Dermatologists warn against self ‘microdosing’

Illegally obtaining low dose isotretinoin (Oratane, Roaccutane) online or taking the acne treatment differently to how it was prescribed by a doctor is both unnecessary and dangerous, warn dermatologists.

Dermatologists are warning against unsupervised ‘microdosing’ with isotretinoin (taking small doses) after recent media articles reported the practice.

The media articles refer to people purchasing low doses of oral isotretinoin online or reducing the dosage prescribed.

Dr Mei Tam, dermatologist and All About Acne member, said isotretinoin is a highly effective treatment for severe acne that is now available in a range of doses from 5-40mg.

“This is a serious medication that requires careful assessment and monitoring, especially in females, which is why it can only be prescribed by dermatologists,” said Dr Tam.

A doctor will typically run a blood test looking at cholesterol, liver and blood count before prescribing isotretinoin. In addition, a pregnancy test and then two effective forms of birth control are recommended for women as the treatment is linked to birth deformities.

“As with any medication, it’s important to take isotretinoin and all acne treatments as your doctor has instructed. If you’re concerned about side effects, talk to your doctor, as this may be simply managed by starting with low doses of isotretinoin,” explained Dr Tam.

Potential side effects of isotretinoin include skin dryness and sun sensitivity. These side effects can be managed with cleansers and moisturisers for acne-prone skin as well as lip balm, and your doctor may provide you with a patient support pack which includes these items.

Isotretinoin is a treatment for severe cystic acne

Isotretinoin is available on the Pharmaceutical Benefits Scheme (PBS) for severe cystic acne and acne that has not responded to other therapies. It is only one of a range of acne treatments available.

“The benefit of discussing your acne with a healthcare professional, such as a dermatologist, is that they will tailor an acne regimen specifically for you. That may mean a lower dose of the treatment, combining treatments as well as providing advice on skin care, diet and exercise. Some patients with a tendency towards scarring may require higher doses of isotretinoin with other anti-inflammatory medications to be effective,” explained Dr Tam.

“We understand that people who have endured acne and then enjoyed clear skin will want to maintain it. Solutions are best found by talking to a health professional.

“The risks of purchasing medications online can be very costly – for your skin, your wallet and ultimately … your health,” concluded Dr Tam.