Acne Scar Revision On Accutane / Oratane

Acne Scar Revision On Accutane At A Glance

  • Best Results2-8 sessions
  • Treatment Recovery2-4 days
  • Procedure Time20 min
  • Skin SpecialistDermatologist, nurse
  • Duration of ResultsLife
  • AnaestheticNumbing
  • Back to Work1-3 days
  • Cost$-$$$

Acne Scar Revision On Accutane / Oratane

Acne scars are best treated early (less than 3 months old). With revised guidelines in 2016, patients on Accutane-Oratane are able to undertake most scar revision procedures. Treatments include vascular lasers, focal deep peels, minor skin surgery & fractional lasers/microneedling. Early treatment can often reduce the requirement for more invasive future procedures.

FactsFacts on Treating Acne Scars On Oratane

  • Recent guideline revisions in 2016 & 2017 have changed the way we manage acne scar patients on isotretinoin
  • Early remodeling of scars mitigates more invasive procedures
  • There is a paradigm shift amongst procedural dermatologists to treat scars early
  • Red acne marks can be effectively treated with vascular lasers
  • Brown acne marks can be treated with Pico lasers
  • Atrophic scars can be treated with Tixel or fractional lasers

Acne Scar Revision

Essentially all scar revision procedures can be safely performed on patients on oral isotretinoin, apart from fully ablative lasers & deep global or segmental peels. This consensus has been revised in 2016 & 2017 in peer-reviewed journal publications reflected on evidence-based medicine.

This means the following procedures have no higher risks cf. patients, not on oral isotretinoin- microneedling, Dermarollers, Dermastamping, fractional lasers, nano RF/Sublative, RF microneedling, focal deep peels, Tixel, steroid injections, punch excision & elevation, limited surgical subcision.

Out of courtesy, either I or one of my colleagues will inform your supervising medical dermatologist of the intent of scar revision procedures.

What procedures can not be performed on Accutane?

As per revised guidelines, fully ablative laser resurfacing procedures including CO2 & erbium laser can not be performed whilst on Accutane. Deep segmental & global peels with TCA or Phenol Croton are also excluded (note this is different form TCA Paint, CROSS as this is classified as focal deep peels). Extensive surgical procedures are also excluded. This includes complex flaps, extensive excisional procedure should be limited. Subcision can be performed with caution.

Discuss these procedures with your dermatologist or plastic surgeon as they would be familiar with the JAMA guidelines. If they have not read the current literature, you may be enforced a 6 to 12 month washout as per original reports from the 1980s.

What are the official guidelines for procedures?

Official PI or Product Information for Oratane – Accutane still stands at a 6-12 month washout. Companies are too lazy to update their policy based upon published safety data over the past four decades.

Your dermatologist may not read journal articles, & hence may choose to follow outdated information.

Why is early management of acne scars optimal?

There has been a paradigm shift in the management of acne scarring over the past decade. Evidence points to early management of acne scars as the standard of practice. With early intervention, the requirement for more invasive treatments such as fully ablative laser resurfacing & invasive surgery may be mitigated.

Davin’s Viewpoint on treating acne scars on Accutane

The revisions 5 years ago has now enabled patients to undertake sensible scar revision procedures. Most procedural dermatologists agree that early intervention of scarring is best practice.

Even depressed scars can be effectively improved with combination treatment such as vascular lasers & Tixel resurfacing. For post inflammatory hyperpigmentation, the use of bleaching creams & pico lasers are highly effective. Red scars do very well with vascular lasers.

Treated early, most patients will not require invasive surgical procedure.

acne scar laser resurfacing
Fractional CO2 & non-ablative lasers are great for patients on Accutane.

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