Keloid/Hypertrophic Scarring- What can I expect from accutane?

[delusivecontentment]

I finally decided that my acne was troublesome enough to see a dermatologist. It isn't just the acne, but mainly the resulting scars that made me decide to seek the help of a professional. I get keloids on most of my body, but not on my face. I do have abnormal/excessive scarring on my face, but I wouldn't compare it to the keloids on my body. The facial scars are generally quite flat, but brightly pigmented (the color of inflamed acne, unfortunately). They do not seem to improve much at all with time.

My dermatologist took one look at how I scar, and decided accutane was right for me. Although I haven't tried any topical or antibiotic prescriptions, and my acne is not severe, they thought accutane would be best as a first measure because it will knock out the acne, which will mean no additional scars. I was not well informed by my dermatologist about what I can expect my scarring to be like during the course of the accutane. She just said that if we stop the acne, we stop the scarring, then several months after we can look into their array of scar treatments.

I've been looking for articles regarding the use of accutane in patients with keloid/hypertrophic scarring, but all I can seem to find are horror stories of people taking accutane and going and having laser treatment/dermabrasion resulting in keloid formation. I would never do that to my skin during such a delicate time! I just want to know what to expect of my keloid prone skin *while taking* accutane. I can't find anything on the subject!

My question is... As a person with keloid prone skin that always heals abnormally, what can I expect with the use of accutane, primarily *during* and shortly after the course of the drug?

I feel this is something I need to know in order to make an educated decision whether or not to try the accutane, and I just can't get a clear answer from my own dermatologist. Thank you for your time!

[delusivecontentment]

So I don't have to worry about my face as much as I thought? Thank you for your answer. I will probably wait about a year before doing anything drastic to improve my skin after the accutane, since I know my skin is very sensitive and will probably take longer than most to recover from such a harsh treatment as accutane sounds. I'd rather be safe than sorry with how I scar.

[Alan Rockoff, MD]

I think your dermatologist's assessment makes sense.  The face doesn't often keloid.  Stopping your acne is the best way to stop getting more scars.  I don't know about these horror stories, but if you consider laser surgery at all, it won't be till at least 6 months after you complete the course.

Best.

Dr. Rockoff