Roaccutane Low-Dose May Clear Resistant Rosacea

Written by on December 7, 2007 in Accutane and Roaccutane, Acne Treatments with 1 Comment

roaccutane

Another article that shows that low-dose accutane (around 10mg a day or so) is a viable option for difficult-to-treat rosacea. This is conversational style article is from a magazine called Skin & Allergy News. For more information from peer-reviewed journals for eg. see the links at the end of this item. There is a good body of evidence that under the right conditions, low dose accutane may be a good treatment option. Hopefully these items will help you and your doctor decide whether accutane is suitable for you.

Skin & Allergy News 30(12):23, 1999.,Barbara Baker, San Francisco Bureau

MONTEREY, CALIF. — Low-dose, long-term, pulsed oral isotretinoin therapy can be a highly effective way to combat resistant rosacea, said Dr. Richard B. Odom, chair and professor of dermatology at the University of California, San Francisco.

It’s a good option for women who are not capable of child bearing and for men, he suggested at the annual meeting of the Pacific Dermatologic Association.

About 70% of patients with rosacea respond to the traditional approaches of topical metronidazole or clindamycin or oral antibiotics, such as tetracycline. But the remaining patients either just don’t clear initially or eventually stop responding.

In these patients, low-dose isotretinoin usually results in resolution of papules and pustules with very mild to no erythema.

The therapy also seems to resolve telangiectasias, “which is surprising because we know the retinoids have been reported to induce angiogenesis,” Dr. Odom said.

He suggested using 10 mg of oral isotretinoin two or three times a week or 20 mg twice a week. He gives the agent for up to a year, at which point he likes to cut back the dosage and eventually discontinue the drug.

It would take 3-5 years of therapy at this level of dose and schedule to amount to one regular 15- to 20-week course of isotretinoin for acne. Because the dosage is so low, Dr. Odom does not order special lab tests as long as patients have not had hepatitis and are not taking cholesterol-lowering or triglyceride-lowering medications.

He avoids using long-term intermittent isotretinoin therapy in women with childbearing potential because the agent is teratogenic. “I prefer to treat them with a regular, shorter course and hope they get a remission,” he said.

“But acne in women in this age group is often hormonally related and isotretinoin doesn’t change the hormones, just the sebaceous glands.

Therefore, these women tend to relapse when the agent is discontinued,” Dr. Odom added.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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1 Reader Comment

  1. nancy skenes says:

    i have rosacea . I’ve had vascular traced laser and am still experiencing burning. I also am depressed over all of it. I am wondering if topicals and oracea will help with inflammation.

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