82 replies to this topic

[Mosey mom]

My son has been on accutane 10 days now and has broken out rather bad with about 20 active acne, he's never had more than about 5 at one time, on both sides of his face. It seems that this is happening quite early so I am worried that accutane may be causing a reaction? Or could it be a bad case of ib since he is on 80mg a day from the start? Any answers would be greatly appreciated.

[Sound of Hope]

Response timing varies from person to person, and I doubt it's anything to worry about if it looks like typical acne. Conveniently, I am also on 80mg per day. My skin started flaking lightly on day 4; oil production was significantly reduced by day 5; and my initial breakout started on day 13, lasting two weeks. So it's not unusual to see changes early in the game.

[Mosey mom]

Thank you for your response. I am having a hard time with the accutane thing but want to support him, since nothing else has worked. I hope this works.

[Sound of Hope]

Thank you for your response. I am having a hard time with the accutane thing but want to support him, since nothing else has worked. I hope this works.

You bet. It's normal for a parent to worry about it due to the horror stories, but I think sadly a lot of those could have been prevented with more vigilant monitoring and increased patient/dermatologist communiction. Rest assured that these incidents are very rare, and he'll most likely suffer nothing more than dryness of the lips and skin, and maybe some temporary muscles aches. Also, chances are very good that his acne will be much improved, despite the failures of previous medications. Feel free if you have other questions.

[Mosey mom]

Thank you. I will have more questions I'm sure. As of last night things still look the same, maybe not as red. I will try to update so that others that are having the same issues can also be helped. I have learned a lot from reading this forum for the past 6 or 7 weeks. I wanted info before starting him on accutane. As a person that never had acne, I had no idea and took it for granted the way my son felt about his acne, to be it wasnt such a big deal, until i read comments here. i am trying not to stare at his face everyday to see the progress or ask him every 10 minutes if any things changed so I may be here on the site asking you guys questions instead lol

[emma b1]

Hi mosey mom, I am currently on my second round of accutane and as soon as I started again I had a very bad breakout. Not as bad as my first round. Sometimes I think its better to break out as soon as you start as I feel things can only get better from there. The only think I hate is the dry lips, also this time around I have had a bit of a tight chest. (Nothing terrible though) I just love accutane. It has helped me so much and is well worth beautiful skin at the end! Just keep telling your son things will get better sooner than he thinks.

[Andrew2890]

I think that is a good thing , first comes the deterioration and before arriving improvements . The only thing you can do is support your son pray  . The acne is a very awful experience that no one can understand ( except who have experienced that shit) , i'm 22 and a poor beard and acne . I'm not an ugly boy but i I look like a 14 year old boy and it's very  very difficult not  feel different than all other . I have to thank my parents who are helping me to be much more peaceful

[chiptharipp]

hey there. ive just began accutane as well and i experienced a wild ib that even shocked my derm considering my acne wasnt ever god awful. lol shit sucked! mine happened around 5 days in and im only on 40mg a day and am a 19 year old guy. if it gets bad for him, call up his derma and they will prolly prescribe him some prednisone which they did for me and it will surpress everything and itll be as if it never happened within 24hrs.

[Mosey mom]

Thanks everyone for all the replies. They help more than the derms answers. I had called his derm today and they suggested I wait til his next appt for them to look at his skin. They weren't much help lol. If it wasn't for these answers I think I may be more worried. Things do look better tonight, acne not as red, i can see he picked at a few because they looked scabbed over. Lips are very chapped. Nose bleeds. Bag balm sold at any drugstore helps out the best.
. its hard sometimes because i want to remind him not to pick, but then i dont want to nag him about his skin either at this time. as a parent you just want your kids to be happy and not see them suffering. i thought he would outgrow the acne like his dad did, but he hasnt. i dont see acne when i see him and his girlfriends dont either. but it doesnt help to tell him that, he just tells me i dont understand. At least he had his girlfriend over tonight. He's been hiding out for the past week.

To andrew2890 there will come a day when you will be happy you look years younger trust me on that and in regards to a poor beard girls like clean shaven these days anyway lol . My husband didn't have a full beard until he turned 27 it always grew in in spots up until then . You still got lots of time

[Mosey mom]

Day 15. Today not so good, more acne showed up. Skin around mouth very dry, even thick moisturizer not working. Each pustule looks really red and large approx 12 active. Has anyone found a good moisturizer for around the mouth that does not encourage little white pimples in the area?

Edited by Mosey mom, 28 January 2013 - 11:50 PM.

[LeereWorte]

80 mg a day as an initial dose is a terrible idea. Must be an American doctor (I live in America right now myself, so I am very familiar with American incompetence). That is way too high a starting dose and will invariably cause an acne flare. All that matters with Accutane is that you have a cumulative dosage of 120 mg/kg. Trying to achieve that faster with a higher initial dose and shorter course doesn't do anything except increase side effects. He should have started off with something like 10 mg a day and then slowly built up to maybe 20 mg a day and never exceeded this amount. I have the full text of http://onlinelibrary...04.03739.x/full and can give it to you if you like. This study clearly demonstrates the effectiveness of lower dose isotretinoin. 

 

Your son's doctor should lose his license as 80 mg a day is an irresponsible daily dose to prescribe and reveals his ignorance of the current literature on Accutane which all advise on lower starting doses to minimize side effects and flares. iPledge is a horrible program with onerous requirements for both patients and doctors so perhaps the higher dosage is a way for doctors to minimize the amount of time they have to deal with the iPledge system. 

Edited by LeereWorte, 30 January 2013 - 04:42 PM.

[Mosey mom]

Will there be an issue if we ask the derm to lower his daily dosage at the one month mark? I have a problem with such a high dose because of long term effects he may get later. However my son just wants it over and done with. I'm thinking the reason why the doctor put him on such a high dose is because we are paying cash for the accutane, but I'd rather pay more than have him suffer. Will keep everyone updated. Day 18 update. Not much new, he did get a tightening of the chest a day or so ago but said he hasn't felt it since. (Although I'm sure some kids dont tell parents all the side effects because they may think we might take them off of it) Nothing much has changed in the acne dept, cysts still hanging around getting redder and larger , more coming out. Smaller pustule acne in the head and neck, a few places he never got them before. A few of the pustules have dried up though. Dry skin around mouth, lips are okay as long as Bag Balm is put on it constantly. The corner of the mouth is the bad area, dry and cracked. Hurts when eating. Has to use sunblock everyday even though he wasn't the type to burn before being on accutane. If he doesn't, just 10 mins in the sun starts to make him burn.

[BMarieWantsNoAcne]

Every one has different opinions on what doses should be on Accutane. Personally, 80 mg is high for starting, but working up to it should be okay (at least, I hope). That's what I'm doing. At this point you can't really change your first month's dose, so I would just stay with it next month. Other people will definitely tell you differently though. It is only what you and your son feel comfortable doing.

[LeereWorte]

yes, you can most definitely change the dosage. Accutane has a relatively short half-life and if he were to dramatically decrease the dosage to something more reasonable like 10 or 20 mg a day, then your son would notice an immediate relief to the side effects. There is absolutely, 100% no risk in cutting the dosage. Your son can start doing it himself immediately and only take a fraction of the dose he's prescribed. If all you have is 40 mg caps, though, you would still be stuck with a high dose of 40 mg where you're guaranteed severe chelatis and IB. 

 

Even if your son is not experiencing severe side effects or a terrible initial breakout, accutane at such high doses is a rather lethal drug that can potentially damage the liver and intestines. The damage accutane does is dose-dependent. I stand by original statement that 80 mg a day is almost never necessary for acne. 

Edited by LeereWorte, 31 January 2013 - 05:17 PM.

[Mosey mom]

This ib seems to be more of a constant breakout. Cysts are not getting any better. Boy is he moody today. He said its because of the acne looking worse than ever. Have any of you felt that way?

[LeereWorte]

The lowest point of my life was my first course of accutane. I literally had people asking me if I had pox or had contracted some sort of third-world parasitic illness that was eating away my face. It's very common for the skin to get significantly worse before improving. The severity of the IB (acne flare in scientific parlance) can be minimized through lower starting dosages and gradually increasing the dosage if that's what you desire. This is why I think you have a bad doctor. Even if he wants to put your son on 80 mg, there is no reason to start off with such a high dose. This doomed your son to a bad IB. I'll stop harping on this point, but it really annoys me to read things like this. Your son's suffering could have been easily avoided by seeing a doctor who actually knows about Accutane. 

[Mosey mom]

I agree leere, I think if a dr cares they will look out for your best interest. I don't want to cause any problems with changing the dr and mess up his ipledge. Especially since his treatment is only 4 months, but I am definitely going to let them know how I feel. I chose this derm because they have over 20 years experience, but I also found out it was the PA my son saw. I didn't go to the appt when he got put on the meds because he is older, but I'm going this time. I will find out what's going on. I am a lot more prepped thanks to this site to ask questions. Man, I hope I'm not sounding like a momma bear right now...lol.

[Sasch83]

You are an amazing mom - coming here -finding a way to help your soon.  What he is experiencing is quite normal and as many people have said, it is probably better to experience flare ups now than later - i am experiencing flare ups later (4 months in) and it sucks.  Have the derm still prescribe the 80 mg dose but for the first month,have your son only take 40 mg per day with fatty food (this helps with how the drug is absorbed). 

 

 

This period is going to suck and he'll just have to tough it out so be encouraging and help him find other things to occupy his time

 

I promise that it will get better

[Mosey mom]

Thanks Sasch83 . As far as ib goes ...day 21 or so. cysts still hanging around some are actually coming to a head now. Dabbing them with some hydrogen peroxide. Noticed about 5 or 6 new whiteheads or just small pustules that have arrived on the forehead today. This means the ib has lasted around 17 days. Just incase anyone has missed it he does have severe inflamatory and cystic acne. However never had this many actives on his face at one time. Antibiotics and proactive kept it to maybe 3 actives at a time. However he has many scars and pits from the cysts over the years. I read alot of journals here and think from their description that their acne is bad...but when I see pictures it's not that bad at all. To those, I know acne is a horrible thing but just know it could be worse, hang in there and stay positive.

Edited by Mosey mom, 03 February 2013 - 03:12 AM.

[BMarieWantsNoAcne]

I know what you mean about how some people over exaggerate. I wonder why some people are on Accutane all the time...