12 replies to this topic

[indygal]

This is more of a rant than anything, but I'm also curious whether anyone is in a similar situation or has opinions. I'm a 37 year old female and have had acne since I was about 15, in varying degrees of severity through the years, mild to moderately severe. I have tried EVERYTHING! OTC at first (BP, SA, acne washes, etc), then prescription topicals and antibiotics (more topicals than I can even remember and all the "cycline" and other antibiotics for probably too many years). Also BCP, which I haven't taken for years now so no sudden change of that, and spironolactone. Enormous amount of money on chemical peels, microdermabrasion, IPL, Isolaz, thermaclear.....I also took a round of Accutane at age 26 after every other unsuccessful treatment. That worked for a very short time, and the oil and acne came back.
I am now getting ready to go on a second round of Accutane at age 37, as I am having more and more severe outbreaks, and new ones on pretty much a daily basis. I recently started using Ziana gel about a 3-4 weeks ago, which I know can cause an initial outbreak, but this is ridiculous (also started Doxycycline again, haven't used this one for several years, I just came off Solodyn).
The acne is pretty much isolated to my lower face (mostly chin, lower cheeks, jawline, no body acne). It's not hereditary, no one in my family ever had more than the random teenage minor breakouts. It's not a hormonal or PCOS, I've been tested twice in the last few years for both...hormones are normal and I don't have PCOS. I use non-comedogenic, oil free products, wash with mild cleanser twice a day, keep my pillowcases clean, drink a lot of water and have a somewhat healthy diet (and have tried cutting out dairy and sugar at one point with no changes). I am guilty of sometimes popping or picking, but even then, I don't touch my face with my fingers and only extract those that are white and to the suface that you can't stand to leave the house with on your face!! I know this is still a bad habit, but I don't think I've met anyone with acne that hasn't popped pimples here and there either
I am hoping the Accutane will work again, but also afraid it will come back. If you don't know what causes your acne, how can you eliminate it when nothing has ever worked? I do have oily skin and tend to stress out a lot (most of which is due to my skin though LOL).
Whew, sorry that was long and I'm just feeling sorry for myself I would just love to spend part of my adult life with clear skin......and not have to be dependent on medicines and skin care regimens, that don't work. It affects me a great deal socially and emotionally, I constantly think about it and activities that I avoid because of it. I know there are people on this site can understand my frustration.....
I am thankful every day I have a wonderful husband who is very supportive and tries to keep me positive. I am also thankful, even though I do get cysts and have some red marks, I don't have any deep scars and the red marks fade eventually.

[rhys]

Hi Indygal!

Do you know how Accutane works? I mean, on a physiological level? You should spend some time researching it! The details really are quite amazing, and very much encouraging for the prospective patient, whether commencing treatment for either the first or second time around.

The problem however, is that many physicians do not understand Accutane. There are a number of tricks which are necessary in order to get the most out of Accutane, long term, and for making sure that it does not exasperate any existing acne more than it reduces it. Unfortunately, so many Accutane patients experience negative or ineffective results, due to the way in which it is prescribed to them, or the complete lack of advice which they receive from so called medical professionals.

Firstly, it is very important to begin Accutane progressively. That means, starting with only one 20mg tablet per day, and increasing this every week or fortnight by a further 20mgs. So after two weeks, you should step up from 20mg per day to 40mg per day. This will mean that your body will not be shocked into overreacting to the effects of the Accutane. This will also mean that the Accutane will have an increased ability to set-in to your body's physiology, which will be of far greater benefit long-term.

Once you are up to your optimum dose, and have experienced suitable remission of all the acne, the dose should then be reduced gradually, so that you are then back down to 20mg. It is then generally the best approach to remain at this 20mg indefinitely. This is adult acne after all!

It is really good to hear that you already know all about the necessity of Accutane for hormonal acne. It sounds like you have experienced a very difficult time with your acne, and you have been so close, yet so far, at the same time. So frustrating!

But it also sounds like you are on exactly the right path to eventual and long-term success. Be strong. Of course you can. You are already 99% of the way there. It seems like you are on the home-stretch now. Start this course of Accutane properly, and it will then have you clear for life!

I hope this helps. Please let me know if you if you have any more thoughts of question.

[indygal]

Hi Indygal!

Do you know how Accutane works? I mean, on a physiological level? You should spend some time researching it! The details really are quite amazing, and very much encouraging for the prospective patient, whether commencing treatment for either the first or second time around.

The problem however, is that many physicians do not understand Accutane. There are a number of tricks which are necessary in order to get the most out of Accutane, long term, and for making sure that it does not exasperate any existing acne more than it reduces it. Unfortunately, so many Accutane patients experience negative or ineffective results, due to the way in which it is prescribed to them, or the complete lack of advice which they receive from so called medical professionals.

Firstly, it is very important to begin Accutane progressively. That means, starting with only one 20mg tablet per day, and increasing this every week or fortnight by a further 20mgs. So after two weeks, you should step up from 20mg per day to 40mg per day. This will mean that your body will not be shocked into overreacting to the effects of the Accutane. This will also mean that the Accutane will have an increased ability to set-in to your body's physiology, which will be of far greater benefit long-term.

Once you are up to your optimum dose, and have experienced suitable remission of all the acne, the dose should then be reduced gradually, so that you are then back down to 20mg. It is then generally the best approach to remain at this 20mg indefinitely. This is adult acne after all!

It is really good to hear that you already know all about the necessity of Accutane for hormonal acne. It sounds like you have experienced a very difficult time with your acne, and you have been so close, yet so far, at the same time. So frustrating!

But it also sounds like you are on exactly the right path to eventual and long-term success. Be strong. Of course you can. You are already 99% of the way there. It seems like you are on the home-stretch now. Start this course of Accutane properly, and it will then have you clear for life!

I hope this helps. Please let me know if you if you have any more thoughts of question.

Thanks Rhys! I appreciate the feedback. I was obviously needing to vent last night LOL. I think this 30 day waiting period for females before taking Accutane is stressing me out
I have actually spent a lot of time researching Accutane and am very hopeful this time will bring a longer/more permanent remission. "Growing out of it" certainly isn't working in my case!
I actually started seeing a new derm in the last year, who I really like a lot. Very knowledgeable and patient. My old derm was one of those throw you a new prescription/try the latest and greatest on the market kind of doctor without really trying to understand the patient. I will be on a progressive approach with this course of Accutane, however, starting out a bit higher at 40mg and working up to 80, and perhaps tapering back down depending on how my acne reacts (probably based on my height/weight, I'm 5'9" and 135 lbs). Since my first round was gradually increasing from a lower dose and probably not for long enough/reaching a good cumulative dose, I am in agreement with my derm on taking a bit more of an aggressive approach this time. I think this is also based on the fact that I handled the side effects well the first time. If nothing else, I guess my experience from round one can help determine how to approach round 2.
I appreciate your thoughts and support, thanks!

[alternativista]

Try avoiding other common allergens to see if it's an allergic reaction. The severe cystic acne I used to get was also concentrated in certain areas similar to yours and it turned out to be a reaction to citrus.

Try wheat/gluten/all grains, egg whites, soy, peanuts, tree nuts...

[rhys]

Hi Indygal!

It is great to hear that you have everything so sorted for your approach with Accutane this second time round. It definitely sounds like you are on the right path now! It would be really good to hear how it all goes for you. Do post back on this forum whenever you get a chance!

Now, if only it wasn't for that 30 day waiting period!

[indygal]

Hi Indygal!

It is great to hear that you have everything so sorted for your approach with Accutane this second time round. It definitely sounds like you are on the right path now! It would be really good to hear how it all goes for you. Do post back on this forum whenever you get a chance!

Now, if only it wasn't for that 30 day waiting period!

Thanks again, I will be sure and post back with updates. Thankfully, only a little over a week to go of the 30 day wait!! I'm very hopeful.

[strawberryraisin]

I often wonder this too. I had acne from a very young age and as an adult, still living with it. The worst part is the scarring which I tried so hard to remove, it appears to be stuck on my face and won't budge. So I am thinking that maybe there is more to it, like sometimes it could be a hormonal problem.

[indygal]

I often wonder this too. I had acne from a very young age and as an adult, still living with it. The worst part is the scarring which I tried so hard to remove, it appears to be stuck on my face and won't budge. So I am thinking that maybe there is more to it, like sometimes it could be a hormonal problem.

Hi Bollywood, you might want to have your hormone levels checked. It's just a blood test. My obgyn ordered the lab work for me. If it is hormonal, there are ways to target your acne treatment toward that. My hormone levels are normal though....so Accutane again it is

[rhys]

Accutane is definitely the best.

If everyone with acne was given accutane in some form or other, then the world would be a much happier place, and forums like this wouldn't need to exist.

Go accutane!

[orangeorn]

read about zinc and try it.

[Fedupofadultacne]

Rhys - on what foundation are you basing your knowledge? I have had 4 courses of roaccutane & on 2 of them i started low at 40mg but no benefit so increased does which eventually worked but the acne still came back every time. They stopped the treatment once I was completely clear as they dont continue to give low doses. Is far as im aware there is a maximum your body should take on a cumulative basis each time around, so high dose for 3-4 months is comparable to lower does for 6-7 months. (although low dose never worked for me)

Indygal - i feel for you - I have done the rounds too and nothing works. What do do next? Did the spironolatone help at all?

Edited by Fedupofadultacne, 14 September 2010 - 05:05 PM.

[cvd]

Sorry to hear about your struggle but I can sympathize. I'm almost 60 and still break out. Like you, I've tried everything including 2 rounds of Accutane but the acne came back both times. Right now I'm taking 100mg Spironolactone a day and using Retin-A at night, along with washing gently and mineral sheer makeup. I now only get 1-2 pimples at a time, although I seem to get a small cyst every month or so. My derm thinks this is great but I get greedy and want totally clear skin for once in my life. Taking full strength antibiotics also works for me but can't do that for a long time. My derm says to give the Spiro time to work...generally 6 months. Taking birth control along with Retin-A supposedly works better but at my age birth control is more risky. Low dose Accutane is a godsend for some and I'd go for it if it were available here. My skin was totally clear while on Accutane.

Tell us how it goes --- will be thinking of you!

[indygal]

Hi all! I haven't posted on these boards for quite a while now, but I am still a frequent visitor because I am in full prevention mode now I saw this old thread of mine and wanted to post my experience and if nothing else, provide some hope for other adult sufferers.
I finished the round of Accutane in May 2010, a loooooong round. A total of 9 months. And yes, I know this was a LOT. I ended up way over the rec'd cumulative dose.
I started out at 40mg the first month, went up to 80mg for 4 months, then 100mg for 3 months, back down to 40mg the last month. I know that might bring some critical comments, but I will say this was a joint decision between myself and my derm. I tolerate Accutane very well, and didn't have any severe side effects. Just normal dry skin, lips, scalp, etc. Plus, I was slow to respond and it took a long time for my skin to really clear. My blood tests were also normal every single month. I had a ton of clogged pores and under the surface acne (along with the inflamed surface cysts) and it took a very long time to all clear out. I won't say it was easy by any means, but I stuck it out, and am so glad I did.
I have to say, as of right now, this was the best decision I made for my skin. Yes, I know it's only been a few months since my course ended and that it might come back. But my skin is the best it's been in my life right now. Completely clear and I haven't broken out at ALL in months.
I am maintaining right now with Retin A Micro .04% and that is working out very well. My skin isn't overly sensitive and I've eased into use of the RAM, and haven't experienced any major irritation or peeling.
I still come to the boards because they were a major source of help and comfort to me during the past year or two. And I also like to read the tretinoin threads for tips and the products/cosmetic threads because now I'm more of a skin care freak than ever and I want to take the best care of my skin.
I know there are a lot of threads about not letting acne hold you back from living your life, but I have to say it certainly impacted me a lot. Especially when it got SO much worse when I came off of Spiro and antibiotics and I decided to go back on Accutane. My life is back to normal now, my confidence has skyrocketed and I feel better about myself than I have in a long time.
I'm lucky that I didn't have major scarring, and the RAM really helps with the red marks, which continue to fade more and more.
I am just using a gentle cleanser, RAM every other night, and Peter Thomas Roth 10% Glycolic Hydrating gel every other night, and Cerave as a moisturizer.
Good luck everyone!