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Dabbie
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from Singapore asked a question

What acne scar treatment is suitable for me if I am on Isotretinoin?

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Acne & Scars Aesthetic Medicine

I'm a 22 female. I have been on Nimegen (Isotretinoin) 10mg/day for 2 months. I'm wondering if I can have any acne scar treatment while on the medication as I know that Isotretinoin makes your skin really really sensitive. Additionally, what kind of acne scars treatments do you think will be more suitable for me with minimal downtime. Thank you in advance!

DOCTOR’S ANSWER (3)

Hi Dabbie,

As Dr Wu has pointed out, it is generally safe to commence acne scar treatments whilst on Isotretinoin.

Personally, 2 main factors will determine the treatment plan:

1)  Condition of your skin

If your skin is irritated, flaky and sensitive from the Isotretinoin, then it might be best to delay intense ablative treatments till later so as to minimise the side effects associated with such treatments.

2)  Severity of your acne 

If you are still having constant outbreaks/ cystic acne, then it would be best to treat your acne first as acne itself can cause further scarring and would be counter-intuitive if you were to start acne scar treatments now.  

Treatment of acne and scars do take time so be patient and discuss your options with your doctor.  

Hope this helps.

All the best!

0 520 views 0 Doctors agree Tue Jun 19 2018 04:25:12 GMT+0000 (UTC)

Hello Dabbie

Thank you for your question. You can actually start acne scar treatment while you are on isotretinoin. 

There are studies done in recent years that show insufficient evidence to support delaying treatments such as chemical peels, non-ablative lasers or fractional ablative lasers on patients receiving accutane treatment. (Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations; 2017 Aug 1) 

The type of acne scar treatment will ultimately will depend on the type of acne scar you have:

  • Tethered scars - Subcision 
  • Box/ Rolling scars - Fractional laser resurfacing/ Microneedling RF 

Microneedling RF and fractional erbium laser will usually have a shorter downtime (3 to 4 days) compared to fractional CO2 laser (5 to 7 days). Bruising from subcision may take a few days to subside.

You can conceal the bruises with makeup in the mean time. Speak to a doctor to get a proper assessment first before deciding on your treatment. Hope this helps!

Regards

Dr Jiwei Wu 

0 545 views 0 Doctors agree Mon Jun 18 2018 10:29:09 GMT+0000 (UTC)
Dear Dabbie,


Understand that you have already been on isotretinoin for 2 months for your acne problem. 

The question on if you are suitable to start on any treatment for your acne scar would depend on several factors. 

First of all, is your skin getting more sensitive? If you find that your skin get red easily and is more fragile to scratch, it will be important to be more careful as the healing of your skin might be affected. 

Second, how is the condition of your acne now? Is it well controlled or are you still getting new acne? Some treatment for acne scar might aggravate the condition of your acne, while others might actually benefit you. 

Third, how severe is your acne scar? Different acne scar would require different strategy. While you might been able to tolerate certain treatment while on isotretinoin, it might or might not be the correct treatment. 

It is therefore more important to have an open discussion with your doctor to understand your condition and concern. Discuss on the risks and benefits of the proposed treatment before embarking on the therapy for a safer journey. It might even be a combination therapy. 

Remember to be patient. Treatment for acne and acne scar takes time and multiple sessions. Be moderated on your expectation as well.  More and more treatments are available. Take your time to understand them. 

Be safe & be happy.

Regards,

Dr Elias Tam

0 531 views 0 Doctors agree Mon Jun 18 2018 16:05:26 GMT+0000 (UTC)
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