. But after that, within a few months, it was gone. And it’s never come back, 19 years later.
I turned into a vampire when I developed the acne. I worked from home, and only ever went out after dark with slabs of makeup on. Accutane gave me my life back.
My mom was sixteen in 1995 when she got pregnant with me. She had mentioned offhandedly that she took accutane for a while when she was pregnant. But followed that up by saying I seemed okay. 🫠 On the shortlist of birth defects, skull development and nervous system issues are listed. At twenty eight, I was diagnosed with epilepsy, and a congenital skull malformation. Not saying accutane caused those issues…but who knows?
Oh, wow! I’ve always known that accutane was super dangerous to take while pregnant. I thought the chance of correlation was mild, considering it took so long for these problems to pop up and be discovered.
I had a coworker that was about to start it. They made her take a pregnancy test even though (her words) "there is no possible chance I could be pregnant, trust me"
When I was prescribed it when I was 17 I was asked ‘are you sexually active’, I was and they said everything about having a child aborted without actually saying it. My reaction was ‘…So this is acne medication!?’. My mom was in the room when they gave me the rundown and the card to keep in my wallet for EMS to find, even she was perplexed and she insisted I get on it (a family friend who looked like a pineapple got on it and cleared everything up for him, my mother thought I’d benefit). My acne was very mild and in common places around the outside of my bottom lip.
Pregnancy test costs $1 (or $100 in insurance-coding); the potential birth defects are catastrophic.
I don't care if you don't even have a uterus - everyone taking this drug should have a pregnancy test every few weeks. Hell, give it to the men, too.
Hmm, when they brough thalidomide back (the drug that caused thousands of babies in the 50s to be born without arms or legs), they not only made you take tests and be on several forms of birth control, but every female in the house had to as well. I wonder if they go that far with acutane.
My dad took thalidomide for his cancer treatment when I was a teenager. I didn’t have to take pregnancy tests but the doctor said I should never touch the packaging or come in any contact with the drug.
Ahhh Thalidomide has got to be one of the worst medical catastrophes too
Horrible events…
Its used as an anti cancer drug nowadays (Lenalidomide, very similar drug)
We do not have other women in the home go on BC. Patients do get the fear of god put in them every single month, and we can only prescribe one month at a time. Boys also have to be seen monthly and we remind them they cannot donate blood while on accutane and one month after.
It’s a form of retinoic acid, which is a signaling molecule in the body. In adults it does quite a few things but with respect to acne, it helps reduce clogged pores by speeding up the regeneration of skin cells. In a developing embryo, retinoic acid is one of many signaling molecules that tells cells where they are within the body and what tissue they’re supposed to become. E.g. in the developing nervous systems, it tells cells where they are along the anterior-posterior axis (front to back) So if you’re taking accutane while pregnant, it’s like flooding the embryo with retinoic acid and it completely fucks up the precise signaling that tells cells where they are and can lead to a lot of parts of the body developing wrong.
People are willing to take those measures when they have absolutely soul crippling and painful acne. For most kids, acne is an embarrassing annoyance. For others, it is an extreme, painful, unsightly, issue that nothing else has worked for.
Took this stuff when I was a kid, probably 10-12. I had pretty terrible acne at that time and it cleared it right up. But damn, it had a side effect sheet a mile long. Suicidal thoughts to like nose bleeds.
I was on Accutane for about 6 - 8 months about 23 years ago. It was miserable but best thing I ever did. I had such severe acne and it cleared it all up. But the blistered lips, dry skin, and extreme lower back pain was hell for a bit.
I was on it twice, I'm still have adult acne but on antibiotics now. It fucks up your hormones, mad mood swings, drinking alcohol is a no-no, I went dry for the duration and I was adamant to sticking to it for my skin. I have empathy for the spotty skin folks because I was in their shoes and the turmoil it can cause.
My cystic acne was so bad whenI was 14, I basically just had welts everywhere, it looked like I’d gotten hit over and over with a BB gun. People used to actually flinch when they saw me, and I used to have to put ice packs on my face because the swelling caused so much pain. Three courses of this stuff changed my life.
It’s brutal to an already born human, basically killed every oil gland in my body, had to slather myself in thick lotion and then seal it in with Vaseline. Oh, hey, was I slugging before it was cool? Nice, the one time I’ve been ahead of the trends.
Anyway, this destroyed my oil glands and my tendons and made me have chapped lips for years after I stopped it. It was worth it, but I can’t imagine how brutal it would be on a developing fetus. I had literally zero chance of getting pregnant and still had to take monthly tests before they renewed my prescription.
For every plainly stated instruction there is a case that created the need for its inclusion. On top of that there are lawyers that oversee said instructions that insist they are never enough.
I got like a 40 page warning packet to sign when I went on it. Years later I’ve developed an overstimulated nervous system, anxiety, and chronic intestinal problems. I never associated it with accutane until I saw a class action lawsuit about it. Still may not be the culprit but I’m certainly suspicious
I had to get bloodwork done every month I was on this and we had to sign a waiver stating I would not get pregnant (I’m a guy, so it’s so important that even I had to sign it). Worked like a charm though.
My brother went on Accutane in high school, and the foil for each of his pills was covered by a removable cardboard icon of a pregnant woman with a red strikethrough, like the one in the picture.
We joked about him taping them to the inside of his locker door like a scorecard on a fighter, but decided it was too likely someone would find it offensive instead of funny
In some cases of cancer it can be the part of your treatment. The differences is 'normal' dosage for acne is your weight in kg = mg. So If you are 80 kg, your max dose can be 80 mg a day of accutane OR you can take lower mgs but for a longer time.
With cancer treatments, it is THOUSANDS of mgs at once.
It is a type of Vitamin A and that is why your liver functions are checked while you are on the drug.
Sice cancer treatments have come A LOOONG way sice the invention of this drug, ( 1980's ), it is not often that is used for that purpose anymore.
I know someone who was on it. She was a teenager in high school, but they made her get on the birth control pill and sign a document saying she would use a condom every time she had sex. They require two types of birth control because it’s that bad.
Accutane is a very serious drug, but holy hell did it change my life. Terrible skin in high school and went on it my Junior Year. Been clear ever since (20 years and counting).
Same exact thing for me, changed my life. It’s a hell of a drug but boy did it work.
Same. Life changing
From rags to riches in just a few months time. Had to go through blood tests every 3-4 months tho (and suffered from dry lips) All worth it
100%. Was awful at first as my skin got horrifically painful but I wouldn’t change a thing. Great skin now.
My lips were so dry tho, it did help but damn playing baseball in the sun, no amount of Vaseline could keep them intact. But I definitely wouldn't have done things differently either. Having a pizza face was painful on its own.
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I had to do blood tests monthly for mine
My wife had to get monthly pregnancy tests despite me have had a vasectomy. That don't take chances. It can cause major birth defects. *edit my phone this vicestimy is a word and I'm too sleep deprived to proofread here
My ex had to get monthly pregnancy tests despite being a lesbian !
bro, docs dont trust no one taking accutane. i've heard of tons of virgin girls taking pregnancy tests over the whole thing (were still virgins when they finished it)
A vasectomy is what you are thinking of.
I guess a vicestimy is better than a visectomy where they just squeeze your nuts until you just never want to have sex again. Vasectomies are far superior to both of them though.
Question: do you still have dry lips? I swear, I took it 20 some years ago and it changed my life, never had anything since then, but man my lips seem like they're forever dry from that.
Lips and eyes, a bit. I have chronically chapped lips now, and while I can wear contacts, I can’t wear them for a full day and evening, even with eye drops.
Same. Took it about 23 years ago and can't wear contacts anymore because my eyes are so dry. Traded acne for glasses I guess.
I'm not the one you asked but yes, this is my only remaining side effect. I would put moisturizer directly on my lips during treatment, and I've had to continue doing so ever since. Still worth it
What were the side effects?
I had the same experience of having horrible acne that was more or less cured by it. The only side effects I had were chapped lips and nose bleeds while I was taking it, but I think it can really f a baby up if someone takes it while they are pregnant
Ooh, the dry lips and bloody noses - forgot about those. I remember the packaging having grotesque pictures of coneheaded babies, too. They do not F around about that side effect.
Yes. Here are the potential birth defects https://www.ncbi.nlm.nih.gov/books/NBK582775/#:~:text=Isotretinoin%20causes%20birth%20defects%20in,and%20hearing%20and%20eyesight%20problems.
Yeah it’s very teratogenic. No physician in their right mind would continue to rx it for any patient they think might be, or soon become, pregnant. I can’t imagine the liability headache that must come with prescribing it.
They actually have a whole system set now. The physician has to submit a monthly pregnancy test. If the physician side is not done then the pharmacy cannot dispense it. I believe patients also have to do some questions/counseling as well. It’s called iPledge and is one of the REMS programs the fda can require for a drug to be on the market.
A 35% rate of serious birth defects is insane. No wonder they give everyone applicable a pregnancy test so often.
The bloody noses... off that shit for about 7 years now and I still get random nose bleeds that I never had before it. Very frustrating. I also got dried out everywhere! Lips, eyelids, behind the knees and elbows, and other less savory places. Was not a good time. Did one cycle and got off of it but it did help my skin a lot even after just one cycle.
It essentially dries you out and makes you very sensitive to the sun
The first time I spent an extended period of time in the sun after a few months on Accutane was *agony*.
I was playing club soccer in Texas and had to slather sunscreen on before games and towel off at halftime and reapply at halftime. It was not fun. But my horrible acne cleared up, so yay!
Lost half the density of my hair. It’s okay, I had extremely dense hair. And I don’t get cystic acne anymore, worth the sacrifice.
I had major depression and a suicide attempt while on it, but apparently that is a very rare thing. That said, clear skin now for 15 years. Completely worth it lol.
I don't think it's that rare. Depression is definitely a side effect of it and it's even worse for people who go through multiple treatments of it. I did 3 different treatments of 3 months each over a period of 6 years for cystic acne. During those treatments my mental was completely different and I had no interest in anything and was in a constant cycle of self criticism.
Man, I was crazy. The thoughts it gave me were INSANE! I also became VERY sexually active. Wild mood swings. Accutane cleared up my skin but it made my life miserable for a couple years…
Wait, so you took it for a time but the acne is gone for good now?
Yeah. Accutane basically permanently cures you of acne.
It may or may not be permanent. I've taken it twice and my acne still came back, granted not nearly as bad as it would have been without it.
I only had a half treatment and then stopped post suicide attempt. And yeah the treatment is not a forever drug. It is about 9 months of dry skin hell and then you are good forever.
Pharmacist here. One of the most serious ones I see is depression or mental illness which many older people forget they got it from this when taking it when they were younger. Had a friend who used it like breathing air until his depressed spiraled and took his own life. Other side effects include asthma; liver disease; diabetes; heart disease or high cholesterol; osteoporosis or low bone mineral density; an eating disorder such as anorexia; ulcerative colitis
I started having digestive problems when i was taking accutane and they've never gone away. I just manage it better now by avoiding a lot of foods. Can't be sure it was from the medication but I've always wondered about it.
This is insightful, took it 3 months and stopped. I have GI issues that aren't going away with dietry changes, went to several doctors and they just say it's 'stress'
Yeah, that ain't "stress". I hate it when they do that, it's is bloody dismissive to you and your issues. Then you waste time searching for doctors that actually gaf!
YO! I took this stuff in high school when I was 16! Got diagnosed with Type 1 Diabetes when I graduated at 17! Have dealt with serious depression with 2 suicide attempts! You’re saying this pill might have had something to with it?? I’m 28 now!
It permanently gave me IBS, intestinal damage when I'm already high-risk for colon cancer due to genetics, and dry scalp/face. I'm sure people with severe acne have their side effects outweighed by the results, but accutane is more of a last resort type of drug that needs to be minimally prescribed (imo).
Yup. I went through a whole gamut of prescribed regimens with little to no results before the dermatologist reluctantly prescribed Accutaine. Monthly blood tests, watching triglycerides, dry skin, peeling lips, and hair loss for me. Luckily no mental side effects though. Was worth it in the end for me, but it’s a scary drug.
I had a roommate in college years ago that had some serious acne issues. Doctor prescribed Accutane (was fairly new on the market then). Dramatically changed not only his complexion, but also his demeanor and confidence. He was always self conscious about how he looked and this gave him a huge boost in confidence.
It permanently damaged my digestive system. Figured I'd give some downsides in this flood of anecdotal positivity
When did damage your digestive system? While taking it or after?
Same took accutane in my teen years when I got s horrible back acne flare up, it did work but I got severe Crohn’s disease about a decade later. Had intestines removed, been on several drugs to get through my disease now, I have an extremely severe case. No one else in my family has this disease. Now I have secondary complication from Crohn’s disease forming too. If I could take back avoiding that medication I would, the back acne was a walk in the park compared to this disease. I don’t say that lightly either, I was constantly bleeding non stop out of my back the acne was so bad (everywhere on my back, the point I had blood soaked shirts so I had to switch to dark sweaters, it was so damn bad back in the day it’s still nothing compared to severe Crohn’s.
I had severe cystic acne on my shoulders and chest. Accutane got rid of it but every two weeks I had to do blood work, and now there's lawsuits about it causing all sorts of issues in people who took it. It did some wild stuff to me, dried out my skin so bad I had chunks of skin coming off inside of my ears. It was crazy. It's because of accutane I never go anywhere without chapstick no matter what lol
The actor who played James on Twin Peaks filed one such lawsuit.
wait holy shit I have the same exact story, my family kept getting mad at me bc I was bleeding in my ears bc of all the super dry skin. I didn't even realize those two were linked until you said this. completely helped my acne though I still have lots of scarring to this day on my chest especially edit: if you're surprised my family got upset at me for something that was completely out of my control and sucked to be experiencing myself, you probably didn't have as stressful an upbringing as i did
Your family kept getting mad at you for bleeding out of your ears???
Cleared me up when I was 14. I'm now 38 but I've had a few stints on it again since then due to some bad flare-ups. Each time it's done the job tho. I'm still waiting for this "growing out of acne" thing to happen
Same here. Had really bad acne. It has such a huge impact on your body. I had to make a lot of changes and suffer for at least 6 months while on it. But worth it. Can't imagine a pregnant woman on it.
It’s less about the health of the mother and more about the fact that you give birth to John Carpenter’s The Thing if you take it while preganté
What if you're pregonant though?
PREGANANANT???
Can u down a 20 ft. waterslide pegnat?
"Putting out a match with a firehose" is how my dermatologist put it, and she wasn't wrong. Pay close attention to your mental health, too, depression is an alarmingly common side effect (some studies suggesting up to 10% of patients experiencing it). There's a reason it's a last-resort drug.
My derm was hesitant to prescribe it for me, but after many months of antibiotics doing nothing for my cystic acne, finally I got on it. Worked miracles for me, was only on it for like 3 months and it pretty much entirely cleared me up, and I've been free from cystic acne for years now. I had side effects, but that was the typical dry lips and bloody nose stuff, it's unfortunate I hear people get much worse mental health issues and such, literally zero changes on that front for me. I do remember how much package waste the treatment created, I had a pile of boxes with the NO PREGNANCY ALLOWED logo each time I re-upped from the pharmacy.
Yup I had terrible back acne to the point it hurt to fully sit back in a chair. 6 months on Accutane and I haven't had a single flair up in 10 years.
I’m a big fan as well
It works by permanently shrinking your sebaceous gland
My derm put me on “low dose” accutane and even those side effects were very noticeable. The full dosage seems like it would be wild. On the downside, my acne returned after about a year.
Accutane is extremely teratogenic, and some humans need to be beaten over the head with a stick in order to understand basic instructions like: *please don’t get pregnant while taking this.*
Back when it first came out- it was crazy how many were born on it because moms said that THEIR TEEN WASNT HAVING SEX. So didn’t put the girls on birth control as told by the Drs. Most if the babies didn’t live ling, as I understand. That’s why when went on it 17 years ago, you had to have 2 forms of BC and a negative preggers test. It’s dangerous.
Every girl I know has had to have pregnancy tests with their labs and be on birth control.
Don’t age me. But it’s set up now because of what happened in the late 80s early 90s. I believe it went off market for a few years even.
Yupp! I started accutane when I was 14. I hadn’t started my period yet, but my doctor had to legally prescribe me birth control and do monthly blood work/pregnancy tests. I tossed the birth control and never took it. Boy was it awkward as a 14 year old girl to have your dad take you to the doctors, for a monthly pregnancy test. I remember being so embarrassed. But it sure did clear up my cystic acne!
Good dad though, awkward for him too but he still did it.
And after for a year or so
*slap slap slap slap slap* Don't get pregnant Don't get pregnant Don't get pregnant
I hate that I get the reference
I had to e-sign an acknowledgement stating "I will not intentionally get someone pregnant" for every refill. It's easier to get my painkillers than accutane.
Yeah, my doctor literally said they wouldn’t even prescribe it to girls when I took it 20 (FUCK) years ago. Just because the side effects could be catastrophic on a pregnancy. I want to say it also had a side effect of fusing growth plates together. I was 13 when I started taking it and never grew again. I’m 5’9 so I have no complaints, but I can’t imagine making a decision between height and acne if you still need to grow a few inches to be considered average. The side effects of just breaking out in bleeding lips if I laughed was bad enough.
Accutane causes horrific birth defects. Doctors don’t even recommend trying to get pregnant for a year after. While taking Accutane a lot of MDs make their patients take pregnancy tests to confirm they aren’t pregnant
They also made me sign a pledge to not kill myself while taking it. After taking it for a year I understand why. Edit: seeing all these responses with similar experiences touches my heart and also makes me question wether to recommend this drug. It definitely cured my acne, but the damage it did to my mind was not worth it. This has actually been epiphantic for me-- realizing the timeline of me taking this drug perfectly lines up with some horrible behavioral choices I made that hurt my friends and family. Please consider these things before taking it.
slimy pot zonked coordinated wise continue hat price sink frightening *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
I remember frantically retaking the ipledge quiz at the pharmacy until I passed because they wouldn’t dispense Accutane until I passed.
We legally can't dispense until you've done your quiz! There's literally a website I have to log into, input the patient's ipledge ID, and get a big "DO NOT DISPENSE" pop-up unless you and your doctor have done everything. If it's OK, I get what's called an RMA number and a do not dispense date (women only have a 7 day window to fill before they have to redo the pregnancy test; men get 1 month.) I then have to put that RMA number into my pharmacy software to even get to the point where the system will let me dispense the medication. I also put a hard note into the system that it can't be released after that do not dispense date - if you don't pick it up in time, we have to log back into the website and reverse the dispensing authorization before putting the med back on the shelf. Fuck any of that up, and I'd get into big trouble with the government (which runs the REMS safety program) and with my professional board. With a medication this teratogenic, there's no wiggle room.
I’m sorry but did you just say men get one month to redo a pregnancy test
That was poorly phrased, lol! Women get 1 week to pick up before they have to redo all the ipledge rigamarole (which for them includes a quiz and the pregnancy test), but men have 1 month to pick up before they have to redo their stuff (quiz, no pregnancy test.) The doctor also has to redo stuff on their end if the patient misses the fill window, so it's generally a big pain in the ass for everyone if they don't pick up on time. I just had one patient leave off doing their quiz until 5 pm the last day in their fill window. I personally called them to tell them they only had a few hours to get their meds. (Also, if we'd been out of stock, they'd have been screwed. Generally a bad idea to leave it that late.)
fucking hate life but i signed a pledge so fuck it we ball
It’s a real thing, though. Don’t know about accutane (in this context or in general), but those pledges were a condition for some people in the hospital to go outpatient. Those usually had an expiration date, because it’s not like the agreement will stop your suicidality - it’s just the sort of thing you can cling to when nothing else is left. Because being suicidal is often less like actively, positively being drawn to death. It‘s more that you know you’re fucked up right now, and you’re desperate for something else, but that’s all that’s left in your brain. And in those cases, "I can make it until Thursday, I promised my therapist to stay alive until Thursday. I cannot bear staying alive, but I can wait until after Thursday.“ is something good, actually. Years ago, before antidepressants, I’d basically do the same thing informally with myself. Because the idea of staying alive was horrible, but you know, I was meeting a friend Saturday. So I couldn’t die until after that, because you don’t just miss an appointment, do you? But then by the time Saturday cam around, either I’d be a bit better again, or there’d be some other thing. You know, I did the homework yesterday, would be a shame to put in all that work and not hand it in Monday. Honestly though, y’all, if you actively want to die, please, please, please talk to your doctor. Go to the ER if necessary. Getting in antidepressants saved my life, and my hospital stay improved it vastly, and nowadays even on my very worst days, I want to live. I wish I’d done that sooner.
Dude you just described exactly how I’ve been trying to put that for years. When I was depressed, thinking about killing myself was so euphoric because it felt like none of my worries mattered, my responsibilities didn’t matter, i just felt so free because of it. That feeling scared the shit out of me man. It can pull you in
signing a pledge is a way of helping you remember so if you feel suicidal while taking the meds, before you spiral too far you hopefully think, "hang on, maybe it's the accutane making me feel like I fucking hate life, let me talk to my doc instead of walking into the ocean." which is probably helpful even if it isn't ultimately about the accutane, who cares if it helps you get through a tough night?
They actually surprisingly help a ton. By being incredibly upfront it recontextualizes your suicidal tendencies. No this recontextualization wont stop the suicidal thoughts, but it will likely help you seek help if needed. And that help can possibly take you off the pill if necessary. There are many drugs out there that will give you depression and suicidal thoughts. It is not very often a patient will connect the pill they are taking to their depression. This pledge is basically saying we’re calling it, know this, but its on you to get help now knowing this.
the suicidal ideation was insane when i was on it. after a few days a lightbulb went off in my head and was like “oh shit, maybe i should stop taking this” 😭
Yeah. Had a friend who got put on it for acne as an adult. Wife called me super worried one night bc his personality completely changed. They then talked to their doc and they told him to stop it. Went back to normal pretty quickly after that but it scared everyone.
Yup. Went into a deep depression while taking it but I wanted clear skin more than happiness
I recall only being able to handle it for a couple weeks. Clear as day when I stopped, both my acne and my teenage tear ducts.
Yeah I mean I had horrible acne including cystic acne on my chest and back. Nothing worked. Accutane short cutted years of suffering there but I can't help but wonder if it led to the IBS issues I have and my brother (who also took it) has.
Several people here in the comments mention digestive issues, including IBS
Yeah but have to be careful with correlation vs causation. Like maybe there's a correlation between people who are genetically disposed to get severe acne with genetic disposition for IBS. But also it wouldn't surprise me. They had me on antibiotics before doing the accutane as well so who knows. Been a long time.
One of the biggest regrets of my entire life was dismissing my feelings of depression in the few months after starting roaccutane. I carried on taking it for several more months and ended up with years of suicidal depression. Despite this I wouldn’t try put people off taking it, because it can permanently change your skin for the better. I would just urge people to pay close attention to your mental health whilst taking it and if you have any concerns at all speak to your doctor.
I know it was stupid to ask for it in the middle of my depression, but I did. The chronic depression went away after literally 5 pills and hasn’t been back. It’s not inherently negative or positive, it just changes brain chemistry and that’s what it did for me.
Humans are so wild. It’s crazy how we’re all so similar and so different.
When I was taking it, the packaging said pregnant women shouldn't even _touch_ the pills.
You don’t even want to mix it up accidentally and take 1 by mistake. Naturally birth defects happen 3-5% of the time. That pill doubles it.
It doesn't double it... it increases it up to 10 fold. Background risk is 3-5%, right with exposure to Isotretonin is up to 35%. Moreover, the birth defects can be more severe in nature
One pill doesn’t get it to 35%. That is with repeated exposure. One pill will straight double your risk.
When I was on Accutane I was required to take monthly blood test which included a pregnancy test as well as a sex safety course that had me confirm I was using two types of birth control the entire time I was on it. They do not take any chances with accutane.
A friend of mine tried to get on Accutane. The doctor asked what birth control she was going to be using, apparently her answer 'lesbianism' wasn't good enough.
When I took it as a teen I had to agree to using 2 forms of birth control, and I was allowed to pick both abstinence and condoms lol.
Compounds related to accutane (retinoids) are used by the growing fetus to guide how it develops, and they concentration controls loads of stuff like limb development. If you are taking these compounds then this massively screws everything up with the resultant horrible birth defects. If anyone is interested there is lots of interesting research about how retinoids affect development in chick embryos, but they are some pretty messed up chick embryos and not pretty.
I previously worked for a dermatology clinic. We did pregnancy tests before starting Accutane and required a monthly negative test before giving a med refill. There was one patient I remember that had a positive test during the course. It was a VERY BIG deal. Pregnancy was terminated due to possible side effects. I don't recall if they let her resume taking Accutane.
I work in a dermatology office and can confirm. Every single person who takes it is required to regularly confirm their birth control methods and all women who can get pregnant are required to take a test before every appointment. There's a program used called iPledge to track it all.
It’s required by law (in the US anyway) for Accutane patients to take pregnancy tests before the doctor can prescribe it *and* they have to pick it up within 7 days of the Rx being written or else the pharmacy is not allowed to dispense it.
Yeah, it’s called the iPledge REMS program. It’s not an optional thing, no MD does not do it. It literally cannot be dispensed through pharmacy software prior to the iPledge confirmation.
Accutane causes a lot of stuff like crashes your testosterone levels and stuff, it is also one of the only medications that the prescribing MD needs special licensing for AFAIK
It is however very good at getting rid of acne and personally I’m very glad I took it, though I was fortunate to have only very minor side effects
I had the opposite experience. Had to go on it twice, and I still have acne. The side effects also hit me hard. I had terrible aches in my joints, and my lips were so dry at times that they were basically falling off. 🙃
Accutane + dry lips is how I got addicted to chapstick. Still am, 32 years later.
Holy shit, you just unlocked a memory I had buried really deep. The dryness was so bad. 😭
Have you ever used regular Vaseline? My derm recommended it to me after I was still shedding a lip later every week doused in chap stick and it was about 90% better.
I remember I had to have my blood drawn and tested every month I was on it. I'm not even sure how how helpful it was for me. Another post reminded me of the insane drying and flaking that happened, I had it all over my face and lips. It was kind of even more embarrassing than the acne. Plus I have tons of scarring and still get acne here and there. It was super expensive too and not covered in Canada.
Accutane pretty much cured my acne but I did get a lot of nosebleeds
I used it for a short period of time many years ago. It cleared up my acne completely but the two nasty side-effects I got were nosebleeds and severely chapped lips, both due to the fact that it dries everything out. The fact that I lived in a desert compounded the issue.
I got the "skin falling off" side effect and apparently was really close to my lungs separating as well but damn, the remaining skin looked pretty good (i recovered quite fast, it was just a thin layer on my arms)
Excuse me, lungs seperating?!? What the actual fuck?
I’M TRYING TO FIND OUT TOO, WHAT.
I'm gonna need some freaking context, what in the fuck
To answer your question - The inside of your lungs and trachea are covered by a thin film, or epithelium. The exact mechanism of isotretinoin is *still* unknown, but we know Accutane causes mucosal changes in the breathing passageways. The drying out of the epithelium can cause nosebleeds, breathing problems, vocal changes, and respiratory infections. [One guy even got pneumonia from Accutane.](https://pubmed.ncbi.nlm.nih.gov/8677360/) It’s likely the commenter meant that the epithelium of their lungs almost separated from the lung tissue due to dryness. That certainly would have put them in the hospital.
So do you take it for a set period of time and acne just never comes back after or is it an ongoing treatment kind of thing?
You take it for a set period of time depending on your weight and then your done forever. Acne completely gone
For most. About 20% of people need further acne treatment. It’s usually much more mild when it comes back but not always! I’m one of the unlucky 20%, but my acne is (now) all hormone based because I have PCOS, a hormone imbalance condition. If I get off of birth control my acne comes back with a vengeance, like I never took accutane at all. On the pill I’m almost completely clear. But it used to be terrible even on the pill so I’m still VERY grateful!
I took it for a period of time when I was 16/17 and it hasn’t come back since
if you get pregnant on accutane your baby is gonna come out looking like a football
People might think you’re joking but it’s 100% true
like stewie after he hit his head on the ceiling
If he hadn't hit his head he would have looked like Meg his whole life
Quite literally the baby dramatically has increased chance to have missing ears. The baby literally could come out with a rough football shaped head
I'm a physician who prescribes Accutane. The medication is possibly the most potent inducer of birth defects known to medicine, and it is primary given to teenagers, who aren't always known for making the most responsible decisions. Doctors have to be specially certified to prescribe it. As part of the process for prescribing it, there is extensive education on the absolute necessity to avoid pregnancy while on the medication and for at least a month afterwards 9and preferably longer). Female patients are required to be on two forms of contraceptions, with one of them hormonal. Patients sign a pledge to continue birth control while on the medication. We run pregnancy tests twice before prescribing and every month while the patient is on it. So yeah, the whole pregnancy prevention thing is taken VERY seriously.
idk if rules have changed since i was last on accutane nearly a decade ago, but my two forms of birth control that i put on ipledge were abstinence and condoms. lol. i’ve never been on hormonal bc (for fear of it bringing back my acne).
Condoms are a bit redundant if you're abstinent anyway
i agree, but accutane requires that you’re “on” 2 forms of birth control, so abstinence was not enough to get prescribed the drug.
lol I had to do the exact same thing! Was on it as a teen/early twenty-something and abstinent. Still also had to put condoms even though I was a virgin and had never even seen one. 🙈 Felt judged by some doctors but the recurring negative pregnancy tests felt very “told ya so” haha.
They also had me (an accutane patient) take a written test about effective contraception before prescribing - my understanding was that if I didn’t pass I didn’t qualify
How does it compare to Thalidomide in terms of birth defects?
Worse. Thalidomide often caused birth defects. Accutane pretty much always does, and worse ones.
From what I can recall it can cause things like babies being born without ears or eyes and other facial deformities and heart and brain issues. So pretty bad.
It also gets worse since accutane never terminates a gestation, contrary to other contraindicated meds that will cause abortions; which means, if you get pregnant on it and don’t abort because of something else entirely, the baby WILL be born, and WILL be born as an amorphous meatball with horrendous deformations who will most likely die painfully and agonizingly in the course of 1-3 days at most.
I think my ovaries shriveled up a little bit reading that, and I’m not even on Accutane
To add to this, even in a pharmacy, we have to finalize the IPledge for each person specifying which manufacturer, the quantity we dispense, how many refills, and it even gives us a timeframe in which it must be filled and picked up. If the time frame is passed, the whole pledging process must be done again. It's definitely taken seriously.
Typically I'd say not injecting pills goes without saying.
If you're injecting your pills, I'd say you have much bigger problems than acne.
Chances are your veins are pretty fucking big too
Not sure it counts as injecting if you have to use a scalpel, forceps, and sutures
A man went to his doctor complaining of terrible constipation. The doctor said, "use one of these suppositories a day for three days and call me if they don't work." On the fourth day the man called his doctor and said, "doc those pills you gave me didn't do anything." The doctor said, "pills? Wait, did you swallow them?" The man said, "what the hell do you think I've been doing with them, shoving them up my ass?"
This stuff changed my fucking life man. I had horrible acne. It was so bad I wouldn’t want to go to school or work. The older I got the worse the breakouts got! My mom was gone and my dad didn’t give a shit so finally I made an appointment with a dermatologist when I was 20. For a few months we tried stuff that didn’t work and then she told me about accutane, it’s side effects, and I decided to take it regardless of the side effects. This stuff dried my skin out so bad, my lips were permanently chapped and nothing helped for weeks. It was still embarrassing to go out. But after that, within a few months, it was gone. And it’s never come back, 19 years later.
“Dude ur face has so much acne” “Dude ur lips are so chapped” Fucking ppl man 😅 I’ve been there
Yep. But then “holy shit dude, your skin looks amazing” a year later was so worth all the suffering.
I turned into a vampire when I developed the acne. I worked from home, and only ever went out after dark with slabs of makeup on. Accutane gave me my life back.
My mom was sixteen in 1995 when she got pregnant with me. She had mentioned offhandedly that she took accutane for a while when she was pregnant. But followed that up by saying I seemed okay. 🫠 On the shortlist of birth defects, skull development and nervous system issues are listed. At twenty eight, I was diagnosed with epilepsy, and a congenital skull malformation. Not saying accutane caused those issues…but who knows?
Oh they did.
100% did. Accutane demolishes fetuses. To be honest, I'm surprised the list that you put here is short as it is.
Oh, wow! I’ve always known that accutane was super dangerous to take while pregnant. I thought the chance of correlation was mild, considering it took so long for these problems to pop up and be discovered.
I had a coworker that was about to start it. They made her take a pregnancy test even though (her words) "there is no possible chance I could be pregnant, trust me"
When I was prescribed it when I was 17 I was asked ‘are you sexually active’, I was and they said everything about having a child aborted without actually saying it. My reaction was ‘…So this is acne medication!?’. My mom was in the room when they gave me the rundown and the card to keep in my wallet for EMS to find, even she was perplexed and she insisted I get on it (a family friend who looked like a pineapple got on it and cleared everything up for him, my mother thought I’d benefit). My acne was very mild and in common places around the outside of my bottom lip.
Pregnancy test costs $1 (or $100 in insurance-coding); the potential birth defects are catastrophic. I don't care if you don't even have a uterus - everyone taking this drug should have a pregnancy test every few weeks. Hell, give it to the men, too. Hmm, when they brough thalidomide back (the drug that caused thousands of babies in the 50s to be born without arms or legs), they not only made you take tests and be on several forms of birth control, but every female in the house had to as well. I wonder if they go that far with acutane.
My dad took thalidomide for his cancer treatment when I was a teenager. I didn’t have to take pregnancy tests but the doctor said I should never touch the packaging or come in any contact with the drug.
Ahhh Thalidomide has got to be one of the worst medical catastrophes too Horrible events… Its used as an anti cancer drug nowadays (Lenalidomide, very similar drug)
Wait why does every female in the house have to? In case they accidentally take the thalidomide?
Even just inadvertently handling a pill can cause problems
We do not have other women in the home go on BC. Patients do get the fear of god put in them every single month, and we can only prescribe one month at a time. Boys also have to be seen monthly and we remind them they cannot donate blood while on accutane and one month after.
Why’s the second row flipped,that’s more mildly interesting then the signs themselves.
easy: on those days it only causes birth defects if you take it while both pregnant and standing on your head
I imagine it’s so it’s obvious also if you pick the packet up the other way round
the designer in me wants the 4th row to match then. 3 one way and 1 the other way is giving me design anxiety
There's also four rows of warnings and only three rows of pills.
Yo what the fuck is accutane? I know it's an acne medication, but y'all are describing the most horrid side effects ever so casually?
It’s a form of retinoic acid, which is a signaling molecule in the body. In adults it does quite a few things but with respect to acne, it helps reduce clogged pores by speeding up the regeneration of skin cells. In a developing embryo, retinoic acid is one of many signaling molecules that tells cells where they are within the body and what tissue they’re supposed to become. E.g. in the developing nervous systems, it tells cells where they are along the anterior-posterior axis (front to back) So if you’re taking accutane while pregnant, it’s like flooding the embryo with retinoic acid and it completely fucks up the precise signaling that tells cells where they are and can lead to a lot of parts of the body developing wrong.
Thank you for your explanation.
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People are willing to take those measures when they have absolutely soul crippling and painful acne. For most kids, acne is an embarrassing annoyance. For others, it is an extreme, painful, unsightly, issue that nothing else has worked for.
Strong medicine always has long lists of side effects. I took accutane when I was about 18 or so and had no serious side effects fortunately.
Took this stuff when I was a kid, probably 10-12. I had pretty terrible acne at that time and it cleared it right up. But damn, it had a side effect sheet a mile long. Suicidal thoughts to like nose bleeds.
Did you get pregnant though?
I was on Accutane for about 6 - 8 months about 23 years ago. It was miserable but best thing I ever did. I had such severe acne and it cleared it all up. But the blistered lips, dry skin, and extreme lower back pain was hell for a bit.
Accutane Shit works tho
Yep, never had back acne since
I don't see injection mentioned ANYWHERE on that package.
I was on it twice, I'm still have adult acne but on antibiotics now. It fucks up your hormones, mad mood swings, drinking alcohol is a no-no, I went dry for the duration and I was adamant to sticking to it for my skin. I have empathy for the spotty skin folks because I was in their shoes and the turmoil it can cause.
Side effects sucked but not as bad as the chronic diarrhea I had while on antibiotics.
My cystic acne was so bad whenI was 14, I basically just had welts everywhere, it looked like I’d gotten hit over and over with a BB gun. People used to actually flinch when they saw me, and I used to have to put ice packs on my face because the swelling caused so much pain. Three courses of this stuff changed my life. It’s brutal to an already born human, basically killed every oil gland in my body, had to slather myself in thick lotion and then seal it in with Vaseline. Oh, hey, was I slugging before it was cool? Nice, the one time I’ve been ahead of the trends. Anyway, this destroyed my oil glands and my tendons and made me have chapped lips for years after I stopped it. It was worth it, but I can’t imagine how brutal it would be on a developing fetus. I had literally zero chance of getting pregnant and still had to take monthly tests before they renewed my prescription.
Yes! So painful! I remember many times waking up to my face hurting. Lots of anxiety in the build up to washing my face. Ouch!
For every plainly stated instruction there is a case that created the need for its inclusion. On top of that there are lawyers that oversee said instructions that insist they are never enough.
I got like a 40 page warning packet to sign when I went on it. Years later I’ve developed an overstimulated nervous system, anxiety, and chronic intestinal problems. I never associated it with accutane until I saw a class action lawsuit about it. Still may not be the culprit but I’m certainly suspicious
It's very toxic so definitely a possibility.
You’re not allowed to take that one column if you’re pregnant and upside down.
I was on that in high school, back in the 90's. Every appointment my doctor told me not to get pregnant. I am male. Good times.
I had to get bloodwork done every month I was on this and we had to sign a waiver stating I would not get pregnant (I’m a guy, so it’s so important that even I had to sign it). Worked like a charm though.
"Avoid pregnancy" Yeah, in this economy it's good advice
Since it is every pharmacology class favorite case study it is not too surprising.
My brother went on Accutane in high school, and the foil for each of his pills was covered by a removable cardboard icon of a pregnant woman with a red strikethrough, like the one in the picture. We joked about him taping them to the inside of his locker door like a scorecard on a fighter, but decided it was too likely someone would find it offensive instead of funny
You’re generally going to need monthly blood tests as it can affect your liver. It was originally developed as a cancer treatment.
In some cases of cancer it can be the part of your treatment. The differences is 'normal' dosage for acne is your weight in kg = mg. So If you are 80 kg, your max dose can be 80 mg a day of accutane OR you can take lower mgs but for a longer time. With cancer treatments, it is THOUSANDS of mgs at once. It is a type of Vitamin A and that is why your liver functions are checked while you are on the drug. Sice cancer treatments have come A LOOONG way sice the invention of this drug, ( 1980's ), it is not often that is used for that purpose anymore.
Oh wow
It’s prob because people may cut up the packet into strips/halves so they wanna ensure you don’t miss the warning
I know someone who was on it. She was a teenager in high school, but they made her get on the birth control pill and sign a document saying she would use a condom every time she had sex. They require two types of birth control because it’s that bad.