Is Oral A Acid Making My Acne Worse? Seeking Solutions for Severe Breakouts - Dermatology

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It sounds like you're experiencing a challenging situation with your skin while on oral isotretinoin (commonly referred to as Accutane or oral A acid). It's important to understand that while isotretinoin is a powerful medication for treating severe acne, it can sometimes lead to an initial worsening of acne before improvement occurs. This phenomenon is often referred to as "purging," where existing acne lesions come to the surface more rapidly.

However, the severity and persistence of your symptoms, including the development of painful cystic acne and ongoing redness, may indicate that your body is reacting differently to the medication. Here are some considerations and recommendations based on your situation:
1. Initial Worsening is Common: Many patients do experience an initial flare-up of acne when starting isotretinoin. This can last for several weeks to a few months. However, if your condition is worsening significantly and you are developing numerous painful cysts, this may not be a typical response.

2. Consult Your Dermatologist: It is crucial to communicate your concerns with your prescribing dermatologist. They can assess whether the current dosage is appropriate for you or if adjustments need to be made. Sometimes, a lower dose can be more effective and cause fewer side effects.

3. Possible Allergic Reaction: While rare, some individuals may have an adverse reaction to isotretinoin. Symptoms of an allergic reaction can include severe skin reactions, swelling, or intense discomfort. If you suspect this might be the case, seek medical attention promptly.

4. Skin Care Routine: Ensure that you are following a gentle skincare routine. Use non-comedogenic products that won’t clog your pores. Avoid harsh scrubs or exfoliants, as your skin is likely more sensitive while on isotretinoin. A mild cleanser and a good moisturizer can help manage dryness and irritation.

5. Hydration and Nutrition: Staying well-hydrated and maintaining a balanced diet can support your skin health. Omega-3 fatty acids, found in fish and flaxseeds, can help reduce inflammation.

6. Consider Adjunct Treatments: Sometimes, dermatologists may recommend adjunct treatments to help manage severe breakouts while on isotretinoin. This could include topical treatments or even short courses of antibiotics to help with inflammation.

7. Patience is Key: Acne treatment, especially with isotretinoin, can take time. While it’s frustrating to see no improvement, many patients start to see significant changes after the first few months of treatment.
8. Alternative Options: If after discussing with your dermatologist you feel that isotretinoin is not the right fit for you, there are alternative treatments available for acne, including hormonal therapies, other oral medications, or different topical treatments.

In summary, while some initial worsening of acne can be expected with isotretinoin, the extent and severity of your symptoms warrant a thorough evaluation by your dermatologist. Open communication about your concerns and symptoms is essential to finding the right treatment plan for you. Remember, managing acne can be a journey, and it’s important to find a solution that works for your unique skin type and condition.