This capsule remains as one of the most effective ways to treat acne and is restricted for use by Specialists.

Roaccutane / Accutane / Oratane is also known as isotretinoin and is a form of vitamin A.

This capsule remains as one of the most effective ways to treat acne and is restricted for use by Specialists. It is vitally important to treat scarring forms of acne early- as this can prevent further scar formation. In severe cases of acne, Roaccutane maybe indicated.

This form of treatment can have side effects, and careful monitoring by a Dermatologist is needed.

Research has shown that low doses of Vitamin A can also decrease scars, and help collagen remodel.

Facts on Oratane / Roaccutane treatment:

  • This capsule is a form of vitamin A and is used for the treatment of acne by Specialist Dermatologists
  • This tablet is effective in treating acne in 99% of cases, especially in severe acne
  • Over 80% of patients will receive long term cure after a course of this drug
  • The average course of Roaccutane therapy is 7-10 months
  • Early and effective treatment of scarring acne prevents further scars
  • Roaccutane remains as the most effective treatment of acne
  • Studies have shown that Vitamin A in small doses can improve acne scarring
  • Laser treatment is NOT compatible with Roaccutane treatment, however other treatments for scarring can be conducted
  • New research has shown that low level Radiofrequency devices can improve acne scars
  • Supervised fractional RF can be used with low levels of Roaccutane under Specialist supervision
  • This combination can be very effective in the management of scarring acne

FREQUENTLY ASKED QUESTIONS:

This tablet is also known as isotretinoin and is a form of vitamin A called a retinoid. It has been the mainstay for the management of severe acne or scarring acne in Australia for the past 30 years.

Roaccutane works by targeting the oil glands, and reducing oil production. In lower does it can help remodel dermal collagen and reduce scar formation- including acne scars. The main aim however is to PREVENT acne scar formation.

Roaccutane should only be used if your acne is severe, cystic or scarring. An off label indication of Roaccutane is if your acne does not respond to normal acne medications. An assessment and discussion with a Dermatologist is needed to ascertain if you are suitable for this medication, as there are numerous side-effects associated with this drug. Additionally females will need to take extra precaution in regards to contraception – if applicable.

The flip side is that this drug is 99% successful in treating cases of acne. An average person will need a course lasting between 7-10 months. Improvement is seen within a few weeks of starting this medication.

In severe cases of acne, an early and transient ‘flare up’ maybe seen, however your Specialist will undertake steps to minimise this side-effect.

The most common side effect is dryness of the lips and skin. Universally seen common and very easy to manage. Moisturise frequently and you will sail thru the course of treatment. Use a lip balm at least 3-5 times per day, and moisturise your skin at least twice a day.

Some patients may get dry eyes on Roaccutane/ Oratane, and using eye drops may help, especially if you wear contact lenses.

Your Dermatologist will also order special blood tests throughout your treatment course, making sure your Liver and Cholesterol levels are in check. Female patients are warned in regards to the serious consequences in regards to Roaccutane/ Oratane and pregnancy.

Roaccutane and Oratane are associated with other side effects that are less common including-

  • Flare up of acne ( usually early in the course of treatment)
  • Headaches
  • Abnormal period cycles
  • Muscle aches and pains
  • Ingrown toe and finger nails
  • Abdominal symptoms

For full list of side effect patient should refer to the product information accompanying the prescription.

The course of Roaccutane/ Oratane is variable and will depend on many factors including the type of acne, your body weight, the location of your acne and the side effects you may experience on this tablet. As a guide-

  • Average length of treatment: 6-9 months
  • Severe acne involving bacne acne, trunkal acne: 10-12 months
  • Low dose Roaccutane / Oratane program: 14-20 months

Your Dermatologist will decide as to what is the optimal course of Roaccutane / Oratane treatment based upon your acne type and your lifestyle.

Acne will be cured in 80% of patients who complete the course of Roaccutane. 20-25% of patient may need a second course.

There are several predictors as to the likelihood of a second course of this drug, including -

  • Bacne, trunkal acne
  • Family history of acne
  • Acne at an early age
  • Severe cystic acne

Patients who are on Roaccutane are not candidates for laser treatment of their scars, and a wash out period applies. This is important as skin healing can be delayed after laser therapy. As a rule we adhere to the following-

  • Fractional laser (deep fractional): 3 month wash out after Roaccutane
  • Full laser resurfacing for acne scars: 6 month wash -out
  • TCA cross chemical peels: 3 month wash out after stopping Roaccutane
  • If you would like to get acne scarring treated on Roaccutane, we have developed a program called Acne Free RF Program.

Patients have 2 choices in regards to acne scars that are visible whist on Roaccutane/ Oratane therapy.

Firstly, be patient. Some scarring may improve on Roaccutane (though this drug is not designed to treat acne scars, some patients have an immune system that ‘self heals’ scars once the acne subsides. If you still have scars at the end of therapy your may go onto further scar revision such as Fractional laser or Full Laser resurfacing for acne scars, or even TCA Cross for your scars. Red scars can be treated with V Beam Vascular lasers.

Secondly patients can under take NON LASER treatments such as RadioFrequency whilst on Roaccutane. This treatment remodels scars at the same time as acne is being treated. RF is non-laser based, and has minimal damage to the upper layers of the skin. This new treatment gently heats the dermal scar layers of your skin, and remodels acne scars gradually. Patients will need to be under Specialist supervision for this treatment.

Until recently, acne scar revision during the course of Roaccutane- Oratane treatment was not considered possible. This was primarily due to poor wound healing. Treatments such as TCA cross, Fraxel, ProFractional, Pearl Fraxel, skin needling are contraindicated in Roaccutane patients.

New technology over the past 12 months have enabled specialist to treat acne and scars at the same time. Patients on low dose Roaccutane can safely enter the Acne Free RF Program. This method of scar revision can occur early on in your Roaccutane treatment. In fact in many cases the early the better, as scar remodelling works best for newer scars.

RF or RadioFrequency does not use laser energy to target scars, but radiowaves to heat up the dermal layers of skin.

Yes it can, but not when you are on Roaccutane treatment. Some patients may get redder and flush easier on Roaccutane, and this is due to a few factors including sunsensitivity, dry skin and changes in your skin’s blood supply. Some patients may also have an overlap of Rosacea.

Laser such as V Beam Vascular laser can reduce the redness of your face. Several treatments are needed, however this can only be done 3 months after you stop the drug.

That is a difficult question to answer, as results are variable. Roaccutane is not designed as a treatment for acne scars, but a treatment to treat and cure acne. Treating active acne forms the foundation for acne scar management-ie. Find an effective treatment to cure acne and reduce the severity of acne scarring.

In regards to Roaccutane and acne scars the following facts apply-

  1. Some patients can receive mild improvement of acne scars on this drug. Low dose roaccutane has been shown to remodel scars and increase collagen production.
  2. Roaccutane patients are not candidates for laser scar revision during the course of Roaccutane, and a wash out period of 3-6 months will be needed.
  3. We now have a method of treating acne patients on Roaccutane with a non- laser method of scar revision called RF or RadioFrequency. This treatment has proven to be safe and effective in the majority of patients, however careful monitoring is needed. This forms the basis of the Acne Free RF Program, which was designed by Dr Davin Lim.

Looking after your skin whist on Roaccutane/ Oratane is vitally important and can markedly reduce the side effects of this medication. Keep your acne skin care regime simple, and moisturise frequently!

Clean your skin twice a day with a low irritant cleanser- we recommend Cetaphil, QV Wash or Neutrogena Gentle wash.

Moisturise your skin twice a day- we recommend Cetaphil moisturiser. Moisturise your lips 4-6 times a day, most importantly just before bedtime as this will reduce severity of ‘dry lips on roaccutane’.

Using a high factor SPF sunscreen twice a day can reduce the incidence of sunburn on this medication. We recommend La Roche Posay .

The good news is that in the majority of patients Roaccutane is on the PBS, so the average cost to the patient is between one to two dollars per day! Roaccutane is a Specialist only prescription, and is subsidised by the Government. This drug is obtained through an Authority script via your Dermatologist.

Moisturise your skin twice a day- we recommend Cetaphil moisturiser. Moisturise your lips 4-6 times a day, most importantly just before bedtime as this will reduce severity of ‘dry lips on roaccutane’.

Using a high factor SPF sunscreen twice a day can reduce the incidence of sunburn on this medication. We recommend La Roche Posay .

There are several very important things to ask your self before considering Roaccutane treatment for acne, including -

  • Am I motivated to undertake the full course of therapy (this ranges from 7-10 months on average)?
  • Have I tried other treatments for my acne, including prescription creams, washes and tablets from my GP?
  • In potential child bearing females- has adequate contraception issues been addressed?
  • Am I dedicated towards the follow up appointments needed for patients  on Roaccutane-Oratane?
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