Acne, Accutane and teen mental health concerns, anyone faced this decision?

[Superspecs]

My son has acne and it is really getting him down, he is struggling to get up and out to school in the morning on a more spotty day and it’s is making him sad and anxious, his dermatologist has suggested Accutane for him.

I would be all for this but we have a close family history of poor mental health and suicide, and I am terrified of the small potential suicide risk in people who take Accutane.

It feels like being stuck between a rock and a hard place because my son’s mental health is being severely effected by the acne, but then I am struggling with the idea that he may be taking a drug that heightens a potential risk of suicide, even by a little bit.

Has anyone been in this situation and come to any conclusion? All advice is gratefully received. I spoke to his psychiatrist (who he sees for anxiety) and he said that on balance he thinks it would be okay to go ahead with the Accutane, but the idea of it is still making me very nervous. My son would like to take it.

Thank you

He is 15

One of mine with serious mental health issues went on it. The dermatologist didn't warn us of the risks despite having full knowledge of his issues.

He ended up very depressed and verging on suicide. I think if he currently doesn't have major MH issues I'd do a trial of roaccutane and monitor very closely.

I would be extremely cautious after a couple of people I know ended up with suicidal depression due to vitamin A overdose (accutane is basically vitamin A). It can take years to get it out of your system..

Have you tried optimising zinc levels? Supplementing carnitine? Vitamin B5 (pantethine form)? I'd try those before considering Accutane. There's a protocol for using carnitine + B5 together which you'll find if you Google. One of my family members has had a lot of success with carnitine supplements reducing acne.

Probiotics and probiotic foods like kefir or raw milk can also be very beneficial.

Try a led mask worked for my son

I went on Accutane a few years ago for really bad acne on my back, it cleared it up and it has never returned. I was lucky in that I only had mild symptoms which were mainly feeling tired & it made me bruise really easily, I still have this issue now. In terms of mental health I had a low level feeling of sadness which came & went

Norse organics also meant to be good. I’d avoid the accutane too.

if you’ve reached the point where the doctor is suggesting this, then the dietary and over the counter cosmetic suggestions are not going to work.

I took it as a teenager and it changed my life in less than 3 months. The bullying stopped, my confidence increased and I felt like I might actually get a BF one day.

I would have a frank discussion about the fact you will be keeping a very close eye on him while he’s on it and make sure he knows why and agrees to any extra monitoring then let him take it.

Thank you all for your input, it’s really helpful to hear everyone’s experiences.

My son knows the risks and knows that is why I am saying no at the moment. We have kind of reached the end of all the prescribed topical treatments, diet, supplements and antibiotics the dermatologist is able to offer which is why it has come to this unfortunately. We have not tried LED though so that would be worth looking into too.

Any more experiences and opinions gratefully received.

People who have not had bad acne often do not appreciate the serious physical and mental effect it can have. I had bad acne as a teenager, to the point where my self confidence and mental health was destroyed because of it, tried everything medical and non-medical and the only thing that finally worked was Roaccutane. It saved me and my mental health and I would not hesitate if one of my children ever needed it.

My DS took it. The dermatologist spoke to me on several occasions about mental health and DS was fully aware about the need to monitor this. Severe acne can lead to terrible scarring and as you seem to have tried everything else I would try it. Acne itself can cause bad self esteem issues and that in itself can make mental health worse.

Since his poor MH is caused by the acne, the accutane will help his MH.
The advisory is more for kids/people with poor MH caused by other issues.

I would go for it and monitor him. Get him a therapist he can chat to privately about his MH once a week.

I had acne as a teenager and would have loved to have had this opportunity to cure it.

Let your son try it - it’s not a given that it will affect his mental health in a bad way.

People who haven’t had problem skin can’t understand how it can destroy a persons confidence

My DSS took it. His skin was awful. His Mum and Dad were concerned about the side effects but decided to go ahead. His skin cleared up and has remained acne free.

We ended up doing AviClear laser treatments instead for DD. You need three sessions and they're expensive, but apparently ultimately do the same thing as accutane without the need for a systemic medication.

That said, I know numerous kids who have take accutane without a problem.

My DD took it. She had no previous MH problems but within 6 weeks was suicidal, the difference in her mental health was dreadful. It took months to deal with the fallout. She wishes she had avoided it.

@Superspecs You said your son has tried all the topical and antibiotics treatments? My son had severe acne from age 15. Sometimes, it is genetics. His Dad had it (we met when he was about 21) and his Dad went on Roaccutane and it did clear up his really bad acne but he had quite nasty side effects from it so he wasn't keen for him to go on it. Anyway, we went down the whole route of trying different treatments. Basically, the third course of antibiotics he went on (was three months long and last try before we got referred to the Roaccutane clinic) did the trick with a combination of topical treatment and skincare routine. He's now 18.5 and it took us a good three years to get a handle on things. He still has oily skin but it has really cleared up. So, here's a list of things that work and don't:

• Epiduo - Currently using and works for him as a topical treatment
• Antibiotics - Third course worked but the first two courses made mild improvements but regressed after coming off them
• Norse Organics - Did not work
• Skin+Me - Worked but was expensive
• Skinoren 20% Cream Azelaic Acid - Very harsh on the skin, needed getting used to and he preferred the milder Epiduo
• The Ordinary cleanser and moisturiser. Very reasonable and great for everyday use. He's also using the rosehip oil.

Hope that helps! It was devastating watching him go through it, but his skin is really clear now. I don't know if age has anything to do with it too.

I took my Son to a private specialist for his acne when he was a teenager. She wanted to put him on Accutane but needed to do blood tests first, which he refused. Instead she recommended Dermol.200. to wash with and Dermol 500 to bath in. You can get it on prescription or purchase from a pharmacy. It was life changing. You wash with it, gently pat the skin dry then apply more as a moisturiser. This cleared up his acne without any side affects
please, please try this first.

My sister had horrendous acne and eventually got prescribed that to clear it up. She’s obviously a girl and she was 18 which is different to a younger male. It worked without mental health side effects, and ended the battering her mental health was getting from the acne.

My son took roccutaine at 17 after 4 years of bad acne. Sept - March. dry skin, dry lips - otherwise good. His skin cleared and has stayed clear. We had 3 years prior to this of trying different products and diets - all nonsense. Seriously all these suggestions of washes and creams do not work - see a dermatologist and get proper treatment.

My DD had mental health issues - under Cahms and on antidepressants
went on accutane for cystic acne
no problems with mental health
skin cleared up beautifully-
no regrets

I’ve had highly treatment resistant acne and taken 6 full doses of accutane and been on a low maintenance dose for the past decade. I’ve had some mental health struggles with quite severe anxiety during my life but accutane never made it worse. I would say it has massively helped my mental health as my acne made me very depressed at times. Obviously everyone is different but purely based on my own experiences, I have found it very positive.

My DS developed bad acne out of the blue aged 16 and his mental health declined sharply. He also started school refusing. Antibiotics did nothing for his skin so we went down the Roaccutane route, despite my concerns. His skin cleared up over time, as did his mental health. He suffered some side effects though, predominantly very dry mucous membranes and really bad chapped lips to the point where they were bleeding. But overall, I think it was the right decision. Best of luck - it’s a really tough one.

My DD had took it aged 15. This was after a MH crisis. We later realised that acne was a factor in this. So we found that the benefits outweighed the risks. Also she was monitored closely. It's not an easy medication to take. DD had very dry lips and an aching back. It's worth looking into any specific side effects for males. It also cleared up her scarring from the acne and her skin is lovely now.

I became suicidal on this medication as a 20-something. I would still let my child go on it if their acne was bad enough and causing them distress. The problem for me was that no one told me it could have that effect. If you’re aware and he’s aware you can monitor it and he can stop taking it the minute he gets any ill effects. The negative symptoms went away very quickly once I stopped it.