12 replies to this topic

[PJ-2005]

Hey all,

1. Accutane Dosage

I'm taking 70/mg daily (60mg one day, 80mg the other), and was wondering if I should be taking perhaps 40mg in the morning and 40mg at night. I was told it really didn't matter unless I was getting abdominal pains (I am not), but just read the half-life of this drug is always less than 24 hours, so once a day doesn't make sense to maintain constant levels in the body.

Any insight from a Doc on this? Or even anecdotal reports of what YOUR dermatologist has/had you on would be helpful...might just make the switch on my own if determined to be beneficial.


2. Initial Breakout

I've been on less than a week, and have more pimples than I ever have (no cysts). I actually just laugh because it's out of control...then again my standards might be different than other users (but I *definitely* have reached at least 'moderate' acne).

Anyone notice the following when they took the drug?

a. You are breaking out in areas of your face that you never have (eg: throat, nose, etc.)

b. This is too soon for an initial breakout, and thus is probably attributed to something else? (eg: coming off other acne treatments, etc.)

Thanks for your help,

PJ

[lexilex]

hi pj:
1. i feel like it might be a good idea to take the doses in the morning and evening as opposed to only once a day. but i would ask your derm before you make that switch.
2. as for the initial outbreak, i feel like i broke out immediately with whiteheads. and yes, in places i wasn't used to breaking out---hello---eyebrows??

good luck.

[Arpazia]

From what I understand it doesn’t matter. As long as you are taking the prescribed 60 mg one day and 80 the next, the timing doesn’t really make a difference. What does make a difference is what you are taking your Accutane with. The label says to take it with food. Since Accutane is a synthetic form of Vitamin A, it absorbs better if you are taking with food that contains a high fat content. If you aren’t into eating fatty foods, a glass of whole milk will suffice. Trust me, you will get better results this way. If you are truly concerned about this, call your dermatologist and see what his/her opinion is.

Personally, I have skipped whole days, even months, taken my Accutane in the morning, afternoon, dinner, before bed, etc., and haven’t noticed any difference whatsoever in its effects due to the timing. What I have noticed is that if I don’t take it with something fatty, the effects are definitely lessened.

The initial breakout truly sucks on Accutane. I don’t believe that any other prescription medication on the market delivers the same punch as the Accutane initial breakout blues. It is very possible that you are at the beginning of your initial breakout already. Your dose is very high and the higher the initial dose, the more likely you are to suffer a more serious breakout at a earlier time.

My otherwise clear forehead had a zit party during my initial breakout and my acne became even more cystic than usual. The cysts were all around my jaw line. I even had one at the corner of my earlobe and cheek bone. Disgusting. I am so happy it’s over even though my skin is still red in the aftermath.

Your spirits due seem to be up and that is a good thing. Keep them there. Your skin might get worse in the next few weeks and you will need at least a giddy outlook towards it

[twocanyan]

From what I understand it doesn’t matter.  As long as you are taking the prescribed 60 mg one day and 80 the next, the timing doesn’t really make a difference.  What does make a difference is what you are taking your Accutane with.  The label says to take it with food.  Since Accutane is a synthetic form of Vitamin A, it absorbs better if you are taking with food that contains a high fat content.  If you aren’t into eating fatty foods, a glass of whole milk will suffice.  Trust me, you will get better results this way.  If you are truly concerned about this, call your dermatologist and see what his/her opinion is.

Personally, I have skipped whole days, even months, taken my Accutane in the morning, afternoon, dinner, before bed, etc., and haven’t noticed any difference whatsoever in its effects due to the timing.  What I have noticed is that if I don’t take it with something fatty, the effects are definitely lessened.

The initial breakout truly sucks on Accutane.  I don’t believe that any other prescription medication on the market delivers the same punch as the Accutane initial breakout blues.  It is very possible that you are at the beginning of your initial breakout already.  Your dose is very high and the higher the initial dose, the more likely you are to suffer a more serious breakout at a earlier time. 

My otherwise clear forehead had a zit party during my initial breakout and my acne became even more cystic than usual.  The cysts were all around my jaw line.  I even had one at the corner of my earlobe and cheek bone.  Disgusting.  I am so happy it’s over even though my skin is still red in the aftermath.

Your spirits due seem to be up and that is a good thing.  Keep them there.  Your skin might get worse in the next few weeks and you will need at least a giddy outlook towards it

Hi Arp,

You think something like Presidone (not sure if I spelled it right) would help with the initial breakout?

[Arpazia]

Prednisone is a life-saver for people who are having a cystic breakout on Accutane. It works by bringing down the inflammation of the cysts. By doing this, it makes the side effects of the Accutane less traumatic and the skin less susceptible to scarring. However, if your acne is not cystic, Prednisone could actually make things worse. Some people can suffer from a steroid-induced breakout. Therefore, weigh your options carefully and be sure that you are dealing with cystic acne before seeking a prescription.

[twocanyan]

Prednisone is a life-saver for people who are having a cystic breakout on Accutane.  It works by bringing down the inflammation of the cysts.  By doing this, it makes the side effects of the Accutane less traumatic and the skin less susceptible to scarring.  However, if your acne is not cystic, Prednisone could actually make things worse.  Some people can suffer from a steroid-induced breakout.  Therefore, weigh your options carefully and be sure that you are dealing with cystic acne before seeking a prescription.

thanks arp for the reponse.. i guess i am still an amatuer about my acne.. i have sometimes these very big zits.. that eventually come to a head.. i doubt these are cyst.. do cyst have to be dormant under the skin for awhile to be considered a cyst? i guess i can ask my derm what i have before asking for the prednisone.. you think i can ask for some other anti to hold off the potential intial flare? i am on doxy now .. you think amocycilin will be a good addition?

[PJ-2005]

Absolutely wonderful post - thank you for your help.

PJ

[Arpazia]

Be Careful!!!

First of all, Doxycyclin can cause brain swelling if taken in conjunction with Accutane. There is only one member of Acne.Org who is currently taking a Tetracycline with Accutane and that is because his dermatologist is extremely skilled and able to closely monitor his progress. Most dermatologists will not prescribe a Tetracycline such as Doxycyclin or Minocycline to their Accutane patients.

I’m not familiar with Amocycilin but I know that many doctors will prescribe Erythromycin to their Accutane patients in order to combat bacteria growth. Less common are the antibiotics Ampicillin and Trimethoprim-Sulfamenthoxazole. The problem with antibiotics is that they indiscriminately kill all bacteria and eventually the possibility of building an immunity to the drug. Most people will build a quick immunity to Erythromycin so be sure that your doctor is aware of your desire to use it sparingly.

If your doctor decides to put you on an antibiotic to prevent a flare-up, please buy yourself a bottle of Acidophilus to protect your digestive track from loosing vital bacteria.

To determine what type of acne you have consult your dermatologist and check out this link: http://www.acne.org/typesofacne.html. This will help you and your doctor to make a decision as to whether or not an oral steroid or an antibiotic would be beneficial.

[lexilex]

arp: you are so helpful..thanks for the advice.
i think i spoke too soon about not having that inital outbreak. i felt like i did break out, but not THAT much more than usuall. and just yesterday i was posting all optimistic and all...but then BAM--this morning, my face (my right jaw line) was like, "HI I AM GOING TO KICK YOUR ASS WITH PIMPLES"....so my question is. what do we do with the zits? if they are at a head, we still shouldn't pop, right? they feel all cysty and inflammed and red and hot. ugh. can i use any topicals? i will ice and see if that helps. i don't even know if makeup will help today.

fun fun fun.
till the cows come home.

[Arpazia]

I remember the first few weeks on Accutane were difficult because I kept thinking, “okay, this is the initial breakout,� and then, “no, now I am having my initial breakout.� The thing to keep in mind is that it is normal to break out while on Accutane - - sometimes even through the whole course.

Jaw line acne is usually related to hormones more often than not. Girls can usually combat this type of acne through use of birth control pills. If the acne has come to a head, my favorite thing to use is Klaron Gel. Klaron is sulfur-based and unlike other antibiotic and retinoid topicals, it doesn’t irritate or overly dry your skin. It is excellent for spot treatment. If your acne hasn’t come to a head, the options usually aren’t as successful. If it’s cystic, by all means, get a prescription to Prednisone. If this something your dermatologist is willing to do, try to get a cortisone injection. If your acne isn’t cystic, you can try out an antibiotic such as Eythromycin.

The problem is that most topical lotions will cause more harm than good while your on Accutane. Dry skin is more susceptible to scarring and overall irritation and, whether or not you can feel it right now, Accutane is drying out your skin.

I’ve tried ice in the past but after having Prednisone and Cortisone injections, it doesn’t even compare.

[lexilex]

thanks again... yeah. i'm kinda terrified, because i am just weening off the prednisone, thinking that if it WAS helping the initial outbreak, i gonna be kinda screwed now. i'll look for some of that klaron gel.

thanks again, and have a good day.

[Arpazia]

Lex: Klaron Gel is only available through prescription. Since you will need to call your doctor for this anyway, why not ask for an additional week or two of prednisone?

P.S. If you have to actually see your doctor in order to get prescriptions, ask for samples of Klaron since they last a really long time.

[Scotch]

i am on 20mg of isotretinoin on alternate days to treat my mild acne.. i am 3 weeks into my medication and i am clearing experiencing my initial breakout. My zits are big and i have 2 cysts.
But i guess its slowed down now. but i am really worried about how long this will last... HELP!!!