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Low Dose Accutane: Results without side effects? Too good to be true?

Last time we talked about Accutane, we talked about the drug’s effectiveness in treating moderate to severe acne, typically the cystic acne of the teenage years. Accutane is a great treatment option for this otherwise difficult skin condition. However, it often comes with side effects such as dry eyes, nose and lips, muscle aches, etc. And like a TV drug commercial, I have to mention the less frequent but more severe possible side effects like vision loss, hearing loss, bone growth abnormalities, suicide risks, and GI symptoms.

But what if there was a dosage of Accutane that would still clear acne (or excessively oily skin or rosacea papules) often without the same side effects of the typical dosing?   Sound too good to be true? It’s not! Normal dose Accutane is regularly dosed based upon body weight and often increases slowly over the course of several months. A low dose regimen uses less milligrams and is taken less often. For example, instead of taking a high dose of 40mg twice a day, the lower dose protocol might be 10mg, twice a week.  

This off-label use of Accutane provides great control of oiliness, as well as eliminating many, if not all of the common side effects.  We call it “off-label” because the original FDA approval tests did not use this dosage or this frequency when the medication was approved.  This also means we do not know what effects this protocol may have when used long term, or if this eliminates any or all of the more serious side effects.  We do, however, still believe that absolute birth control is a must for female patients.  

If you have persistent acne or oily skin into your adult years, come see us at Dermatology Realm and let us determine if the off-label use of Accutane may be something that is appropriate for your skin.

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Accutane – The Answer for Acne?

Memphis AccutaneAccutane, otherwise known as Isotretinoin, is a powerful drug used in the treatment of severe acne, or acne that is not responsive to typical treatments. The word acne may have you thinking this is a drug just for teenagers, but Accutane is prescribed for patients of all ages. It is a derivative of Vitamin A and can be a miracle drug for those suffering from acne – able to stop and reverse acne, prevent new scarring, and reduce existing scarring.

Acne occurs due to over-active sebaceous glands in the skin producing too much sebum, or oil. The oil then blocks the glands and causes an accumulation of sebum under the skin. The bacteria associated with acne thrive in these conditions. Accutane is able to decrease the size and activity of sebaceous glands, reduce the amount of sebum produced and reduce the amount of keratin that clogs the pores. Accutane can actually cure acne in about 80% of patients (which means little to no acne for 5-15 years). There is really no other medication that even comes close to being this effective.

It’s important to know that Accutane is not just a prescription; it’s an acne treatment program in which the patient will be actively involved. Women who are considering Accutane should not have any interest in getting pregnant while on the drug as it can cause major birth defects. There are other guidelines and side effects (some severe) that people considering Accutane should be aware of so make an appointment with Dr. Baker to discuss whether or not this acne “miracle” drug is right for you.

Stay tuned for more information on Accutane, including an off-label way of using Accutane in adults with excessive oil, female adult acne, or rosacea.  

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Memphis Sun Safety: Protecting Your Skin

Sunscreen vs Sunblock – The weather can be misleading and, despite the lower than normal temperatures this year, you should always remember UV is present even when it is cloudy and cold. Many weather forecasts provide a UV index which is an indicator to the level of UV penetration. There are two kinds of UV, UV-A and UV-B. All sunscreens protect against UV-B, however they don’t all protect against UV-A. Using a broad-spectrum sunscreen that is at least SPF 15 is recommended whenever you will be outside. Sunscreens do not provide immediate protection and should be applied 30 minutes before you go outside. Sunblocks, however, do provide immediate protection. Sunscreen/sunblock should be applied liberally, but how often do you need to reapply? Some studies suggest that most people don’t apply enough sunblock in the first place, perhaps with only putting on 25%. If you’ve ever read the instructions on sunscreen or sunblock products, you’ll know they can be quite vague as to how much is enough product to apply and how often you should reapply. It has been shown that people who reapply sunscreen within 45 minutes, seem to have better protection. This strongly suggests that the first application of sunscreen perhaps wasn’t enough. So go for it! Don’t be afraid to really put some on.

What is SPF? – Sun protection factor is a number which represents how much protection a product will provide; or rather how much longer your skin will take to burn. For example, if you would normally burn within 10-minutes, then SPF 15 will increase your time to burn by 15 times, or 150 minutes. A higher SPF also provides greater coverage protection, but beyond SPF 40 the increase in coverage is negligible. It should be noted that SPF is only a representation for UV-B. There is currently no uniform measure of UV-A absorption. Be careful when using combinations of products. Using some insect repellents will reduce the effective SPF considerably, so be sure to apply more frequently.

Lip Service? – Your lips are made of skin and can burn just like other parts of your skin. So don’t forget to use some kind of protection.

Sun Protective Clothing – Did you know that a typical t-shirt only offers protection from UV of approximately SPF 4? So don’t be fooled into thinking you are protected just simply because your skin isn’t exposed. Many apparel manufacturers, especially of athletic attire, are now making clothes with SPF 30 or more.

Sunglasses – Be sure to wear a pair of sunglasses labeled “100% UV protection” to protect your eyes from the damaging effects of both UV-A and UV-B. If you can, find a pair that are “wrap-around” style. This will help to reduce the chance of UV finding it’s way around the edges of your sunglasses.

Hydration – Do you drink enough? Proper hydration is necessary for our bodies to perform optimally and to be healthy. Some factors, such as becoming hot from the sun and heat of the day, can put physical demands on your body and change how much water you need for your body to remain properly hydrated. Proper hydration is so important for healthy skin. You have probably heard that 8 x 8oz glasses of water is what you should drink each day. Has it ever seemed odd that this is a “one size fits all” kind of approach? It’s a great start, but a better approach to knowing how much daily water intake you need is to take your weight in lbs, and divide it by two. The result is how many fluid ounces of water you should drink each day for your body to be optimally healthy. For example, if you weigh 140 lbs, you should drink at least 70 fl oz of water each day.

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