DermTV – Low Dose Accutane [ Epi #376]

Hello, I’m Dr. Neal Schultz [pause] And welcome to DermTV. Accutane, in my opinion, is one of the most
important “wonder drugs” of the 20th century. In curing otherwise untreatable
cases of acne, I have seen it literally turn around lives
and careers of people that were otherwise limited or even in decline
as a result of the physical and emotional stigmata of relentless
scarring acne. For accutane to “cure” acne, it must be
taken at a dose of at least 1 mg/kg of body weight for approximately five
months. So for example, if you weight 130 pounds,
you need 60mg per day. But accutane has certain unpleasant short
term, albeit reversible side effects. These include
dry skin, chapped lips, increased muscle aches and pains
after sports or workouts, and even elevations of blood
levels of triglycerides, one of the fats in your blood. These and other short-term side effects are strictly dose dependent. That means they
increase with higher doses of accutane. So they are
more apt to occur at a full dose of 1mg/kg than they are at
a quarter mg or even a half mg/kg. And interestingly, these lower, or “low
dose” accutane treatments do a pretty good job of controlling acne and stopping even severe acne breakouts. So why not just take low dose accutane and avoid the dose dependent side effects
that occur in so many people at full dosage? Very simply because low dose accutane controls
acne, it doesn’t cure it. Actually, when you stop
low dose accutane, your acne comes right back. So low dose accutane, meaning doses less that
1mg/kg, while able to control acne, does not cure
it. While there are some circumstances where low
dose accutane may make sense, such as in post-menopausal
women with ongoing acne breakouts, in general, teens and young adults with acne should be treated with a full dose to eradicate and cure their
acne once and for all. Like most other things in life, if you’re
going to do it, you may as well do it right. And in this case, if you’re going to do it, please… do it only under the supervision of a doctor.

Comments 63

  • my son start using accutane like a year ago and his face looks beautiful now thanks god everithin its ok

  • where can i get accutane ?

  • I`m 42, when I was 18 and 19 I took the accutane, In Spain called, Roacutan!! It was very new in here, so I don´t know if I had the right daily amount of the product, because the next year, my acne appeared again….It was just for 4 months each time, if I remember it was 30mg per day. 20+10. I´ve got scars that still I try to fix with AHA Glycolic.

  • @randominternetgoer Pero veo que ahora durante más tiempo. en mi caso sólo fueron 4 meses. No sé, yo creo que no había mucha información hace 20 años sobre esto y por eso fui un poco conejillo de indias!!! Gracias por tu contestación 😉

  • @lulanami Hola, creo que hace 20 años poco se sabía sobre como utilizarlo de una manera correcta. Lo que he visto es que ahora te lo dan durante más tiempo. A mi cada vez, sólo 4 meses, claro después de dos veces y gracias a dios ya no me volvió a salir, pero me dejó con muchas cicatrices. Gracias por contestar. 😉

  • Fortunately, I didn´t had any bad second effect. Just my hands and lips got very dry. Then I had a blood test every month because the colesterol rise up. But it was controlled. Apart from that, I was ok eveytime I took it!

  • Thank you so much for this video! I have terrible acne and it started about a year ago (i have a video of my foundation routine you can see my acne in that video) I have been prescribed another acne medication and its basically vitamin and benzoyl peroxide and it makes my skin extremely dry and flakey (it even makes it burn sometimes) i dont understand why i suddenly got acne at the age of 21 🙁 i feel so terrible and insecure. sometimes i dont even want to leave me house :'(

  • @lulanami I think your acne scars will take a little longer to heal. Try using Aloe gel. it does wonders for my fresh acne scars!

  • Thank you Dr. Schultz, very insightful now i know why I made a treatment,,just one and my acne came back..i might consider redoing with full dosage, dont want to control it i want to get rid of it

  • @IluvKirito I'm so sorry to hear about all that :/
    So what do you suggest taking? I have a lot of acne scars on my cheeks and so I was thinking of using Retin-A…

  • Is this really correct?
    Im on a low dose ad this kind of scared me… I weigh 67kg and Im on 20mg as of right now due to sid effects. If this dose wont cure my acne I want to increase my dose or stop. My doctor is controlling my dose, why would you know more than her?

  • Going on Accutane was the best thing I ever did. I went on a full dose for five months and it cured my severe acne I struggled with for 15 years. My life has extremely improved, I am so happy. Thank You!!

  • @IluvKirito Thanks for replying back!
    and yeah, I'm thinking about taking the Retin-A cream form (or gel?)
    Actually… my acne is hereditary too, because both my parents struggled with acne… :/ AND i also have sensitive combination skin! lol
    I'll just try Retin-A and hope that it clears/lightens my acne scars

  • My whole family has used accutane and no problems for generations, ive taken it no problems but BEAUTFUL skin! ACCUTANE WORKS WONDER! <3 Idk wt id do with out it! Literally!

  • @IluvKirito haha yeah i guess we are (:, it makes me feel a little better knowing that there are other people that suffered from the same things I have to go through :p
    thanks so much for the info! i'll try and get my hands on some soon

  • Is Accutane even still on the market?

  • i could be wrong but iv heard accutane is linked to vitamin A in some way, iv been taking small doses and it works really good and is cheap too,but its not a water soluble so too much is bad for the liver gotta be careful.

  • i loveeeee accutane it changed my lifee !!

  • Accutane ruined my dad's life.. They put him on it when it first came out years ago and he had collitis that almost killed him and continues to have health problems that have been proven due to Accutane. Idk how it is these days but needless to say my brother did NOT go on it when the doctor asked!

  • I need to know if Accutain is expensive because I don't have insurance. Please let me know, I have horrible cystic acne marks on my back, chest and face!

  • Fantastic treatment, the best thing I´ve done in my life…

  • do you have any tips or opinions on taking antibiotics for acne?

  • I went on full dose Accutane treatment 1 year ago, for 4 months, and my cystic Acne (side effects of hormonal disfunction caused by PCO) just disappear after that. During the treatment I suffered from chapped lips and nose bleeding, but It's all gone, and you just have to drink a lot of water! It was the best thing to do after 17 years of acne and a lot of scars… now I'm my way to get rid of the stupid scars I have left! If you suffer from acne, and have tried everything, go for Accutane!

  • @deathmanual For some people, it isn't just "being pimply." In my case, I had my acne pretty much under control until two years ago. I started having cysts develop under my skin, where no topical agent could reach. When it finally did reach the surface, it was painful and scar-inducing. It even got to the point of becoming staph infections at every occurance. Id rather go through this for 6 months than be on antibiotics months at a time, which eventually would become antibiotic resistant.

  • @BIGSTABZ if you do not have insurance, accutane can cost up to $800/month for the medication alone. This does not include derm visits and mandatory bloodwork. With insurance, mine is $8/month. You are better off paying $200/month for individual insurance than going without.

  • I've been on this and it worked fine. I just have left over redness

  • I have been on Accutane for probably 9 months my dermatologist had me on 70 MG? best decision i ever made. my skin is amazing i dont have extremly oily skin anymore or acne(woo hoo), i find myself wearing very little make up because it's so clear but i do have a few acne scars behind. yes i did experience very dry lips, sensitvity to the sun, and weird white patches on my arms; but then again i did participate in my high school swim team. overall my skin type now is normal:0)

  • Low dose accutane can cure or permanently reduce the severity of acne. I weigh 60 kg and took 0.3 mg/kg a day instead of the recommended 1 mg/kg and my acne has practically been cured. I say practically because once a month or so I will get a very minor breakout that will resolve within a day or 2, and I used to have moderate and extremely persistent acne.

    And this was on 30% the recommended amount!

  • how much does Accutane cost without insurance?

  • I was on full dose accutane and after 3 years, it's started to come back as folliculitis and in the scalp. I have access to some accutane right now and I'm going to open the capsules and take the granules in low dosage to decrease the oil production which apparently seems to be my issue since all of a sudden I can feel and smell the increased oil in spite of showering daily. I used to notice an increase of issues if I drank coffee for more than a couple days in a row, now I havent touched coffee

  • thanks so much i have my first dermatologist appoint next Thursday i hope they prescribe
    me this. am just tired of having acne

  • nice tan doc

  • i'd rather have organ problems than acne

  • what is accutane? and is it recomended to a 14yr old Asian girl?

  • i have moderate but recurring acne & im on low dosage (20mg) right now & just finished 1month. nooo im afraid my acne would be back anytime if i stop using accutane

  • Omg thanks for the video! I have been taking 20mg daily only, for the past few weeks, and i was wondering why it wasn't really helping! For my 110 lb (or 50kg) weight, im supposed to need at least 50mg a day! Grr gotta tell my doctor to pls increase my dosage…

  • That's cos uv never experienced organ problems, and how debilitating it is on your quality of life. But then again, looking at your username, ure probably trolling, lol

  • I wish you could prescribe accutane for me, Dr. Schultz! I know you would if you saw and talked to me just by your philosophy and everything I've tried already. I have a derm appointment in a few weeks and I'm hoping I can talk to him about it.

  • Why not use what I use. "Milk Thistle ". This product can be bought at GNC it's very cheap . It's a natural liver cleansing supplement. drink plenty of water you will be fine.

  • Hey, so I just began my accutane treatment 4 days ago, but the dosage is 40mg and I'm 160 pounds. I need my acne cured because I know it will come back, will it be worth continuing with the 40mg dosage for the first month and then increasing the dosage for the months after? Or should I go back and try and get a higher dosage as soon as possible. Would really appreciate an answer.

  • 1 mg/kg!? I took about 0,6 mg/kg and the sides effects were SO bad, SO painful I had to start to take half of that! Are you saying it will relapse even if I reach the commulative dose of 150mg/kg? It's that it's impossible to me to take more than I'm taking now! The pain is unbearable!

  • My first week now on 60mg per day. Dry skin, weak bones and chapped lips!

  • Usually, you start with lower doses to make sure your liver can handle it (which is why you get the blood tests each month). If your tests are good, your dermatologist will increase the dosage, depending on the severity of acne. My highest was 60 mg. So 40 mg is a good dosage to start with, I started on 30 mg. Hope this helped!

  • And if u started accutane for 2 months and u had high lever enzyme levels what should u do ?!

  • Low dose could cure acne too. But its just that you need to take longer period time

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  • did you have the same side effects as most people get when on higher doses of accutane?pls reply i want to know coz i have some moderate acne recently but want to stay very clear so i want just a lower dose

  • accutane is tons of vitamin A and Pantothenic acid from research ive made!

  • so do you still have acne o not?

  • No, obviousily not. Thank´s God. But I´ve heard the young people who are taking Accutane now, and the treatment is very different as it used tobe. Which is normal mine was 26 years ago. The thing I still have acne scars and spots. 🙂

  • Low dose !DOES! cure acne. But it takes much longer….typically from 10-22 months. Read the published studies easily found with Google and don't be fooled by someone in a white suit. These dosages of 1mg/kg were established in the 80's and accepted as the norm in 1997. It does work but it comes with terrible side effects many of which ARE irreversible. Dry skin, chap lips, some hair fallout, a bloody nose—that's nothing. In the end it does not guarantee acne are cured, in fast at 1mg/kg there is 20-3'% chance of coming back and often with a vengeance. Have you ever asked why Roche (the company who makes it) stopped making it! Yeah Accutane works, works really good, it's a chemotherapy drug, but be VERY careful how you do it, start low dosage and progress slowly, take 0.4mg/kg till total dose is 80-120mg/kg is reached (10-22 months) and that's the "safest" way to take it, if at all. Studies show a relapse rate of 7-10% with MINIMAL side effects. Anyone thinking of going on it MAKE YOURSELF EDUCATED REALLY WELL, it's not candy or a harmless drug, it works, really well so be careful. Hope I helped someone 🙂 Peace

  • This is very informative. I'm on 40mg per day and weight 63kg. At first I thought it was too much but now I see that it's quite low!

  • Should I take doxycycline or go straightaway to roaccutane? I've had one antibiotical therapy many years ago but my acne has been always there moderate but stubborn. Should I take chances with doxycycline?

  • My doctor recommend me 30mg in a day i have 60kg is this enough?

  • LMFAO I know many many many people that have gone on low does accutane and it's cured there acne 100% you just said it doesn't cure it. Your supposed to be a doctor, jesus…

  • oh woow now i am scared!! i am only on 20mg 😯😐

  • This "doctor" is obviously not educated on the latest accutane studies .5mg/kg is adequate especially for the first month. And to all the people saying "I need to tell my doctor to up my dose" you're derm knows whats best for you not a stranger on youtube.

  • I weigh 130, my doctor prescribed me 10 every other day first month. 10 everyday 2nd month. 20 everyday 3rd month and 4th month. 40 everyday 5th and 6th. Then my treatment ended. 3 Months later I broke out badly with cystic acne and was put on my second course. I think low dose doesn't CURE acne.

  • It apparently can cure acne, as others have said it just has to be taken over a longer period of time. It all depends on the accumulative dose. So as long as you end up taking the same amount in the end it should have the same affect. Also the good thing about low dose is if it does come back you can just go back in it because he doesnt harm your body


  • Hi I'm from India I'm on sotret 10 mg from bach 50days and nw I got heavy cold caught and headache shivering too my doctor gave some medicine bt it didn't work as well pls anyone can suggest dat I can take painkiller injection at dis time

  • Hi I'm from India I'm on sotret 10 mg from bach 50days and nw I got heavy cold caught and headache shivering too my doctor gave some medicine bt it didn't work as well pls anyone can suggest dat I can take painkiller injection at dis time

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