How effective is Accutane for clogged pores that does not respond to topical treatments such as BHA/AHA?

Hi,

Comedones, commonly known as clogged pores, is a chronic relapsing problem due to increase sebum secretion and blockage at the pore opening. As such, a long-term safe strategy to reduce comedone formation is usually based on topicals as well as physical therapies.

The best topical for treating comedones is not AHA/BHA but topical tretinoin and adapalene.

Effective physical therapies include superficial chemical peeling and gentle comedone extraction.

Only for the most resistant of cases, where patients are very bothered, that low dose isotretinoin may be considered. This treatment is extremely effective but results are often seen only after several months of treatment. Its effectiveness, however, needs to be carefully weighed against its potential side effects, some of which are rather serious, especially for the treatment of just comedones which do not cause scarring in the long term.

After successful clearance, continued topical maintenance treatment will be required to prevent relapses.

Hope this helps!

Comedones are follicles in the skin that is filled with dead skin and oil. I normally use a combination of topical BHA and retinoid i.e. differin gel, to treat comedones. If the patient has very oily skin with episoidic breakouts due to the hormonal cycle, I sometimes prescribe oral Accutane on a weekly dosage to reduce oil production. The medication also increases the turnover of the dead skin the follicles, thus removing the dead skin. I find this effective.

However, I constantly remind all my female patients that they are not advised to get pregnant whilst taking Accutane and have to stop the medication for at least four weeks before conceiving.