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Thread: Does Accutane destroy sebaceous glands permanently?

  1. #1
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    Default Does Accutane destroy sebaceous glands permanently?

    Is it true that Accutane destroys sebaceous glands permanently? i.e. there will be no return of normal oil/sebum production when you stop taking it?

    I don't want my skin and hair to remain as dry as they are now after 9 months on Accutane. It's helped enormously with inflammation and getting rid of p&p's but the excess oil I used to have kept wrinkles at bay. And that's not a bad thing when you're getting older, believe me!

    Sally

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    Marc, How does Accutane repair sebaceous glands?

    Thanks.

    Ghost

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    Regarding my question on sebaceous gland repair and accutane:

    Never mind. I just read the Dr Nase post that he put up this morning about accutane and sebaceous glands. It sounded like accutane works like a facial from the inside [I paraphrase] 'pushing the illegal stuff upwards and out'.

    Ghost

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    Thanks Marc

    My dermatologist says I may have to stay on Accutane for a couple of years. I stopped taking it (probably too abruptly) after 6 months and the p&p's came back. The thought of this long period of time worried me because I can see my skin getting drier and drier. And my hair is like straw.

    I thought that it wasn't the actual amount of sebum produced that caused Rosacea but more the inflammatory response in the skin. And somehow Accutane acted on that.

    Seeing my derm again tomorrow and want to sound knowlegeable.

    Sally

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    Sally,


    On low dose, it actually shrinks them by about 50% but normalizes the thick abnormal secretions.

    If you go on accutane for more than one year, there is only one concern which is rare. In a small percentage there is minor calcification of parts of the vertebral column (just bone spurs) and in even less, there may be slight calicification of tendons -- keep mobile and it wont happen or go to a DO. and he can check you out every 6 months to assess flexibility have him check hand ligaments and achilles tendon --most susceptible.

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    when you say shrinks the seb glands, does that mean permenantly? even after being off accutane for over a year?

    This would be huge!!! I'm thinking of going on low dose in two months.

    Thanks,
    Trey

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    Nope, they return to normal or plus/minus 10% even on the high doses.

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    Interesting, so what is it that would potentially reduce sebum production post accutane?

    Thanks again (enormously helpful in making such a decision)!
    Trey

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    Trey,

    In many cases it is not the amount of sebum that is the problem, it is the sebum cells (immature sebacytes) that are the problem. Normally the sebacytes are produced in the gland and the sebacytes migrate upwards and out the pore, conditioning the skin. In certain skin conditions, the sebacytes get sticky. They stick together and form a plug, which oxidizes and makes a mess. Accutane can permanently decrease the stickiness and thus no plugs form. This is why it is so great for acne and seborrhea.

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    In order to "train" the sebaceous glands, do i have to take a normal full course? If training is similar to that done for "teenage" acne patients, the below study would seem to imply that. If that is right, and I want to be on low dose, would I have to take accutane for nearly 3 years to up my chances of its effectiveness (fully course [120mg/kg] / low dose [.1mg/kg] /365)?

    Thanks so much again! Enormously helpful per usual!
    Trey



    Low-dose schema of isotretinoin in acne vulgaris.

    Mandekou-Lefaki I, Delli F, Teknetzis A, Euthimiadou R, Karakatsanis G.

    State Hospital for Skin and Venereal Diseases, Thessaloniki, Greece. drfsn@yahoo.com

    In severe papulopustular and in nodulocystic/conglobate acne, oral isotretinoin is the treatment of choice. It is also required for patients with moderate to severe acne, especially when acne scars start to occur A new therapeutic approach consists of a low-dose regimen of isotretinoin. We performed a comparative study of high- and low-dose schemas of isotretinoin per os for the treatment of acne. The purpose of this study was to assess the therapeutic effect and tolerability of low doses of isotretinoin in the treatment of acne vulgaris and compare low-dose with high-dose regimens. Sixty-four patients (35 women and 29 men) with different types and grades of acne vulgaris were divided into two treatment groups of 32 patients, in a trial that compared a low dose of 0.15-0.40 mg/kg per day with a high dose of 0.5-1.0 mg/kg per day. These regimens were analyzed with reference to clinical history of acne, baseline investigations, dose and response to isotretinoin, clinical and laboratory adverse effects, relapses and cost of therapy. The mean success rate of the low-dose schema was 69%. The total dose up to 120 mg/kg should be followed for optimal results (success rate of 91%) and avoidance of relapses. The low-dose schema produced fewer adverse effects and offered a very beneficial effect on pre-existing scarring. Our results confirm the beneficial effect of the low-dose schema. We recommend a total dose > or = 120 mg/kg, as this therapeutic regimen of isotretinoin has proven to be the most successful in preventing relapses and scarring.

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