Sebaceous gland hyperplasia, enlarged oil glands, and cosmetics
In my younger years I had painful cystic acne, and now as an adult I
have sebaceous gland hyperplasia, which is the technical name for
enlarged oil glands. I produce lots of oil and you can actually see my
oil glands below the surface of my skin. I have been on a full-dose
regimen of Accutane five different times and on two longer-term
low-dose regimens. Accutane seems to be the only thing that helps, but
it comes with lots of nasty side effects, and as soon as I stop taking
it the problem returns.
I went to a new dermatologist several weeks ago and he gave me a
prescription for a topical cream that contains the same ingredient in
Accutane. It contains 6 percent "Accutane" in an emollient base. The
prescription had to be filled at a special pharmacy and it still needed
the special sticker about risks and everything. Now my skin is
flawless. This topical form of Accutane works great without the need
for blood tests or any of the other side effects. This has been a
miracle for me and I want to share what I've discovered with as many
people as I can.
_ John, Torrance, Ga.
A: I certainly understand your joy at finding a solution to your
problem. I felt the same way when I took Accutane many years ago, and
for the first time went weeks without noticeable blemishes. But unlike
you, Accutane worked fairly well for me and it did feel like a miracle.
Sebaceous gland hyperplasia is a common disorder related more to sun
damage and aging than to the typical problem of oily skin, which is
strictly hormonal. As you discovered, Accutane can work while you are
taking it, yet typically the problem recurs soon after you stop taking
it, and long-term usage is not recommended (Source: www.emedicine.com,
Sebaceous Hyperplasia, November 2005).
Topical Accutane (which goes by the trade name Isotrex, and has the
same active ingredient as Accutane, isotretinoin) isn't available or
approved for use by the FDA in this country (Source:
http://www.fda.gov/foi/warning_letters/g4280d.htm), which is why you
had to find a pharmacy that could mix it for you. It is, however,
available in other countries.
While I understand your enthusiasm over finding something that
finally worked, the research just isn't there for me to echo your
praises, at least not without some strong cautions. The few studies
that do exist demonstrated that topical Accutane does show some
benefit, but it was not as effective as benzoyl peroxide. On the other
hand, it was just as effective as Retin-A. There don't seem to be any
systemic problems connected with topical application of Accutane, but
again, the research is so limited that there is no way to state that
definitively (Sources: Clinical Experimental Dermatology, May 1992,
pages 165-168; Journal of the Medical Association of Thailand,
September 1999, pages 868-875; and Acta Dermato-Venereologica, January
2001, pages 14-17). Especially for women, this could potentially be a
risky drug to apply daily, given the risk of birth defects that are
found when Accutane is taken orally. For a man, I guess if other
treatments have failed, it may not be a problem, but I would definitely
talk this over with your physician or dermatologist.