Accutain is some heavy chemistry and you need to be careful. It slows cell growth at a fundamental level. That is why it has pregnancy warnings, and there are concerns about brain growth. It is a reasonably effective anti cancer agent, you can find some of the clinical trial data if you look hard.

Huh, I used accutane for years for acne (no acne now) and my doctor never mentioned this to me. The only thing they mentioned is I shouldn't take vitamin A supplements with it.

Who is to blame?

The customer who didnt research?

The physician who gets lunch twice a year from Accutane?

The government for stopping freedom?

Note: none of this is /s, I would like to discuss why this happens, and if there are any solutions.

I mean I was 15 years old when I started using Accutane, it's not exactly when humans are known to be at peak intelligence. I definitely believe I have some agency and thus some responsibility, but I thought part of doctors' job is to inform patients of potential side-effects. I don't know how government comes into this play, in my mind: doctor explains me the benefits/side-effects of a drug, they claim it will ultimately be useful all things considered, I accept, they write me a prescription, I take the drug. Government's role stopped when they approved this person can work as a doctor.

I went on Accutane after a decade of tetracycline kept persistent mild acne under control but never got rid of it.

Accutane worked amazingly, and very fast. Acne gone in a week, and never returned. I stayed on Accutane til I hit the target dose (maybe 3 months, I forget exactly). Twenty years later, I'm still acne free.

Though without a doubt, Accutane is the strongest drug I've ever taken. I needed a liver function test before starting, and monthly during the treatment. My nasal lining and lips were unbelievably dry. I carried lip moisturiser and creams with me everywhere, used them several times an hour. I remember my dermatologist telling me to avoid the sun, and treatment was over the winter months.

To anyone on long-term courses of tetracycline, I suggest trying Accutane. Be prepared for the side effects. And only do it under medical supervision.

It's possible to take a lower dose for a longer time period to lessen the side effects.

I've used it for multiple cycles and still have acne. I'm going to be 34 in a couple weeks.

It's also been linked to increased suicide rates https://www.nejm.org/doi/full/10.1056/NEJM200102083440616

I was acne free as a teen, but was put on Acutane anyway. (Ah, the wonders of middle America being the testing bed and profit source of Pharma)

Remained acne free until suddenly getting cystic acne in my early 30s.

Here's what helped me:

- Do laundry more often ( Increase the rate you clean your: sheets and pillow cases!, face cloths, clothes. If this is impractical you can simply buy more pillowcases and swap out clean ones more regularly; especially if you're a prone to sleep drooling or have greasy hair. )

- Stop washing your face with soap ( Just use water and a wash cloth on your face; use firm pressure to get into pores but light enough to avoid giving yourself 'rug' burns or tears. This is great for exfoliating dead skin and removing surface oil. Do this twice a day; morning and evening. Buy multiple face cloths and use newly cleaned ones regularly; every 2-3 days. )

- Apply moisturizers twice a day; morning and evening ( My skin had an amazing response to Sea Buckthorn: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438513/ . Its coloring is very intense so for my twice daily moisturizer I cut it with Rosehip Oil usually only putting 5-10 drops per 2 oz of Rosehip; experiment for your skin color. To increase my skin's recover time and the effectiveness of the Sea Buckthorn I will take a regular long bath where I apply it directly, almost like a mask, and wipe it off after the bath. It has proved great at reducing redness and blemishes as well as healing open wounds such as exfoliated dead skin and bleeding pores. )

- Spot care for cystic acne with pure Salicylic Acid ( Only rub this on cystic pores. Avoid trying to pop any pores without a clear white 'head'. )

- Cold showers ( Or at the very least end the shower by holding your face under cold water to close your pores. )

- Exercise ( General health will aide skin health. Also great for hormone balance which can be a cause factor for acne. )

- Wrangle your hormones ( Through masturbating less, and eating a hormone nutrition informed diet. For example, if male, eat more cruciferous foods for Testosterone maintenance. )

Hope these suggestions can make the difference they made for me for you too.

Thanks. Not sure why you're being downvoted – your comment is very insightful.

I appreciate these tips and I do follow most of these so I can vouch for their value as they do seem to help. I will try the more unique suggestions...!

> Testosterone maintenance

What do these words even mean?

Aromatase is an enzyme that is responsible for biosynthesis of estrogens from androgens; subsequently, aromatase inhibitors suppress the biosynthesis of androgens into estrogens.

Helping your body's androgens ( Testosterone ) to maintain ( maintenance ) their natural levels.

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Also, cruciferous plants are good sources of vitamins and minerals that appear to positively affect testosterone levels; for instance, Vitamin K and A and zinc.

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[1] https://en.wikipedia.org/wiki/Cruciferous_vegetables

For a list of cruciferous plants.

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[2] https://en.wikipedia.org/wiki/Testosterone#Regulation

> Nutrients: Vitamin A deficiency may lead to sub-optimal plasma testosterone levels. The secosteroid vitamin D in levels of 4001000 IU/d (1025 µg/d) raises testosterone levels. Zinc deficiency lowers testosterone levels but over-supplementation has no effect on serum testosterone. [2]

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[3] http://www.whfoods.com/genpage.php?tname=foodspice&dbid=9

> A third area of increasing research interest involves the metabolism of vitamin D. Broccoli is not a source of this vitamin, but it is an excellent source of vitamin K and also of vitamin A (in one of its precursor forms, beta-carotene). Many individuals have large vitamin D deficiencies that cannot be remedied through diet alone, and these deficiencies require sizable amounts of vitamin D to be provided through dietary supplementation. When large supplemental doses of vitamin D are needed to offset deficiency, ample supplies of vitamin K and vitamin A appear to help keep our vitamin D metabolism in the proper balance.[3]

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[7] https://en.wikipedia.org/wiki/Aromatase

> In particular, aromatase is responsible for the aromatization of androgens into estrogens.[7]

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[5] https://en.wikipedia.org/wiki/Androgen

> Testosterone, the major androgen.

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[6] https://en.wikipedia.org/wiki/Estrogen

> All of the different forms of estrogen are synthesized from androgens, specifically testosterone and androstenedione, by the enzyme aromatase. [6]

> Quantitatively, estrogens circulate at lower levels than androgens in both men and women. [6]

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[7] https://www.ncbi.nlm.nih.gov/pubmed/23090135

> The aim of this study was to evaluate the effect of white cabbage and sauerkraut juices of different origin and indole-3-carbinol (I3C) and diindolylmethane (DIM) on expression of CYP19 gene encoding aromatase, the key enzyme of estrogen synthesis. [7]

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[8] https://www.ncbi.nlm.nih.gov/pubmed/26840393

> indole-3-carbinol and diindolylmethane. These compounds occur as glucosinolate conjugates in cruciferous vegetables and are released when one chews or otherwise macerates the vegetable.

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[9] https://www.ncbi.nlm.nih.gov/pubmed/19524224

But of course this is nutritional science so there is lots of conflicting and grounding counter research.[9]

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My take away from all of this is that having a varied diet is the most important.

I said 'cruciferous plants' to actively avoid listing a single item as a cure all.

Also, my guess is that our diets have narrowed as we have stopped seasonally cooking for ourselves and buy processed foods with a lot of ingredient overlap likely confusing our bodies which were designed to function on the ingredients found in the varied foods we ate.

Good list of references - you should add boron, shown to lower SHBG, raising free testosterone in the body (much more important than total testosterone). Also estrogen in men isn’t a bad thing. Too low is just as bad as too high. Aromatase is highest in fat cells, so losing weight (fat) will raise testosterone levels by reducing its conversion to estradiol. Also would be good to note that testosterone is highest when you wake up, and may decrease by 30% over the course of the day. Also, Dom D’Agostino said on a podcast (I think it was a Ferris podcast) that the fastest way to raise your testosterone levels is to get a new girlfriend. Shows the power of the brain in its production.

> the fastest way to raise your testosterone levels is to get a new girlfriend.

I hope this is less bleak than it reads.

If you are already in a healthy and happy relationship is hope you’d stay rather than seek a ‘new’ relationship solely to manipulate your T levels.

If you are instead implying that a single person should ‘get a new’ relationship I would hope you would get into that relationship for other reasons than to manipulate your T levels.

Unless I suppose you lead with that and both people are into it?

I want to note that ‘girlfriend’ is an unnecessary specificity.

Most of the literature simply refers to ‘sexual activity’.

Also, the link between sexual activity and Testosterone is rather varied.

Most of the literature tests on older populations where it is already widely known that age reduces T levels.

Also, there is still debate on which is the cause.

Some say less sex leads to low T levels. Some say low T leads to less sex. Others suggest it is feedback loop.

Either way it seems the results tend to peak and be short lived.

But anyone with an otherwise healthy, functioning, body is guaranteed through exercise and a varied healthy diet to set up their body for optimal Testosterone maintenance.

“Get a new girlfriend”

I think it was a tongue in cheek comment about how a man’s brain has a huge influence over their testosterone levels. Men see their testosterone levels drop after being in a relationship for a while, and drop further when they have children. Although, I guess it could be argued that they are likely having less sex in these situations.

Look, I agree with almost everything we’ve both said in this discussion. I even created a website that shows my agreement (http://max-testosterone.com - not designed to make money, rather to market the domain name which is for sale). I think I just didn’t like the phrase “testosterone maintenance”, implying it’s something that’s broken that can be fixed. For most men, low testosterone can’t be dramatically improved (double or triple) by simply improving their diet.

maintaining a certain level of testosterone in the human body

Where on earth did you read this? Testosterone levels are mainly the result of your hypothalamus’s response to circulating levels of testosterone in the blood. Lack of sleep, large alcohol consumption, stress all cause the brain to down regulate the production. Exercise causes it to be upregulated. Food probably has a very small effect on your day-to-day levels.

There was a story on the BBC site about accuntane recently.

https://www.bbc.com/news/health-47952076?intlink_from_url=ht...

I approached my GP after suffering with acne who put me on tetracycline which has some horrible side-effects such as staining your teeth and it didn't work for me at all.

I bypassed my GP and bought accutane online. The side-effects are some of the worst I've had from a medicine, dry skin and eyes, regular nose bleeds, sensitivity to the sun etc. Nothing mental though. That said. It works.

Before I used accutane I had several acne spots turn into keloid scars which I have been treating over the last decade with corticosteroid injections.

PSA to anyone reading this thread: Do not take Accutane without a prescription. There are very good reasons that doctors don’t want to prescribe it, and if you can’t find someone willing to do it, it means that the risks very likely don’t outweigh the benefits in your case. Doctors are going to want you to try more conservative treatments first, and you shouldn’t second-guess that.

Accutane makes the “horrible side-effects” of Tetracycline look like a mild headache. Aside from being a powerful teratogen (i.e. it causes nasty birth defects), Accutane is linked to suicidal tendencies, liver damage, heart damage, and more. It’s not a drug anyone should be taking without supervision.

OTOH, it's often that the risks _to the doctor_ outweigh the benefits _to the doctor_ of recommending you use it. Correlated with but far from the same as the risks/benefits to you.

Yeah I didn't have the dry eyes, but I did have some nosebleeds 2-3 times a week for a while. The dry skin was the worst part for me, and I kept having to moisturize my face here at work.

I also wasn't used to chap stick before, but now I carry it all the time.

For your keloids try Lugols iodine solution.

My wife conquered her acne with low doses of a blood pressure drug, which apparently alters the expression of hormones.

Update: Spironolactone (Aldactone) is an androgen blocker drug that, at a lower dose, can help with hormonal acne.

Be careful, Accutane can have some pretty bad side effects. I decided not to use it, and many years later still think it was the right choice.

There are big risks to it from what I've read.

Yep. Only thing that worked for me to get rid of my acne. My original dermatologist wouldn't prescribe it, so we moved to one who we knew would. Worked really quickly (within a year, it was mostly all gone), and haven't had issues since.

Aren’t retinol creams just as effective and much safer? They worked well for me from in my late teenage years.

No? Accutane is often the last resort option when everything else fails.

Not in the same solar system in terms of effectiveness.