My (hopefully) final post on this Accutane Log!
So my course ended back in March.... Well, not really, because I had slowly been taking less and less Accutane instead of stopping abruptly like in my first course. I weaned from twice a day to once a day, then to once every two days, then twice a week, and finally once a week. However, by the time I got to that point, I was getting quite a bit of uninflamed bumps on my forehead and my skin was getting oily again. This happened the first time I came off of Accutane back in March of 2013. I think at that time, I had gotten as low in my outlook as ever on my skin. I thought I was pretty much destined to relapse a second time. What are the chances?
I was pretty miserable, but I still had quite a supply of Accutane left so I started ramping back up and taking 40 mg once a day. Within about a week, my uninflamed bumps went away and my skin dried out again. I then stopped altogether. My plan was to just ride it out for as long as the pills lasted (I had about 60 pills at this point). I figured every 5 pills would give me about 3-4 weeks of clear skin. I made a plan to just have the best time I can for as long is it was possible. I was filled with dread for that last pill, knowing that I was going to have a relapse. I did this off/on schedule for about two cycles. Each 5 pills gave me about 3 weeks of relief, after which, the acne and oily skin would slowly creep back. Finally, in the middle of May, I decided to just stop and stay stopped. I figured, give the skin a chance to recover, go on retin A micro (generic) and see if you can just stay relatively clear. I figured I wasn't going to live the rest of my life being scared of acne coming back. If it was going to come back, better to just get it over with instead of living with the constant dread.
So I stopped, and started retin A micro (this regimen did not keep me clear last time). I told myself I wasn't going to take another pill. The uninflamed forehead bumps never really came back and I am definitely not 100% clear. HOWEVER, every time I think my acne is going to have a full blown relapse, it hasn't really happened. I'm still getting some tiny whiteheads every now and then, but for the past 1.5-2.0 months, I haven't really had a deep cystic zit. My skin still gets a little oily during the day, but it hasn't necessarily translated to anything serious. I think I've learned some important lessons while on Accutane:
1. Take Accutane with food
This is so important and something I neglected the first time around. Isotretinoin is lipophillic, meaning it dissolves readily in fats. If you take it on an empty stomach, you'll be getting less than 50% of the dose!
2. During an Accutane dose, it's a good time to give your skin a break
If you're like me, then you probably use every product under the sun. While these products feel refreshing and cleansing, they're actually pretty harsh on the skin. Towards the end of my course, I was washing my face every 2-3 days or so.
3. Don't abruptly stop Accutane
I know this one is controversial and debatable. There's a school of thought that Accutane stays in your system for months. This is absolutely not true. The effects of Accutane may stay for months after you stop taking it, but most of the medicine is gone from your system in less than a week. The half life of isotretinoin is only about 20 hours. There have been anecdotal examples of people having a post-Accutane breakout (i.e. me). I think this is the same mechanism as people having an initial breakout when they first start taking Accutane. The abrupt increase or decrease of the medication in the bloodstream may cause the body to overreact in either direction.
4. Use a maintenance regimen
I've been using retin A micro since I've stopped. I can't say for certain if this is helping, but I seriously doubt it is hurting.
5. Exfoliate only a couple times a week
You certainly don't need to exfoliate every day. In fact, this may be harsh on sensitive skin types. I've been using a neutrogena scrub with those beads about once or twice a week to scrub away the dead cells. I feel like this is all I need.
I hope people have found something useful in my blog. I sincerely wish every one of you the best in your struggles against acne. I won't tell you to just forget about acne and live your life because I know it's almost impossible. I know it's unbearable sometimes and you might have those dark thoughts creep into your mind every now and then; I certainly have. It's hard to explain to someone who doesn't have acne the struggle we have every day when we look into the mirror. I don't consider myself a superficial person or that concerned with looks, but I know acne has been a shadow in my mind since I was 15. I struggled through college being shy and timid and going into the professional world, where 99% of people don't have acne, it's unbelievably crushing to have to take time off because you were too embarrassed by your acne. Don't be afraid to go to a dermatologist; it doesn't make you shallow.