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Ultra Low-Dose Accutane Users, Help!

accutane low dose prescription help ultra isotretinoin maintenance

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#1 AKanel

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Posted 16 August 2012 - 07:54 PM

I need some counseling from other people who have been on ultra low dose Accutane. I am currently on 40mg twice a week - one 40mg pill on tuesday and one on friday. It's has been a little over a month since I started treatment and I haven't seen any evidence of the Accutane doing anything except for the occasionally dry lips.

I was on a normal course of Accutane around 2 years ago but my acne came back, sadly. It was only after reading such amazing things about ultra low-dose treatments that I decided to bite the bullet and take the medication again. Many said that they were able to notice significant changes in their skin on the low dose in short periods of time, e.g, a couple of months.

I just want to hear from some other people who have done ultra low dose treatments:

- When did you start seeing results, e.g, reduction of oil, less inflammation, less active spots, etc.
- Did you have any purging/initial breakout on such low doses? If so, how long did it last and did you do anything extra to remedy it?
- Did you use anything for your skin topically or orally in addition to the Accutane to treat your skin while the medicine was kicking in?

Any information someone can provide is greatly appreciated, but please, only post if you are on, have been on, or are familiar with ULTRA low-dose treatments, i.e, 20mg to 40mg twice a week or less.

Thank you!

#2 will1578

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Posted 17 August 2012 - 01:03 PM

Hi Akanel,

Were you prescribed this by a doctor? That is the ONLY way you should take this medication. This is a daily pill so only twice a week wouldn't make much sense or show any results.

Were you prescribed this by a doctor?

#3 AKanel

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Posted 17 August 2012 - 01:10 PM

Yes, prescribed and given by my dermatologist who has decades of experience in dealing with Accutane and its various doses. I highly trust her opinion. She has given low dose treatments to repeat Accutane patients and seen great results for the long term.

#4 bella3927

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Posted 17 August 2012 - 05:27 PM

I always had pretty good skin growing up, with the occasional pimple right before my period but it was always one or two small ones that would go away in less than a week. I also always wore some sort of makeup because I had a bad habit of picking those one or two pimples, which left dark scars on my tan, ethnic skin. No matter what I used on my skin though, I didn't seem to break out from it. Around freshman year of college, I had a few more pimples due to drinking and harder classes, but again nothing noticeable at all and I was usually still clear after my period. However, being from a family that is very conscious about looks and appearances, my mother suggested I go to my dermatologist (that I had always had since I was in middle school...despite hardly having acne). He prescribed me retin-a which made my skin perfect by the time it was the summer. But suddenly, at the beginning of my sophomore year of college, I started breaking out horribly and in places I had never broken out in before (I also ended up getting mono at the same time and was sick pretty much the whole semester). It started getting worse and worse until I saw my derm again and he suggested accutane because it had gotten so severe. I did a low dose treatment starting in December and stopped by the first week of July of this year. It worked great during the time that I was taking it. I had a few breakouts here and there at the beginning of my treatment, but became totally clear by the last few months (maybe a random small pimple during that time of the month, that would go away in less than a day or two). The great thing about a low dose was the lack of side effects. My lips never really became dry nor did I experience anything else (thankfully). I was on 40 mg twice a week just like you. Because my skin was clear, we stopped the treatment at 6 months, which was cutting it too short now that I look back on it. My acne has come back again since a month after I stopped...not as bad as before...no cysts but tons of whiteheads all over my face which still looks hideous. I also started using retin-a .1% then switched to tazorac .1%, so it could be a combination of an initial breakout and cutting the treatment to short. Anyways, I saw another derm this past week since mine wasnt available (and i was freaking out about my acne ridden face), and she told me I needed to go on a real course of accutane to really get rid of it. So by the end of semptember I'll be doing 40 mg EVERYDAY for 6 months...which I'm a little scared about. I think the low dose accutane works if you're acne isn't completely horrible, or if it was sudden like mine (and not genetic), as long as you continue with the treatment for more than the usual 6 months. You'll probably see results in a few weeks...but be patient since it is a lower dose. Just wanted to warn you that even though I was clear for a while, cutting it too short has caused all my acne to come back within a month. Hopefully the next course will actually work and keep me clear so I can have my old skin again...

Edited by bella3927, 17 August 2012 - 05:28 PM.


#5 AKanel

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Posted 17 August 2012 - 05:38 PM

Thank you so much for the info, bella3927!

It's good to hear hear directly from someone who is doing what I'm doing. In terms of getting off too soon, odds are, I'll remain on this dose (or even lower once I'm clear) for an undetermined duration; maybe a year, maybe two... who knows.

Anyway, was there a specific month for you that you started noticing clearance?

#6 bella3927

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Posted 17 August 2012 - 07:46 PM

Sorry I didn't really answer much of your questions from your first post! I started seeing reduction of oil pretty quickly..id say by the end of the second week but then again I started in the winter. I wasn't really keeping track but I think by the end of the first month I didn't have many active spots left, maybe like two or three. Its hard to say when you'll be clear because everyone is different...I was lucky at the time and was pretty much clearing up by the end of the first month. I'm also not sure if I had an IB because I already had so much acne to begin with...but if I did actually have one then it was very mild and short. The only thing I used while on the accutane was the cetaphil wash, and because my face wasn't dry I didn't even use moisturizer much after the weather started getting warmer. Even on a low dose though, I noticed my knuckles and skin in general was thin and it would easily scratch. When I did have the occasional pimple during the course I used an over the counter spot treatment and it would be gone by the next day. I don't remember what it was though but I think any of them should work. Good luck! I'm sure you'll be clear in no time

#7 AKanel

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Posted 18 August 2012 - 03:03 PM

Thanks again for the info, bella!

Anyone else have some advice or answers to my questions?

#8 hitman87

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Posted 19 August 2012 - 03:31 AM

I've been on low-dose accutane for years (on and off). Usually 10mg per day. I started Accutane years ago with a 40mg a day dose, but I suffered from the side-effects big time, so thats why I lowered the dose.

For me, low-dose Accutane really kicks in after about 2 weeks. Then I'm completely clear. Side-effects like dry lips, feeling tired, stomach problems and anxiety are there, but in a milder form. Once I stop acne comes back in about 4 weeks. This is the problem with low-dose Accutane I believe. It doesn't cure you from acne, it only suppresses the symptoms. On the other hand, the kind of acne that I had is gone. I still have it, but in a milder form. A great thing about low-dose accutane is that you don't get the initial breakout (at least i didnt). While on accutane, the only things I did was use a moisturizer and wash my face in the shower with a PH neutral soap.

Right now I'm off accutane and on Inderm (topical antibiotic called erytromycin). I've tried it before accutane and the result were terrible. This time however, my skin seems to really benefit from it. I also use Differin from time to time and that also works a lot better now than before accutane. I suggest you retry those topical solutions again if they didnt work in the past.

Ultra low-dose Accutane is a lot better than normal doses, but it's still poison. Side-effects are less severe but still there. I really urge you to retry other solutions before going back on Accutane.

Good luck! Posted Image

Edited by hitman87, 19 August 2012 - 03:32 AM.


#9 AKanel

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Posted 19 August 2012 - 08:40 AM

Thanks, hit man.

How long were you on the 40mg before you switched to your lower dose? I'm just curious.

#10 Roaccutane Journal

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Posted 20 August 2012 - 03:20 PM

I am on lose does of roaccutane 20mg a day but i started out taking 3 a week, then 4 until everyday
I had an initial breakout, i suffer mainly from congestion so bumps under the skin and black heads
my breakout was just that all my congestion looked more obvious and closer to the surface, the blackheads have now gone (I am on my third month)
but whitehead bumpy things are still there, i think a few have gone but not as much as i would like it to.

i started seeing a reduction in oil probably after 1 month, its great for that

Inital breakout i used dermologica overnight clearing gel and aloe vera but i dont think they helped much, i think its honestly best to wait it out because these products seemed to be too strong

i take inner health plus, fish oil tablets as well but no other topical treatments

wish you all the best, good luck

#11 AKanel

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Posted 20 August 2012 - 05:23 PM

Thank you for your info, Roaccutane Journal.

I hope you start to see desired results soon. I know I want to! Does anyone else in these boards have some info or answers to my questions?

#12 waasted

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Posted 20 August 2012 - 11:38 PM

hey just wondering did any of you guys get an ib for these low doses, im starting my cycle of 10mg every day for 3 months and would like to know if i would egt one or not. ty and wish me luck!

#13 hitman87

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Posted 22 August 2012 - 06:06 AM

Thanks, hit man.

How long were you on the 40mg before you switched to your lower dose? I'm just curious.


About 4 months on 40mg. Posted Image

@Waasted: what do you mean by "ib"?

Edited by hitman87, 22 August 2012 - 06:07 AM.


#14 AKanel

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Posted 23 August 2012 - 08:11 AM

hey just wondering did any of you guys get an ib for these low doses, im starting my cycle of 10mg every day for 3 months and would like to know if i would egt one or not. ty and wish me luck!

About 4 months on 40mg. Posted Image

@Waasted: what do you mean by "ib"?


He's talking about an initial breakout or purging of the skin due to the Accutane. My answer, would be yes, it is possible. That's just the nature of the beast. Accutane, more often than not, causes purging of the skin. However, on these super low doses that initial breakout can be GREATLY reduced. But, at the same time, at low doses, it's harder to tell exactly when the breakout will begin, and once started, exactly when it might end.

#15 LittleMsSunshine

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Posted 09 September 2012 - 05:24 PM

I've been on low-dose accutane for years (on and off). Usually 10mg per day. I started Accutane years ago with a 40mg a day dose, but I suffered from the side-effects big time, so thats why I lowered the dose.

For me, low-dose Accutane really kicks in after about 2 weeks. Then I'm completely clear. Side-effects like dry lips, feeling tired, stomach problems and anxiety are there, but in a milder form. Once I stop acne comes back in about 4 weeks. This is the problem with low-dose Accutane I believe. It doesn't cure you from acne, it only suppresses the symptoms. On the other hand, the kind of acne that I had is gone. I still have it, but in a milder form. A great thing about low-dose accutane is that you don't get the initial breakout (at least i didnt). While on accutane, the only things I did was use a moisturizer and wash my face in the shower with a PH neutral soap.

Right now I'm off accutane and on Inderm (topical antibiotic called erytromycin). I've tried it before accutane and the result were terrible. This time however, my skin seems to really benefit from it. I also use Differin from time to time and that also works a lot better now than before accutane. I suggest you retry those topical solutions again if they didnt work in the past.

Ultra low-dose Accutane is a lot better than normal doses, but it's still poison. Side-effects are less severe but still there. I really urge you to retry other solutions before going back on Accutane.

Good luck! Posted Image



My story is almost exactly like yours! I started off with 20 mg/day and even at this low dosage my side effects were horrible.. I only lasted about 4weeks. I am now on 20mg every other day. My Dr said it should help me but if my acne didn't respond I would have to go back to 20 mg/day.



I need some counseling from other people who have been on ultra low dose Accutane. I am currently on 40mg twice a week - one 40mg pill on tuesday and one on friday. It's has been a little over a month since I started treatment and I haven't seen any evidence of the Accutane doing anything except for the occasionally dry lips.

I was on a normal course of Accutane around 2 years ago but my acne came back, sadly. It was only after reading such amazing things about ultra low-dose treatments that I decided to bite the bullet and take the medication again. Many said that they were able to notice significant changes in their skin on the low dose in short periods of time, e.g, a couple of months.

I just want to hear from some other people who have done ultra low dose treatments:

- When did you start seeing results, e.g, reduction of oil, less inflammation, less active spots, etc.
- Did you have any purging/initial breakout on such low doses? If so, how long did it last and did you do anything extra to remedy it?
- Did you use anything for your skin topically or orally in addition to the Accutane to treat your skin while the medicine was kicking in?

Any information someone can provide is greatly appreciated, but please, only post if you are on, have been on, or are familiar with ULTRA low-dose treatments, i.e, 20mg to 40mg twice a week or less.

Thank you!



While I was on 20mg/ day for 4 weeks I had a really bad initial break out! I am now on 20mg every other day. I've been on this mg for a little more than 2 weeks and my ib has pretty much healed. I think my IB lasted like 4 weeks. I would say give it around 2 weeks before u see improvement... I noticed less oil production within a few days. Idk if you consider 20mg every other day a low dosage? I think it is considering what other ppl are taking. Anyway, I'm starting my own weekly log if you're interested in checking out my progress. Good luck :)

my skin needs help! :

my journey on low dose accutane

http://www.acne.org/...hp/topic/320393


#16 AKanel

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Posted 09 September 2012 - 06:12 PM

Thanks fo letting us know what's going on with your course, LittleMsSunshine!

Just to update people - I ended up asking my Derm if there was any antibiotic I could take to handle things before the Accutane kicks in and she prescribed me Cephalexin. Well, it's only been about 2 weeks and I'm pretty much clear.

Now I'm just waiting for for a couple more months before I know the Accutane is working before I get off of the Cephalexin.

#17 LittleMsSunshine

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Posted 10 September 2012 - 12:28 AM

Thanks fo letting us know what's going on with your course, LittleMsSunshine!

Just to update people - I ended up asking my Derm if there was any antibiotic I could take to handle things before the Accutane kicks in and she prescribed me Cephalexin. Well, it's only been about 2 weeks and I'm pretty much clear.

Now I'm just waiting for for a couple more months before I know the Accutane is working before I get off of the Cephalexin.


I'm hoping to start my logs tomorrow :)
I'm new to this site and I just have a question... How do I know when someone has posted something new to a certain topic? Is there a way to get notifications? I think I am following this topic but I had to actually click on the topic link to check if there was anything new. I checked my notification setting which say I should be getting a notification hmmf...

Anyway, I'm glad to hear you're clearing up :) Just curious how bad was ur acne before you decided to go back on accutane? How does it compare to when you went on accutane for the very first time?

my skin needs help! :

my journey on low dose accutane

http://www.acne.org/...hp/topic/320393


#18 AKanel

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Posted 11 September 2012 - 09:58 AM

At the top, all the way to the right of the title of the thread there should be a gray button that says follow this topic. If that's pressed you should be all good. If you have that button pressed and still aren't getting notifications, then I don't know what's wrong =/.

Anyway, as far as my acne severity, initially before I went on my first course of Accutane, my acne was moderately severe, characterized by mostly inflamed acne and cysts. A bad breakout would consist of maybe 10 inflamed pustules or papules and maybe 2 cysts or so. It was also unbelievably persistent. I exhausted nearly all dermatological options before trying the Accutane route.

After about 8 months of being off of the Accutane, I began breaking out again. At first, not bad at all, just little things here and there. But after a while, it worsened to the point of me worrying that it was coming back full force. Long story short, it did come back, but not NEARLY as bad or frequent. Also, I don't really breakout in the area I did before (cheeks). Oddly enough, the acne came back in different areas, like my jawline along my sideburns, which by the way, I credit to facial hair growth.

My acne just a month or so go before the second course would still be characterized as moderate acne, i.e, inflamed pustules and papules. What was nice about this time around was I don't get cysts anymore, and I can go for a week or two most of the time without a bad breakout, as long as I follow my diet and don't irritate my face with chemicals and such. When it does get bad I tend to breakout with maybe 3 or 4 inflamed spots and a few accompanying smaller spots.

The reason I went on again is because there is simply nothing left for me to try for my acne. It is so INCREDIBLY persistent. I know everyone on here says that, "They've tried everything" and then they go on to list 5 or 6 products that are always initially prescribed for acne patients. I can honestly say that if you can name something to try on my face, short of the urine method, I've used it; this goes for both prescription and over the counter options. Even options that are not for acne but supposedly work wonders; this includes silly herbs that are supposed to do something.

So yes, I'm hoping long term low-dose Accutane is my answer to a TRULY worry free life without acne =D (at least until it goes away after my teenage years like it has for the rest of the men in my family *fingers crossed*).

Sorry for the long response. Just want to get it out there for anyone else who visits the thread.

#19 LittleMsSunshine

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Posted 11 September 2012 - 08:43 PM

Ok yay the whole notification thing is all figured out now thanks! Dont worry about the long response because well now it keeps me from asking so many questions Lol. I really do hope you find success! I'm a little worried about my acne coming back since being on accutane is no walk in the park. But like you I am hoping that this low-dose approach will be the answer to my problematic skin!

my skin needs help! :

my journey on low dose accutane

http://www.acne.org/...hp/topic/320393


#20 Tom Frearson

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Posted 12 September 2012 - 10:28 AM

Hi,

I'm new here but, sadly, not new to acne. I'm 32 and have suffered with mild to moderate acne and extremely oily skin since I was about 15. As a fitness and grooming consultant (at Smart Body Image) the last thing I need is a face full of acne when meeting clients.

My skin has been consistently clear for the first time since 2011 when I finally decided to give ultra low dose accutane a try. To cut a long story short, I've managed to get my accutane dosage down to 10mg twice a week with the addition of Isotrex every other day and a salicylic acid cleanser morning and evening.

What I wanted to highlight is that, despite having extremely oily skin, I've been able to normalise my oil production with only 10mg twice a week. I think the Isotrex plays a small part in reducing oil production but I can tell you from a recent trial that it's nowhere near as effective as the accutane.

Having said that, I did find I needed to increase the dosage to 20mg twice a week (with everything else the same) when I lived in a tropical climate but I guess that's to be expected.

The only side effects I experience are dry lips. I used to have dry eyes too (even before accutane due to Blepharitis MGD) but I've found that taking a high dose of Omega-3 (usually from Flaxseed) keeps that under control.

Anyway, hope that helps somebody.


Tom.




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