Minocycline and Accutane questions?? Dr. Nase

[BloodRed]

Hey Everyone,

I was just wondering how long you need to be off Accutane before you can start up on Minocycline? I'm on Minocycline 100mgs 2 times a day and have almost completed a months worth. So far I haven't seen much of a result. How long does it usually take for the antibiodics to "kick in"?

Also, I finished a cycle of low dosages of accutane about 6-8 weeks ago. I stayed on it for about 4 months and it worked really well. However, I never get the long-term results that some people are talking about. I've done about 5 cycles of low dosases (20mgs) of accutane within the past 4 years. My results are great on the drug, but about a month or so off it my skin goes back to being oily and flushed. I'm getting nervous about continuing with my endless cycles on Accutane because I don't know if it's healthy or not. Is a person more prone to side-effects the more the more cycles they have on the drug? Is it safe and wise to continue doing a cycle of accutane every year or so? Would 5mgs a day do anything for acne and redness?

Thanks

Blood

[clsykes00]

Bloodred,
Have you been doing 4 to 5 months on these cycles everytime?

From what I understand about using accutane for treating R, you have to take it for at least 1 year. This gives the skin chance to heal and most imporant fully break the nearly unbreakable inflamation cycle.

Hope this helps.

Best,
Trey

[BloodRed]

Thanks for the reply.

Ummm.....well I've done various times. Once I did six months, 5 months, 4, 2, 2. I've never done a year or more. I'm kind of freaked out about doing it that long. I'm not sure my dermatologist would go for it. Can you go any lower than 10mgs a day and get good results if you do it long term? Also, I always get really paranoid that I'm going to lose my hair every time I'm on accutane. Is this just paranoia or is there a decent chance?

[clsykes00]

Bloodred,
From what I understand and based on the time that you have used it, you have not given your skin the chance to reduce inflamation. This is critical in your fight against R and really one of the primary reasons to use accutane.

Dr Nase has said that you do not need 10mg and that in fact a dose as low as .5mg would work (this dose is not available to the general yet).

I would say that you are your own best judge of the progress and affects of the drug on your body. But, I also question whether you have really given yourself the proper chance to benefit from accuntane. So much so, I would say that the on/off strategy is not benefiting you at all.

The doctor may not give you accutane for a year but you wont know til you ask. Also, if he says no, try doctors til you find one that will. Call offices to see whether they have done such a treatment for rosacea before. You have to fight for what you want.

As for side effects, drugs including accutane affect people in different ways. 10mg is generally a dosage level where many people do not get side effects or the side effects are mild. I have heard that some hair falls out on high dose accutane, but have also heard that this affect is temporary (once off accutane, the hair comes back).

Hope this helps,
Trey

Remember, Im not a doctor, and you should take very careful precautions whenever you consider taking drugs, especially accutane. Check with your physicians to answer questions important to you. I feel like I need to add this disclaimer since I am not a physician and I have only provided information based on what I have read.

[BloodRed]

Thanks for the info.

I may bring it up to my derm. whenever I go back in a few weeks. I first want to gather all my info. I'm just worried if it's healthy to keep doing accutane? I always get really paranoid about my hair falling out too which causes stress for me. However, I'm already getting sick of my skin flushing in all my classes. I can't relax and I'm not enjoying my college life.

[BloodRed]

I have keratosis pilaris on my skin and on my face. It's different from rosacea, but I have many of the same sort of symptoms along with pesky bumps. The problem I have is that the number one thing to treat KP is Vitamin A. This is in many topicals such as Differin, Retin A, and Tazarac. However, whenever I use them my skin gets redder, but if I don't use them my skin get lots of bumps and terribly oily. The only thing that works GREAT for this is Low doses of accutane. I wish I could stay on that drug and never get any side-effects. To me that would be heaven.

[drnase]

Hey Everyone,

I was just wondering how long you need to be off Accutane before you can start up on Minocycline? I'm on Minocycline 100mgs 2 times a day and have almost completed a months worth. So far I haven't seen much of a result. How long does it usually take for the antibiodics to "kick in"?

Also, I finished a cycle of low dosages of accutane about 6-8 weeks ago. I stayed on it for about 4 months and it worked really well. However, I never get the long-term results that some people are talking about. I've done about 5 cycles of low dosases (20mgs) of accutane within the past 4 years. My results are great on the drug, but about a month or so off it my skin goes back to being oily and flushed. I'm getting nervous about continuing with my endless cycles on Accutane because I don't know if it's healthy or not. Is a person more prone to side-effects the more the more cycles they have on the drug? Is it safe and wise to continue doing a cycle of accutane every year or so? Would 5mgs a day do anything for acne and redness?

Thanks

Blood

Hey Blood,

Good to see you on here. Let me give you one suggestion that is not mine -- it is from physicians "in the trenches". It is much better to stay on the drug for 12 plus months than do cycles of 4 to 6 months because the dose is so low that you never get to breaking that cycle. Remember that this has been beating up your dermis and vasculature for years/decasdes before you even knew it.

Four to six months is way too short.

This is not medical advice. I am concerned that you have done so many cycles though. If you and your doctor decide to go long term, get all the liver tests,renal tests and get some bone scans and ligament scans to make sure there is not calcification.

While it is certainly not a perfect drug that works in 100% of the rosacea/kp population, if you cut it down to short cycles I can almost guarantee no long term results. If I remeber correctly, I took it everyday for over 12 months and then every other day for a few and once a week for a while to see if anything would come back. Nada. 6 years later. Your KP combo also throws in a little bit of a twist and it would be wise to talk to your doctor about the other oral retinoids for this.

I really like Ramabazole. This will be a keeper.

Keep us posted blood and get those tests done. Wait at least a month between accutane and antibitoics or vice versa -- some say two months, but definitely not at the same time.

[BloodRed]

Hey Dr. Nase,

I have my dermatologist appointment next friday. I'm getting really frustrated with my skin. I've been using Tazarac 1% gel and 100mgs of Minocycline a day. I can already see my skin going back to hell. My forehead is getting really oily and little bumps are appearing. I'm flushing a lot more in class. My skin is having an affect on my social life too. I'm getting scared to talk to anyone. My self-esteem is dropping as I speak. Whenever I'm on Accutane it's a totally different story. However, I don't know if I should keep doing it if it doesn't work long term. Dr. Nase, do you think that taking 10mgs a day for a year would help long-term with acne? Do people still lose their hair on really low dosages like 10mgs a day? Also, am I more prone to side-effects since I've already done like 4-5 short cycles of accutane?