Re: cea Treatment with Accutane/Roaccutane

[Guest guest]

> I am a 54 year old male. I suffered from persistent acne vulgaris

> from early teens until I was 40 in 1988. Then I took Roaccutane for

> three months. All acne cleared up in afew weeks and stayed away for

> 12 more years. I had no side effects whatsoever other than the

> expected dryness of face and scalp. Nothing else bothered me. My

> life changed for the better and my skin was very clear.

> Two years ago the acne returned again, this time a different type.

I

> got hard painful pustules that felt like thorns in the flesh and

were

> sore until they popped and the pus was released. My MD put me on

the

> usual acne treatments which had little noticeable effect. The acne

> was concentrated in the front of the face, upper lip area and chin.

> About three new pustules formed rapidly each day and took two/three

> more days to ripen and burst. I looked a mess and felt depressed.

Pustules in this distribution which occur and resolve quickly and

have a yellowish hue as compared to a whiter colored pustule are

highly suggestive of gram negtive folliculitis. Especially, if

you've been on antibiotics for a long time. But the incidence of

gram negative folliculitis is very low 2-3%, so you probably didn't

have this. In any case, for gram - folliculitis, your choices are

accutane or an appropriate gram negative covering antibiotic.

> After much arguing with my MD he reluctantly referred me to a

> dermatologist.

> I went to the dermatologist with a request that I should perhaps

> repeat the Roaccutane treatment again, believing it would once

again

> be a quick fix to rid me of the acne.

> The specialist suspected that it was not acne I now had but

cea.

> He said that low dose Roaccutane was effective in treating this

> incurable disease. I was alarmed at the thought of rosacea being

> incurable and became deeply worried.

> The specialist said that he was almost certain I had rosacea so in

> order to find out if he was right he said there were two tests. One

> was to go on a full course of Roaccutane and if I had acne it would

> clear up. If I had rosacea it would be aggravated and become worse

> from a full course of Roaccutane because of the severe drying of

the

> skin. The other test was a much gentler one and he put me on a tiny

> dose of Roaccutane of just 5mgs/day for six weeks. He said if it

was

Yes, finally someone who gets it. The 5 mg accutanes supposedly

aren't being made anymore. Roche in its european market used to have

2.5 and 5 mg capsules, but allegedly these have been discontinued.

> rosacea I had it would improve markedly over the six weeks. I had

> great doubts of the effect of 5mgs compared with the 40-80mg I had

> been on in 1988. I got my supply of drug from the pharmacy (costing

> very little compared with the full dose I had in 1988)and felt

> cheated when I saw the tiny capsule I was to take. I calculated I

was

> now on a dose of about one-sixteenth of that in 1988.

> Three weeks have now passed and my skin is clear again. There has

not

> been a new pustule for a week. The oiliness of my skin has reduced

> and I have experienced no adverse effects.

> The downside of this remarkable remission from rosacea is that I

was

> told that I would have to remain on the 5mgs/day for the rest of my

> life. It is not the quick fix I expected this time. I've researched

> the Internet for information on low dose Accutane/Roaccutane and

> cea and was pleased to learn that this treatment has been

gaining

> popularity but with a dose of 10mgs/day. I was delighted that it

> worked for me at just half that dose (5mgs).

It is popular at 10 mg/d because in the US we only have the 10 mg.

It is based on the .1mg/kg/d dose guideline -- one tenth of the acne

dose guideline of 1mg/kg/d.

> Has anyone been on this low dose treatment and how long have they

> been on it? I read in one research paper that the long term benefit

> of low dose Accutane treatment may be limited because of the

> cholesteral side effect. My dermatologist says I need not worry

about

> that with the low dose I'm on.

No increased cholesterol or abnormal liver enzymes have been reported

with the 10mg /d dose. Incidentally, per Roche, no reports of

pseudotumor cerebri with taking accutane with or without

tetracyclines have been reported for doses under 40 mg /d.

> Grateful for any information anyone might have on this treatment

and

> in particular I would like to hear first hand from those who have

> been on low dose Accutane/Roaccutane for long periods.