32 replies to this topic

[Hanoian]

Hey there! This will be where I record my "Accutane Experience" for the next couple of months.

I saw a dermatologist yesterday and had my initial blood work done. I'll find out the results mid next week and if everything's okay, I should start the medication on Friday.

Here's my history:

Age: 22 (Female)
Weight: 130lbs

I began breaking out on my forehead when I was 13/14 but it was mild enough that it didn't really bother me and I looked like I had perfect skin.

At 15/16 something changed and I began having "acne"--my entire face started breaking out in medium sized pimples, but they weren't very inflamed.

At 17 I started getting cysts everywhere, on top of my already bad skin. I had at least 7 cysts on my forehead, cheeks and chin at one time. I went from being very outgoing and popular to almost a total recluse. Makeup didn't help hide my bad skin.

When I got into college my skin began to clear but I still had persistent acne on my cheeks and sometimes my forehead, but only the occasional cyst.

I decided to go on Ortho Tri-Cyclen just before turning 20, to see if it would help. It cleared up my acne almost completely until about 3 months ago. I was still on the pill but my skin suddenly erupted in cysts like it used to do in high school. Something has changed in my hormones I guess for this to happen; it's almost like "adult-onset acne" because it's so different from the breakouts I was getting right before the pill.

So, now I am going to try Accutane because it seems like my only hope for a long-term cure.

I am worried though because my sister, who has had persistent, scarring acne since her early teens, still has acne and she's 27. She had a major flare of cysts when she was 24 that scarred her skin pretty badly. So, this probably means that I am destined to have acne into my late 20s and god knows how long after that.

So, I wonder then if Accutane will prove a temporary cure for a year or two before my acne returns. I have a feeling that people who are permanently cured after Accutane would have cleared up in a few years anyway. I don't think it does anything to them that "cures" them permanently; it's just that it stops their acne for the few remaining years they would have continued to have it. But for people who would have kept breaking out, well, I think they are likely to relapse. Because I have a sister, I can kind of see into the future. I will ask my dermatologist about this. I really really hope I'm wrong and that I don't have a relapse. If I break out again hopefully it'll be something I can control with Ortho Tri-Cylcen or something else.

Argggghhh! Why can't I just have clear skin? It's almost worse to have clear skin for a while and then break out again. You get used to not worrying about how you look all the time, and then bam! You're back to trying to hide your face from people. Looking beautiful isn't even a concern anymore, it's just trying to look presentable. Oh well, I am putting all my hopes on Accutane. I know it's got some serious side effects, but I am willing to take the risk:)

So, I will update this again when I start my course!

[Hanoian]

I just realized that I will need another pregnancy test during my period before starting Accutane, so I guess that means I can't start until next month:( I was really hoping to be on by the end of next week. I understand the need for precautions but it's kind of ridiculous because I have been on the pill forever and I'm not even sexually active. Oh well.

[Hanoian]

I called to find out how much everything will cost (my Mom has offered to pay for my treatment) and was told that WITH my insurance, which pays 50% of the cost of the medication, I can get the generic version called Amnesteem for $250 to $300 a month. I am so surprised; I had no idea it would be that much, and it's for the generic! Is Amnesteem as effective? Will my side effects be worse? I know it's the same medication but what about fillers and quality? I don't want my mother to have to spend $300/month for 4 months if this isn't going to even be effective (let alone have to suffer through the side effects). Oh well, I guess these are questions I'll have to ask my derm on Wednesday.

[Hanoian]

Okay, just got back from the derm's office. I had another pregnancy test and more bloodwork; they forgot to check my lipids last time and I wasn't fasting this time so I might have to get them checked yet again when I go in on Friday.

I asked the derm about Accutane's permanent remission rates for adult acne and she seemed to think there's a good chance that I will never have such severe acne ever again after Accutane, even though she didn't really get into much detail about why she thought that. She doesn't think my acne is from elevated androgen levels because I don't have irregular periods or hirsuitism (excessive hair), even off the pill, and said Spironolactone probably wouldn't be a good idea.

I feel better about this but I still fear that Accutane is going to just be an expensive way of clearing up for a year or two. I know what it feels like to have crystal clear skin for a period of time and then break out like crazy---it's a painful experience physically and emotionally. But the only thing I can do is try to be positive that this will work, despite my doubts. Maybe I can talk to another dermatologist who can explain this to me better.

So, she said I'll be on for 5 months; 40mg/day for the first month and then 60mg/day for the remaining 4 months. I mentioned that this was more than the oft recommended 125mg/kg cumulative dose (it's 140mg/kg) and she said 125mg/kg was the minimum for best results. I also want to lose about 20lbs and get back to my comfortable weight of 110lbs (I'm 5'2") so I will be using the next 5 months to do that as well. It will be my Accutane/Weight Loss Journey!!:)

My second test results will be in on Friday so I am going to assume that she will give me the prescription at that point (my second pregnancy test does NOT have to be during my period because I am on the pill), which means I will start Accutane either Friday or Saturday!

I asked her about taking antibiotics in the beginning to minimize the initial breakout if there is one and she said "maybe." She refused to prescribe either Erythromycin or Zythromax; not sure why. She said she might prescribe Amoxicillin for a month. Have no idea what impact that will have---anybody?

Another piece of good news is that I called Costco and their pharmacy has Amnesteem for $170 for 40mg X 30 pills and $130 for 20mg X 30 pills---so with insurance I will be paying a total of less than $700 which is significantly less than I thought I would have to pay after calling around yesterday!

I will have another update on Friday:)

[Hanoian]

Okay, so I just got back from the doctor and guess what? I got the prescription, yellow sticker and all! So, I am heading to Costco now to get the stuff and I'll be popping the first pill tonight:) I am sooooo nervous but really excited as well!

My lipid tests came back a little high because I wasn't fasting when they took my blood on Wednesday, but my derm said it was normal and went ahead and gave me the prescription. I was fasting when I went in today so I had more blood taken so that they can figure out my base level for next time.

I also got the Amoxicillin prescription; I'll be taking 500mg/day for the next month in order to help prevent an initial breakout. So I might not know what's working, the Accutane or the Amoxicillin. But since Accutane clears almost everybody who goes on it, I am not too worried about whether or not it'll "work." (My concerns in that department are long term---how long it'll keep me clear)

I guess now's the time to do a "before" profile:

Face: I have lots of inflamed acne on my forehead, cheeks and chin...with about 6 cysts on those areas as well. My skin is pretty dry and peeling from using BP and salicylic acid I guess.

Other Skin: My skin is naturally on the dry side, so I guess Accutane will make this even worse:( Whatever the case, I am starting out with skin that's already pretty dry and flakey in areas if I don't put lotion on.

Hair: I love my hair and I am so worried that Accutane is going to wreak havoc on it. I have long, straight dark brown hair that is really shiny and healthy. I've been losing more hair than usual after restarting BCP a couple of months ago, but it's not enough to bother me and I can see where it's growing back in (shorter pieces) just as fast.

Body/Movement: Everything feels normal here of course, but I am a bit more tired than usual, probably because of stress.

Anything else: I am trying not to bite my nails and skin around them because I know Accutane means slower healing.

Mood: Nervous but excited. Stressed from lots of work and exams coming up (end of the semester). A little bummed about my skin being so horrible.

I will try to post "before" pictures if I can borrow a digital camera since I don't have one of my own at the moment.


Oh---for those of you who are interested, I read an article from a medical journal that had a graph showing that the longest remission rates occur with cumulative doses that approach 160mg/kg. 120mg/kg is truly the minimum and anything below that has SIGNIFICANTLY shorter remissions.

[Hanoian]

DAY 1

Pill #1 (40mg) swallowed! I've officially started Accutane, let's hope it's a smooth ride, or at least not too bumpy. You are supposed to take the medicine with a high fat meal for maximum absorption so I just ate 2 slices of buttered toast, 2 slices of cheese and a glass of milk. Overkill? Well, it's the only fat I've had all day so I should be fine. That will be my strategy, not to increase the amount of fat I eat but to just allocate it all to the time of day that I take Accutane.

Incompetent people at the pharmacy only gave me a 10 day supply on accident, rather than 30, but they're closed now so I have to go back tomorrow.

I also just took pill #1 (500mg) of Amoxicillin. I read all the warnings on the Accutane package and it says that nausea is one of the symptoms of increased brain pressure which can lead to major problems and even death, but guess what? It's also a normal and harmless symptom when you first start taking antibiotics, so how will I know? Hopefully I won't have any nausea at all.

Man, I know I'll start to experience side effects within a few days/weeks, like chapped lips, but even though I am expecting it, it still scares me! I've never taken any medication like this before, so wow, this is kind of surreal.

Not sure how to organize this journal. I like weekly logs but I know I'll want to update more often, especially at first. I guess I can do it everyday or whatever for now and then general weekly updates later:)

[Hanoian]

Day 2

Well, I haven't taken my second dose yet, so I guess it's technically still "Day 1." No changes to report yet:)

My eyes are naturally very dry and they get red and irritated very easily, even in some kinds of florescent lighting, so needless to say I am super worried about how they'll fare on Accutane. I can deal with temporary side effects, but I wonder if I am at higher risk for those "rare" permanent effects that can occur. My derm recommended OTC lubricant drops (nothing like Visine), so I'll try those, but if it gets bad I'm going to ask her to prescribe something more effective.

Tip for Vaseline/Aquaphor users: I have been using Aquaphor for the last week and it was making my lips pretty dry. I think this is because petroleum has the ability to seal in moisture but can't actually replenish it, so there's no use smothering it on dry lips; it will just cover the dryness until it's removed the next day. So, yesterday I applied some body lotion (not oil-free) on my lips first and then applied the Aquaphor, and voila! Smooth, supple lips today. The lotion actually moisturizes and the petroleum seals it in. I am going to try this with a bit of Vitamin E oil to see how that works as well.

[Hanoian]

I must be imagining things. I was dead tired so I decided to take a nap, which lasted like 31/2 hours. When I woke up and looked in the mirror I swear to God my skin looked different. Maybe it's been like this all day and I just noticed. Yesterday before I took my first pill I had quite a few cysts and inflamed pimples all over my face. Now, most of them feel dry, like they are still there but the inflammation is suddenly gone. One cyst that has been persistently sitting on my cheek for 1 week isn't just drier, it has shrunk. I wonder if this is the effect of the antibiotic more than the Accutane?

[Hanoian]

Day 3

Today was a rough day. I was extremely tired all day, didn’t feel like getting out of bed. I woke up with a bad headache (localized around my right temple) which lasted all day and has only just subsided after I took some painkillers. I felt nauseated and very dizzy at one point. I even vomited, even though I had nothing in my stomach (no appetite all day). I don’t know if these are side effects of the antibiotics or the Accutane, but I wrote an email to my derm, so hopefully she’ll let me know tomorrow whether I should stop taking either. I have a feeling the loss of appetite, nausea and dizziness are just side effects of the Amoxicillin. The headache is probably from the Accutane and not serious, but who knows? It would suck to have to stop the Accutane, but not as much as having serious brain problems and loss of sight! So, we’ll see. No other side effects to report.

[Hanoian]

Well, I started feeling a lot better so I decided to be brave and take pill #3 and the Amoxicillin as well. I'll know more tomorrow and hopefully my derm will give me some advice. So, in the mean time, I'll post my routine:

Morning:
--Wash with Cetaphil Daily Facial Cleanser for Normal to Oily Skin
--Pat dry; apply Equate Beauty Lotion, Sensitive Skin Formula
--Apply makeup
--Rub a dab of body lotion onto lips and apply thin coating of Aquaphor

Get home (afternoon):
--Wash off makeup with Cetaphil and washcloth
--Apply lotion
--lotion and Aquaphor on lips
(I usually apply BP, but have stopped since starting Accutane, apart from spot treating a couple of inflamed pimples)

Before Bed:
--Wash face with Cetaphil
--Apply lotion
--Lotion and heavy coating of Aquaphor on lips

I don't like the Equate lotion at all; it stings and contains stearic acid, which causes breakouts, so I'll be switching to something better with SPF in it as well. I love Olay Total Effects and Regenerist, even though both are pretty expensive--you can definitely tell the difference in quality.

I think my routine will soon include eye drops/ointment because my naturally dry eyes are starting to feel slightly worse (could be my imagination or that I am spending more time on the computer writing papers, etc.)

Diet:

I have a pretty healthy diet as it is, so I am not too worried about this issue. My derm said to cut out soda/caffeine as well, so I will have to work on that. I guess I'll be eating very little fat during the day so I can gather it all up for dinner when I take the Accutane.

Other stuff:

I have so much work this week (and next) it's unbelievable. Three presentations, a debate, three massive papers...oh I could go on. And I wish I could say it'll be over soon, but summer classes begin right away!

My Mom is coming into town in a few days. I am so happy because she's a nurse and is always really comforting to be around:) I need to clean the house tomorrow though. Uggh. I just pray to God that I don't feel sick again like I did today because I have too much to do.

Later;)

[Hanoian]

Day 4

The good news is that I have felt completely normal all day; no headache, no nausea, no dizziness. I'm going to assume it was my body adjusting to the antibiotic, but I don't know, that was a scary headache. My derm sent me an email saying she had no idea what it could be but that I could stop taking the antibiotic and see if I feel better and if not, I should make an appointment to see her. Seeing as I'm already feeling better, I think I'll keep taking it.

No other side effects to report. Actually, I wonder if my lips should start getting dry soon or what. They don't feel chapped at all. Most people seem to start noticing dryness within the first week, so I guess I have 'til Friday.

[Hanoian]

Day 5

Still no side effects. I am feeling extremely down about my skin. It looks like I am going to have quite a few scars on my cheeks and forehead from this nasty breakout. Wow, just a few months ago my skin was scar-free. I wish there was some way I could have prevented this. I don't understand why the pill isn't keeping my skin clear this time when it did for so long. Ugghh! I am thinking about stopping the pill to see if it's actually making my skin worse. My face is so badly broken out right now it's horrible. Makeup doesn't help because the bumps are everywhere--I look like a monster. I don't feel like going anywhere or doing anything, but I have final presentations and exams so I have no choice. The summer is going to be packed with intensive classes as well, so no respite there. When will this get better? I never thought I'd have to look in the mirror and see such horrible skin again, but here I am, back at square 1 and now I'm scarring from it. I wonder if this scarring will improve over time; I hope so.

[Hanoian]

Realized how negative my post was so I thought I'd add something positive. For the last few months every tiny pimple that's appeared on my cheeks has morphed into a painful cyst within a day or two; but so far, the two small ones that popped up last week have remained small, so I guess cyst formation has been halted. I know many people still get cysts well into treatment, so maybe this is only temporary and who knows if it's from the Amoxicillin or the Accutane, but hey, it's good news for now:)

[Hanoian]

Day 6

Well, still no real side effects to report. Although, last night I noticed two large blackheads on my upper cheek area on either side of my nose. Strange because I never get blackheads there! Also, while my active acne doesn't seem to be budging, I have no new pimples, so that's good!

Bad news about my lipid test. My derm called me earlier and told me that my base levels (before starting Accutane) are a little high for the cholesterol. She thought it was odd because I am at a healthy weight, I eat really well (lots of fruits and veggies) and I don't smoke. She mentioned that it could be genetic and that whatever the case I should watch what I eat and that my plans to lose weight will help, even if those things aren't the cause.

I actually think it's because of my weight because although I am at a "healthy" weight, I have gained so much over the last couple of years and really don't feel comfortable at this weight (130lbs). I keep saying I want to lose weight but my family and friends always say, "You don't need to! Do you wanna be anorexic?" So annoying since 110lbs, my "normal" weight, is healthy for my height and body frame. So, whatever, I told my doctor and she thought it was a good idea so now when I get any crap for it, I can say my doctor told me I had to because of my cholesterol, LOL!


Man, shouldn't I be noticing some dryness by now?

[Hanoian]

Day 8

Well, I've taken a total of 280mg of Accutane so far, only 8120mg left, hahhaha. Okay, so I still don't have any side effects to report; my lips are maybe a little drier.

Last night I started getting a sore throat; when I woke up this morning I could barely swallow. I have the sniffles and I’m sneezing too though, so probably just a viral infection. Doubt it has anything to do with Accutane. My acne seems to be looking better; a lot of the inflammation seems to have subsided. But, I have a new "lump" on my temple and a few inflamed thingies on my forehead and one on my chin. Hope they disappear soon!

[Hanoian]

Day 9

Ugh, I feel like crap. Not sure if Accutane is making my cold symptoms worse or if I might have the flu (my whole body aches). Not a good time to be sick because I have a million things to do.

My lips are definitely DRY. I can't stand the way they feel without a good coating of Aquaphor. Well, at least I know the stuff is working! My skin just looks smoother. A lot of the bumps have gone down so makeup looks nicer. I do have a couple of new spots but it's the week before my period so I was expecting it.

I think I'll be able to take some "before" pictures soon but they won't be accurate because my skin already looks so different than it did a week ago.

[GIMojo]

guessing from your usernam... you are vietnamese?

im not an accutane user. my derm begs me to use it but i wont. cmon its either

depressed because of acne or depressed because of tane + risk serious side effects

[Hanoian]

Day 10


Well, I finally got some before pictures. My skin feels so much smoother than when I started, but the red marks are still there to prove how bad things were. Not sure what's helping, the Amoxicillin or the Accutane, but something's happening!

Forhead:



Right Cheek:



Left Cheek:



Chin:

[Hanoian]

Your skin actually isnt too bad at all just got some darker pimples that will clear in no time just be patient good luck

Thanks! I just hope the cysts I had (which are healing) don't scar too badly.