9 replies to this topic

[SPIDER1981]

I need to kind of apologise as i realise that this is not the relevant section to post this subject in but i just want as much advice as possible

I have spent the last few days trying to make a huge decision, and i just don't think i can decide without some advice. I went to a dermatologist a couple of months ago and he said i wasn't bad enough for accutane, and he prescribed me with tetralysal (antibiotic) i have given these a chance but they didn't seem to do much. so a few days ago i paid £110 to see a private derm, and much to my surprise he prescribed me with accutane.

Now i just don't know what to do. I'm 25 and i took accutane when i was 18 and it never cleared me up completely (about 70% perhaps) and i also suffered alot of side effects (aching muscles which affected my sports, unbelievably dry and irritated skin, and bright red skin) but the difference this time is i'm only going on 20mg per day, but before i was on abou 60mg a day i think. this decision is so huge - the main reasons for this are;

1) red marks - if you read my previous posts you'll see i have problems with slow healing already - i have some REALLY obvious red marks that have been on my face for weeks, some for months. i feel like accutane will probably just stop them healing completely.

2) initial breakout - i know some people are lucky enough to not suffer from this but when i took the stuff before i broke out BIGTIME, it was horrible.

3) sun sensitivity - i'm very sensitive to the sun without being on this drug, but i've yet to find a sunscreen that doesn't break me out like crazy.

so please guys - help me make this decision, i really need your advice here. might it be different this time? what's can i expect on a lower dose? do i go for it, or avoid the risks? i'll hope for your replies!

[near]

I was on accutane 2 years ago, and it never helped me. I suffered the side affects, lost money, and still suffered. I wouldn't go for it from my personal experience, and it doesn't sound like you really want to either.

Good luck on either choice.

[Charybdis]

60mg a day??? i was only on that after about 3 months, i started on 40 and then worked up to 60.

accutane did work for me thankfully, but i cant offer any advice on your mental well being or if 20mg will make much difference.

[xmiss_behavex]

The only thing that i can offer as a positive is that a lot of people have their red marks and scars reduce and become less noticeable whilst on accutane due to the peeling effect of the skin. The IB will always come although i think with a lower dose it won't be too bad, or you may not have one at all. And as for the sun sensitivity look for sun screen recommendations on the site as they will more than likely be good for acne prone skin. Also again on a lower dosage your sun sensitivity may not increase too much.
Good luck with your decision, i hope you make the right one.

[Elsewhere]

Hey there, I just wanted to say you'd probably get more responses if I'd moved this thread here!

[maddy001]

I can only give you encouragement. Whether you want to take accutane, it really depends on you and discussion with your derm. There could be reasons as to why accutane didn't work, one of them could be the duration of your previous treatment was not long enough. You said that you were cleared by 70% percent, this shows that accutane did work. From this, I also believe that you may benefit from a second course as well.

I'm on 20mg per day on accutane and I weigh about 42kg so its pretty low dose for me as well. I am doing really well considering I'm only into my second month and its my first course. I didn't have any initial breakout and very minimal side effects that already disappeared so you can say I am acne free, plus no side effects. You got such massive breakouts and side effects because the dose 60mg is quite high. The higher the dose, the more side effects. I think your derm perhaps already know this was the case for your previous treatment and has decided to change the dose for your second course.

[mx123]

Personally I wouldn't. Accutane was the biggest mistake of my life. Didn't help my skin, just gave me side effects and false hope.

[SPIDER1981]

This is just an update to let everyone know.... i went for it. last night i ate my dinner and just thought what the hell, so i just popped my first 20mg pill. I'm only supposed to be on 20mg per day. those antibiotics (tetralysal) I was on weren't doing a damn thing so i threw them away and just decided to go for it! i must admit i'm pretty scared now, thinking about initial breakouts, slow healing and side effects etc, but my skin has just got out of control these last few weeks (several huge angry spots & dozens of whiteheads have appeared) so i just felt it was my only option... wish me luck.....!

[Wynne]

Good luck! I hope the low dose prevents you from getting bad side effects and clears you painlessly.

[Azrael]

I went to a dermatologist a couple of months ago and he said i wasn't bad enough for accutane, and he prescribed me with tetralysal (antibiotic) i have given these a chance but they didn't seem to do much.
My NHS (free healthcare in UK) derm said i wasnt bad enough for Isotretinoin. I disagreed. She put me on a 2 month course of 1 antibiotic, followed by a 3 month course of a second antibiotic. I had already been taking them for 1 month. She said antibiotics take 6 weeks to start working for acne. I knew it was bad enough and i wasnt prepared to wait another 5 months to get the treatment i needed. I always knew the longer i left it, the more scarring i would get, as the spots keep on coming. I knew my acne was resistent to antibiotics as i'd tried them before.
I am 29. I went on Isotretinoin (accutane) when i was 18. weighed 72kg. took 70mg for 4 months. Cumulative dose 70 x 28days x 4wks DividedBy 72kg=108mg per kg. I had average side effects - more spots, dry skin, dry lips, but it cleared up eventually. when i stopped the course, i was clear for 8 months then it came back. i then tried lots of other different pills - Dianette and creams etc.
I finally decided to get Isotretinoin again in march 07. NHS refused me, so i went private and got it immediately.
I believe my acne came back last time because i didn't have a high enough cumulative dose.
Statistically speaking, patients have the best chance of achieving long term remission if the course gives you a total cumulative dose between 120-150mg/kg.
To calculate this, add up the total milligrams of drug taken over the course, then divide by your weight in kilograms.
So, this time i will make sure i get the correct longterm dose.


so a few days ago i paid £110 to see a private derm, and much to my surprise he prescribed me with accutane.
Yep, same as me. when you are willing to pay, you can have whatever you want! You can take Isotretinoin for very mild acne too. it has brilliant success rates. But the NHS (free healthcare) will not let patients go on it unless they have severe acne because they are trying to keep they're costs down!! sod the suffering of the patient, as long as they dont spend over their budget each year!

Now i just don't know what to do. I'm 25 and i took accutane when i was 18 and it never cleared me up completely (about 70% perhaps) and i also suffered alot of side effects (aching muscles which affected my sports, unbelievably dry and irritated skin, and bright red skin) but the difference this time is i'm only going on 20mg per day, but before i was on abou 60mg a day i think.
I know the side effects are crappy. but wouldn't you give the earth to have clear skin? the side effects are so worth it. I def think you didnt take enough cumulative dose last time. work it out for yourself. do the calculation. This time if you're on 20mg a day, just bear in mind, it's gonna take you a long time to get to the cumulative dose 120-150mg per kg. I'm going to be on 70mg per kg (i'm 73kg) for the rest of my course. so i'll be on the drug for about 5.5 months. I'd have to take the drug for 1.5 years to get to my cumulative dose if i stayed on 20mg a day.
When you take a lower dose, you do experience less severe side effects. but i wanna get this out of the way before christmas, so i can drink alcohol again!!!

this decision is so huge - the main reasons for this are;
1) red marks - if you read my previous posts you'll see i have problems with slow healing already - i have some REALLY obvious red marks that have been on my face for weeks, some for months. i feel like accutane will probably just stop them healing completely.
2) initial breakout - i know some people are lucky enough to not suffer from this but when i took the stuff before i broke out BIGTIME, it was horrible.
3) sun sensitivity - i'm very sensitive to the sun without being on this drug, but i've yet to find a sunscreen that doesn't break me out like crazy.
You made the decision to start already.
you may heal slower, get an initial outbreak, and get sunburnt. but for clear skin, it will be worth it. I would consider upping your dose from 20mg to 60mg a day though. coz it will take you more than a year to get enough drug into you to keep your acne away forever. Can you handle not drinking alcohol for that long??!!!

good luck.