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Fri Apr 16, 2010 5:06 am  |
Hello,
I was wondering if anyone has been using low-dose oral isotretinoin (i.e. Accutane) for photoaging purposes.
For some time I've been thinking that I'd also like my overall skin to look better. I have some sunspots in my legs, chest that I'd like to get rid of and I'd like to prevent sagging of the skin and wrinkling.
I thought about buying a 10000 tubes of Retin-A but I obviously thought that the idea was crazy, I would not have the discipline to put it on every night and that I was concerned about safety (putting Retin-A in your face and/or your back is quite different from all over!)
I also had a failed run with Obagi  I used it for... 6-8 weeks. My skin was always hurting, dry and NL folds actually started appearing! Maybe it would have all improved after but I couldn't take it anymore.
So... I had been reading about using oral istotretinoin for photoaging. I was scared of the side effects, etc, etc but I took the plunge!!
There are some controlled studies published in peer-reviewed journals on the effect of isotretinoin on photoaging. And patients did not experience side effects and had good results. I will be referencing these articles later today.
So anyways, I've been taking oral isotretinoin for over a month and I'm actually quite pleased with the results so far! I'm sure it's too early for any real antiwrinkle effect to be apparent but my face looks smoother and my tone is more even. A friend of mine actually asked me what I was doing to my skin that it looked so nice 
I don't think I have noticed any particular chance on my body skin though (at least yet).
As a side effect I have dry, cracked lips and my eyes feel drier as well (I have naturally dry eyes). They don't feel horribly dry but I've had to put drops here some days.
I plan on taking it for 3 months (that's the time they followed the patients for in most studies) and then just probably continue with Retin A.
Anyone else using it?? |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Fri Apr 16, 2010 5:50 am |
Hi Josee,
I used Accutane when I was in my early 20's for the treatment of cystic acne. It was a true life saver! My skin was the best it had ever been. And I've never suffered from acne at that level ever again. I do get a few blemishes from time to time, but that's it.
However, I've never heard of it being prescribed as an anti-aging treatment, but it makes sense that it would help the skin on your entire body.
I would definitely be willing to try it, but I'm not sure a derm or plastic surgeon would even prescribe it for that purpose in my area.
Please keep us posted on your progress!! |
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50 Is definitely NOT nifty!! |
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Fri Apr 16, 2010 6:33 am |
| I have never heard of accutane being prescribed for this purpose. I think you would have a hard time finding a dr to rx. |
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Fri Apr 16, 2010 7:38 am |
My story is similar to Kims when I took it over 24 years ago. Best skin and no pores! However, my skin did stay thinner and drier.
Back about 5 years ago my derm put me on a low dose for 4 days a month during hormone fluctuations for breakouts, but I haven't found a derm since that will do that. Also, only because I had a hysterectomy but was left one ovary did he agree. He said he would not do it unless I had been sterilized due to risk of birth defects.
Now because of suicide rates and risk of intestinal problems most will not. I will follow up by saying I did end up in the hospital having two feet of small intestines removed at that time and we did not know what led to it. Years later, we suspect it was the accutane. |
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Joined the 50 club several years back, blonde w/ fair/sensitive skin, Texas humidity and prone to rosacea, light breakouts and sunburns, combo skin type, starting to see sundamage and fine lines |
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Fri Apr 16, 2010 9:24 am |
| Josee, what dose did you take? My derm was also talking about putting me on low dose accutane for sebaceous hyperplasia (I have some flat wide ones which are not amenable to laser or electrocautery because they are spread over a wide area). But I was reluctant due to the possiblity of side effects. But he said that in all the years that he has used it, he has not had much trouble with side effects from his patients (maybe we are a different population - in South-East Asia). |
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Fri Apr 16, 2010 11:47 am |
| m1rox wrote: |
| Josee, what dose did you take? My derm was also talking about putting me on low dose accutane for sebaceous hyperplasia (I have some flat wide ones which are not amenable to laser or electrocautery because they are spread over a wide area). But I was reluctant due to the possiblity of side effects. But he said that in all the years that he has used it, he has not had much trouble with side effects from his patients (maybe we are a different population - in South-East Asia). |
I'm taking 20mg every other day.
I had back acne some years ago and my dermatologist wanted to put me on accutane but I was scared of the side effects. Reading that the people in the studies had no side efects and realizing that the dose was a lot lower convinced me to take the plunge! |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Fri Apr 16, 2010 11:53 am |
OK so here is an abstract of a study on the effects of low isotretinoin on skin aging. I'm not going to post all the abstracts because then I'll make it super long but I'll post all the references and you can find the articles on medline.
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J Eur Acad Dermatol Venereol. 2009 Feb;23(2):115-23.
Oral isotretinoin in photoaging: clinical and histopathological evidence of efficacy of an off-label indication.
Rabello-Fonseca RM, Azulay DR, Luiz RR, Mandarim-de-Lacerda CA, Cuzzi T,Manela-Azulay M.
BACKGROUND: Despite evidences of the beneficial clinical effects of oral
isotretinoin in the treatment of cutaneous photoaging, scientific evidences are
still scarce, mainly supported by histopathological and morphometric studies.
OBJECTIVES: To analyse possible clinical and morphological changes resulting from
the treatment of photoaging with oral isotretinoin. METHODS: Thirty female
patients, aged 40 to 55 years, phototypes II to IV, with moderate to severe
photoaging were randomly assigned to two groups of 15 each. Group I (G I)
patients were treated with 10 mg of isotretinoin and group II (G II) with 20 mg
of oral isotretinoin thrice a week for 3 months. Skin biopsies were performed
before and after the end of therapy, and the various sections were submitted to
specific staining for collagen and elastic fibres. To analyse the changes,
morphometric studies were performed, and the results obtained were analysed by
Student's t-test (paired and non-paired). Clinical results of therapy regarding
texture, colouring and aspect of the wrinkles were assessed by both physician and
patient. RESULTS: The increase in the amount of collagen fibres was statistically
significant with both dosage regimens (mean, 37.8%, increasing to 44.4%; P =
0.029 with the 10-mg dosage; and mean, 36.6%, increasing to 41.9%; P = 0.01 with
the 20-mg dosage). A pattern pointing toward a decrease in the number of elastic
fibres was found (mean, 15.3-12%; P = 0.014 with the 10-mg dosage; mean,
15.5-14%; P = 0.125 with the 20-mg dosage). Additionally, there was improvement
in the general aspect of the skin, regarding texture, wrinkles depth and skin
coloration. LIMITATIONS: Despite ethical considerations, a lack of a control
group using placebo may render the results less accurate. CONCLUSION: Low dosages
of oral isotretinoin seem to be an effective therapeutic option for cutaneous
photoaging. |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Fri Apr 16, 2010 12:12 pm |
Here are the 2 other references. Both are clinical studies:
1. Kalil CL, Fachinello FZ, Lamb FM, Comunello LN. Use of oral isotretinoin in photoaging therapy.Skinmed. 2008 Jan-Feb;7(1):10-4.
Conclusions: Isotretinoin improves photoaging with few adverse events because of the low dose used and to the short treatment duration.
2. Hernandez-Perez E, Khawaja HA, Alvarez TY.Oral isotretinoin as part of the treatment of cutaneous aging.Dermatol Surg. 2000 Jul;26(7):649-52.
Conclusion: Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin. |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Fri Apr 16, 2010 12:37 pm |
| I wonder if taking a relatively high dose (by supplement standards) of a high quality vitamin A supplement would achieve similar results? |
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Fri Apr 16, 2010 1:22 pm |
| shelly wrote: |
| I wonder if taking a relatively high dose (by supplement standards) of a high quality vitamin A supplement would achieve similar results? |
The doses of Vitamin A would be around the toxic level. |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Fri Apr 16, 2010 2:30 pm |
| Interesting that accutane works on sebaceous hyperplasia. I had some lasered but it did not work at all. I will ask my derm about that. |
_________________
Joined the 50 club several years back, blonde w/ fair/sensitive skin, Texas humidity and prone to rosacea, light breakouts and sunburns, combo skin type, starting to see sundamage and fine lines |
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Sat Apr 17, 2010 5:47 am |
| AnnieR wrote: |
| Interesting that accutane works on sebaceous hyperplasia. I had some lasered but it did not work at all. I will ask my derm about that. |
I think because istotretinoin in acne patients has shown to diminish secretion and size of sebaceous glands so some people have tried it for sebaceous hyperplasia.
There have been some case reports published in scientific journals:
-Grimalt R et al. Premature familial sebaceous hyperplasia: successful response to oral isotretinoin in three patients. J Am Acad Dermatol. 1997 Dec;37(6):996-8.
- Grekin RC et al. Isotretinoin for the treatment of sebaceous hyperplasia. Cutis. 1984 Jul;34(1):90-2.
- Kauffman R et al. [Diffuse (presenile) hyperplasia of the sebaceous glands, a new entity? Successful treatment with 13-cis-retinoic acid]. Hautarzt. 1987 Jan;38(1):31-5.
- Burton CS et al. Premature sebaceous gland hyperplasia: successful treatment with isotretinoin. |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Sat Apr 17, 2010 5:58 am |
| AnnieR wrote: |
| Interesting that accutane works on sebaceous hyperplasia. I had some lasered but it did not work at all. I will ask my derm about that. |
Yes, I had some lasered and electrocautery for another round but he couldn't flatten the wide-based ones and there are also a few quite near to the eyes which he does not feel comfortable to do. That's why he suggested the low dose accutane. He was thinking of 10mg on alternate days for me. However, I have managed to get some further improvement using Tazorac gel and I did not feel that the risk of side effects from Accutane is justified at this point in time because they aren't looking too bad and actually they are mostly hidden by my spectacles.
Josee: I wonder if a short course would suffice for the photoageing and would the effects be reversed after you stop taking them?
The studies did not cover the post-Accutance follow up. |
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Sat Apr 17, 2010 7:32 am |
| That is a good point on the results reversing. After awhile, I know mine did when I took it years ago. The oiliness and pores came back. |
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Joined the 50 club several years back, blonde w/ fair/sensitive skin, Texas humidity and prone to rosacea, light breakouts and sunburns, combo skin type, starting to see sundamage and fine lines |
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Sat Apr 17, 2010 12:26 pm |
| Josee wrote: |
Hello,
I was wondering if anyone has been using low-dose oral isotretinoin (i.e. Accutane) for photoaging purposes. |
Does anyone have a source for this? I did not see it on alldaychemist nor medsmex. |
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No longer answering PM's due to numerous weird messages. |
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Sat Apr 17, 2010 9:28 pm |
The low dose treatment does look somewhat promising from the studies for aging skin.
There are a lot of companies online that sale generic forms of accutane, but there was a study done in 2006 that found that out of 14 generic brands of accutane...that 11 of them failed to match the effectiveness of the Roaccutane brand.
Taylor PW, Keenan MH. "Pharmaceutical quality of generic isotretinoin products, compared with Roaccutane." Current Medical Research and Opinion. 2006 Mar; 22(3): 603-15.
And some of the forum posts over at acne.org there seems to be some people who used the brand name Roaccutane and certain generic brands and found the generic brands somewhat less effective.
The generic brands Claravis and Amnesteem seem to be generic brands that are as effective as the brand name and ones that people at acne.org have had just as good results as they had with the name brand. |
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Sat Apr 17, 2010 9:40 pm |
| lisacollins00 wrote: |
The low dose treatment does look somewhat promising from the studies for aging skin.
There are a lot of companies online that sale generic forms of accutane, but there was a study done in 2006 that found that out of 14 generic brands of accutane...that 11 of them failed to match the effectiveness of the Roaccutane brand.
Taylor PW, Keenan MH. "Pharmaceutical quality of generic isotretinoin products, compared with Roaccutane." Current Medical Research and Opinion. 2006 Mar; 22(3): 603-15.
And some of the forum posts over at acne.org there seems to be some people who used the brand name Roaccutane and certain generic brands and found the generic brands somewhat less effective.
The generic brands Claravis and Amnesteem seem to be generic brands that are as effective as the brand name and ones that people at acne.org have had just as good results as they had with the name brand. |
This is an excellent find...thanks!! |
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No longer answering PM's due to numerous weird messages. |
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Sat Apr 17, 2010 10:17 pm |
| Of course, there is other research that indicates a link between isotretinoin and psychosis, with the average onset > 6 mos of usage. I suppose if you commit to just three months, you may not be as susceptible. |
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Sun Apr 18, 2010 9:13 am |
| AnnieR wrote: |
| That is a good point on the results reversing. After awhile, I know mine did when I took it years ago. The oiliness and pores came back. |
Did the accutane take care of your acne? I still deal with oiliness, blackheads, and large pores, but the cystic acne never returned.
I still can't imagine any derm or ps in my area who would prescribe it for anti-aging purposes!
Also, with the low doses, is lab work required? I remember having blood drawn every month to check levels. |
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50 Is definitely NOT nifty!! |
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Sun Apr 18, 2010 10:34 am |
From information at acne.org if you are taking accutane for acne the people who did a full dose course it is estimated that about 80% of them will not have future acne issues again....and people who did a low dose course where estimated at about 60% not to have future acne issues again.
So there is about a 20% difference between the regular course and the low dose course as to if individuals will have a continuing recurrence of acne issues after treatment. |
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Sun Apr 18, 2010 11:41 am |
| Hermosa wrote: |
| Of course, there is other research that indicates a link between isotretinoin and psychosis, with the average onset > 6 mos of usage. I suppose if you commit to just three months, you may not be as susceptible. |
There have been a lot of case reports but epidemiologic studies have failed to see a link. However... with these rare side effects sometimes it takes time and LOTS of patients to finally find an association.
There is a good review in Int J Dermatol. 2006 Jul;45(7):789-99. that analyzed studies as well as case reports. The review concluded:
"This review, however, has established that retinoids can influence mood, and the lack of studies does not suggest that there is no link between isotretinoin and mood disturbances. Until stronger scientific studies are performed, the question of causality between isotretinoin and psychiatric disease will continue to go unanswered"
So please let me know if I suddenly start sounding incoherent! |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Sun Apr 18, 2010 11:44 am |
| m1rox wrote: |
Josee: I wonder if a short course would suffice for the photoageing and would the effects be reversed after you stop taking them?
The studies did not cover the post-Accutance follow up. |
I guess that the action is probably the same as Retin-A. Retin-A improves photoaging but it doesn't "stop the clock". We will sadly get wrinkles anyways
Retin-A (and isotretinoin) increase collagen production and skin proliferation so you get more even toned, firmer skin. But if you stop taking it, your collagen will start to break down at the same rate as before the treatment and you'll get wrinkles. Also if the sun hits you, you'll get sun spots again |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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Sun Apr 18, 2010 1:30 pm |
Yes, at the time it did cure my cystic acne, which the huge doses of antibiotics never did.
I did have to have my blood drawn then and later even on the lower doses. And although it is a pain, is entirely necessary to monitor your liver enzyme levels.
Even on the lower doses, my pores disappeared which was a huge plus. |
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Joined the 50 club several years back, blonde w/ fair/sensitive skin, Texas humidity and prone to rosacea, light breakouts and sunburns, combo skin type, starting to see sundamage and fine lines |
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Sun Apr 18, 2010 2:06 pm |
| AnnieR wrote: |
Yes, at the time it did cure my cystic acne, which the huge doses of antibiotics never did.
I did have to have my blood drawn then and later even on the lower doses. And although it is a pain, is entirely necessary to monitor your liver enzyme levels.
Even on the lower doses, my pores disappeared which was a huge plus. |
Yeah, I also chose to have blood drawn despite the low doses. The trials are too small to show much of adverse effects so I wanted to be cautious.
BTW, I finally caved in and started putting aquaphor on my lips and they are A LOT better.
My eyes are still sometimes dry. Today, for example, I had to put eye drops in the morning... but now I'm fine. |
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37, light brown hair, green eyes, very fair skin. Oily T zone, broken capillaries... Current regime: Tretinoin 0.05% every night, hydroquinone 4% twice per day, lachydran every other day, random moisturizers and sunscreen |
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