When Stronger treatment is right for You?
The reason Dr Freeman prescribes Roaccutane is that, more conventional acne
treatments (such as antibiotics) have been unsuccessful in breaking the acne
You probably haven't been prescribed Roaccutane earlier because it's
generally considered a good idea that more conventional treatments such as
antibiotics and creams are tried first.
You do have to be careful whilst on your Roaccutane treatment, and follow the
dosing guidelines very carefully. However, by following Dr Freeman's advice and
the instructions in this notebook you should be able to break the vicious
recurrent acne cycle with relative ease. Roaccutane is successful in curing acne
in a large percentage of patients where other therapies have failed.
Acne is a common complaint
80% of Australians have at one time suffered from some form of acne. Of these,
5% suffer from very severe acne.
There are many misconceptions about acne, the main being that it's caused by
junk foods and uncleanliness. Acne is a skin disease, and should be treated as
Recurrent acne can be treated and stopped. This isn't just so you can enjoy life
today. You can also prevent long term scarring and pitting which may affect your
life in the future.
What is ROACCUTANE?
The medical term for Roaccutane is isotretinoin and it is the only known cure
for acne. It is essentially a substance that is similar to Vitamin A, but has a
very different action. In short, Roaccutane works by reducing the oily
substances in your skin, caused by oil producing glands. In turn, this reduces
the amount of bacteria in the skin which is the cause of the inflammation and
'pus' associated with acne.
Roaccutane has also been shown to have an anti-inflammatory effect on the skin.
How long will I be taking ROACCUTANE for my Acne Treatment?
A full course of Roaccutane will vary from person to person. In most cases,
treatment lasts for around 20 weeks. It may take longer. In over 80% of cases
acne will be completely cleared so long as the dosage instructions are strictly
In cases where a cure is incomplete, a second course of Roaccutane may be
prescribed. However, this will only be considered after a two-month break. This
is because the healing process often continues after Roaccutane is stopped.
Be aware of some expected side effects of your Acne Treatment.
Whilst on Roaccutane, you will experience some side effects. These include
dryness in several parts of the body and possible tiredness of the muscles and
bones. Side effect concerns are dealt with at length in the side effect section
of this notebook.
ROACCUTANE can cause birth defects.
Under absolutely no circumstances should Roaccutane be used by pregnant women or
by women who intend to become pregnant - during treatment and for one month
after stopping Roaccutane therapy.
All possibility of pregnancy must be ruled out one month before and after you
start your Roaccutane treatment. This should include the strict birth control
One month after you've finished your treatment, life can continue as normal,
Who's suitable for ROACCUTANE
Roaccutane is suitable for any person (male or female) with acne, regardless of
age. The only people who shouldn't take Roaccutane are pregnant women or women
who are breast feeding.
Dosage instructions you must follow on Roaccutane.
To gain the most from Roaccutane, it's important to follow your dosage
instructions. It's also important that you do not miss your medication, or take
too much. You should also try to follow the information given to you in the
Lifestyle section in this notebook. This will help maximise the benefits of
Follow Dr Freeman's Directions.
Dr Freeman has prescribed the dosage that is right for you, according to your
weight and the severity of your acne.
To help you remember to take your Roaccutane treatment we have enclosed a fridge
This will remind you to take your Roaccutane. Remember, Roaccutane should always
be taken with food.
Dosage and length of Therapy.
Your treatment with Roaccutane will usually last around 20 weeks, although it
may be longer. You must:
· take Roaccutane with meals
· swallow the capsule whole and unchewed - either with water or a non-alcoholic
If you forget to take one dose, you should not make up for the missing does by
taking double the medication the next time. You should always take your
Dr Freeman has prescribed a specific dose for good reason. You must not alter
the prescribed dosage because you think it is too weak or strong without
consulting Dr Freeman.
Depending upon how you respond to Roaccutane, Dr Freeman may choose to increase
or decrease your dosage. Only he or she should do this!
When you finish your ROACCUTANE Course.
It's important that you return any remaining capsules to Dr Freeman and not give
Roaccutane to anyone else.
At the conclusion of your Roaccutane course, your skin should have cleared up
significantly and your life will be all the better for it.
Birth control is vital for women on Roaccutane.
You must prevent yourself from getting Pregnant.
Whilst not every women taking Roaccutane will be sexually active, it is a vital
issue that every woman or girl should know about regardless.
Roaccutane is teratogenic. Basically that means women of child bearing potential
must use strict birth control methods to protect themselves against pregnancy
whilst on Roaccutane treatment and for one month after stopping. This is because
(as with many other medicines) there is a risk that an unborn child may become
deformed. It also means if you were to become pregnant, you may be advised to
have a termination.
Some Strict Guidelines.
Before you can begin your Roaccutane treatment, certain preventative measures
must be taken:
· you will be required to take a pregnancy test before your Roaccutane course
· you must use strict birth control for at least one month before you start
treatment and one month after stopping treatment.
· you should wait until the 2nd or 3rd day of your next menstrual period before
you start your Roaccutane treatment.
· in the event that you do become pregnant whilst on Roaccutane treatment, stop
taking it immediately and tell Dr Freeman.
Roaccutane has no effect whatsoever upon fertility as it does not affect the
reproductive organs. (It is the developing baby, not you, that is at risk.)
It is your responsibility to not become pregnant whilst on your Roaccutane
To be sure, prior to the commencement of your Roaccutane treatment, Dr Freeman
will request that you have a pregnancy test.
In this day and age, it's really quite easy to prevent yourself from getting
pregnant if you are sexually active. If you're unsure, you should ring your
doctor or your local Family Planning Clinic who are experts in this field.
(Numbers are in this book.)
The most effective method of contraception is the oral contraceptive pill plus a
barrier method (condom or diaphragm).
After your acne treatment, life returns to normal, only better.
One month after you've finished your course of Roaccutane, you will be free to
conceive again, should you wish.
The small sacrifices you have made will pale in comparison to the improvements
in your skin and general well being.
Expected short term side effects on Roaccutane.
Some short term readjustments.
With Roaccutane, you will probably experience some side effects. To what extent,
varies from individual to individual.
However, in most cases side effects are minimal, particularly if you follow the
advice of Dr Freeman and the information contained in this notebook.
The most obvious and frequent side effect of your Roaccutane treatment is
dryness. This is dealt with thoroughly in the Lifestyle section.
Compared to the advantages of breaking the acne cycle, putting up with some of
the side effects for a short period of time is really worth the effort.
Side effects are a positive sign.
If you do experience some of the expected side effects it proves that your
Roaccutane treatment is working. Side effects are a normal part of the healing
You may suffer from an initial acne flare up. This is also an indication that
your Roaccutane treatment is working. It is normal for your condition to get a
little worse before it gets much better.
In the unlikely event that you do experience side effects that become
intolerable, it could mean that your dose has to be altered. Do not do this
yourself. You should consult Dr Freeman.
What are the Side Effects?
The most common and expected side effects are cracked lips and dryness of the
skin. It is important that you take steps to manage this occurrence so as to
avoid complications. How to manage this is dealt with thoroughly in the Skin
Other less common side effects resulting from your Roaccutane treatment are nose
bleeds and dry eyes. Dryness of the eye can result in conjunctivitis. For this
reason, people who wear contact lenses should change them regularly and avoid
wearing them overnight or for too long.
Some rarely felt side effects you should know about.
Though most patients can carry on as normal, in a few cases some people have
reported tenderness or stiffness in the bones and muscles. This can hamper
strenuous physical exercise.
Other more serious (but rarely experienced) side effects include skin
infections, peeling of the palms and soles, bleeding and inflammation of the
gums, headache, weight loss, diarrhoea and an abnormal menstrual cycle. In some
cases a thinning of the hair may occur. This is more prevalent in men.
All these conditions are important for you to know about, but will rarely
happen. If they do, you should advise Dr Freeman.
It is important to remember that whilst there are some less common side effects,
they are not permanent, and will reverse once treatment has stopped.
Pregancy and ROACCUTANE
The one thing that you absolutely must not do is get pregnant whilst on your
Roaccutane treatment. This is because babies can experience birth defects. You
must take all precautions to ensure that this does not happen.
However, one month after your treatment has ended, you will be able to conceive
Skin care with Roaccutane.
Some positive therapy.
Whilst on your Roaccutane treatment, it's very important that you take extra
care of your skin.
The healing process of Roaccutane dries up the oily glands in your face.
Consequently this will make your face drier and more fragile than normal during
your course of Roaccutane.
When you experience dryness on any part of the body, there is no need to panic.
This merely proves that your Roaccutane treatment is working.
However, there are certain positive steps you can take to make your life easier.
You should use the appropriate products mentioned in this notebook when you do
feel dryness in any part of your body.
Whilst on ROACCUTANE:
· Do not squeeze pimples.
· Do not remove scaly skin.
· Do not have facials.
· Do not have waxes.
· Do not use acne creams or soaps.
· Do not have body piercing as this may cause infection.
· Do not have electrolysis.
· Do not use hair colouring containing peroxide, perm or use hair rollers. (If
you do have a perm, make sure to organise this at least 2 weeks before starting
· Do not use solariums.
· Do not take overly hot showers.
Dry skin and how to help it.
Dryness is an expected consequence of your Roaccutane treatment. Naturally, if
you notice unusual occurrences on your skin or are worried, you should see Dr
Freeman or local doctor. It's also a good idea to record any concerns in this
notebook to raise at your next appointment. Following is a list of some
recommended products that can help alleviate any dryness:
A very common effect of Roaccutane treatment. You are advised to apply a lip
ointment to the lips and corners of the mouth regularly (every 1-2 hours). Carry
a tube with you during the day and see your doctor if cracking is bad (eg.
bleeding or very irritated).
Another common effect of treatment with Roaccutane is dry nostrils which may be
mild in some cases, but may lead to nose bleeds in others. Dry nose can be
managed by applying Vaseline with a cotton bud on the inside of your nose a few
times daily. Nose bleeds may need treatment with a prescription product. If nose
bleeds persist and are difficult to stop, consult Dr Freeman or local doctor.
This may cause pain on intercourse so a lubricant will help.
You may find that during Roaccutane Treatment and for a time after you may
suffer from dry eyes. This condition may be a problem if you wear contact lenses
or work in an air-conditioned environment. Preservative free eye drops in
convenient single use vials e.g. REFRESH(tm) are recommended for dry eye and
helps soothe dry, irritated and tired eye and can be used whilst wearing contact
Dry skin is an expected symptom and can occur all over the body. Keep showers
short (if possible less than 2 minutes) and make them luke warm as hot water can
irritate the skin. You should also try to avoid soaps. Consider using bath oils
as an alternative.
Roaccutane makes your skin more sensitive to the sun so you may burn more
easily. You need to be properly protected. Cover up, wear a rimmed hat and a 30+
sunscreen (oil/alcohol free varieties). Don't sunbake or use a solarium.
Dryness of the scalp and hair may also be experienced. To counteract this you
should wash your hair with mild shampoo designed for dry hair. A conditioner
should always be used. If dandruff becomes a problem, a medicated shampoo (tar
based) may help. Avoid using hair dye products particularly those containing
peroxide, as they may cause additional drying effects to the hair or possibly
irritate the scalp.
Cosmetic for your condition.
It's advisable to use oil-free products while on Roaccutane. Most face powders
are suitable, as are cover sticks.
If you're considering cosmetic surgery, it's advisable to wait 6-12 months after
treatment is complete.
You may experience some dryness and irritation of the anal area. Apply Vaseline
to relieve and reduce the symptoms several times daily.
Looking after yourself with Roaccutane.
Some Lifestyle adjustments to be made.
There could be some general lifestyle changes that you may have to make whilst
taking Roaccutane. However, with some minor modifications your life can run as
Whilst on your Roaccutane treatment, it's important that you look after yourself
and eat sensibly. This is so you can achieve the most successful therapy
Some dos and dont's:
Don't drink an excess of alcohol.
Don't donate blood until at least four weeks after stopping treatment.
Don't take any Vitamin A supplements.
As with everyone going out in the sun, ensure you use a sunscreen. A 15+ or
stronger product is best as your skin may be particularly dry and hence more
sensitive than usual.
Some other factors to consider.
During your Roaccutane treatment, you should not take any tetracyclines. These
are antibiotic products which you may have used in the past (including Doryx®,
Minomycin® and Vibra-Tabs®).
Roaccutane can also affect you if you're involved in physical training. You may
suffer muscle fatigue which can result in poor performance. As a result, you may
want to delay your Roaccutane course until a more convenient time, or after a
specific sports event you may be training for.
As a general rule, you should try to avoid contact sports as much as possible.
You should also avoid applying preparations to your skin which could cause
irritation. These include sports gels and arthritis creams.
A guide to lower cholesterol and triglyceride levels.
Follow good eating habits. Broadly speaking, you need to:
¨ choose a nutritious diet from a variety of foods
¨ avoid eating too much fat
¨ eat more breads and cereals (preferably wholegrain), vegetables and fruits
¨ avoid eating too much sugar
¨ limit alcohol consumption
¨ use less salt
The National Heart Foundation of Australia makes the following recommendations
as a guide to healthy eating by avoiding an excess of foods, which may raise
blood cholesterol and or/ triglycerides.
1. Eat a Variety of Foods
Include a variety of foods in your diet, meals will be more interesting and you
can take advantage of "in season" specials. By including foods from each of the
following groups every day, you will benefit from nutritious eating:
¨ cereal and grain products (bread, breakfast cereal, oatmeal, rice, spaghetti)
¨ fruits and vegetables
¨ fish, lean meats, poultry, dried beans, peas and lentils
¨ low fat dairy products
¨ oils and spreadable fats (but only minimal amounts)
2. Maintain Normal Weight
Check your weight regularly to ensure you are not overweight. To help prevent
and control overweight:
¨ eat less fat and fatty foods, sugar, confectionery and other sugar-containing
foods and drinks
¨ limit alcohol intake
¨ fill-up with low kilojoule foods such as steamed vegetables, salads and water
¨ avoid "fad" or "crash" diets - they do not work long term
¨ say NO to seconds
¨ keep physically active
¨ read the National Heart Foundation's booklet "Guide to Losing Weight"
3. Eat Less Fats and Dietary Cholesterol
The amount of fat in the average Australian diet should be reduced by 25%.
Particularly the amount of saturated (animal) fat and cholesterol.
¨ choose lean meat and poultry, trim excess fat
¨ use more fish or vegetarian dishes based on dried beans, peas or lentils
¨ use more low fat dairy products instead of full cream varieties
¨ eat fewer high fat foods; fried foods, fatty take-away foods, cakes, biscuits,
pastries, chocolates, salad dressings, sauces
¨ select polyunsaturated oils and margarines
¨ only eat these foods sparingly - offal meats, prawns, squid, fish roe, eggs
4. Eat Less Salt
Most Australians use much more salt than is needed.
A reduction in salt intake may help prevent high blood pressure.
¨ add no salt to cooking or at the table; table salt, sea salt, rock salt,
¨ limit your intake of high salt foods; cured, corned, canned, luncheon meats,
salami and meat pastes, smoked and canned fish, cheese, vegetable extracts,
commercial sauces, MSG, many take-away and snack foods
¨ CHECK LABELS for salt or sodium - if available, choose brands containing "no
added salt" (or sodium)
5. Eat More High Fibre Foods
Dietary fibre helps fill you up and high fibre foods are usually rich in many
¨ wholemeal breads and pastas
¨ wholegrain breakfast cereals
¨ wholewheat, corn, oats, barley, brown rice
¨ vegetables (especially dried beans, peas and lentils)
¨ nuts and seeds (in moderation)
6. Eat Less Sugar
Sugar contains only non-essential kilojoules and may replace other more
Limit the following:
¨ white, brown and raw sugar
¨ honey, jams, syrups
¨ confectionery, soft drinks
¨ cakes, biscuits, pastries, puddings, ice-creams
¨ fruits canned in syrup
¨ beer and sweet wines
It is recommended that you contact your nearest National Heart Foundation office
for further information and ideas on how to put these suggestions into practice
by using the National Heart Foundation Cookbook.
On ROACCUTANE your life is pretty much the same.
It's okay to do most things - unless told not to, by Dr Freeman, or advised
against it, in the Roaccutane starter pack. (Driving, diving and flying are not
It's important that you familiarise yourself with all the possible side effects
(which are discussed in a separate section). To gain maximum benefits from
Roaccutane, you must finish the entire course to cure your acne.
Contact Us at The Skin Centre.
By Telephone: +61 7 5597 7170
By Fax: +61 7 5597 7370