Q: My teen has bad acne and wants to try Accutane. I’ve heard that some people are “microdosing” the drug to reduce the side effects. Does that work?
When teens (and adults) have severe, painful acne that causes scarring, makes them feel self-conscious and is resistant to other treatments, dermatologists often prescribe isotretinoin, an oral medication commonly known by the brand name Accutane.
Isotretinoin works by shrinking the skin’s oil glands and keeping skin cells from clumping, both of which can clog pores, said Dr. John Barbieri, an assistant professor of dermatology at Harvard Medical School. It may also lower inflammation that causes redness, swelling and pain.
Most people who take isotretinoin enjoy clear skin for the long term, Dr. Barbieri said. But the drug’s side effects can be distressing and sometimes severe. These can include dry skin, lips and eyes; nosebleeds; headaches; muscle aches; joint pain; depression; irritability; and high cholesterol. In some cases, Dr. Barbieri said, acne may return.
For those who have had side effects (or worry about them), or if their acne has returned after treatment, dermatologists may prescribe lower doses of isotretinoin, often referred to as “microdosing,” said Dr. Sara Perkins, an associate professor of dermatology at the Yale School of Medicine.
What is a microdose?
There’s no standard definition of an isotretinoin “microdose,” Dr. Perkins said. How much you take depends on your weight, how severe your acne is and how well you tolerate the medication when you take it, she explained.