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

Is it safe? How much was it if you don’t mind saying?

A friends ds took this. It caused permanent erectile dysfunction. He was late teens. Was told he would never get an erection again.
he became a heroin addict because of this.
not a drug to take lightly!

He only used Epiduo at night. Washed face at night and in morning with cerave normal face wash. Used suntan lotion. I think it was just too strong for his face. He doesn't have eczema but I guess his face is a bit sensitive.

It's definitely safe, although the price is painful. We paid around 4000 for the course of three treatments, but that was over a year ago when it was brand new to the UK. The price might have come down a bit now that more places are offering it.

How did accutane do this? It's not listed as a known side effect.
https://www.drugs.com/sfx/accutane-side-effects.html

My DD (18) took accutane last year after exhausting everything else, including LED.

It’s an amazing drug. Her skin is now perfect. She never had any mental health issues nor do they run in the family but she was still very strictly monitored by the consultant with check- ins about her mental health.
I imagine if you are concerned, you can obviously monitor yourself but also ask for more check-ins with the consultant.

And she needed regular blood tests throughout.

Thank you. Were there any side effects on this treatment?

Two of mine took it, just monitored them closely, they were fine. Mental health was actually lifted due to resolving severe acne. One of them had several risk factors for mental illness including severe depression but we decided to trial, monitor and they were fine. They knew the importance of raising the flag immediately if necessary.

My son took it after exhausting all the other prescription treatments. Like others have said it was highly effective and life changing. Having acne made him so miserable. I wouldn’t hesitate to try it. Why not trial it and any problems then you can stop it.

If you have tried everything else and he is asking to take the medication, I would support his decision and closely monitor.

Please remember, once he's 16 he can decide for himself and stop you speaking to doctors on his behalf, potentially leaving you with no input into clinical decisions. It's much better to listen to his wishes now with you monitoring than him deciding and not telling you later.

She said the treatments themselves were a bit painful, but nothing she couldn't handle, and then after the first one there was sort of a purge where she broke out badly for a few weeks, but I think that can happen with the roaccutane too? Other than that, no side effects.

We saw Dr Mahto at this clinic (referred by our GP) and found her to be incredibly medically knowledgeable about the range of treatments and very forthright about the positives and negatives of all of them. We decided on the aviclear both because of the usual concerns and because DD was getting ready to go on some gap year travels/work and then on to university and it wasn't an ideal time for her to be trialling a medication with potentially serious side effects.

https://selflondon.uk/clinic/?gad_source=1&gad_campaignid=22903427897&gbraid=0AAAABBFoKiMqq3rbZ8owNV_3KzzWUEctz&gclid=CjwKCAjwzNTUBhAjEiwA7zcvWsKNzFSDrVXWSwRj3wQIlzrLYbX30MPGEXQm_JME3KR_MjTrbolujBoCz1wQAvD_BwE

My son has taken it and the dermatologist we saw said he had prescribed it 5 x a week for 35 years and only had one report of lower mood and he also said that actually the latest research isn't sure that the depression rates are higher on the drug versus the rates for those with acne. Obviously I'm not medically qualified and just passing on what he said. My son's acne is now clearing up well after 2 months on it and no side effects apart from dry skin /lips. X

I took with a history of mild depression, family history of severe depression.

No side-effects except aching bones and joints and my hair started falling out, and it worked great! I wish I took it earlier as I now have bad scarring...

Also my acne has come back after 5 years, I was told by a private dermatologist that the initial dose was not high enough for my body weight and I hadn't reached a cumulative dose and therefore needed to take it again. So those were the downsides

Sorry to hear he's doing through that. I went on it years ago, it was life changing for the best. I have some depression etc but nothing severe. It didn't affect my mental health. My lips peeled when I was on it. I have no regrets taking it, it was a real blessing. Changed my skin forever it a very positive way. Went from wanting to stay in the house at times, feeling like I needed to plaster my face in foundation etc to not feeling at all self-conscious about my skin. All the best to him.

My brother took it decades ago and is adamant it negatively affected his mental health.
If it was my DS,and his skin was really bad, I'd let him take it, but be very watchful.
It's worth remembering that medications affect each individual differently.

It should have fewer potential side effects than the isotretinoin.
Its a blood pressure med - so the main risk is things like dizzy spells or feeling light headed. Too early to tell yet if my daughter is effected.

Thank you

Thanks a lot.

Hi op. I have taken accutane 3 times. I have a strong family history of depression, bipolar, and suicide and I was fine. If anything i was happier because my skin was clearer. There is a lot of fear mongering around accutane that isn't warranted. I think it's because most other medications are to treat bothersome symptoms and accutane is mostly given to "healthy" people, so side effects can be more noticeable, as well as people assuming acne is cosmetic and overstating the fact it's treated with drugs.
I would say go for it. The dr will monitor and you can too. Acne is a terrible disease and the last thing your son wants is scars and pits for the rest of his life when he may not have any side effects at all from the medication. I would say get some aquaphor as lip balm and thick moisturiser as it really dries you out. That was my only side effect.

My son is currently taking Roaccutane and is prescribed 40mg per day. He has another 6 weeks of Roaccutane and his dermatologist has said he’ll stop it then. His acne was severe, he wasn’t going out and socialising at all. His skin is now clear apart from PIE scarring which gets less noticeable everyday. He’s a different boy. It was a risky move though as he had very raised cholesterol levels so he’s been carefully monitored with 4 weekly blood tests. My only regret is not seeking specialist advice sooner and he wouldn’t have as much scarring. His MH is good, much better as he can face people now. Topicals and antibiotics can only help mild to moderate acne. I’ve spent a fortune.

Interesting about the cholesterol. I didn't know it raised cholesterol but a quick google has shown that it does.
DS cholesterol was quite high in his last blood test, surprising to me as his diet is good. He's stopped roaccutane now (it was fabulous for his skin and very glad he did it) and I think that means his cholesterol will drop back down.

@SomersetBrieyes it has an implication on the liver which increases cholesterol levels. My son reduced his red meat and cheese consumption and it did reduce and stay with acceptable parameters for him to have Roaccutane prescribed.

If you have exhausted all other medical avenues, then the risk is worth it. It was the only medication to clear up my acne and I was in my 30's by the time I had it prescribed. Spent years on various antibiotics and birth control - I was miserable.

Clean eating etc is all well and good, but true acne, will not clear without additional support.