Relative Risk – A Near Fatal Case of Acne

By Richard Sontheimer

Professor, Department of Dermatology, University of Utah School of Medicine,

Keywords:  Acne, isotretinoin, Accutane, depression, suicide

He was an intense young man who interacted with me differently than other patients. Each time I entered the exam room, he welcomed me by using my first name.  Unusual, as he was 40 years my junior and not a personal acquaintance prior to his first clinic visit.

He had presented for scarring cystic facial acne. Five months later, he had completed a course of oral isotretinoin (Accutane®) with complete clearing of all inflammation from his face.

While winding up my last clinic visit with him, I asked the required question “Have you had any blue moods or depressive feelings over the last month?”  Like each time I had asked him this question over the last five months, his answer was “No.”

Jokingly, I asked “Now that your face is clear are you heading to Hollywood to get into the movies?”  After a further bit of banter, with an unflinching expression on his face his final statement to me was, “Doc, I was going to kill myself if you had not been able to clear up my acne.  You were my last hope.”

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2 comments on “Relative Risk – A Near Fatal Case of Acne

  1. djelpern on said:

    Mahalo for your thoughtful words.

  2. Doug Johnson on said:

    We must all be aware of the tremendous discouragement and dispair felt by our young adults with severe or even moderate acne. The minimal risk involved with clearing with isotretinoin by far ecclipses the risk of depression and withdrawl of a young adult harnessed with this mutilating disease.