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28 M, First Time, Totally Depressed But Hoping This Is The Turning Point

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#1 good3nough

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Posted 13 December 2013 - 06:25 AM

Hey everyone, I've been lurking for a couple of months now, finally got the urge to post my own log.  I'm a 28 M, had very clear skin until I was 23.  Never really even had a single breakout up until then.  About a year after I graduated, I decided to forgo the standard corporate route and decided to try to start my own business.  After an extremely stressful deadline for a project, I started breaking out, and it hasn't stopped since.  

 

I've tried changing my diet to the point where I'm only eating brown rice, whole wheat bread, fish and chicken, and veggies.  No sweets, very little alcohol, and 8-9 hours of sleep a day. About 2 1/2 years ago started going to the gym 6 days a week, lifting, cardio, and yoga, but it actually made it worse.  Whenever I did a physically stressful activity, I would experience a lot of inflammation and I'm sure the sweat didn't help either.  But I ended up loving working out and feeling great so I haven't stopped until recently when my IB got out of control and I couldn't face seeing all those people.  Before when I would breakout, I would just go at 2 AM when there was literally no one at the gym except a couple employees.  Now the gym has cut the hours from 24/7 to being closed from 12AM - 4AM.  As I was a regular for a couple years already, I am friends with dozens of people there, so I don't feel comfortable going anymore.  I plan on going at 4AM starting next week, but that time is really inconvenient for me so we'll see.

 

Anyway, I've been diagnosed with rosacea on top of the acne.  I started on doxy, which worked decently well for a couple of months, then I tried minocycline which worked for about 3-4 months and then actually came back worse than ever.  I've tried tretinoin, erythromycin, metrogel, finacea, proactiv, and 5 % bp wash.  They all helped reduce the acne by about 20-30%, but the 70% leftover was still pretty awful.  It was also exhausting always having to have these creams and pills to deal with day in and day out.  Changing the pillow cases, going through new towels every time I washed anything, very stringent shower schedules, and then of course obsessing in the mirror and whenever I thought things were getting better, constantly getting gut punched by another couple of inconveniently placed cysts.

 

It's been the most frustrating 5 years of my life.  I never visit my clients in NYC because I can't bear the embarrassment.  I used to think "everyone is too busy with their own lives to care about my acne", but it's really not true at all.  The first time I went to see my clients, I had one of them ask me, "hey have you been eating a lot of greasy food lately?".  And then he launched into a 10 minute discussion about it.  Also, I have family members who will come right up to you and ask you what's wrong with your face.  I'm very outgoing but nowadays I just hibernate.  It's also funny to see the difference in my luck with women.  Before I had acne the energy was so much different, and if we hit it off, then naturally things would progress.  Nowadays, even when we hit it off, I can tell that they don't find me attractive.  I don't blame them at all, I just find life to be very unjust at this point.

 

So enough of the rant.  I finally got sick of everything, and despite reading all the dangers of accutane, about 2 months ago I got my derm to prescribe it to me.  He prescribed 60mg (I weigh 150lbs) for the 1st month.  I didn't have too bad of an IB (hence I was still willing to venture out to the gym), but was extremely sore after workouts, to the point where I was sleeping 12 hours a day.  Another side effect I experienced were the headaches if I didn't drink a ton of water.  I was also depressed, not because of accutane, but just because of acne making me feel helpless.

 

On the 2nd appt, my derm said he wanted to up my dosage, and said that studies have shown that higher dosages increase the likelihood of permanent remission, and asked me if I wanted to get aggressive with it.  Of course, I said hell yes.  So he prescribed 100mg.  A few days into it I got the official IB, with about half a dozen cysts, a couple of which were HUGE.  I've been pretty good about not picking, even though everyone in my large extended family stares at me and pities me, which really makes me want to pick some days.  So i'm now 15 days into 100 mg, and hopefully I'll stay at 100mg for the rest of the course.  The only thing I'm worried about is my triglycerides getting too high, as my last blood test shows that it shot up a bit from 150 to 251.  Still just in the range of good, but I just need it to stay that way for a couple more months!  Anyway, I'll try to post updates.  Good luck to everyone else!



#2 elkhoundgold

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Posted 13 December 2013 - 12:03 PM

Hey everyone, I've been lurking for a couple of months now, finally got the urge to post my own log.  I'm a 28 M, had very clear skin until I was 23.  Never really even had a single breakout up until then.  About a year after I graduated, I decided to forgo the standard corporate route and decided to try to start my own business.  After an extremely stressful deadline for a project, I started breaking out, and it hasn't stopped since.  

 

I've tried changing my diet to the point where I'm only eating brown rice, whole wheat bread, fish and chicken, and veggies.  No sweets, very little alcohol, and 8-9 hours of sleep a day. About 2 1/2 years ago started going to the gym 6 days a week, lifting, cardio, and yoga, but it actually made it worse.  Whenever I did a physically stressful activity, I would experience a lot of inflammation and I'm sure the sweat didn't help either.  But I ended up loving working out and feeling great so I haven't stopped until recently when my IB got out of control and I couldn't face seeing all those people.  Before when I would breakout, I would just go at 2 AM when there was literally no one at the gym except a couple employees.  Now the gym has cut the hours from 24/7 to being closed from 12AM - 4AM.  As I was a regular for a couple years already, I am friends with dozens of people there, so I don't feel comfortable going anymore.  I plan on going at 4AM starting next week, but that time is really inconvenient for me so we'll see.

 

Anyway, I've been diagnosed with rosacea on top of the acne.  I started on doxy, which worked decently well for a couple of months, then I tried minocycline which worked for about 3-4 months and then actually came back worse than ever.  I've tried tretinoin, erythromycin, metrogel, finacea, proactiv, and 5 % bp wash.  They all helped reduce the acne by about 20-30%, but the 70% leftover was still pretty awful.  It was also exhausting always having to have these creams and pills to deal with day in and day out.  Changing the pillow cases, going through new towels every time I washed anything, very stringent shower schedules, and then of course obsessing in the mirror and whenever I thought things were getting better, constantly getting gut punched by another couple of inconveniently placed cysts.

 

It's been the most frustrating 5 years of my life.  I never visit my clients in NYC because I can't bear the embarrassment.  I used to think "everyone is too busy with their own lives to care about my acne", but it's really not true at all.  The first time I went to see my clients, I had one of them ask me, "hey have you been eating a lot of greasy food lately?".  And then he launched into a 10 minute discussion about it.  Also, I have family members who will come right up to you and ask you what's wrong with your face.  I'm very outgoing but nowadays I just hibernate.  It's also funny to see the difference in my luck with women.  Before I had acne the energy was so much different, and if we hit it off, then naturally things would progress.  Nowadays, even when we hit it off, I can tell that they don't find me attractive.  I don't blame them at all, I just find life to be very unjust at this point.

 

So enough of the rant.  I finally got sick of everything, and despite reading all the dangers of accutane, about 2 months ago I got my derm to prescribe it to me.  He prescribed 60mg (I weigh 150lbs) for the 1st month.  I didn't have too bad of an IB (hence I was still willing to venture out to the gym), but was extremely sore after workouts, to the point where I was sleeping 12 hours a day.  Another side effect I experienced were the headaches if I didn't drink a ton of water.  I was also depressed, not because of accutane, but just because of acne making me feel helpless.

 

On the 2nd appt, my derm said he wanted to up my dosage, and said that studies have shown that higher dosages increase the likelihood of permanent remission, and asked me if I wanted to get aggressive with it.  Of course, I said hell yes.  So he prescribed 100mg.  A few days into it I got the official IB, with about half a dozen cysts, a couple of which were HUGE.  I've been pretty good about not picking, even though everyone in my large extended family stares at me and pities me, which really makes me want to pick some days.  So i'm now 15 days into 100 mg, and hopefully I'll stay at 100mg for the rest of the course.  The only thing I'm worried about is my triglycerides getting too high, as my last blood test shows that it shot up a bit from 150 to 251.  Still just in the range of good, but I just need it to stay that way for a couple more months!  Anyway, I'll try to post updates.  Good luck to everyone else!

 

I want to say those family members and clients are extremely immature. Would they go up to a random person and say that on the street? No--I think they'd be shot. o.O Anywaiz, try to stop worrying about them it is they who have the problem and not you...anyone who focuses on your face more than themselves means they are insecure no?? Please watch yourself on a dose that high i am going for low dose but those doses can kill your hair if you have any terrible side effects you should probably stop and lower dose



#3 megtree

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Posted 13 December 2013 - 04:30 PM

Wow! I am probably completely wrong,  but I have looked at alot of personal logs and stuff for Accutane and I haven't heard of anyone being on 100mg except for things like hidradenitis supperativa. In any case, if you are having a severe IB, you should definitely talk to your doc, he might be able to prescribe you corticosteroids and/or antibiotics  (non-tetracycline) to reduce the inflammation. My derm recommended prescribing azythromicin to me during the first couple weeks (I start the Monday after next) to pre-empt or counter-act the IB. Maybe you could bring this up to him?

 

Also, please don't listen to your clients or family members who say things like that. People without chronic acne simple cannot understand the pain and frustration that it brings. Yes, everyone has had a "break-out" here and there, but unless you have dealt with consistent levels of acne for extended periods of time, you cant understand. Many people still see acne as having either behavioral or psychologically routed causes (ever hear, "if you stop worrying about it, it will probably go away"), but in fact, acne - especially adult acne- it is a chronic disease we have to live with and treat throughout our life-time. Perhaps reminding these people (your family especially, perhaps not your business clients) of that will help.

 

Also, congrats for being a non-lurker! I suppose I still have lurking status since I haven't yet created a post of my own, but I have noticed that since I have increased my activity on this site, that I feel much better about my acne. For the most part, everyone here is extremely supportive, understanding and kind.

 

My Accutane log (with pictures):
 
 http://www.acne.org/...r-accutane-log/
 
26 y/o female- approx. 54kg
Absorica -40 mg, 1 daily, December 26, 2013 - February, 25, 2014
Absorica - 60 mg, 1 daily. February 26, 2014 -
Probiotic - 1 daily
Fish oil supplement w/ vit D - 1 daily

Morning:
Cetaphil cleanser
Food Grade Rose water - Toner
La Roche Posay Mineral Water Spray
Vichy 50+ Capital Soleil Cream for Sensitive Skin


Night:
Cetaphil Cleanser
Food grade Rose Water - Toner
La Roche Posay Mineral Water Spray
Aveeno Positively Radiant intensive night cream
Cerave Facial Moisturizing Lotion- PM
Cerave Moisturizing cream
Avene Cicalfate (as needed)


#4 good3nough

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Posted 25 December 2013 - 05:38 PM

@elkhoundgold: thanks for replying.  It always makes me feel a little less alone in this battle when there are people like you guys out there that can empathize.  I have been careful to watch for any side effects, but to be honest, I felt more side effects during the first month at 60mg than the 100mg.  Probably just my body getting used to the drug.

 

@megtree: you're right about it being irregular for such a high dosage.  I scoured the logs and there's only a handful of people who have been on 100mg+.  Seems like everyone else is at the 20-80mg range.  I asked my derm about it and he said that he didn't want to dogmatically stick to the guidelines, and that the more aggressive we are, the higher likelihood that I won't relapse in the future.  With that said, he's advised me that if I ever felt any side effects, I should just skip a pill to effectively lower the dosage to 60-80mg.  I've been feeling pretty good lately, no real side effects (knock on wood) other than chapped lips and an epic IB earlier in the month.  I wish I could explain what chronic acne is like to my family, but they aren't the kind of people to be thoughtful and empathetic enough to understand.

 

As far a general update, I'm now at day 56!  4 more days at 100 mg!  I had my derm appt a few days ago, and it looks like my cholesterol levels are getting pretty high, my LDL is at ~200.  I know the jump from 60mg to 100mg has something to do with this, but I've also been pretty depressed lately and eating somewhat poorly.  Nothing too crazy, just not as clean as I used to.  Additionally, since my epic IB I stopped going to the gym, which I was doing 6 days a week previously.  Everyone is always staring at me, so it was just better for my mental well being to stop for a little while.  I normally go at 2 AM when the gym is empty but they reduced the hours so now the best time is to go at 4AM when only a few people are there.  In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course.  My derm mentioned that if my cholesterol levels get worse I'll either have to lower the dosage or take a cholesterol lowering drug.  As far as my skin goes, it's been a lot better since the beginning of the month, but since I have done almost ZERO picking (very proud about this since it takes all of my willpower), everything just seems to take much longer to heal.

 

Another thing I wanted to share was that I celebrated x-mas yesterday with the extended family.  It's about 30+ people, so it's a pretty decent sized gathering.  B/c of the horrible IB, my skin was not looking so hot and everyone made sure I knew it.  My aunts and uncles would say 'PIMPLE PIMPLE PIMPLE, eww', or 'let me pop those for you.  it looks so DIRTY and DISGUSTING'.  'His problem is that he just needs to get laid'  'he won't listen to our advice!  Ha!  Only DOCTOR DOCTOR DOCTOR!'  My cousins would bring their digital SLR camera right up to my face and start taking pictures to make everyone laugh.  They even zoomed in on it and passed around the pictures.  I didn't want to be defensive about it and tell them where they could stick it, because a) i'm tired and exhausted of it and b) I wanted to try to just go with the flow and let the bullets bounce off.  My shield was surprisingly strong, but I just felt bad for myself in this weird 3rd person point of view.  I was really disgusted by their actions, just on a human level.  No one stood up for me at all.  If someone else was in that position I would have grabbed the camera and told them they were being a disrespectful dickhead and that they just lost my respect.  These are people I cared about, and whenever they were down on their luck I would empathize with them and always try to make them feel better and just laugh about life.  And then when I'm going through something terrible like chronic, cystic acne, they go the complete opposite route and shit all over me in this really inhumane way.  It's totally crazy.  ON CHRISTMAS too!  I just can't understand it at all.  The whole 'no one cares as much as you' is totally BS and the world constantly proves this to me.  Lost a lot of faith in the world last night.  MERRY CHRISTMAS!  LOL



#5 igotyouu

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Posted 25 December 2013 - 07:14 PM

Wow, that sounds like a pretty terrible experience, my friend.  It makes me very sorry you had to sit there and be a model to all that crap, but it makes me even more mad that people can do things like that, that's fucking disgusting, excuse my swearing here. Inhumane is a good word to use here exactly like you did. No man on earth should go through something like that,

 

I have been in a situation just like yours some years ago. I had a gigantic pimple just at the tip at my nose, one of those that were really obvious, red and inflamed. It was my younger sisters birthday so the whole family were gathering at our house for the party. I was sitting at the table when my aunt shouted "That's the biggest zit I've ever seen in my life" and soon everybody was gathering around me to inspect it. Damn, I felt low at that moment and several days later not to be kidding. It was that moment, yes that moment, that made me so incredible obsessed with my skin, back before that I didn't really care about my acne that much. 

 

I'm still obsessed with my skin, but its getting better. When I have bad skin days I feel so extremely low and frustrated and I have that moment to blame for it.. I know how you feel.

 

We're in this together.


Edited by igotyouu, 25 December 2013 - 07:19 PM.


#6 Frasier

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Posted 25 December 2013 - 07:47 PM

Wow, what a sad story. I feel so bad for you and so pissed about your family's behavior. I really hope you managed to have a decent day. I spent Christmas Eve alone since I have an ongoing 'fight' with my family so you are not alone :P

Be strong, my friend, you seem like a very intelligent and funny guy and please get in touch if you feel for it. 

 

And who knows, maybe Hydrogel will make everything go away faster than we believe. Gotta have faith!



#7 jjj333kkk2

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Posted 25 December 2013 - 09:26 PM

Interesting.


Edited by jjj333kkk2, 12 May 2014 - 08:54 PM.


#8 megtree

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Posted 26 December 2013 - 12:52 PM

@elkhoundgold: thanks for replying.  It always makes me feel a little less alone in this battle when there are people like you guys out there that can empathize.  I have been careful to watch for any side effects, but to be honest, I felt more side effects during the first month at 60mg than the 100mg.  Probably just my body getting used to the drug.
 
@megtree: you're right about it being irregular for such a high dosage.  I scoured the logs and there's only a handful of people who have been on 100mg+.  Seems like everyone else is at the 20-80mg range.  I asked my derm about it and he said that he didn't want to dogmatically stick to the guidelines, and that the more aggressive we are, the higher likelihood that I won't relapse in the future.  With that said, he's advised me that if I ever felt any side effects, I should just skip a pill to effectively lower the dosage to 60-80mg.  I've been feeling pretty good lately, no real side effects (knock on wood) other than chapped lips and an epic IB earlier in the month.  I wish I could explain what chronic acne is like to my family, but they aren't the kind of people to be thoughtful and empathetic enough to understand.
 
As far a general update, I'm now at day 56!  4 more days at 100 mg!  I had my derm appt a few days ago, and it looks like my cholesterol levels are getting pretty high, my LDL is at ~200.  I know the jump from 60mg to 100mg has something to do with this, but I've also been pretty depressed lately and eating somewhat poorly.  Nothing too crazy, just not as clean as I used to.  Additionally, since my epic IB I stopped going to the gym, which I was doing 6 days a week previously.  Everyone is always staring at me, so it was just better for my mental well being to stop for a little while.  I normally go at 2 AM when the gym is empty but they reduced the hours so now the best time is to go at 4AM when only a few people are there.  In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course.  My derm mentioned that if my cholesterol levels get worse I'll either have to lower the dosage or take a cholesterol lowering drug.  As far as my skin goes, it's been a lot better since the beginning of the month, but since I have done almost ZERO picking (very proud about this since it takes all of my willpower), everything just seems to take much longer to heal.
 
Another thing I wanted to share was that I celebrated x-mas yesterday with the extended family.  It's about 30+ people, so it's a pretty decent sized gathering.  B/c of the horrible IB, my skin was not looking so hot and everyone made sure I knew it.  My aunts and uncles would say 'PIMPLE PIMPLE PIMPLE, eww', or 'let me pop those for you.  it looks so DIRTY and DISGUSTING'.  'His problem is that he just needs to get laid'  'he won't listen to our advice!  Ha!  Only DOCTOR DOCTOR DOCTOR!'  My cousins would bring their digital SLR camera right up to my face and start taking pictures to make everyone laugh.  They even zoomed in on it and passed around the pictures.  I didn't want to be defensive about it and tell them where they could stick it, because a) i'm tired and exhausted of it and b) I wanted to try to just go with the flow and let the bullets bounce off.  My shield was surprisingly strong, but I just felt bad for myself in this weird 3rd person point of view.  I was really disgusted by their actions, just on a human level.  No one stood up for me at all.  If someone else was in that position I would have grabbed the camera and told them they were being a disrespectful dickhead and that they just lost my respect.  These are people I cared about, and whenever they were down on their luck I would empathize with them and always try to make them feel better and just laugh about life.  And then when I'm going through something terrible like chronic, cystic acne, they go the complete opposite route and shit all over me in this really inhumane way.  It's totally crazy.  ON CHRISTMAS too!  I just can't understand it at all.  The whole 'no one cares as much as you' is totally BS and the world constantly proves this to me.  Lost a lot of faith in the world last night.  MERRY CHRISTMAS!  LOL

To be honest, While you are going through this, I would simply stay away from those people and seek out others to spend time with. Most people are just NOT like that. I would say my case is rather moderate/severe, and I have never been treated with that level of disrespect by anyone in terms of my acne, much less friends or family. I've noticed that most people don't even really want to talk about it! Right now you need to take care of your health and sanity so you can go into remission and come out of this experience with a sound mind and body. If you can, make an effort to avoid those family members.

In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course. 

 
You are taking absurdly high daily doses for your weight (150 lb => 68 kg). Both 100 mg/day and your planned 120 mg/day are dangerous and unnecessary. The chances of acne remission are correlated with cumulative dose, not daily dose.
 
What is the severity of your acne? With a daily dose so high, it seems that your derm wants to take you higher than the highest recommended cumulative dose, which is 150 mg/kg. But you shouldn't do that, unless your acne is of exceptional severity.
 
Even a ridiculously high cumulative dose of 200 mg/kg could be done at your weight with 7 months at 65 mg/day. It is much safer to take relatively low doses for a long period of time than the reverse.
 
You are risking permanent side effects once you are done your course with such a high daily dose. The more severe a side effect is during your course, the more likely it will remain with you once the course is over. For example, you have been diagnosed with roseca. Isotretinion at high doses is just about the worst thing for roseca, since it makes your skin fragile and causes you to flush quite easily. Just do a Google search for "Accutane-induced roseca" or "flushing on Accutane." 
 
Just for comparison, I weigh close to what you do (140 lb => 64 kg), and I'm starting out with 30 mg/day and topping out at 40 mg/day for a 7-month course totaling a cumulative dose of 120 mg/kg. This is what a typical dose for this weight looks like.

My Accutane log (with pictures):
 
 http://www.acne.org/...r-accutane-log/
 
26 y/o female- approx. 54kg
Absorica -40 mg, 1 daily, December 26, 2013 - February, 25, 2014
Absorica - 60 mg, 1 daily. February 26, 2014 -
Probiotic - 1 daily
Fish oil supplement w/ vit D - 1 daily

Morning:
Cetaphil cleanser
Food Grade Rose water - Toner
La Roche Posay Mineral Water Spray
Vichy 50+ Capital Soleil Cream for Sensitive Skin


Night:
Cetaphil Cleanser
Food grade Rose Water - Toner
La Roche Posay Mineral Water Spray
Aveeno Positively Radiant intensive night cream
Cerave Facial Moisturizing Lotion- PM
Cerave Moisturizing cream
Avene Cicalfate (as needed)


#9 megtree

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Posted 26 December 2013 - 01:20 PM

From what I understand, 120mg/ kg is the MINIMUM cumulative dose recommended. I weight about 120 Ibs (54 kg) and my doctor is starting me off with 40mg, and he said he will definitely be increasing my dosage, probably to 60, I'd Imagine. If you have good labs to begin with or your doctor trusts you to be compliant (I.e., stopping at the first sign of severe side effects) then higher dosages aren't so scary. Honestly, from what I've read and based

@elkhoundgold: thanks for replying.  It always makes me feel a little less alone in this battle when there are people like you guys out there that can empathize.  I have been careful to watch for any side effects, but to be honest, I felt more side effects during the first month at 60mg than the 100mg.  Probably just my body getting used to the drug.
 
@megtree: you're right about it being irregular for such a high dosage.  I scoured the logs and there's only a handful of people who have been on 100mg+.  Seems like everyone else is at the 20-80mg range.  I asked my derm about it and he said that he didn't want to dogmatically stick to the guidelines, and that the more aggressive we are, the higher likelihood that I won't relapse in the future.  With that said, he's advised me that if I ever felt any side effects, I should just skip a pill to effectively lower the dosage to 60-80mg.  I've been feeling pretty good lately, no real side effects (knock on wood) other than chapped lips and an epic IB earlier in the month.  I wish I could explain what chronic acne is like to my family, but they aren't the kind of people to be thoughtful and empathetic enough to understand.
 
As far a general update, I'm now at day 56!  4 more days at 100 mg!  I had my derm appt a few days ago, and it looks like my cholesterol levels are getting pretty high, my LDL is at ~200.  I know the jump from 60mg to 100mg has something to do with this, but I've also been pretty depressed lately and eating somewhat poorly.  Nothing too crazy, just not as clean as I used to.  Additionally, since my epic IB I stopped going to the gym, which I was doing 6 days a week previously.  Everyone is always staring at me, so it was just better for my mental well being to stop for a little while.  I normally go at 2 AM when the gym is empty but they reduced the hours so now the best time is to go at 4AM when only a few people are there.  In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course.  My derm mentioned that if my cholesterol levels get worse I'll either have to lower the dosage or take a cholesterol lowering drug.  As far as my skin goes, it's been a lot better since the beginning of the month, but since I have done almost ZERO picking (very proud about this since it takes all of my willpower), everything just seems to take much longer to heal.
 
Another thing I wanted to share was that I celebrated x-mas yesterday with the extended family.  It's about 30+ people, so it's a pretty decent sized gathering.  B/c of the horrible IB, my skin was not looking so hot and everyone made sure I knew it.  My aunts and uncles would say 'PIMPLE PIMPLE PIMPLE, eww', or 'let me pop those for you.  it looks so DIRTY and DISGUSTING'.  'His problem is that he just needs to get laid'  'he won't listen to our advice!  Ha!  Only DOCTOR DOCTOR DOCTOR!'  My cousins would bring their digital SLR camera right up to my face and start taking pictures to make everyone laugh.  They even zoomed in on it and passed around the pictures.  I didn't want to be defensive about it and tell them where they could stick it, because a) i'm tired and exhausted of it and b) I wanted to try to just go with the flow and let the bullets bounce off.  My shield was surprisingly strong, but I just felt bad for myself in this weird 3rd person point of view.  I was really disgusted by their actions, just on a human level.  No one stood up for me at all.  If someone else was in that position I would have grabbed the camera and told them they were being a disrespectful dickhead and that they just lost my respect.  These are people I cared about, and whenever they were down on their luck I would empathize with them and always try to make them feel better and just laugh about life.  And then when I'm going through something terrible like chronic, cystic acne, they go the complete opposite route and shit all over me in this really inhumane way.  It's totally crazy.  ON CHRISTMAS too!  I just can't understand it at all.  The whole 'no one cares as much as you' is totally BS and the world constantly proves this to me.  Lost a lot of faith in the world last night.  MERRY CHRISTMAS!  LOL

To be honest, While you are going through this, I would simply stay away from those people and seek out others to spend time with. Most people are just NOT like that. I would say my case is rather moderate/severe, and I have never been treated with that level of disrespect by anyone in terms of my acne, much less friends or family. I've noticed that most people don't even really want to talk about it! Right now you need to take care of your health and sanity so you can go into remission and come out of this experience with a sound mind and body. If you can, make an effort to avoid those family members.

In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course. 

 
You are taking absurdly high daily doses for your weight (150 lb => 68 kg). Both 100 mg/day and your planned 120 mg/day are dangerous and unnecessary. The chances of acne remission are correlated with cumulative dose, not daily dose.
 
What is the severity of your acne? With a daily dose so high, it seems that your derm wants to take you higher than the highest recommended cumulative dose, which is 150 mg/kg. But you shouldn't do that, unless your acne is of exceptional severity.
 
Even a ridiculously high cumulative dose of 200 mg/kg could be done at your weight with 7 months at 65 mg/day. It is much safer to take relatively low doses for a long period of time than the reverse.
 
You are risking permanent side effects once you are done your course with such a high daily dose. The more severe a side effect is during your course, the more likely it will remain with you once the course is over. For example, you have been diagnosed with roseca. Isotretinion at high doses is just about the worst thing for roseca, since it makes your skin fragile and causes you to flush quite easily. Just do a Google search for "Accutane-induced roseca" or "flushing on Accutane." 
 
Just for comparison, I weigh close to what you do (140 lb => 64 kg), and I'm starting out with 30 mg/day and topping out at 40 mg/day for a 7-month course totaling a cumulative dose of 120 mg/kg. This is what a typical dose for this weight looks like.

From what I understand, 120mg/ kg is the MINIMUM cumulative dose recommended. I weight about 120 Ibs (54 kg) and my doctor is starting me off with 40mg, and he said he will definitely be increasing my dosage, probably to 60, I'd Imagine. If you have good labs to begin with or your doctor trusts you to be compliant (I.e., stopping at the first sign of severe side effects) then higher dosages aren't so scary. Honestly, from what I've read and based on what others have said- your dose is rather low, and 7 months is a rather long time to be on the drug if you don't have to be. Most doctor's I've spoken to seem to think it better to get your cumulative dose in as fast as your body can healthfully tolerate, rather than dragging out the time on the medicine when it might not be necessary. As long as you stop taking the medicine AS SOON AS you notice potentially negative side effects, it is unlikely for them to become permanent.

My Accutane log (with pictures):
 
 http://www.acne.org/...r-accutane-log/
 
26 y/o female- approx. 54kg
Absorica -40 mg, 1 daily, December 26, 2013 - February, 25, 2014
Absorica - 60 mg, 1 daily. February 26, 2014 -
Probiotic - 1 daily
Fish oil supplement w/ vit D - 1 daily

Morning:
Cetaphil cleanser
Food Grade Rose water - Toner
La Roche Posay Mineral Water Spray
Vichy 50+ Capital Soleil Cream for Sensitive Skin


Night:
Cetaphil Cleanser
Food grade Rose Water - Toner
La Roche Posay Mineral Water Spray
Aveeno Positively Radiant intensive night cream
Cerave Facial Moisturizing Lotion- PM
Cerave Moisturizing cream
Avene Cicalfate (as needed)


#10 ciaraki13

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Posted 26 December 2013 - 06:25 PM

@elkhoundgold: thanks for replying.  It always makes me feel a little less alone in this battle when there are people like you guys out there that can empathize.  I have been careful to watch for any side effects, but to be honest, I felt more side effects during the first month at 60mg than the 100mg.  Probably just my body getting used to the drug.

 

@megtree: you're right about it being irregular for such a high dosage.  I scoured the logs and there's only a handful of people who have been on 100mg+.  Seems like everyone else is at the 20-80mg range.  I asked my derm about it and he said that he didn't want to dogmatically stick to the guidelines, and that the more aggressive we are, the higher likelihood that I won't relapse in the future.  With that said, he's advised me that if I ever felt any side effects, I should just skip a pill to effectively lower the dosage to 60-80mg.  I've been feeling pretty good lately, no real side effects (knock on wood) other than chapped lips and an epic IB earlier in the month.  I wish I could explain what chronic acne is like to my family, but they aren't the kind of people to be thoughtful and empathetic enough to understand.

 

As far a general update, I'm now at day 56!  4 more days at 100 mg!  I had my derm appt a few days ago, and it looks like my cholesterol levels are getting pretty high, my LDL is at ~200.  I know the jump from 60mg to 100mg has something to do with this, but I've also been pretty depressed lately and eating somewhat poorly.  Nothing too crazy, just not as clean as I used to.  Additionally, since my epic IB I stopped going to the gym, which I was doing 6 days a week previously.  Everyone is always staring at me, so it was just better for my mental well being to stop for a little while.  I normally go at 2 AM when the gym is empty but they reduced the hours so now the best time is to go at 4AM when only a few people are there.  In any case, for month 3 I'll be increasing to 120mg, which is where I'll probably stay at for the rest of the course.  My derm mentioned that if my cholesterol levels get worse I'll either have to lower the dosage or take a cholesterol lowering drug.  As far as my skin goes, it's been a lot better since the beginning of the month, but since I have done almost ZERO picking (very proud about this since it takes all of my willpower), everything just seems to take much longer to heal.

 

Another thing I wanted to share was that I celebrated x-mas yesterday with the extended family.  It's about 30+ people, so it's a pretty decent sized gathering.  B/c of the horrible IB, my skin was not looking so hot and everyone made sure I knew it.  My aunts and uncles would say 'PIMPLE PIMPLE PIMPLE, eww', or 'let me pop those for you.  it looks so DIRTY and DISGUSTING'.  'His problem is that he just needs to get laid'  'he won't listen to our advice!  Ha!  Only DOCTOR DOCTOR DOCTOR!'  My cousins would bring their digital SLR camera right up to my face and start taking pictures to make everyone laugh.  They even zoomed in on it and passed around the pictures.  I didn't want to be defensive about it and tell them where they could stick it, because a) i'm tired and exhausted of it and b) I wanted to try to just go with the flow and let the bullets bounce off.  My shield was surprisingly strong, but I just felt bad for myself in this weird 3rd person point of view.  I was really disgusted by their actions, just on a human level.  No one stood up for me at all.  If someone else was in that position I would have grabbed the camera and told them they were being a disrespectful dickhead and that they just lost my respect.  These are people I cared about, and whenever they were down on their luck I would empathize with them and always try to make them feel better and just laugh about life.  And then when I'm going through something terrible like chronic, cystic acne, they go the complete opposite route and shit all over me in this really inhumane way.  It's totally crazy.  ON CHRISTMAS too!  I just can't understand it at all.  The whole 'no one cares as much as you' is totally BS and the world constantly proves this to me.  Lost a lot of faith in the world last night.  MERRY CHRISTMAS!  LOL



I tried to reply but ended up just quoting you somehow. Unsure. I'll type my reply again!

 

That's devastating about your experience. So, so cruel. I haven't that much faith left in humanity after how I have been treated in the past about my skin, but that is soo low.  That is underground. But well done, because (a) you were able to face a group of 30 people and didn't let your skin hold you back (I couldn't do it, or would do it with extremeeee anxiety) and (b) you handled it with such dignity (I would have either cried, told them all to fuck off, smashed their camera or all of the aforementioned). That must have been brutal. When people are being evil about my skin and trying to take a bit of my happiness I like to think of the line: The robbed that smiles, steals something from the thief. Good luck with your journey




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