Well, i doubt this will help anyone else, but it will help me keep track of the course, so here goes.

I did my first course of Accutane about 15 years ago, when i was a teenager. I think it started at 30mg/day and eventually topped out at 50mg/day. My acne was moderate/severe - i had lots of deep, painful nodules/cysts and it was pretty well generalized. I had it on my face, chest, back, shoulders, upper arms, and an occasional one on my butt or thighs which doctors claim is a different condition, but i don't really beleive them haha. So i took Accutane for about 6 months and still hadn't cleared, and the doctor kept extending the course another month until i'd been on it 9 months when he said i had to stop. He said i could go back on for a second course after a rest period. About 2 months after stopping the medication, i cleared dramatically, completely. I stayed clear for a long time afterwards.

It began to creep back after a few years, at first very mild and easy to control with OTC products, but as time passed it became more moderate and the nodules and cysts returned to my face, then my back and chest. It became persistent and no longer responded to OTC treatments.

So i went back to the dermatologist, and after jumping through many dermatological hoops i got my prescription for a second course. My cholesterol is pretty high (runs in my family), so she started me on 20mg/day. I had to give up alcohol completely to get my triglycerides and liver enzymes down before she let me begin the course, which was suprisingly easy to do given how much i was drinking.

Day 1: 10/05/05: Began course with generic version of Accutane this time - Claravis. Stupid packaging. I'm taking the dose with breakfast and a fish oil supplement, and a milk thistle liver supplement as well.

Day 4: 10/08/05: I was amazed to realize that i was already experiencing the dryness. My skin was flaky and my lips were horribly chapped and split when i woke. The Aveeno lip balm i was using was obviously insufficient, i had applied it right before bed. My arms, legs, feet, and hands seemed to shed their top layers.

Day 7: 10/11/05: Woke at 3am with a headache. Took Advil and tried to go back to sleep. Got up and went to work, took another dose of Advil - it was able to suppress the ache but not entirely. I went home early to try to sleep it off. My boyfriend came home and i showed him where it hurt on my head (not the place i normally get headaches), and he said that's where he gets headaches when his eyes are dried out from his contacts. I put in eyedrops, and like magic the headache was gone. Bought a couple bottles of Refresh Liquigel the next day, one for home, one for work. This type of headache recurs if i forget to use the eyedrops several times a day, and it's sort of weird because i don't have a sensation of dryness, just the ache if i wait too long.

Day 9: 10/13/05: Chapped lips and flaky skin are bugging me. My face has developed that attractive Accutane sunburn look. I buy a Clinique lipbalm i've used before called Superbalm and a tub of cream called "Exceptionally Soothing Cream for Upset Skin". These products rock. The Superbalm healed my lips by the next morning and they haven't chapped or cracked since then. So far an application at bedtime lasts until morning. The cream helps a lot too, it moisturizes and reduces the redness.

Day 11: 10/17/05: I'm amazed at how fast this is working this time, and at such a low dose comparatively. I've had a minor initial flareup, but no worse than my normal acne. The difference is that after the blemishes in an area heal, the skin seems clear under it, instead of just brewing new acne. I've had acne surface en masse in areas i normally break out only rarely, but where the pores are always clogged. It seemed to move cyclically, one area breaking out and healing, then the breakout moving to the next area. Right now i have a few active zits on my chin, back, and upper arms, but much less than normal, and less severe than normal as well. Some of the pores have just unplugged without turning to pimples - little plugs of keratin rise to the surface and pop out.

I'm starting to feel the fatigue, and strangely seem to be craving saturated fatty foods which would not help with the cholesterol, gah. I noticed this weekend that i can see the veins through my pale skin much more clearly than normal, but maybe i'm imagining that. Anyways, that's all for now.

Hi Btdt,

I started just 5 days after you. I'm amazed at how much more quickly you seem to be moving along, with your skin already being flaky on day 4. My lips are really chapped, but otherwise not a whole lot of changes...other than a dry nose (inside).

Where do you get Exceptionally Soothing Cream for Upset Skin?

I am glad to hear you're craving foods. I am not necessarily craving any one type of food, but I am always hungry. I need to make better choices before I have a weight issue too!

Good luck, I am sure I'll follow your log since we're so close to our start date.

Well, this is my second course even though it's about 15 years later, so maybe that explains the quick response, or it may be because i'm thirty years old and so my skin isn't as oily as it was before. I certainly didn't respond so quickly the first time.

At the Clinique counter in major department stores. Otherwise you can order it from their website. And i have to say again that their lipbalm is the best.

Wooo, it's kind of weird. I'm not actually hungry, i just really want stuff i shouldn't be eating. I hope that passes soon, i can only resist the call of fried chicken and junk like that for so long.

I feel hungry all the time!!!! And craving sweets. Maybe it is the birth control pills messing with me.......they have messed up my cycle already!

I'll have to check out that Clinque Soothing Cream. Does it help with redness for you?

Yes, it helps a lot. The Accutane redness is reduced in the worst areas to a faint pinkness, and in the better areas it's completely banished. Other than the huge cyst on my chin, my skin hasn't looked this good in years. It's kind of funny to be feeling so confident in my appearance with a big ole honking zit on my chin lol.

Day 15: 10/19/05: Have to use the eyedrops as soon as i wake up or i can't keep my eyes open, so dry it burns. Have to use them several times a day or my head hurts, but i am on a computer constantly. My lips are in great shape since i switched to the Clinique lip balm, no chapping or flaking. My skin is dry and flaky right after i wash it, but the cream takes care of that no problem. No new active pimples on my face, everything is healing up, and the monster chin cyst has passed it's worst, most painful point now and started to improve. Red marks are lingering more than normal, but my facial skin is smoother than it's been in years, no little clogged pores waiting to make like a volcano on me. My back still has lots of spots, but it's sort of hard for me to tell what's active and what's just red marks.

Thank you very much for you reply of my question about birth control pill. Just drop by also to wish you best of luck with treatment.

Thanks jojoz!

Day 20: 10/24/05: I must be getting used to this dosage. My skin is dry but only flaky on my face after i wash but before i put my face cream on. The skin on my body feels sort of dry, but it's not extreme or flaky anymore. Had a cyst pop up on my chest (ugh, those are the ones that scar the worst for me) and some new ones on my back, but overall they are much smaller than normal. My chin is still breaking out - the cyst i was talking about earlier is on the wane but a new one has arisen nearby. Hopefully that one will go away soon. Overall my face is much clearer and all of the Accutane sunburn effect is gone. In fact i am pretty sure that my face is less red than it was before i started Accutane, i'm not sure if that's because those areas aren't breaking out anymore, or if this Clinique facecream is really that good. Maybe a little of both. I know i'm sure going to buy it again when it runs out.

Day 27: 11/01/05: Went in for my bloodwork today. They always bruise my arm. The dryness on my face is about the same, flaky until i use my cream, but fine after that. Lips are doing pretty good although i'm using up my lipbalm fast hehe. My scalp is flaky and dry, i think i could go two weeks without washing my hair if i could stand it. The oiliest part of me, my back, feels papery and dry, going to have to start contorting myself to get some lotion there. I have no new zits at the moment, everything is small and in healing mode, except a fairly small cyst that's pretty deep under the skin on my chest. It doesn't seem like it will ever come to a head, and those take forever to go away. My face looks pretty good. There are of course some redmarks, but overall there is a clarity to my skin i haven't seen in years.

Cross your fingers for me that my bloodwork is still ok and the derm doesn't pull the med. I don't think i'd mind if she wants to just keep me on this relatively low dose, i seem to be responding to it better than i ever hoped, and the side effects are so much less intense than they were the first time around at a high dose.

Hi!

How much are the clinique products you mentioned? I really need some good products, hate the cheap, greasy pharmacy stuff... Thanks

The lipbalm is about $12, and so totally worth it. The face cream i'm using was around $32, and i like it a lot. Those 2 together is probably enough for whatever "free" gift they are offering. I know what you mean about the cheap stuff. I can never find something that suits me, and by the time i try a couple cheap products i could have just got the Clinique stuff instead.

yeah... and I really feel that the cheap stuff clogs my pores.... I'm not very dry yet, tho..
But REALLY sensitive... But since you're on the tane too , I assume it won't burn or anything ? I've seen a lot of people here recommending the Olay moisturisers, but tried them and I'm too sensitive ....

Yep, no burn. There is no fragrance, no dye, no sunscreen (those always sting me), no anti-aging junk like is in the Olay products. Very gentle, allergy tested. If you aren't too dry yet, just dot a little around your face, i am somewhat dry and i don't need much. The first day i used a little too much and it felt sort of greasy, but now my skin feels soft and balanced after i adjusted how much i was using, and it's not shiny which is nice. It absorbs to a nice dewy finish. I don't use makeup but i imagine it would be easy to smooth some over it.

Hm... Funny I didn't figure it out myself... I think the sunscreen component is the problem... But it's absolutely necessary in Australia...

I've always liked the Clinique make-up, but not their other products... But they gave me a sample of the repair-wear eyecream, and it's really good

Thank you for the advice

I'm in Florida, i avoid sun exposure beyond what i get walking to and from the car, very brief. When i have to go out in it, i use a Neutrogena brand sunscreen, oil free, and for sensitive skin. It doesn't burn me, but i haven't tried it on Accutane and i don't know how well it would work in a daily use situation. Possibly using it over a gentle moisturizer might shield your skin from the sting.

I'm usually not a big fan of Clinique myself, but i've only tried their cleanser/toner products and they just don't do it for me. The lipbalm i've always liked, and on Accutane it works better than any other that i've tried, and the face cream really is soothing. I think i'm a Clinique convert lol. Maybe if Accutane clears me up again i might splurge on some makeup.

Day 31: 11/04/05: I went to the dermatologist for my check-in yesterday. The day before, i began to experience lower back pain - very low actually, the hip area or upper butt or very lower back. I've always had some low back pain whenever i stand too long, and i know my abs are weak and i have a very long torso, so that doesn't help. But even as a teenager when i was in fabulous shape i've had pain from standing or walking too long. I can't definitely blame my first Accutane course because i can't remember if i had the pain before it, and i certainly didn't connect it at the time, but maybe it was a permanent side effect. Anyways the derm said to just take something for it if it bothers me. She said my cholesterol went up again (not really suprising since i've been craving fatty foods), and it's up to 225. I really need to get a handle on that.

If you remember, i failed my first Accutane pre-screen due to an elevated liver enzyme (drinking too heavily, too regularly). She said the initial value was 57, and that 40 is normal. I quit drinking and after a month that value was down to 35. I started taking Accutane (along with a dose of an herbal "liver support" formula that contains milk thistle and dandelion and some other stuff, and a fish oil caplet), and after a month of that the liver enzyme is down to 20. She said i could have a glass of something now and then if i want to, so i'll probably have something at Thanksgiving, but i still plan to basically abstain. During the same month that i stopped drinking, i also started really watching my diet to try to lower my cholesterol which was right about 200. At my second blood screening, my cholesterol had gone up about 15 points! That was very discouraging and may have given me an excuse to give into my fat cravings this last month. At any rate, i'm going back to a low fat diet as of today, but allowing myself one cheat meal on one day of each week if i want. Hopefully leaving that "out" for myself will allow me to fulfill any overwhelming cravings without going crazy. I'm considering adding some plant sterol tablets (studies indicate it can help lower cholesterol) i saw at the drugstore, but i'm already taking so many pills... maybe i'll drop the milk thistle and see what happens at my next bloodtest.

Soooo the bottom line is that since i seem to be clearing pretty well on this low dose, and i'm feeling the side effects pretty intensely for such a low dose, and my cholesterol level is even higher, she decided to just keep me on the same dosage. Which is fine by me, i was secretly dreading that she'd up it and the side effects would kick my ass. Here's to month two!

Hi jg....I feel like you and I are neck in neck with our Tane course....you're just a few days ahead of me.

I have always had back problems too....haven't really had anything different since starting tane though. Maybe a low back twinge here and there, but I hadn't thought about that being related to Tane until you said something.

My cholesterol was up to 212....I went out an bought some Garlic Pills and I'm going to take Flax Seed and a Omega 3-6-9....see if I can get this down.......Do you know if people who have problems with cholesterol while on tane, have problems with it when they are off? As weird as it sounds, I know about 5 people who have done the Atkins/South Beach type diets and their cholesterol has gone down....even though they are eating eggs and bacon and meats, etc....I guess because it is how all those things work with carbs that give the problem w/cholesterol. Hmmmm, good be a good thing for me to do South Beach....I wouldn't mind losing a few lbs.

I'm glad to hear that your derm said you could have an occasional drink. I don't drink that much, but wanted to tomorrow night....not get drunk or anything, but bowl with a beer in hand, ya know!?!

Well good luck with Month 2!

It really is nice to have someone to compare notes with. My first course i was on it and no one i knew had even heard of Accutane, it was a very isolating experience. Hooray for the internet!


Yeh, my bowling really sucks until i get a couple drinks in me lol!


Well, my father has a cholesterol disorder (his ratio is messed up, way too little of the good kind compared to the bad type, even though overall his cholesterol is fine), and while i don't seem to have his specific disorder, it's apparent that i probably have some sort of genetically linked elevation in overall cholesterol. Cholesterol is supposedly linked pretty directly to genetics and saturated and trans-fat intake, i've never seen a link to carbs. I could easily beleive that cholesterol goes down on South beach because it emphasizes lean meats and veggies, and possibly even Atkins if they weren't going too crazy with the bacon and aren't genetically pre-disposed to high cholesterol. Even when you concentrate on reducing carbs, you have to remember that much of our "empty" carbs in the form of baked goods and junk foods also contain high amounts of saturated and trans-fats, so cutting those out could have a definite impact on cholesterol sort of incidentally.

As far as the Accutane-related increase in blood lipids, your levels will return to pre-Accutane levels after your course. However, that may still be too high if you're anything like me. I should also go back to gym i suppose, losing weight and exercising also helps cholesterol, but i'm a bit worried it may increase my back pain. Maybe i could stick to the recumbent bikes instead of walking the treadmill.

Day 34: 11/07/05: Arrgh, my nose! (Warning: impending gross details!) It's been slowly drying up inside