Tips on forcing an Accutane prescription?

In My Humble Opinion (IMHO)
1

Hey,

I’m a 23 year old male and have relatively clear skin which breaks out randomly and is extremely oily. I’ve tried all sorts of stuff over the years and nothing really helps very much.

I’m really eager to try Accutane to just dry it up for good, and am aware of the risks and possible side effects. However, my dermatologist is reluctant to prescribe it since it is usually reserved for severe, persistent acne. So, instead, he haphazardly gives me prescriptions for everything else.

Does anybody have any tips on how to force a doctor to give you a prescription? I have good insurance right now and it will cover it… When I get an idea in my head, I get obsessed.

Thanks.

2

I doubt that it’s a good thing to try to “force” a prescription for Accutane, particularly if you (as you described) have “relatively clear skin which breaks out randomly and is extremely oily”.

What sort of things has your doctor tried? Generally they don’t things at random, but it can take tests with different prescriptions to find something that works for you.

My impression of Accutane (it was offered to me, but I decided that mine is really not bad enough to need it. A topical antibiotic does the trick) is that it’s for severe acne, not “I get some zits occasionally, so I want this wicked strong prescription”. I doubt that you’ll get your doctor to prescribe it.

3

Try a dermatologist with poorer ethics, I suppose.

I took Accutane…twice. Hated every second of it. It screwed with my vision so that I am still very photosensitive even 7 years later. Be careful what you wish for is all I’m saying.

4

Accutane works but it is not something to play around with. The side effects are SEVERE an REAL. Your lips will split and bleed for 6 months, your night vision will randomly fade in and out, and you might just decide to pull that trigger because of the suicidal thoughts that crowd out everything else in your head. That is just for starters. There is a reason that your doctor is a dermatologist and you are not. However, if you are that determined to take it, ask for a second opinion. Some doctors are more likely to give in to pressure than others. Why don’t you just ask your doctor why he is reluctant to put you on Accutane. The response may highlight why it is not a good idea for you.

5

Well let me give me 3cents worth…

I’m now on my 3rd treatment with Accutane (Or Roaccutane as it is called in the US). Recent research shows a lot more side-effects than previously (4 years ago) assumed - heck they made me sign a Form of Consent

Accutane is really strong. I’m in my second week and my skin is dry as hell - my lips crack at the slightest touch if I don’ keep up wityh my blistex, my skalp itches like crazy. Every 4 weeks I need not only to get my blood tested but also to have x-rays taken of my spine. Among the side-effects are (severe) dry skin, hyperosteoperosis (sp?), liverdamage…I doubt the whole depression-claim but we’ll see.

Have you tried any of the cyclenes (sp?)? Monocyclene or doxycyclene should help for your problem…since you’re only 23, your glands will produce less oil/talg as you grow out of puberty. My bad luck that they didn’t - so I suffer from subcutane nodular cysts.

Given the side-effects and hassle involved I don’t understand why somebody would go through all that just for oily skin with occasional outbreaks…

6

Thanks for the input guys. I did say “relatively” clear skin, which means that compared to the pictures of people on the pamphlet, my acne isn’t that severe. Still, it’s not anything nice to look at, and it definitely affects my daily life.

I’ve tried all sorts of medications since I was about 13 or 14. The three cyclines (two gave me awful headaches), Retin-A, Differin, erithromycin (sp?), etc. They just seem to be a lot of trouble for minimal results.

Yeah I know my case isn’t the best for Accutane, hence this thread. It just seems that if I’m willing to try it, what’s the trouble? It’s not like it’s morphine and I’m trying to get an addiction fix or something. I don’t know.

7

I took it around 20 years ago, at age 19, when it was pretty new. I had had recurrent outbreaks of acne for several years (since around age 14 or 15, I guess) which I found annoying at the time, but not at the really brutal cystic level that it’s usually prescribed for. I had previously been prescribed Retin A, and had gone to dermatologists for some time, receiving pretty cursory treatments (ultraviolet light and some prescription that I no longer recall), generally getting the impression that the specialists were milking the insurance.

Our family GP prescribed the Accutane with some warnings, primarily dryness, light sensitivity, and risk of liver damage. I’d imagine that depression and the rest are things that have been discovered over the intervening years.

Though I’d rather not feed Qazzz’s obsession, I have to report that my side effects were rather mild. Our doctor commented on them being more mild than most of what he’d read about. I had the seriously dry/cracked lips, and was annoyed to have to stay out of the sun for a whole summer (though I’m not the outdoorsiest sort anyway), but that was about it. It worked decisively on the acne, and I’ve never been bothered by other than the scattered stray pimple since.

Of course, this same doctor routinely gave me monthly cortisone-based anti-allergy shots during the summer months through my late teens/early-20s. Doctors were a lot more cavalier with steroid prescriptions back then, I suppose. They worked like a charm, but after he retired, no other doctor would go near the stuff. Side-effects are always a roll of the dice, and I’d always be hesitant to second-guess the doctor. I don’t know if any detailed studies have been done regarding all these side-effects, and whether they are associated with particular health problems or synergies. If you “force” your doctor(s) to do anything, I think it should be limited to making sure to keep up on the research.

8

When i was between 15 and 23 I had a medium case of acne, and my doctor had reccomended that I see a dermatologist and he was forever giving me newer and newer perscriptions for anti-biotics.

First pennicillian , then tetra-clycline , myno-cylcine all raising the dosage as time went on , still no check on the acne, which to that point had included scar tissue daily outbreaks on the forehead , nose , ear, and um, other places :slight_smile: .

Then I was reading in the Toronto Star about this new british wonder drug , called accutane , which would clear up most cases of acne with in a matter of weeks.

Say what you will about acne , its the worlds best contra-ceptive next to those black plastic framed glasses. My family doctor after pouring over some thick , about 3 inchs thick catelogue for drugs , shook his head ,and nada , nothing regarding accutane.

I walked away with a perscription for actinac I believe it was called which did some good , but it was a matter of too little too late. Bout a year later ,walking into the doctors office regarding a flu , my doc bursts out , hey theres this really neat new drug out , for your acne , tada accutane ,lol.

After ribbing him, that I had heard of it a year previous , he set me up an appointment to have some blood tests , and i think a week later , the first pills were picked up at the drug store.

The whole experience with having dry skin, peeling whole huge sections , sometimes a cheeks worth were something to believe.

Six weeks later , my face looked like it had never seen a lick of acne, with the exception of my neck which still has scar tissue ,and of course backne that still makes me wonder if i had of kept the perscription going for another couple of weeks , would that have killed that , but oh well.

If you think accutane is what it takes to deal with your acne ,then keep at it ,and switch doctors till you get what you want. But there is a pychological aspect as well, depending on your experiences with dealing with acne and your peer support or lack of.

Declan

9

Qazzz, can I be the dickhead who suggests that if your doctor won’t prescribe something for you, maybe you shouldn’t be on it? :stuck_out_tongue:
Seriously, your doctor is in a better position to judge whether it’s appropriate for your case, and even you admit that it probably isn’t. It’s not a matter of addiction, but it’s got some potentially severe side effects (see above). I’ve had friends with acne problems SCARED of going on stuff like this, not jonesing for it. You’re more worried about ‘bad’ skin than suicidal depression? I admit I’m lucky enough to have had good skin compared to most people, but your priorities might need some examining. I’m sure what you’re dealing with is very frustrating, but a good doctor won’t prescribe you something you don’t need (especially if it could get you hurt or him sued) just because you say you want it.

10

Heheheh. Yeah yeah yeah. Maybe everybody’s right. But it sucks that people with persistent mild acne are pretty much stuck slathering gobs of crap onto their faces at night for years and years because they don’t “merit” the use of Accutane.

Of course I agree that doctors are in a better position to decide whether to prescribe things and what; however, my derm’s behavior led me to suspect that he’s more interested in securing future appointments than clearing up my face. The rapidity and seeming haphazardness with which he threw (literally) four prescriptions for various creams and antibiotics (which I told him I had already tried) my way made me wonder what his method is when it comes to prescribing medication. Maybe I should try a different doctor. Or maybe I should just use one of those sketchy internet pharmacies. :slight_smile: Hehehe, just kidding, of course.

11

I’m pretty ambivalent about this advice. Yes, if you feel a doctor is not meeting your needs (not your wants, your needs) or doesn’t listen to you, by all means look for someone else. However, doctor hopping until you get what you want is, well, manipulative and irresponsible. Find a doctor you trust who listens to you and discuss the matter with her or him, then abide by his/her recommendations.

After all, you may have the type of acne that isn’t usually helped by Accutane, in which case you’re taking a big risk for nothing, and no responsible doctor would write you that script. You could also have some other condition which is a contraindication for Accutane, in which case no responsible doctor would write you that script. By jumping from doc to doc to get what you want, you increase your chances of ending up with someone who’s not as responsible and ethical as they should be.

12

Qazz, I took accutane for several months, got mild side effects, but it improved my acne. It improved the condition to mild, persistent acne, kind of like what you describe. I still have pimples every day, just not the deep cystic type. People I know who have taken accutane over the years have had mixed results, some have no acne at all, some have just as bad acne a couple years later. Really, Accutane is not a miracle drug, and during at least some of the treatment, your skin looks worse, not better.

Don’t knock the goop, either. Topical medications can’t generally screw up your health, and the right one might give you better results than accutane.

13

Qazzz, I suppose it all depends on your dermatologist. My roommate’s dermatologist prescribed it to her on her first visit to him. She has nice skin to begin with, and she bailed halfway thru the 6 month course. My skin has always been oily and acne-prone, but my dermatologist prescribed me two other meds before going on Accutane. It is serious stuff, as others have stated. It worked, and three years later, I would like to try a shorter course.

14

If your acne is not severe, this is just not the right drug for you. Could you find a doctor somewhere who would prescribe it for you? Probably. Should you? Not at all.

I did two courses of Acutane with good results in my opinion. But I still have break outs regularly. At least now they are mild. And mild is something I can live with. Being on Accutane is not an experience that I enjoyed. I am phobic of needles and having my blood taken. I had extremely dry skin. My lips cracked and bled a lot. I became severely depressed in my second course (though Accutane probably only aggravated my depression) and was forced to stop treatment.

It sounds to me like your doctor is treating Accutane like what it is, a last resort for many people. Treating you with all these other drugs trying to find one that works, that’s a good thing. Be glad that he is willing to look for another option. In the end, if he exhausts all the other possibilities, he may prescribe Accutane.

You should never try to “force” a prescription. It’s a really bad idea and doesn’t guarentee anything. Good luck finding an acne solution that works for you. I know how horrible it is. I am still dealing with it as well.

15

My dermatoligist was acutally quite horrified to learn that I had started a treatment of accutane. It was my family doctor who actually prescribed it.

After going through something like five years of both acne and highschool , something had to be done , and for all the suicides that accutane may have caused , quite frankly there are probably more that happen because of peer degradation because of a skin problem.

And this was back in 83 i believe , so cosmetic drug consumption was heavily frowned upon , specially with a doctor who was from a school of thought that it was a virus.

Em , you are quite correct in that someone who may have a few pimples and requesting accutane would be quite rightfully refused the nuclear bomb treatment, so the original poster would have to decide if he needs to assess the level of acne that he suffers.

And at something like 5 thousand dollars for the whole treatment , unless he had insurance to cover it , would be a major deterent in itself.

Thanks though , that was something that I had not thought of.

Declan

16

Another Accutane side effect: your hair falls out.

Dude, have you tried Retin-A? Did you know Accutane and Retin-A are forms of the same drug, just a concentrated vitamin A that encourages/increases exfoliation? If you haven’t already, try the Retin-A!

The Accutane worked for a time–but it’s been about 9 years since I have been on it, and I still get acne every day. I would definetly recommend against it. The peeling skin and lips, and the loss of hair, actually looks much worse than the acne.

17

I took Accutane, but my acne was never HORRIBLE. The reasons were that it never went away. I started getting Acne when I was a freshman in HS, and by my last year of college, I decided that 8 years of acne was just about enough. I did have to do a little convincing with my dermatologist though. The thing is, my acne wasn’t all that visible. It had the kind were it was like cyst’s, I usually compared them to roughly the size of an M&M under my skin and they hurt like hell, I ALWAYS had at least one at a time, it was never ending. That and my forehead was greasey as hell. I didn’t like the fact that I was 21 years old, and my face was still oily enough to leave marks on things. Accutane dried that up after about a month, then it keeps going. I had to carry kleenex with me everywhere, since my lips cracked up several times per day. Towards the end of the treatment I had a cold and I had some somewhat nasty nosebleeds from blowing my nose and cracking the skin inside my nose. Oh, and the sunburns you can get with it. I NEVER NEVER NEVER burn in the sun (I live in Wisconsin), but Accutane and one day in Florida, going out on jetski’s in the ocean, wow, sunburnt like hell. Anyways, Accutane will make your face much less oily, but just be sure that you want to deal with REALLY dry skin for 5 months (and little no pregnent sticker things floating around all over your house), it’s a VERY powerful drug. And if you go for it don’t give up in the middle (I think most people contemplate giving it up around the three month mark, you get so tired of the bleeding lips and flaking skin, there will be times that your lips and nose will be SOOOO dry it will hurt to smile or laugh) but DON’T give up or you’ll have to start over.

18

Joey P, not to hijack the thread, but if you are used to the sun in Wisconsin, I STRONGLY suspect a day out in the Florida sun would cause you to burn like hell, Accutane or no Accutane. Hell, the sun HERE is noticeably stronger than in Georgia, and it was pretty strong THERE too.

It seems like this stuff would be way overkill for most people. Personally, from what I hear, unless I had REALLY BAD acne I’d rather live with the zits.

19

[hijack]
You know, whiterabbit, last time I drove down to NO from the ATL, I got a drivin’ burn on my arm. And I could FEEL it getting hotter as I drove South.
[/hijack]

20

We do get some hot sun here to. Either way, I never had any problems on my previous trips to Florida or Nevada.