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Derm Prescribed Over 150 Mg/kg Cumulative Dose... Good For Extreme Oil?

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Hello friends. I'm a 27 year old female finishing up my fourth month of accutane (technically Absorica) and upon seeing my face at a recent derm appointment (I had two pimples and 1 cyst that was in the process of shrinking) she said she's putting me on another month of it. I wasn't too happy to hear this because I've been experiencing lots of annoying side effects like: dry lips (duh), eczema on tops of hands, dry skin, dry bloody nose, fatigue, minor short-term memory loss, lack of concentration and lethargy (probably all from the fatigue), joint pain in knees and back, occasional mild face and arm flushing, mild tane face burn that others have noticed, curticles in nails stopped growing, nails are weak and split and crack easily, and weight loss. I think that's about it in terms of side effects. The most annoying ones are the fatigue, weight loss, and knee pain.

My accutane doses have been the following: month 1: 30mg, months 2 though 5: 60mg. I'm pretty tiny so I weighed about 49kg at the start of my accutane course. According to research, the best and ideal accutane course is a cumulative dosage of 120-150mg per kg. According to that formula, my cumulative dose will be 128mg/kg at the end of 4 months (which I will finish in a few days). At the end of 5 months, which is what my derm just prescribed, my cumulative dose will be 165mg/kg, which is above that 150mg/kg limit.

My acne is moderate to semi-severe at times but persistent and hasn't responded well to all other prescription meds until accutane. My skin is about 92% cleared at this point and continues to improve. My skin was extremely oily before accutane. I could soak one or two of those oil blotting sheets within 1 hour of washing it before starting accutane. It was that bad and the extreme oil would melt any makeup and concealer (even mattifying/oil absorbing powder) I had on within an hour or two to try to cover up my acne. I'm soooo happy with what accutane has done with my oily, shiny disco ball of a face in addition to clearing the acne.

My questions are: should I stop the accutane early once I reach the 150mg/kg? Will going over help prevent as much oil from coming back? Has anyone gone over 150mg\kg and want to share their experience (positive or negative)? Or just share your experiences if you've been in a similar situation, particularly with extremely oily skin? Thanks!

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Hello friends. I'm a 27 year old female finishing up my fourth month of accutane (technically Absorica) and upon seeing my face at a recent derm appointment (I had two pimples and 1 cyst that was in the process of shrinking) she said she's putting me on another month of it. I wasn't too happy to hear this because I've been experiencing lots of annoying side effects like: dry lips (duh), eczema on tops of hands, dry skin, dry bloody nose, fatigue, minor short-term memory loss, lack of concentration and lethargy (probably all from the fatigue), joint pain in knees and back, occasional mild face and arm flushing, mild tane face burn that others have noticed, curticles in nails stopped growing, nails are weak and split and crack easily, and weight loss. I think that's about it in terms of side effects. The most annoying ones are the fatigue, weight loss, and knee pain.

My accutane doses have been the following: month 1: 30mg, months 2 though 5: 60mg. I'm pretty tiny so I weighed about 49kg at the start of my accutane course. According to research, the best and ideal accutane course is a cumulative dosage of 120-150mg per kg. According to that formula, my cumulative dose will be 128mg/kg at the end of 4 months (which I will finish in a few days). At the end of 5 months, which is what my derm just prescribed, my cumulative dose will be 165mg/kg, which is above that 150mg/kg limit.

My acne is moderate to semi-severe at times but persistent and hasn't responded well to all other prescription meds until accutane. My skin is about 92% cleared at this point and continues to improve. My skin was extremely oily before accutane. I could soak one or two of those oil blotting sheets within 1 hour of washing it before starting accutane. It was that bad and the extreme oil would melt any makeup and concealer (even mattifying/oil absorbing powder) I had on within an hour or two to try to cover up my acne. I'm soooo happy with what accutane has done with my oily, shiny disco ball of a face in addition to clearing the acne.

My questions are: should I stop the accutane early once I reach the 150mg/kg? Will going over help prevent as much oil from coming back? Has anyone gone over 150mg\kg and want to share their experience (positive or negative)? Or just share your experiences if you've been in a similar situation, particularly with extremely oily skin? Thanks!

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Thanks for the advice! I'll stick with it this 5th month. As a fellow oily skinned person, I have a few questions I hope you could answer about your accutane experience:

What was your cumulative dose (total mg per kg) for your first round?

How long did the oiliness take to return after stopping your first round?

When the oil returned was it exactly as oily as it was before accutane or was the oiliness reduced by a certain small percentage after accutane compared to before accutane?

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Thanks for the advice! I'll stick with it this 5th month. As a fellow oily skinned person, I have a few questions I hope you could answer about your accutane experience:

What was your cumulative dose (total mg per kg) for your first round?

How long did the oiliness take to return after stopping your first round?

When the oil returned was it exactly as oily as it was before accutane or was the oiliness reduced by a certain small percentage after accutane compared to before accutane?

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I found this peer-reviewed article of a scientific study that suggests that significantly higher cumulative doses (≥220 mg/kg) of isotretinoin are effective for decreasing relapse rates without increasing adverse effects, with the exception of eczema/retinoid dermatitis rashes. The article is entitled: "High-dose isotretinoin treatment and the rate of retrial, relapse, and adverse effects in patients with acne vulgaris."

The group that had cumulative doses less than 220 mg/kg had a relapse rate of 47.4% 12 months after finishing their course. The average cumulative dose for this group was 170mg/kg.

The group that had cumulative doses greater than or equal to 220mg/kg had a relapse rate of 26.9% 12 months after finishing their course. The average cumulative dose in this group was 306mg/kg.

Relapse specifically means that they needed some sort of prescription medication (topicals, etc.), but not accutane, to control their acne within those 12 months. Retrial rates were also measured. Retrial means that the patients needed a second round of accutane within those 12 months. There are more statistics and info in the full text versions of the study. The full text links of the study can be found within this link:

http://www.ncbi.nlm.nih.gov/pubmed/24173086

or directly here: http://archderm.jamanetwork.com/article.aspx?articleid=1764027

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I thought I was the only one that had some of those side effects. I'm about to finish up my 5th month on accutane 80mg/day. I have the common side effects dry lips ,skin, nose bleeds, sore muscles/joint pain, fatigue ,mood swings,weight loss. I started out weighing 182lbs and now I'm 173lbs. I'm going back to my derm tomorrow and I hope this is my final month. My skin has cleared dramatically and I hope this lasts forever. I won't ever subject myself to this medicine again. Too many side effects. I hope your results last forever and your side effects slowly and totally disappear!

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I thought I was the only one that had some of those side effects. I'm about to finish up my 5th month on accutane 80mg/day. I have the common side effects dry lips ,skin, nose bleeds, sore muscles/joint pain, fatigue ,mood swings,weight loss. I started out weighing 182lbs and now I'm 173lbs. I'm going back to my derm tomorrow and I hope this is my final month. My skin has cleared dramatically and I hope this lasts forever. I won't ever subject myself to this medicine again. Too many side effects. I hope your results last forever and your side effects slowly and totally disappear!

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That's awesome news that your skin is staying clear and the oil hasn't returned. My derm said that I need to take 1 more month of accutane. I'm kinda bummed out cause of this but if 1 more month gives me a better shot of never having acne again then I'll suffer a little bit more. I hope that once I finish with accutane that all my side effects will slowly disappear too. I'm happy for you!

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Hi everyone-

So Queen- what did your final cumulative dose end up at? I'm on my second course… my first one I ended up having around 130 cumulative dose… I wanted to reach 150 this course, but am wondering if I should just go for the 220mg if my Dr. will let me.

Here's my question:

My derm wanted me to take 40mg a day first month, then go to 60mg a day (like last course). I would LOVE to minimize the side affects and stay at 40mg a day. Is it the same result if I take 40mg a day for longer (like 7 or 8 months) because it's still accumulating? Or should I get large amounts in quicker?

Thanks :)

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Hi everyone-

So Queen- what did your final cumulative dose end up at? I'm on my second course… my first one I ended up having around 130 cumulative dose… I wanted to reach 150 this course, but am wondering if I should just go for the 220mg if my Dr. will let me.

Here's my question:

My derm wanted me to take 40mg a day first month, then go to 60mg a day (like last course). I would LOVE to minimize the side affects and stay at 40mg a day. Is it the same result if I take 40mg a day for longer (like 7 or 8 months) because it's still accumulating? Or should I get large amounts in quicker?

Thanks :)

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