Dear Stephanie,
I am so glad that you wrote this question! I took Accutane 13 years ago when I was 25 years old, and I can honestly say that it was the very best decision I ever made in my entire life. Here's my story -- when I was 13, I started getting acne. I wasn't covered from head to toe, but I would get 5 or 6 large acne cysts in the same places on my face every month. I went to several dermatologists who prescribed all sorts of topical treatments as well as anti-biotics. They didn't really work. The only thing that would work was getting a cyst injected with cortisone. However, I would have to drop everything and go to the doctor for an injection any time I got a cyst ( I don't think its fair to even call these things pimples -- they were deep, hard, red, painful, with no head like a white head would have.) This went on for years. I had read a few articles about Accutane in magazines like 17 and was turned off by the side effects, and my pediatrician who was very conservative was against it for concerns about long term side effects (this was in 1985 so there wasn't a lot of data yet.) So, I didn't take it as a teenager.
When I was 24, I went to see a holistic doctor. He "prescribed" a diet with lots of veggies and NO sugar at all, in combination with various vitamins and herbs and a viatmin A pill every day. (Vitamin A is the main ingredient in Accutane). I did this for two months, and I did see a dramatic improvement in my skin. However, I found his regimen exhausting. There were so many little pills (about 50 each day) that it took me 2 hours a week to count them out and put them in little baggies to take with breakfast, lunch, and dinner every day. Frankly, it was ridiculous, so, I started to give up on that. Although this may be a healthier way to go, I don't see how a mother could basically force a teenage son to follow the program I was on. Maybe a really dedicated adult could do it, or maybe I wasn't serious enough about my skin at the time. Anyway, about a year later, I made friends with a woman who was my age and taking Accutane. She told me about her experiences and I was convinced to look into it again. I expressed all my concerns and fears to my dermatologist, who was very understanding and said that if I didn't like the side effects, I could always go off the Accutane before the treament cycle was completed. I was especially concerned about eye dryness since I wear contacts and that is very important to me. Anyway, I took the Accunant for 6 months. Nothing happens for the first 10 days to 2 weeks. Then, for about 2 weeks, I got every pimple and cyst that I ever had or would ever have all at once. That was a bad week, and I was at his office for a lot of cortisone injections. I even had some sty-like things form in the margins of my eyelids from it, which was disgusting. Every morning I would wake up with a forest of blackheads standing up straight from every pore on my nose that had been pushed out from my pores the night before. But then, after the first 4 weeks, my skin started to improve. By 6 weeks in, my skin looked amazing. I did get the dry lips, but they weren't any worse than my lips now thanks to this Chicagoland winter. I got a few small nose-bleeds, but I learned the trick of a little vaseline on a q-tip rubbed up inside my nose at night and it took care of the problem. My skin was very sun-sensitive all during the meds and for about 6 months after it was done, so you would not want to be planning any sort of beach vacation or even time in the sun (no swim team without serious zinc oxide all over or the burns will really hurt and damage your skin.) Also, no alcohol for fear of serious liver damage (this shouldn't be an issue as a teenager, but still...)
I think the biggest issue is really how does your son feel about it? I had become very self-conscious about my acne, and was thinking/obsessing about it more and more. I was a young, single, professional college graduate and I felt that it was ugly/bad/unprofessional/distracting to have pimples and that it was holding me back in my work and social life. Having it just go away and never come back has been wonderful for me. Now, 13 years later, I will get an occasional pimple, but much smaller and not so long-lasting. I didn't get a single pimple for about 8 years after the drug. I understand that there are some people who need to take a second round of Accutane later in life especially if they took it first when they were younger. Your doctor can tell you more about this. I don't think I would want to take it again, even if I felt that the acne was bad, because I don't think I would want my skin or eyes to become any dryer than they are right now.
Good luck helping your son make his decision. I hope this helps (and that it wasn't too much info!)
J.