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Permalink Reply by lisa bova on January 24, 2014 at 7:54pm

Accutane is tricky.  Honestly there is very little you can do during a facial.  Absolutely no products containing acids of any kind and no microdermabrasion.   Light steam, gentle enzymes at best.  Extraction, if you must, should be very delicate.  Much like with topical retinols, pushing too hard may cause the skin to lift or peel leaving much the same reaction as lifted skin from a wax.  Less is more with anyone on accutane.  I would say no to LED as well.  The medicine is doing all the work...helping wth client with the dryness and skin dandruff with enzymes is most helpful.  Not too much heat either.  Light steam for short period of time.  Steam towels should be tepid not hot.  Use some nice natural oils with a pressure point massage, being careful not to stimulate the skin with too many motions.  hope this helps

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Permalink Reply by Amy Sherman on January 31, 2014 at 12:19pm

I don't work on clients who have used Accutane in the l a st 6 months. Accutane actually thins the skin. So I don't do anything to it.

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Permalink Reply by coldsalineplexus on January 31, 2014 at 8:12pm

What you CAN help with during Accutane is provide comfort, professional expertise, and moral support. Focus on making sure they're drinking enough water and properly using occlusive dressings and sunscreens. You could do a cold stone or ice facial massage or refrigerated jade roller or the like. Full fat plain Greek yogurt as a mask, removed with cool cotton compresses. I would not risk extractions until 3-4 months post Accutane. Much too easy to tear the skin. A gentle scalp massage could be nice, but remember even the scalp skin is thinned so go easy. When I was taking it I felt so hot and raw under my skin, and itchy on my legs... My eyes were sensitive. It would have been very soothing to have a confident esthetician provide a cooling treatment, application of something hydrating on my arms and legs, maybe some cold stones or tea bags on my eyes, and a big dose of encouragement. Remember Accutane can also lead to depression, suicidal thoughts and ideation, and even suicide in a short period of time, even for people with no prior history, so if I heard any of that from an oral tretinoin patient, I would be sure to get them into capable medical care ASAP. The big thing is super compassionate care, and helping them let go of the anxiety of "what if my acne comes back?" Each visit you are soothing and supporting them in a way their family might not know how, and also letting them know that you will be there for them if they still need acne care post treatment, and that even if some acne returns, it will be much more manageable through topical means than it was before. Accutane is a drug of last resort, which means these patients have suffered a lot to get where they are, and that being rid of their acne is important enough to them to take serious medical risks. It is a testament to the emotional devastation wreaked by acne, and the service of providing competent, compassionate and personal guidance, physical and emotional comfort, along with helping them keep an eye out for serious side effects they might not recognize on their own, is a true and noble offering.

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