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In summary:

The purpose of this board was to explore the results of using low dose Accutane (Isotretinoin) over a longer period of time than normal therapies with high doses used in a shorter period of time. After becoming desparate with Sebaceous Hyperplasia (enlarged over active oil glands) and mild Rosacea I began reseaching the web heavily and discovered some studies in foreign countries that showed the efficacy of lower doses of Accutane. Why go with lower dosages? To minimize side effects, long term and short term. The end result desired? To go into long term remission for Acne and Sebaceous Hyperplasia. Here is where the debate begins. Some studies have shown significant remission rates with lower dosages. The United States is furthest behind in this type of therapy. Just talk to your Dermatologist and see..... The rule of thumb in this country is "higher dosages = longer remissions and/or possible cures". Individuals have reported the return of their acne with high and low dosages. Other individuals have reported cures and long term remissions with both high and low dosages. We have all heard time and time again that everybody is different. Even though we are of the same species. Its true, drugs seem to effect people differently. I am opting for the lowest dose possible and still maintain an acne oil and rosacea free face. So far I am running perfect, first on 20mg a day and now 10mg a day. I will try to lower the dosage again upon my next appointment. My American Derm is suprised and mildly shocked at the overwhelming positive effect low dosages are having on me. I am 200 pounds. I have referenced links to different studies on Accutane therapy at pubmed and medscape. Talk to your Derm and show them the studies if they are not already enlightend to low dose Isotretinoin therapies. Best of luck....

PS. No matter how I try to explain the positive effect this drug has had on my life it will be understated. I am ecstatic. I have regained my life for the first time in years. I say this knowing that the longterm problems some individuals talk about where this drug is concerned could still be waiting for me somewhere up around the bend.


Disclaimer: Accutane can be a very dangerous drug for some people. I believe this with all my heart. I don't wish to talk anyone into using this drug. Do your homework, consult multiple doctors. And never, ever self medicate off the internet. To many items need monitoring with monthly blood tests to take a risk self medicating. Read about all the possible side effects this drug can cause. At any dose this drug causes birth defects. Remember, what works for one person may be a catastrophe for another.

Summary: Low Dose Accutane for Acne Vulgaris and Rosacea

I am a 49 year old 200lb male and I have been on what is considered (for my body weight anyway) low dose Accutane since February of 2009. I have dual maladies, I am blessed with Rosacea and Acne Vulgaris. Due to the nature of my job I am constantly under fluorescent lights and speaking in front of groups of people. Both Rosacea and Acne look even more hideous under these type of lights. My appearance was affecting my job in a most profound negative manner. I had been aware of Accutane for 20 years, or since its inception into the Acne family of drugs worldwide. I always feared Accutane from day one. One day in desperation I once again began researching this controversial drug and found a study done in Israel on low dose therapy. Hmmmmm!!! I said. I decided I had to try this approach.

I began this treatement in Feb 2009. 20mg daily was prescribed only after convincing my Dermatologist with a barrage of worldwide studies in the efficacy of low dose therapies for certain Acne and Rosacea conditions. Please consult Pubmed and Medscape for all the ammunition you will need to create a portfolio for your Dermatologist. Be prepared for apathy from your Derm over internet research. Make sure you let them know that you have legitimate studies from government reporting sites done by actual researchers. The USA is woefully behind in the low dose approach with this drug. So much so that it is considered off label treatment when other than the prescribed high dose regimens are applied. Have sympathy for your Doc, they want to keep their licenses.

Anyways, I started on a higher dose than I wanted to because my Derm was a little skeptical. I gradually reduced that dosage over time and began to just tell him how much I was taking and he would look at the results and tell me to stay at that dosage for X amount of days. I would ignore him and lower the dosage again. Next appointment same routine. I am now trying just 10mg every saturday. I will let you know how that works for me.

My treatment thus far has been one hundred percent amazing. My life is so much better that I cannot express it in words. My oil is controlled and my pores have close up. Some pores were so damaged from years of popping and picking that they didn't close all the way. So I still have a few big pores in a several areas. I could probably finish the job with some laser type therapies that my Derm and I have discussed once I get off the drug.

So in short low dose Accutane has worked wonders for me. I have Zero side effects that I can detect. It has been like taking a vitamin pill. It is a shame we are in danger of losing this drug. In light of recent events and lawsuits drug makers are re-thinking their bottom lines. Roche has quit selling it, and a few drug makers say they will continue. So for now it appears we can still get Accutane. It is a shame that low dose therapies were never really explored in the good ole USA.

In closing: This drug, like all drugs has side effects. Different people respond differently. If you have excess oil, mild Acne or Rosacea or both, think about low dose. It might be your ticket. However, there is always a risk with any drug.

Best Wishes
LowTane ;)
It is amazing that the low dose approach for lesser maladies has not taken precedence. I have read that celebrities have been using this low dose oil control approach for years. Can't confirm this however.... I can speculate that the strict controls on this drug stem from the birth defects that this drug can and has caused. Horrible, babies with no ears, noses etc.... getting pregnant on this drug at any level of dosing is dangerous. When you think about the birth defects and the fact that the exact mechanism that causes Accutane to work is not fully known you can see why the FDA has such a tight grip on this drug. I do believe it will always be available somehow. It is manufactured in other countries. Low dosing is very much accepted in other countries. See referenced links in this thread for Pubmed and Medscape to confirm. Changing subjects here, I have no excessive oil or Acne at this point. I went in for my first Laser treatment (YAG Laser) and my veins in my nose have already started to disappear and my pores are smaller yet. 250$ a treatment. I have 3 more treatments to go. By my last treatment I will have been off of Accutane for around 5 months. Just to remind you readers out there of my past dosing. I started at 20mg daily for a 200lb male of 48 years of age. I tapered that dose in an almost linear fashion over 6 months down to 10mg every two weeks. So, I went very low dose. I have had Acne, Rosacea and Sebaceous Hyperplasia (oil) for quite some time before trying Accutane. All have come under control on extreme low dosing. My Acne was not deep cyst type acne. Affected areas were nose and chin. Accutane change my life. I recommend printing low dose studies referenced in this thread at Pubmed and Medscape and take them to your Dermatologist. They may or may not play ball. Don't blame them, licenses are at stake for off label treatments. They are more likely to prescribe high dose therapies. I still believe that less of a drug is not a bad thing if the results are the same. But that is each persons personal choice. Its not a good idea to keep your doctor in the dark. I told my doctor every appointment that I was taking less Accutane. He went with it..... When you approach your doctor with internet information they will freeze up. Make sure they know that what your reporting to them is gleaned from official reasearch databases. Pubmed and Medscape. They may be familiar with these sites. Even armed with this information you should know your doctor is restricted by FDA. I guarantee you that if you were trying sell your doctor on higher dosing you would have no chance of success. So far low dose has worked miracles for me. All drugs affect different people differently. Low dose that works for one may not work for another. Don't take this drug under the table, you need blood work. You could die. Cholesterol, Triglycerides and Liver enzymes need to be monitored. Also know that some individuals have trouble long after discontinuing Accutane usage that may or may not have been caused by this drug. I think this drug can be extemely dangerous for some. However 14 million have been served in the USA. So, the number of lawsuits is small compared to this huge number. Worldwide even more have taken this drug. I wish you the best, if low dosing is something you wish to try, go plead your case and see if you can get your Dermatologist to bite. Best Wishes


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