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23/m Moderate-To-Severe Accutane Log

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#1 lookitsme

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Posted 19 January 2013 - 03:07 PM

Hi All,

I'll try to consolidate years worth of history into as smaller as post as possible.

Background

I'm a 23 year old male, 150lbs, living in California. I remember getting my first pimple in the 4th grade. I wasn't really aware of what that meant for me at such a young age. During rest of elementary school, I would occasionally get a few pimples. Nothing too bad at all, it was by far mild. By the time I entered the 6th grade, I had mild-to-moderate acne. I remember being the only one who had acne at such a young age. It definitely made me keep a lot to myself during that year. Thankfully, while my acne never did improve, as middle school progressed, everyone else's skin got worse. At least this way I didn't feel like I was sticking out too bad.

However, by the end of middle school, my acne was terrible. By this time I was getting cysts on fairly regular basis. I would have an uncountable amounts of pimples in any given day. By that time I also was going through the various OTC medicines. Some helped a bit, others didn't really do anything. I remember watching the Proactiv infomercial time and time again. I really thought it was going to fix everything for me. Like I'm sure of many others here, I was severely disappointed with that as well.

By the time I was in high school, I begged my mom to take me to a dermatologist. She finally made an appointment for me, and I remember the excoriating 2 months between the time she made the appointment, until the actual appointment day. I went there several times over a course of about 2 years. We tried various antibiotics combined with topicals. While my skin was improving, I still had very moderate acne. Then came the discussions of Accutane. My mom would not even have the discussion with the derm (uh, what?). So after a very large fight, I stopped asking her to take me to the doctor. That's when I found acne.org and followed the regime for a few years. It definitely helped me out a lot, there's no denying that. But there were several instances I remember going to the school with an extremely bright red face from the BP and moisturizer combined. Extremely embarrassing for someone who was in high school.

Fast forward to a few more years, I entered the workforce. I was still using the regime religiously, and the crazy time commitment that it requires. But after so many years on it, it seemed as if it was losing its efficacy. That's when I decided to go to the derm on my own. Over the course of about a year, we played with Retin A (all the way to the highest strength), with minocycline (later doxy), and Sulfacetamide combined. It worked very well; the clearest I ever was. I did this for over a year. I still had acne. There was no doubt about that, and I would regularly break out.

I moved about 8 months ago. I decided to get a new derm. On my very first visit he had mentioned Accutane, and also let on that I was running out of options. There just wasn't much more left for me. At this point Accutane still scared the living daylight out of me. I was so scared when he mentioned I had very little options left.

He kept me on doxy, Sulfacetamide, and changed the Retin A to Epiduo. We did that for 3 months. It helped, again, I still was breaking out. I got more scared as the dreaded Accutane seemed to loom closer.

We swapped out the Epiduo with Tazorac. I was on Taz for about 2 months, and it was the same story. Again when I got switched, I was so scared. This was my last option. The only thing above this was the highest strength Taz, something he had warned me of. If Taz made things worse, I was officially out of options.

I woke up on Monday morning having two large cysts on my forehead, and several zits around my mouth. After talking with the significant other, I made the decision to go on Accutane. I made an appointment on Monday, for Thursday. And here we are now. I'll post Day 0 (Thursday) as its own day since I had some treatments done.

Treatments Tried

OTC
  • Oxy
  • Clean & Clear
  • Proactiv
  • Nature's Cure
  • Stridex
  • Garnier
Prescription
  • Minocycline
  • Doxycycline
  • Retin A
  • Tazorac
  • Epiduo
  • Erythromycin
  • Sulfacetamide
Regime/Natural
  • Acne.org Regime
  • Apple Cider Vinegar
  • Baking Soda
  • The-do-nothing-but-wash-with-lukewarm-water "regime"
  • Paleo Diet
  • Diet changes (no dairy, no simple carbs, no sugars, no soda)
With a lot of the above, I tried numerous variations and several strengths for most.

Regime

My new regime will be extremely simple (about time!). I'll be using Cetaphil gentle cleanser in both the mornings and evenings. I'll be taking 3 Amnesteem 20mg pills daily, each time with food. I'll be using Cerave moisturizer in the morning, and Cetaphil in the evening. Aquaphor for my dry lips, and then Systane for my eyes since I wear contacts.

I also take Flovent, which is a corticosteroid, with a known drug interaction with Accutane. So I'll be taking a Vitamin D/calcium pill twice daily to help counteract that. I'll also be taking fish oil pills to ensure my cholesterol stays in check.

No alcohol for me, and I will do my best to help keep the fatty foods to a minimum.

Since I am mostly clear now after being on Taz and doxy for so long that, my derm is optimistic that I'll be fine with 4 months of 60mg daily. I've noticed that he has been a bit too optimistic in the past, so I'm not getting my hopes up too much.

Concerns

I'm not really too worried about the crazy side effects. There's definitely a small concern there, don't get me wrong. But what I am mostly worried about is the IB. I've had acne for more than half of my life (how scary is that when you say it?). And in the past 10 years or so, I can point at only 2 separate 1-week incidents where I was not on anything. And it was not pretty at all. So I am very cautious about the IB, but I will force myself through it regardless of what happens.

I'll try to update as changes come in. Posted Image

Edited by lookitsme, 19 January 2013 - 03:08 PM.


#2 letsgetthisoverwith

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Posted 19 January 2013 - 03:12 PM

Hey man,

Looks like were in this together. It definitely seems like you have had a much longer struggle with your acne than I have, but I have tried almost as my different products and regimens, with similar results. I am definitely really hopeful, but I feel you on the initial breakout. I'd really like to be one of those people who somehow avoids it. My brother took this stuff a few years ago and it really worked for him. It is definitely nice to know someone in real life that has had success with it.

I'm also using cetaphil and aquaphor for my lips. What are you using as a moisturizer for your face? I am using Olay Sensitive Skin with SPF 15(although I will definitely be avoiding the sun for the most part). Are you starting off on 60mg a day or are you working up to it? I can't tell which one is better. Good luck though man, I'll be following your updates and feel free to do the same to mine...I took my first pill yesterday!

Currently on Accutane(Started Jan. 18 2013, Finishing Early June 2013)

First 3 Weeks - 20mg(Myorisan)

Month 2 - 80mg(Claravis)

Month 3 - 80mg

Month 4 - 80mg

Month 5 - 80mg

 

Overall cumulative dose will be 9600mg which equals 120mg/kg. 175lb = 80kg

21 year old Male

Log w/ weekly Pics http://www.acne.org/...e/#entry3319932

 


#3 lookitsme

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Posted 19 January 2013 - 03:29 PM

Day 0

I went in and asked to be on Accutane. Derm basically glad you've finally come around. We talk for awhile about it.

I then get a few Corticosteroid injections on a few current cysts. I also had a light therapy done. It's my impression that I will continue the light therapy for each month that its necessary during my regular visit.

I somehow was fasting at that point (anticipation I guess), and was led upstairs to get my blood drawn. I don't do blood tests. Really. I don't do blood tests. The last one I had I passed out and got yelled at by the nurse for not warning her. But somehow this time it was different. I'm not sure if it's because of the person who did it, or how optimistic I was for Accutane. But either way at the end, I had no problems.

Day 1

Technically was yesterday. My prescription got called in. The original pharmacy did not have it, but they were extremely nice enough to get it transferred to a place that had it.

I've also attached a picture of the price. $1,349.99. I am very thankful I have good insurance!

So I was only able to take 2 pills instead of the usual 3 since I wasn't able to pick it up until after work. Nothing noticeable at all. However, I slept terribly. It was a very odd feeling all night long. I'm not sure if it was excitement, nerves, or the actual Accutane. Either way, I did not like it at all.

I'll post my next update when I start getting some of the side-effects and/or noticing things change.

Hey man,

Looks like were in this together. It definitely seems like you have had a much longer struggle with your acne than I have, but I have tried almost as my different products and regimens, with similar results. I am definitely really hopeful, but I feel you on the initial breakout. I'd really like to be one of those people who somehow avoids it. My brother took this stuff a few years ago and it really worked for him. It is definitely nice to know someone in real life that has had success with it.


Absolutely! Struggle is struggle, and I think we all can really relate no matter how bad it is. And really good to know about your brother! Sadly I don't know anyone in real life, so it's going to be really nice talking to people here about stuff like this!

I'm also using cetaphil and aquaphor for my lips. What are you using as a moisturizer for your face? I am using Olay Sensitive Skin with SPF 15(although I will definitely be avoiding the sun for the most part). Are you starting off on 60mg a day or are you working up to it? I can't tell which one is better. Good luck though man, I'll be following your updates and feel free to do the same to mine...I took my first pill yesterday!


Right now I have some free samples of Cerave from the doctor. Tomorrow I'm going to pick up these two from a local drugstore:
http://www.amazon.com/CeraVe-Moisturizing-Cream-16-Ounce/dp/B001V9SXXU/ref=sr_1_1?ie=UTF8&qid=1358630869&sr=8-1&keywords=cerave
http://www.amazon.com/gp/product/B001ET76EE/ref=s9_simh_gw_p194_d1_i1?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-2&pf_rd_r=01A0MJHAK9HERR1C8MFR&pf_rd_t=101&pf_rd_p=1389517282&pf_rd_i=507846

I've been trying to do a ton of research. From what I understand the Cetaphil is a lot thicker, so it's better at night. Cerave is thinner, and supposed to keep moisturizing during the day. We'll see if it works though like that, hah!

Attached Thumbnails

  • rx-retail.png

Edited by lookitsme, 19 January 2013 - 03:18 PM.


#4 letsgetthisoverwith

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Posted 19 January 2013 - 03:35 PM

Thanks for the info! I'm thinking I might need to get something thicker eventually.

Currently on Accutane(Started Jan. 18 2013, Finishing Early June 2013)

First 3 Weeks - 20mg(Myorisan)

Month 2 - 80mg(Claravis)

Month 3 - 80mg

Month 4 - 80mg

Month 5 - 80mg

 

Overall cumulative dose will be 9600mg which equals 120mg/kg. 175lb = 80kg

21 year old Male

Log w/ weekly Pics http://www.acne.org/...e/#entry3319932

 


#5 lookitsme

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Posted 26 January 2013 - 12:34 AM

Day 8

 

So today I finished my 8th day's Accutane.

 

Originally I was taking 20mg 3 times daily, but I wanted to double check with the pharmacist and apparently was taking it wrong. For the past few days I've been taking 3 20mg daily (all 3 at one time).

 

In terms of dryness I haven't noticed a huge difference. I think my face is a bit less oily than usual. But it's so hard to compare since I was always on some topicals, and even now I'm putting heavy moisturizer on. So my face looks a bit shiny, even though when I try to dab it off, it doesn't come off.

 

When I first started I was getting some pretty intense headaches. Usually either some pain relievers or heavy water plus nap fixed that. It stopped for a few days, but I did wake up with one today.

 

My biggest side effect is that I've been sleeping terribly even since my first night. I usually sleep straight through for a few hours, but after that it's constant wake-ups. It's almost like fever dreams, without the dreams. It's crazy. Tonight I'm going to use some sleep medicine since I don't need to wake up early tomorrow.

 

Now for my face. For the first 4 days, I noticed no difference. Around day 5 I got two fairly large cysts. And my face has started to get redder then. Now I have several whiteheads, still the 2 cysts, plus several small bumps on my chins that's probably going to become whiteheads eventually. I have these odd bumps on my forehead, that kinda look like small zits. My blackheads in my nose are definitely more noticeable, and appear much closer to the surface.

 

My chest acne was pretty bad early in the week, but seems to be "drying" out and diminishing. 

 

The acne on my legs and back doesn't appear to have changed one bit.

 

Overall it looks like I'm in the very beginning stages of my IB. It's definitely manageable now, with only a bit of redness and a few spots. I'm worried what the next week is going to bring in though.

 

Here's the right side of my face that I took last Friday.

0.png

 

Here's a picture I took just a few minutes ago.

1.png

 

Fingers crossed that the IB won't get significantly worse for the next week!



#6 whoartthou1

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Posted 30 January 2013 - 04:33 AM

any photos of your body acne?



#7 lookitsme

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Posted 12 February 2013 - 07:07 PM

any photos of your body acne?

 

Sorry, I do not. My body acne is actually pretty mild. I never bothered too much to put any topicals or anything because it never bothered me that much. More of an annoyance than anything.

 

Day 26

 

Been quite a few days since my last update. I have my first derm appointment this Friday, along with my second blood tests. Hoping that goes well! I don't really expect any change in my dosage.

 

I also received my bill today from the first doctor visit/blood work. Almost $300 out of pocket since it's beginning of the new year. Ouch.

 

Literally, I am dry everywhere. I have put vaseline and/or lotion on/in just about every part of my body at some point in the past few weeks. I affectionally refer to my lips as "shedding" now, as it looks like skin is literally just shedding off of them. I apply Aquaphor every chance I get.

 

I was sick for most of last week. It was pure hell. Heavy congestion + normal nose dyness  = not happy Thankfully I feel much better now.

 

I believe my sleeping has improved. It's hard to say since I wasn't sleeping very well when I was sick. I'll try to keep an eye on my sleeping for the next few days to see what happens. Headaches are gone now completely.

 

Face - From my last post to about a week ago, I had about 15 active pimples/whiteheads on my face at any given point. They cleared much faster than any previous medicine I was gone. But they were extra tender, even the smallest one hurt so bad. I also had blackheads everywhere. It looked like every single pore in my nose was filled with one. My cheeks and forehead was also covered in them. Took a lot not to try to squeeze them out since they looked sooo close to the surface.

 

For the past few days, I have been relatively clear. Even my redness on my cheeks are starting to go away. I have only a few active ones at any given time now. Definitely seem to be improving, and it being the first month, it went significantly better than I thought it would. Acne was pretty mild, maybe a bit moderate at times. Blackhead situation is definitely improving. Still more noticeable than day 0, but improving. Now let's just hope the clearing-trend continues, and it doesn't go the other way.

 

Chest acne is gone. Literally, completely gone. I realized this yesterday in the shower. It was getting better for awhile, and then got slightly worse. Seems like it cleared up overnight. So odd, but I'm not complaining!

 

Leg acne appears to be getting better still, but no significant change since last time.

 

I'll provide my next update when I get back from the doctor, or when I get my blood work back.


Edited by lookitsme, 12 February 2013 - 07:17 PM.


#8 whoartthou1

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Posted 13 February 2013 - 08:54 PM

Kool! Which moisturizer are you using?

#9 lookitsme

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Posted 15 February 2013 - 05:36 PM

Kool! Which moisturizer are you using?

I'm using Cerave in the morning, and Cetaphil at night. I know a lot of people prefer one or the other, but I like them both for different reasons. :)

 

Thanks for asking!

 

Day 29

 

Had my derm appointment a bit ago. Overall he was happy with the results, and said I was right on track. We had some discussion about upping my dosage and/or lengthening the course just as a precaution. He's going to hold off on raising me to 80mg at least until next month. I have a strong feeling he's going to up it then since the side effects haven't been too bad at all, and it'll be Spring time so less effects on drying. 

 

I also had the light therapy done today and had about 7 injections today.

 

Did my blood test, and didn't faint! Yaay! Only problem is that I probably won't get my results back for another week or so. Doctor will be away.

 

Other than that, not much as changed since my last update!



#10 whoartthou1

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Posted 15 February 2013 - 06:38 PM

light therapy? And what were the injections for?



#11 lookitsme

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Posted 28 February 2013 - 03:40 PM

light therapy? And what were the injections for?

 

I checked my recent bill, and it's PUVA. Basically they put this paste on my skin for a few minutes, wipe it away, and then shine light on my face. It's supposed to reduce irration, redness, and cleanse the pores.

 

The injections are the cortisone shots. More info, they're usually used for cysts.

 

Day 41

 

I got my blood test back earlier in the week. Pretty much all of my cholesterol numbers are up. It's not enough to take me off Accutane, but she did mention that I need to adjust my diet. So I've increased the number of fish oil pills I take daily, cut down on the diary, red meat and butter. We'll see how that goes.

 

Super chapped lips but manageable with Aquaphor. My forearms are especially dry for some reason, and last week I developed minor eczema (or so it appeared). It went away after a few days. I've been doing full body moisturization a bit more often now as well.

 

I have forgotten to mention in my updates on how dry my eyes get. Sometimes it's pretty extreme pain with the contacts. I've been going through a lot of eye drops and taking my contacts out every other night to give my eyes a rest.

 

Blackheads in my nose are pretty much all gone. Just a few stragglers left. I'll try to upload some pics of those later. It's definitely very gross!

 

Face - It's pretty clear. I have a large cyst on both my chin and cheek. A ton of red spots, but that's pretty much it. Some days definitely look better than others with the redness.

 

Chest acne is still gone. 

 

Back acne appears to be pretty much gone as well. Just a few active ones left.

 

My legs are worse from my last update. Hoping it starts clearing up very soon, especially before summer sits in here.

 

That's pretty much everything for now! Time is going by faster than I thought it would.



#12 whoartthou1

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Posted 28 February 2013 - 11:27 PM

hey, do your cysts go away without the injections, or do you need them in order to flatten the cysts?