DS is on month 4 and can barely play soccer because of the muscle aches. Had a very bad spring season. Also had dry everything but no mood swings. He's 14. On the bright side, his skin is starting to look really good. 20 mg dose.

Anonymous wrote:OP here. This is all very helpful. Has anyone here done the low dose, longer time? Or did you start higher and go down to it? We are very nervous about side effects.

I am an above poster and here’s my two cents based solely on my child’s experience. His first month (on 20mg, a low dose) the side effects were really bad - crazy itchy flaky scalp, and developed muscle aches, bloody noses, dry red eyes and severely chapped lips (the lips sound silly but the level of dryness is no joke). By month 2 when he went up to 40 mg the scalp had resolved and muscle aches were less, but rest of side effects stayed and remained months 3-6 at 60 mg dose. So, going for low dose for longer time doesn’t necessarily mean less side effects (my son’s were the same at 60mg dose as they had been at 20mg and 40mg). I’d start low, probably all derms advise that. But my son got very fatigued dealing with the side effects and logistics by month 6 so I am glad it didn’t drag out longer.

OP here. This is all very helpful. Has anyone here done the low dose, longer time? Or did you start higher and go down to it? We are very nervous about side effects.

My 15 year old daughter takes it. She's in her 8th month. It's working wonderfully. As others have said, lower dose = longer time. She's had minimal side effects: Dry skin, chapped lips, and some lower back pain. The only warning I'd give is logistical. The timing and safeguards against pregnancy are very stringent. If you don't have the monthly consultations, pregnancy tests, pregnancy quizzes, and prescription call-in and pick-up within the requisite time-frames, the pharmacy can't give it to you until those steps are re-done and the dr calls it in again, or worst case scenario, you have to go through the initial one-month waiting period all over again, all of which just prolongs it. So pay close attention to the dates and time frames! Other than that, I'd say it's easy and really works well. Best of luck.

I had depression, muscle aches so bad I couldn’t walk upstairs, nosebleeds, cracked lips, and I got a sunburn in ten minutes in October in upstate NY. Two courses and each time was pretty similar.

Oh and I still have acne in my late 30s. Less than before maybe? Tough to say.

I took several courses in my early 20s and 30s and had all the side effects described: dry skin and lips, needed a stool softener because of bleeding. EVERYTHING gets dry. And it felt like my skin was thinner all over my body. The last couple courses I took (4 in total) I started getting bone pain and then, mood changes that mostly felt like depression. It could've been because I was older and on a higher dose, but I discontinued the final course in my early 30s. My skin has been near-perfect, and I've rarely had a pimple since.

Other than extremely dry lips, my son was really irritable. Of course, his treatment coincided with the pandemic, but he also stopped treatment before the pandemic ended, so I would attribute about 99% of the irritability to Accutane. Still worth it, although I do wonder how differently the college application process would have gone had he been his normal, even-keeled self during the process.

I needed two separate courses of accutane in my teens.

Now my dd is on it and the lab work is a real hassle. It’s a monthly derm appt and then you have to go get lab work somewhere else, then wait for the RX. I’m sure it’s less hassle for boys. I think requiring a 14 to to prove she isn’t pregnant every month is ridiculous frankly.

Both of my sons used Accutane. With my oldest DS, We tried lots of OTC creams and Rx antibiotics before Accutane. It was a 6 month course. Blood work each month and a monthly visit to the dermatologist to get the next month’s script. Dry skin and sun sensitivity were side effects and my kids were swimmers and lifeguards. The good news is that it worked!

To the other poster, I do know of someone who had a second course of Accutane in college. It ultimately worked for him, but scheduling monthly lab work out of state was a challenge.

While on accutane, DS’s lips were super dry and he got a lot of nose bleeds, and his eyes were dry and red (he wears contacts). He also went through a short period of extreme scalp itchiness but that resolved quickly. Unfortunately his acne returned shortly after stopping the full cummulative dose, so he may try a second course of it after a break although I am reluctant because I suspect he may just be resistant. His acne also got a lot worse for the first few minths because he needed to be off all face creams and antibiotics to start accutane, so he now has a lot of scarring.

My son is on month 5 of it. The first four months were 40mg and this month is 60mg. Very dry lips have been the main side effect. The first month was in February and he got lots of bloody noses but we cranked up the humidifier in his room plus some Vaseline in his nostrils helped stop that. That’s it. Two more months to go. Initial bloodwork and then none since then. His skin looks great. No outbreaks since month 3 and the old ones are clearing up.

I have three kids who have taken it. It’s a miracle. The only side effect they’ve had is dry skin and lips.
Accutane is a cumulative dose. So if you take a lower dose, you take it longer. A higher dose, you don’t take as long. Two of mine started at 20 mg the first month and then bumped up to 40. One did 60 mg right from the beginning. She had more dryness.
Females require more documentation for birth control and monthly pregnancy tests (whether they are sexually active or not).

No side effects. Worked really well. It’s been used for 4 decades at this point and is considered the gold standard.

I took Accutane as a 19 yr old. No idea what my dose was, and I only had initial bloodwork done and then never again the entire time I was on it (shitty HMO - I told the dr I wasn't having sex so couldn't be pregnant (which was true) and he just said okay).

I've never been a beach person or someone who spends time in the sun purposefully but yeah, sun screen and hats and sunglasses. The only side effect I had was that I needed to use lip balm in the morning after brushing my teeth, after lunch, and before I went to bed.

It cleared up my cystic acne completely and I never got it again. Just would get one little zit here or there sometimes.

We have now tried just about everything. Derm says it's time. I have been reading about it and am hoping she will go along with a low dose. Can you share anything you think I need to know. I know about monthly bloodwork and visits and sun sensitivity. I am scared of the side effects, etc. What side effects did your teen have?