Managing Oily Skin: Is Oral Isotretinoin the Right Solution?

The oiliness of the face and scalp is becoming increasingly severe?

I have had oily skin since high school, but it wasn't very severe at that time, and regular facial cleansers were sufficient to keep it clean.
However, it worsened after I entered college, and recently, I can style my hair into a greasy look without using any hair wax or oil.
As a result, I even started getting short haircuts.
My face has also become so oily that even strong cleansing facial washes require two washes to feel clean.
Aside from the inconvenience in daily life, everything else is manageable; I occasionally get pimples, but not many, mostly around the nape and scalp.
However, I’ve heard that scalp acne can potentially damage hair follicles and lead to hair loss.
Currently, I know that oral isotretinoin can effectively suppress sebum production and may even offer a potential cure.
I would like to ask the doctor if oral isotretinoin is recommended solely for the purpose of suppressing sebum production, as it seems that online sources often regard it as a treatment for severe acne.

spc, 20~29 year old female. Ask Date: 2022/08/16

Dr. Wu Yuxin reply Dermatology

It can be considered, but it still requires evaluation by a physician.

Reply Date: 2022/08/16

More Info

Managing oily skin can be a challenging endeavor, especially when it becomes more pronounced over time, as you've described. Oral isotretinoin, commonly known as Accutane, is indeed a powerful medication primarily used to treat severe acne, but it also has significant effects on oil production in the skin. Let's delve into the details regarding its use and whether it might be the right solution for your situation.

Understanding Oily Skin and Isotretinoin
Oily skin is characterized by an overproduction of sebum, the natural oil produced by sebaceous glands. This can lead to clogged pores, acne, and other skin issues. While topical treatments and lifestyle changes can help manage oily skin, some individuals find that these methods are insufficient, especially if the oiliness is severe or persistent.

Oral isotretinoin works by significantly reducing the size and activity of sebaceous glands, leading to decreased sebum production. This can result in a marked improvement in oily skin and acne. However, isotretinoin is typically reserved for cases of severe acne that have not responded to other treatments, due to its potential side effects and the need for careful monitoring during treatment.

Considerations Before Starting Isotretinoin
1. Severity of Acne: If your acne is mild and manageable with over-the-counter products or topical treatments, isotretinoin may not be necessary. It is generally recommended for moderate to severe acne, particularly if it is cystic or causing scarring.

2. Side Effects: Isotretinoin can have significant side effects, including dry skin, chapped lips, and potential mood changes. It can also cause birth defects if taken during pregnancy, so strict contraceptive measures are required for women of childbearing age.

3. Monitoring: Patients on isotretinoin require regular follow-ups with their healthcare provider to monitor for side effects and ensure that blood tests are conducted to check liver function and lipid levels.

4. Long-term Commitment: Treatment with isotretinoin typically lasts several months, and while many patients experience long-term remission of acne, some may require additional treatments in the future.

Alternative Options
If your primary concern is managing oily skin without severe acne, there are several alternatives to consider:
- Topical Retinoids: These can help regulate oil production and prevent clogged pores without the systemic effects of isotretinoin.

- Salicylic Acid: This ingredient is effective in treating oily skin and acne by exfoliating the skin and keeping pores clear.

- Benzoyl Peroxide: Known for its antibacterial properties, it can help reduce acne and oiliness.

- Lifestyle Changes: Incorporating a consistent skincare routine, using non-comedogenic products, and maintaining a balanced diet can also help manage oily skin.

Conclusion
In summary, while oral isotretinoin can be an effective solution for managing oily skin and severe acne, it is essential to weigh the benefits against the potential risks and side effects. If your oily skin is not accompanied by severe acne or significant skin issues, it may be worth exploring other treatment options first. Consulting with a dermatologist can provide you with personalized advice and help determine the best course of action based on your specific skin type and concerns. They can also guide you through the process if you decide that isotretinoin is the right choice for you.

Similar Q&A

Can Oral Retinoids Help with Severe Oily Skin?

Hello~ I have very oily skin on my face and scalp. If I go to see a dermatologist, will the doctor prescribe oral isotretinoin solely for oily skin?

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It can be prescribed, but it will be out-of-pocket.

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