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Accutane

Accutane 2Nd Round W/ Retin-A



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#1 1moretime

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Posted 27 October 2013 - 12:07 PM

So I've been a long time lurker and have read with great interest all the posts.  Everyone on this board has helped me in someway, whether the posts have been based on science, personal opinion or even off the wall logic. I finally decided to post some of my experiences to contribute in some small way to the greater community.
 
I've been struggling with acne for most of my life (over 40 now) and extremely oily skin.  I've tried the usual over the counter BP and SA stuff but nothing has really worked for me.  Around 6 yrs ago I was fed up with getting pimples and decided to go on Accutane, I can't remember the dose (I think it was 60mg) and I took it for 3 months and it did wonders for my skin.  I continued to have no major issues with acne (still had oily skin) for 3yrs.  
 
3 yrs ago I started to break out again and started having problems with sebaceous hyperplasia (SH) which is often caused by overactive sebaceous glands.  I was prescribed Retin-a with a hope to minimize the growth and prevent others from forming even though the literature shows limited efficacy.  I've been using Retin A off and on for the past 3yrs with little help for the SH but it seemed to keep my acne at bay.  
 
This past summer my acne became considerably worse and often left hyperpigmentation.  I went back to my derm and basically said WTF!  I'm over 40 and yet I'm breaking out like a teenager with oily skin! He wanted to put me on differin and I told him no because I've used it before and it really irritates my skin with no effect. I told him I've been doing the research and would like to be put on a low-dose accutane regimen.  He said he didn't have any problems with doing that but the research states that a second round of accutane at low-dose isn't as effective.  He prescribed me 20mg and I've been taking it for the past 10days but I've also continued to use .025% retin-a cream.
 
10 Days in:
  • Previous active pimples have completely healed.  
  • I do have a few new small pimples but they seem to heal much faster now.  
  • My lips are fairly dry but nothing lip balm won't fix
  • Seemingly less oily skin but my nose is still oily
  • Hyperpigmentation has diminished
  • Sebaceous hyperplasia seems to be diminishing
  • Skin exfoliates much more than before and I had a great deal of skin cell turnover on retin-A
Random thoughts:
  • My skin is both extremely dry and oily. If I don't moisturize it after I wash, it is like dry mud and will literally crack.
  • I'm also going to try using MoM and Niacinamide to help reduce sebum production
  • I've got sore muscles and joints but thats because I've started back on P90x exercise routine after being a sloth for months.  I know many people are scared of the side effects of accutane and they should be.  But I find that people often mistaken correlation with causation. If you're looking for a problem, you'll most likely find it.
Products I use:
  • 20mg Accutane
  • .025% retin-a
  • Cetaphil Moisturizing lotion (Used to use Neutrogena Sensitive Skin moisturizer but it really leaves my face looking greasy)
  • Neutrogena Ultra Sensitive face wash
I'll post more updates when I have the time.
 
Thanks everyone for all the great info posted!
 

Edited by 1moretime, 29 October 2013 - 05:12 PM.


#2 1moretime

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Posted 29 October 2013 - 05:18 PM

So I tried MoM and I have to say that it actually works! Its not a miracle cure but somehow it slows down sebum production. Today I tried it just on my forehead and nose and my forehead never really got oily and my nose took longer to become its usual greasy mess. I was fairly skeptical but for now it seems to work or at least I think it does and thats all that matters. :)

Tomorrow I may try it all over but it does have a slight discoloring effect on my face, not really noticeable but I feel like i have makeup on.

#3 1moretime

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Posted 31 October 2013 - 08:19 PM

Day 15...

 

Ok the MoM over my entire face experiment was a bust. My face is way to dry after washing to use MoM all over, I'll stick to moisturizer.  I'll keep using it on my nose.

 

  • Face is clear no breakouts!
  • Odd sensitivity: I can wash my face with a exfoliating soap with no problems but last night tried using Neutrogena ultra sensitive skin care and it stung!
  • Nose still oily but the rest of my face is fairly oil free
  • The skin on my face sloughs off like crazy now.  I can literally rub it off with my fingers. Combining topical retinoids and isotretinoin seems to make my skin renew daily!
  • Hyperpigmentation continues to lighten
  • Lips still need lots of balm
  • Some flushing but just make me look slightly more tan
  • No other side effects to speak of

I'm wondering if I'll experience an initial breakout.  I don't know if using retin-a will help mitigate it.  My doc felt that a low dose will minimize any IB.



#4 1moretime

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Posted 05 November 2013 - 11:05 PM

Day 20...

 

I'm amazed at how well 20mg daily is working:

  • Face clear except a small blemish at corner of my nose
  • Using Cetaphil Skin Restoring Body wash as a facial cleanser (gentle on my face and isn't as drying)
  • Stopped using the Retin-A as it was getting a little harsh on my skin
  • Skin has become significantly smoother 
  • Sebaceous Hyperplasia on my nose has all but disappeared with the other larger lesions slowly diminishing
  • Nose and basically the t-zone still oily (not as much) but the rest of my face is dry
  • Still exercising daily with no abnormal joint or muscle aches
  • Lips still dry but I've always had trouble with dry lips
  • No other side effects that I can pinpoint

I'm a little annoyed at myself for not going to the dermatologist a year ago, I would of had a few less scars to deal with!



#5 1moretime

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Posted 10 November 2013 - 09:14 AM

Day 25...

  • Significant reduction in oil on my nose and forehead! surprised.gif
  • No active pimples for the last 5 days
  • Using retin-A every other day.
  • Still using Cetaphil wash
  • Sebaceous Hyperplasia continues to improve!
  • Dry lips and a little drying in the eyes
  • Little more muscle and body aches but that could be due to either exercise or age. wink.png
  • No other side effects

Editorial: 

 

I know many of you are reading these postings to help you decide whether to use isotretinoin and are worried about the possible side effects of the drug.  I think those worries are legitimate and if you are contemplating taking ANY medication, you should have a frank discussion with a physician and do the research on the potential benefits and side effects. My experience with isotretinoin has been great.  It has been everything I could hope for and more. Acne and extremely oily skin has affected both my professional and personal life. Its amazing how even 'small decisions' are impacted by this. i.e. I will often pick a seat where the window or main light source is behind me in order or minimize the glare from the light on my oily skin.

 

I also want to make a comment on some of the topics in this forum that address the possible side effects of the drug.  There is one in particular that has many postings and if you've read it, it can be scary. It seems there are thousands of people posting on that topic with a variety of scary issues but what you will find is that the majority of the posts are from a handful of individuals. These forums (like all forums) can become sort of an echo chamber where very little constructive debate occurs. I would take every posting (including mine) with a large grain of salt!


Edited by 1moretime, 10 November 2013 - 09:15 AM.


#6 JJ

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Posted 11 November 2013 - 06:42 AM

Hi 1moretime,

 

Having just started on low dose accutane (20mg, 3 times a week) I am interested to read your log.

How long are you planning to take accutane for and are you going to taper your dose at some stage?

 

Day 25...

  • Significant reduction in oil on my nose and forehead! surprised.gif
  • No active pimples for the last 5 days
  • Using retin-A every other day.
  • Still using Cetaphil wash
  • Sebaceous Hyperplasia continues to improve!
  • Dry lips and a little drying in the eyes
  • Little more muscle and body aches but that could be due to either exercise or age. wink.png
  • No other side effects

Editorial: 

 

I know many of you are reading these postings to help you decide whether to use isotretinoin and are worried about the possible side effects of the drug.  I think those worries are legitimate and if you are contemplating taking ANY medication, you should have a frank discussion with a physician and do the research on the potential benefits and side effects. My experience with isotretinoin has been great.  It has been everything I could hope for and more. Acne and extremely oily skin has affected both my professional and personal life. Its amazing how even 'small decisions' are impacted by this. i.e. I will often pick a seat where the window or main light source is behind me in order or minimize the glare from the light on my oily skin.

 

I also want to make a comment on some of the topics in this forum that address the possible side effects of the drug.  There is one in particular that has many postings and if you've read it, it can be scary. It seems there are thousands of people posting on that topic with a variety of scary issues but what you will find is that the majority of the posts are from a handful of individuals. These forums (like all forums) can become sort of an echo chamber where very little constructive debate occurs. I would take every posting (including mine) with a large grain of salt!



#7 1moretime

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Posted 11 November 2013 - 08:24 PM

Honestly, I haven't really decided on what I'm going to do.  I didn't expect it to work so fast this time on such a low dose so that has made me somewhat complacent on my 'long term' plan.  Here is what I think I'm going to do:

  • I have a 1 month followup visit with my derm next week where I'll have blood work done. If everything is fine, I'll start to taper off to see how my face reacts.
  • I will try taking 20mg every other day for two weeks to see if there is any negative changes (i.e. more pimples and oily skin)
  • If the every other day/2 week trial has no negative effect, I think I'll then go to 2 days a week.

I would like to eventually try to take 20mg once a week as a long term solution but I first need to see how I react to the other dosage levels.  I know there isn't a tremendous amount of clinical research on low dose, maintenance of isotretinoin but I've read posters in this forum that seem to have good results on low dose programs.  I'm hoping that my body reacts similarly but obviously I won't know until I try it.  I will definitely provide updates as needed.

 

JJ, were you on a 'regular' dosage level previous to your low dose experiment?

 

Hi 1moretime,

 

Having just started on low dose accutane (20mg, 3 times a week) I am interested to read your log.

How long are you planning to take accutane for and are you going to taper your dose at some stage?



#8 JJ

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Posted 12 November 2013 - 11:52 AM

Hey,

 

I did two 'regular' courses, one when i was 19 and one at 20. I am now 32 and as neither resulted in any long-term remission I figured this time I would try a low maintenance dose. So far at day 16 and just breaking out a bit.

 

Honestly, I haven't really decided on what I'm going to do.  I didn't expect it to work so fast this time on such a low dose so that has made me somewhat complacent on my 'long term' plan.  Here is what I think I'm going to do:

  • I have a 1 month followup visit with my derm next week where I'll have blood work done. If everything is fine, I'll start to taper off to see how my face reacts.
  • I will try taking 20mg every other day for two weeks to see if there is any negative changes (i.e. more pimples and oily skin)
  • If the every other day/2 week trial has no negative effect, I think I'll then go to 2 days a week.

I would like to eventually try to take 20mg once a week as a long term solution but I first need to see how I react to the other dosage levels.  I know there isn't a tremendous amount of clinical research on low dose, maintenance of isotretinoin but I've read posters in this forum that seem to have good results on low dose programs.  I'm hoping that my body reacts similarly but obviously I won't know until I try it.  I will definitely provide updates as needed.

 

JJ, were you on a 'regular' dosage level previous to your low dose experiment?

 


#9 1moretime

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Posted 20 November 2013 - 09:06 PM

Day 35...

 

So my 1 month checkup with the Doc occurred 34 days after I started my 20mg journey, so I've had an unintended 5 day (1 extra day for them to get the blood work back and send in my script) break from accutane:

 

  • Only one pimple on my chin but that occurred before my 'break'
  • No other pimples
  • Cheeks remarkably oil free
  • experienced a little more oil on my nose during the break
  • Still very dry lips
  • No other side effects that I've noticed

I think I'm going to try an every other day routine for awhile to see how my face reacts.  One interesting observation I've made with my skin is that the pores on my nose 'appear' larger.  I know they're not larger but because they no longer have any sebum plugs and less oil in them, they seem larger.  I would equate this to seeing pot holes in the road that haven't been patched. smile.png I noticed this the last time I was on accutane as well. 


Edited by 1moretime, 20 November 2013 - 09:07 PM.


#10 1moretime

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Posted 07 December 2013 - 09:09 PM

Day 53

Well my experiment with taking 20mgs every other day ended couple days after I started when I experienced a few pimples but honestly that could of been the extended break I had due to the gap in my prescriptions. Im back on 20mg every day and doing great. No active blemishes and my skin has a very even complexion.

- A little bit more oil on my skin, T-zone especially but still manageable
- Skin moisture has been much better in the last few weeks
- Still dry lips but nothing lipbalm won't cure
- No other side effects

Maybe I'll go back to every other day after 90 days...

#11 1moretime

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Posted 25 March 2014 - 05:16 AM

Well, it's been six months and so far everything is great.  I've actually been basically off the meds for a month (seems to be a short supply in my area):

 

  • No acne in the last 4 months
  • Only oily around my nose
  • Dry lips
  • Dry skin
  • No other side effects

I'm going to try a 1 a week dosage plan for the remainder of my prescription.  Should take me out to about a year.  I'll update my post with any news (good or bad).

 

Thanks and good luck to others who are starting accutane. 




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