Isotretinoin pills vs tetracycline antibiotic pills for acne?

[davinci]

Hello! I'm 20 and on my journey to psl mogger, acne (cheeks and forehead) is what is holding me back the most. My dermatologist suggested two alternatives:

• Isotretinoin pills
• tetracycline antibiotic pills

Having already heard of isotret creams here I was initially inclined to use the first, but after some research I found out that it's basically the same thing as accutane, which I think has quite some side effects. The derm told me the only frequent side effect is dryness of skin and lips, is that true? Is that reversible after the end of the treatment?

However I have already used some antibiotic for acne in the past but with basically no improvement.

Should I not worry and take isotret pills, should I opt for the antibiotic or maybe go for isotretinoin cream?

Picture for current skin condition
Thanks

 

[iblamesols]

nah topical isotretinoin is found not to be absorbed at all and is found low in serum blood levels compared to oral isotretinoin so you can use isotret cream or gel and get the benefits with less side effects that oral isotret has. Also taking accutane for awhile can cause dryness like you said that is yeah... quite irreversible. Don't rely on antibotics orally too much because the bacteria actually just adapts to it. Good luck i recommend benzoyl peroxide and tazoretene that's what helped me the most

 

[aids]

By "isotretinoin cream" are you referring to tretinoin?

 

[aids]

nah topical isotretinoin is found not to be absorbed at all and is found low in serum blood levels compared to oral isotretinoin so you can use isotret cream or gel and get the benefits with less side effects that oral isotret has. Also taking accutane for awhile can cause dryness like you said that is yeah... quite irreversible. Don't rely on antibotics orally too much because the bacteria actually just adapts to it. Good luck i recommend benzoyl peroxide and tazoretene that's what helped me the most

No, it is reversible. Isotretinoin will (temporarily, i.e., while you're on the medication) nuke sebum production which is what Cutibacterium acnes (the bacteria that causes acne) 'feed' off. The lack of sebum production will cause your skin dryness.

The derm told me the only frequent side effect is dryness of skin and lips, is that true? Is that reversible after the end of the treatment?

So yes, your sebum production will return to normal in time, that is just what happens when you take isotretinoin.

 

[iblamesols]

No, it is reversible. Isotretinoin will nuke sebum production which is what Cutibacterium acnes (the bacteria that causes acne) 'feed' off. The lack of sebum production will cause your skin dryness.

No. if it did acne will come back

 

[iblamesols]

By "isotretinoin cream" are you referring to tretinoin?

no there is topical isotretinoin cream. Google it

 

[aids]

No. if it did acne will come back

For many people, acne does come back after isotretinoin.

I do not think an anecdote from Derek is the best evidence to substantiate your claims JFL

 

[iblamesols]

For many people, acne does come back after isotretinoin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009746/

At the end of treatment course, (96.4%) demonstrated complete clearing of their acne, defined as no acne or occasional isolated lesions. In 5-year follow-up, relapse accrued in 11 (7.9%) of patients. All adverse effects were mild, and discontinuation of treatment was not necessary.

 

[iblamesols]

I do not think an anecdote from Derek is the best evidence to substantiate your claims JFL

retard look on reddit they exist everywhere

 

[aids]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009746/

At the end of treatment course, (96.4%) demonstrated complete clearing of their acne, defined as no acne or occasional isolated lesions. In 5-year follow-up, relapse accrued in 11 (7.9%) of patients. All adverse effects were mild, and discontinuation of treatment was not necessary.

A study with 140 people spanning over 5+ years is too insignificant to establish causation when there are so many other variables at play that I doubt are considered, or at the very least are acknowledged as potential flaws of this particular study which I will go to read now. Regardless of what you say, sebum production absolutely does increase again after taking isotretinoin, if it didn't, that would imply that the effects of isotretinoin on the body are permanent i.e., you would never need to take it again after the first dosage because you will never produce sebum again.

retard look on reddit they exist everywhere

I just read the post, not anywhere does it say anything that is against the claims I have made. Yes, you will be producing much less sebum on isotretinoin (contributing to dry skin, lips), that's the entire point of the medication. But you will begin to produce sebum again after you stop taking it, which I said.

no there is topical isotretinoin cream. Google it

OP, you should not consider information from somebody who thinks the above and reads the abstract of studies thinking that they now can now flawlessly refer to them as evidence to substantiate a misinformed claim.

My recommendation is to only take isotretinoin if you must, look at other solutions like fixing your diet beforehand. Let isotretinoin be your final option. Tretinoin is fine for now though, just make sure you're applying sunscreen consistently because you are much more susceptible to burning whilst using tretinoin and/or taking isotretinoin.

 

[iblamesols]

I just read the post, not anywhere does it say anything that is against the claims I have made. Yes, you will be producing much less sebum on isotretinoin, that's the entire point of the medication. But you will begin to produce sebum again after you stop taking it, which I said.

he stopped taking it and he perma chapped and dried out

Tretinoin is fine for now though

dude isotretinoin gel is a real thing that's prescribed i was prescribed it too. Yes Isotret not Tret. I used Tret later.

reads the abstract of studies thinking that they now can now flawlessly refer to them as evidence to substantiate your claim.

You don't have anything to back your claims bud, i at least sourced something

Let isotretinoin be your final option.

we both agree on this

, just make sure you're applying sunscreen consistently because you are much more susceptible to burning whilst using tretinoin and/or taking isotretinoin.

basic info

 

[Zeta]

Isotretinoin is the most known for a reason, take it

 

[aids]

he stopped taking it and he perma chapped and dried out

Individual in the anecdote stated that the side effects "were", implying that they were not permanent because they existed in the past and not present.

dude isotretinoin gel is a real thing that's prescribed i was prescribed it too. Yes Isotret not Tret. I used Tret later.

I admit I'm wrong if this is the case, I can't find anything on the internet about it.

You don't have anything to back your claims bud, i at least sourced something

Let me preface by saying that I understand that your sebum production after taking isotretinoin may be permanently decreased to some extent. My point is that sebum production does re-increase after stopping isotretinoin.
For the sake of the discussion: Changes in long-term sebum production from isotretinoin therapy.

Maybe I miscommunicated my point but isotretinoin does not necessarily have permanent effects unless you have a high dosage of it (low dosage over a very long time or a high dosage over a relatively shorter time).
Here's another thread that notes how acne relapse is 14.6% to 52% after accutane/isotretinoin (no citation).
I think that there were just nuances in how we've articulated our points that may have made it appear like we are not in agreeance when we are regarding the effects of isotretinoin long-term.

 

[iblamesols]

My point is that sebum production does re-increase after stopping isotretinoin.

oh okay i didn't disagree with this i just said that it won't go back to normal pre accutane

Here's another thread that notes how acne relapse is 14.6% to 52% after accutane/isotretinoin (no citation).

I admit I'm wrong if this is the case, I can't find anything on the internet about it.

Topical isotretinoin vs. topical retinoic acid in the treatment of acne vulgaris - PubMed

The patients were assigned randomly to either Group I (isotretinoin) or Group II (retinoic acid). Each group was composed of 15 individuals and, as a coincidence, in each group there were nine women and six men. The clinical differences between the groups at the first visit were not...

pubmed.ncbi.nlm.nih.gov

 

[aids]

oh okay i didn't disagree with this i just said that it won't go back to normal pre accutane

I didn't mean pre-treatment levels necessarily (though it is more likely on a lower dosage), I just mean that it will return to a normal i.e., an acceptable amount since otherwise you'd suffer from permanently dry skin (which may be the case from the anecdotes you've shown but I have not heard of this personally).

Topical isotretinoin vs. topical retinoic acid in the treatment of acne vulgaris - PubMed

The patients were assigned randomly to either Group I (isotretinoin) or Group II (retinoic acid). Each group was composed of 15 individuals and, as a coincidence, in each group there were nine women and six men. The clinical differences between the groups at the first visit were not...

pubmed.ncbi.nlm.nih.gov

View attachment 3081945

Ok, then I am wrong. I can see now from having searched "isotrex gel".
Curious to know the differences in how topical isotretinoin versus oral interacts with the body.

 

[iblamesols]

Ok, then I am wrong. I can see now from having searched "isotrex gel".
Curious to know the differences in how topical isotretinoin versus oral interacts with the body.

not much actually serum levels were measured and it was found to have not much trace compared to oral

timestamped citation here



transcription:

be absorbed into your body to an appreciable level this study monitored the levels of both isotretinoin and as well as its metabolites in the plasma of the participants and shown that there was no appreciable detection of either of these compounds and that's reassuring you know you can put it on the skin

I didn't mean pre-treatment, I just mean that it will return to a normal i.e., an acceptable amount since otherwise you'd suffer from permanently dry skin (which may be the case from the anecdotes you've shown but I have not heard of this personally).

okay fair

 

[aids]

not much actually serum levels were measured and it was found to have not much trace compared to oral

timestamped citation here



transcription:

be absorbed into your body to an appreciable level this study monitored the levels of both isotretinoin and as well as its metabolites in the plasma of the participants and shown that there was no appreciable detection of either of these compounds and that's reassuring you know you can put it on the skin

So it's like shitty tretinoin?

 

[iblamesols]

So it's like shitty tretinoin?

the video's conclusion is that it's basically the same because isotretinoin is just the isomer of tretinoin. soo... same compound just a molecule is moved into a different link. Not much difference, but in my experience comparing the two... isotret is more irritation and peeling so i'd say less shitty. It's more potent

 

[davinci]

nah topical isotretinoin is found not to be absorbed at all and is found low in serum blood levels compared to oral isotretinoin so you can use isotret cream or gel and get the benefits with less side effects that oral isotret has. Also taking accutane for awhile can cause dryness like you said that is yeah... quite irreversible. Don't rely on antibotics orally too much because the bacteria actually just adapts to it. Good luck i recommend benzoyl peroxide and tazoretene that's what helped me the most

do you need a prescription for tazoretene? is it good? I also used benzoyl peroxide in the past but it didn't help much

 

[iblamesols]

do you need a prescription for tazoretene? is it good? I also used benzoyl peroxide in the past but it didn't help much

better and faster in my experience and in studies. Also yeah i'm pretty sure you do it depends on the country but you can get it on indiamart for cheap

 

[davinci]

A study with 140 people spanning over 5+ years is too insignificant to establish causation when there are so many other variables at play that I doubt are considered, or at the very least are acknowledged as potential flaws of this particular study which I will go to read now. Regardless of what you say, sebum production absolutely does increase again after taking isotretinoin, if it didn't, that would imply that the effects of isotretinoin on the body are permanent i.e., you would never need to take it again after the first dosage because you will never produce sebum again.


I just read the post, not anywhere does it say anything that is against the claims I have made. Yes, you will be producing much less sebum on isotretinoin (contributing to dry skin, lips), that's the entire point of the medication. But you will begin to produce sebum again after you stop taking it, which I said.


OP, you should not consider information from somebody who thinks the above and reads the abstract of studies thinking that they now can now flawlessly refer to them as evidence to substantiate a misinformed claim.

My recommendation is to only take isotretinoin if you must, look at other solutions like fixing your diet beforehand. Let isotretinoin be your final option. Tretinoin is fine for now though, just make sure you're applying sunscreen consistently because you are much more susceptible to burning whilst using tretinoin and/or taking isotretinoin.

jfl I was confusing tretinoin with isotretinoin
so should I start with tretinoin (retin A) first and see what happens? What % ?
do you know any specific food to avoid other that the processed ones which I already don't eat?

 

[iblamesols]

so should I start with tretinoin (retin A) first and see what happens? What % ?

0.05 then bump up to 0.1

 

[davinci]

0.05 then bump up to 0.1

ok i'll do thanks again

 

[davinci]

better and faster in my experience and in studies. Also yeah i'm pretty sure you do it depends on the country but you can get it on indiamart for cheap

thanks! i'll look into that

 

[davinci]

By "isotretinoin cream" are you referring to tretinoin?

yes I got confused

 

[aids]

yes I got confused

Apparently there is such thing as isotretinoin gel, but yeah, use tretinoin 0.05% every evening, skip an evening if the side effects are overwhelming for you. Eventually, once you feel you can tolerate 0.05%, increase to 0.1% if your issue has not gone yet.

 

[aids]

do you know any specific food to avoid other that the processed ones which I already don't eat?

Dairy products are thought to exacerbate acne, but I don't think there's any correlation between the consumption of milk and acne. Though, there was a correlation found between the consumption of skim milk and acne, so go for the regular dairy variants if you choose to eat them, don't eat/drink low-fat cheese or milk, etc.