Frequently asked questions about treatment program for severe acne

In the treatment program against severe acne, prescription tablets are used. The treatment is suitable for those who have moderate to severe acne and have tried traditional acne treatment with medicinal creams (read more here ), but which have not had a satisfactory effect. Some people tolerate medicated creams against acne poorly because sensitive skin or underlying eczema condition. Then this drug may be the right treatment. If you have severe scarring acne, it is important to start taking the medicine quickly to avoid the development of scars.

Treatment can also be right if you have a lot of acne on the back and chest, as these areas are not very suitable for cream treatment. The medicine is also suitable for those who suffer from acne in adulthood. For women, it is important to point out that you cannot become pregnant or breastfeed during ongoing treatment.

Before starting, we expect you to have tried acne treatment with prescription creams correctly and for a long enough time. Read more about this here. This is important to clarify whether you need such a cure. If you are unsure, you should first have a regular photo consultation, so that we can help you further. If you have scarring acne, you can still make exceptions.

If you want the treatment, you first order a video consultation with us. Here, the dermatologist will assess your acne condition and whether this medicine is the right treatment for you. You will also receive all the necessary information about the treatment. You will then be enrolled in our treatment program and will be followed closely and regularly throughout the course with blood tests, clinical assessment and answers to all your questions.

All women over the age of 15 must be on safe contraception before starting the medicine. This must be arranged with their own doctor or youth health center one month before they can be enrolled in the treatment program.

You get access to a patient portal where you get an overview of monthly tasks with deadlines. Simply explained, every month you must log in and pay for prescription renewal. In the first two months, you must also upload blood test results.

Women must also upload a negative pregnancy test, in the form of a urine sample that they can take at home themselves. You must book an appointment for blood tests yourself at your GP or Fürst lab.

In our patient portal, you must also upload pictures of your skin, so that we can follow the progress of your treatment. When you upload photos to us, you get follow-up from the dermatologist and monthly e-prescriptions for the medicine.

The drug is similar to vitamin A (retinoid). Treatment with this medicine is only started when other treatments against acne have not had a good enough effect. The medicine affects the various factors that contribute to acne development, such as reducing cell division, sebum production, bacterial growth and inflammation.

The treatment is given as a course of 4-12 months. Most people notice an effect after 2-4 weeks, but the full effect comes after approx. 8 weeks. Before this, there may be a temporary worsening. This does not mean that the treatment must be ended, but if necessary measures can be taken to reduce the deterioration if it is serious.

The medicine is harmful to the foetus, and girls cannot under any circumstances become pregnant while using the medicine, and 30 days after the end of the course. Even one tablet can cause fetal harm. This is therefore very serious. It is therefore absolutely essential to avoid pregnancy during such a course. The authorities recommend double protection, i.e. that you e.g. uses both the birth control pill/coil, and also uses a condom. If for some reason you are infertile (ie unable to get pregnant), you are followed up in much the same way, but with a few fewer blood tests.

The medicine is harmful to the foetus, and girls cannot under any circumstances become pregnant while using the medicine, and 30 days after the end of the course. Even one tablet can cause fetal harm. This is therefore very serious. It is therefore absolutely essential to avoid pregnancy during such a course. The authorities recommend double protection, i.e. that you e.g. uses both the birth control pill/coil, and also uses a condom. If for some reason you are infertile (ie unable to get pregnant), you are followed up in much the same way, but with a few fewer blood tests.

The only birth control pill approved in Norway as a treatment for acne is Diane®. Diane birth control pills increase the risk of blood clots and are therefore only used as a treatment for acne, not as contraception. Studies have shown that birth control pills reduce acne. However, it is difficult to compare the effect between the various birth control pills as there are few comparative studies and the studies show somewhat contradictory results. The active substance drospirenone (Yasmin/Yasminelle/Yaz) is one of the progestogens (drugs with hormonal effects) with the least androgenic effect and can be an alternative for women who want birth control pills with an effect on acne.

Men's sperm quality is not affected by the medicine and there is no risk of fetal harm should the man's partner become pregnant while he is being treated. If a couple has problems conceiving, it is still recommended that the man take a break or end the treatment while trying to conceive.

If you have a soy or peanut allergy, you should be investigated for this before possibly starting the medicine. The reason for this is that the capsules themselves contain soya oil as an auxiliary substance. If, on the other hand, you eat soy without allergic reactions, then you are safe on this point.

It is required that blood samples be taken at the start and end of the treatment. Women must take blood samples (serum-HCG) or urine samples (un-HCG) every month to document a negative pregnancy, and are only prescribed one month's use of the medicine.

The medicine is in most cases very effective against acne. At the start of treatment, the pimples you already have must heal, and this takes time. You have to be patient. After approx. After 6-8 weeks, new pimples stop appearing and you keep getting better. There can often be color changes in the skin where you previously had pimples. We call this post-inflammatory erythema or hyperpigmentation, and this is not a scar. These color changes will usually fade with time and disappear. The medicine has a long-lasting and in some cases permanent effect on your acne problem. The medicine has no effect on scars that are present before the treatment.

Almost everyone who uses the medicine will get dry lips, almost regardless of the dose, especially at the start of treatment. You often don't notice anything for the first few days, but after a few days you get dry lips. It is important to use a good lip balm regularly throughout the day. If not, you often end up licking yourself around the mouth unprovoked. This will cause red eczema around the lips in addition to chapped lips. Those who use lip balm regularly tolerate dry lips well. In addition, we would recommend having a repairing balm on the bedside table which repairs the lips every night and which is fixed on the bedside table for use at bedtime. Purelan can be such an option.

At pharmacies, you can buy moisturizing eye drops and nasal sprays without a prescription that can relieve your ailments. If you have no problems, you do not need to use this.

You often treat eczema with a moisturizing lotion. If you suffer from dry skin in areas where you get acne, it is important not to use overly oily creams in these areas. Fatty creams can cause increased acne. It is better with a light lotion or gel-based cream and rather apply more often. If the eczema does not go away with a moisturizing cream, you can ask for a prescription for a cortisone cream from the dermatologist, or try hydrocortisone 1%, which you buy without a prescription at a pharmacy.

Yes, you can. the drug is used elsewhere in the world where there is strong sun all year round. You may get sunburned more easily when using the medicine. It's about protecting yourself from the sun with a high solar factor and avoiding direct sunbathing. Throughout the summer months, you should apply day cream/sunscreen with factor 30/50 daily and avoid getting sunburnt. If you lubricate yourself well and often, you can be on the beach and enjoy the sun and summer.

You should not sunbathe, but rather seek the shade or sit/lie under a parasol. If you have very sensitive skin, the dose can be reduced during the summer. You must remember to choose a sunscreen that does not cause acne.

You must be careful with the use of alcohol. We check liver samples regularly throughout the course.

Capsules are taken with dinner or with a glass of milk because the medicine is best absorbed into the body together with fatty food/drink.

Prescriptions for fertile women are only valid for 1 week from the date of prescription. For fertile women, only the medicine sufficient for 30 days' treatment at a time must be delivered. Between each prescription, a negative pregnancy test must be documented.

Men and non-fertile women can in principle get a prescription for the medicine for longer use than 30 days, but we also prefer in this case to do monthly follow-ups and prescribing.

Yes, if you have a serious scarring acne condition, if you do not have sufficient effect or side effects from cream treatment, a doctor can apply to get the medicine on a blue prescription. With treatment at Askin, we will be able to do this for you.

No, you cannot donate blood while you are being treated with the medicine and 30 days after the end of treatment. This is because the blood can cause fetal harm if it is given to a pregnant woman.

Questions have been raised about a possible connection between the use of the drug and depression, psychosis and suicide. Studies have not been able to demonstrate any connection. Nevertheless, special caution is advised when prescribing the drug to patients with previous depression.

Should you develop psychological symptoms, it is important to contact your dermatologist or other healthcare personnel so that this can be followed up. Patients using the medicine should also tell at least one other person about this possible side effect, so that help can be obtained if necessary.

Pregnant and breastfeeding women should not take the medicine. Patients with reduced liver function or high cholesterol/triglycerides in the blood should not have the medicine or it should be administered with caution. The medicine should never be taken at the same time as tetracyclines, i.e. antibiotic courses that are often given for acne.

Patients with a soy allergy should be referred for assessment and investigation before starting the medicine. This is because the capsule may contain soy. If the patient eats soy, the person can take the medicine without further investigation. This also applies to patients with a peanut allergy.