b/c it's an assault on your internal system. generally, around here, docs will only prescribe it on teenagers and young adults. trust me, i doc-shopped on this. lol.
once you get close to child-bearing years (b/c it has a relatively high propensity to lead to birth defects), it's not something he is particularly comfortable with b/c it can linger in your system for years. once you exit those child-bearing years, he still doesn't like prescribing it b/c of some of the side effects are weighty for middle-aged adults (e.g. joint pain).
i was sad. i wanted to take it. but now that i have found something that works, i'm ok with his decision.
having said all of this, for many, the benefits outweigh the risks. (i just read back my post and thought it sounded biased against accutane, which i'm not at all).
I took when I was about 33. You have to login to a website (can't remember what it's called) and they give you a quiz each month that basically outlines the risks each month. Then I had to get blood tests each month before I was given my prescription. I can say that most definitely the results have far outweighed the risks. I was pretty depressed and in some pain due to the cysts. I have wonderful skin now, I only use Dove, I don't need anything else on my skin. It was a lifesaver for sure.
i have cystic, hormonal acne too. i actually went to a derm to inquire about accutane b/c i was at my limit! it was so bad and b/c i have darker skin, the scarring was crazy.
i eventually found a topical cream combo that works amazingly. and i tried a lot of things (not that hoity toity laser though [@holly] - i may need to do that if this stops working).
anyway - i use aczone in the morning and finachea in the evening. you've seen my skin - it really works. now, instead of 3-4 cysts every cycle, i get maybe 2-3 a year. no biggie.
eta: derm would not prescribe accutane to me, which is how i ended up on the creams
Hehe, I do have some very posh acne you know. I think the laser was worth it for mebecause I was also sick of dry flakey skin, my skin is dry at the best of times, and like all acne sufferers you know how much you rely on makeup and dry skin and makeup are no bueno. Plus my derm kept prescribing cortisone creams which are no good long term!
I'm on BCP and still get hormonal cystic chin acne Panoxyl face wash does the trick for me. I use my regular wash (Yes to Carrots) and then wash for a minute with Panoxyl just on my chin. I started using it in November and so far, so good.