Accutane: Let's Do This (40 Mg/day Claravis)

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Day 36 (starting week 6!)

Hey everyone! Five weeks down, which makes me 25 percent of the way done with the course! (Well, if my doctor has her way I'll be on it for like 7 months since they have this weird rule about being on 1 mg/kg dose for at least 5 months, but if I feel good at the five or six month point, I think I will just call it quits. But whatever, I can cross that bridge when I get there and the point is, I'm marking down the weeks and that feels good!)

My skin was probably as clear as it has ever been yesterday. Marks were fading. Last night though I noticed a small something forming on my left cheek and I'm kind of bummed about it. It's not huge by any stretch of the imagination and things really do look so much better than pre-accutane, but I'm just constantly waiting for the breakouts to stop and it seems like I get some kind of whitehead (some are virtually microscopic) everyday. It's good that I'm seeing results, but it's frustrating nonetheless. My derm said it will be up and down, but I should generally notice a positive trend. So far that has held true, but I know skin could STILL go downhill. Basically, I don't trust any progress so far, especially since I have to up my dose in less than a month from 60 mg to 80 mg. We'll see how that goes.

Side effects have really been reduced, which I both like and don't like. I worry that if the sides go away, maybe the drug isn't being effective? I'm not sure, I'm probably just paranoid. Dry skin hasn't been bad (it feels like what I imagine normal, non-oily skin feels like) but this could be due to the fact that it has been 90 and humid here the past few days. Hard for anything to dry out under these conditions. The eczema on my hand has calmed down quite a bit, and that's just with applying moisturizer a couple times. Back pain is still present, particularly after I hunch over the sink to wash my face. I get dehydrated from running very easily now. I've never been one to sunburn and I still haven't had a problem with it, but I do get tan a lot easier now, which is kind of frustrating since I get awful tan lines (but this seems like a pathetic thing to complain about haha). Oh yes, and dry lips for sure. They haven't been painful, but I apply Aquaphor like every hour or two.

One weird thing I noticed is that I had a MASSIVE blister on my toe (which is from running, I imagine). It was a little weird though. I've never had a blister quite that large for no apparent reason and it is bright red and I imagine will take forever to heal. It doesn't hurt, so that's a positive, but not like anything I have ever experienced. Probably not 'tane-related, but I like to blame this drug for everything.

A side effect I HAVEN'T been looking for or paying attention to is hair loss. I really don't think I've noticed anything so far. I have ridiculously thick hair (my sister and I both do) and truly it would be nice if it thinned out a little. But I'm worried about this side effect a little and I wasn't before. I really can't imagine anything calming this head of hair down, but knowing how powerful Accutane is, I wouldn't put it past it. So now I'll get paranoid about that.

Overall, five weeks down feels pretty good. I'll feel a lot better once I get to the third month, as that seems to be a good time for people, but I really (knock on wood) can't complain about my results. I know it's early, it hasn't been a super smooth road to clearing but it hasn't been the worst, and I generally do like where my skin is right now. Still waiting for the storm to unleash its fury. I have a few big events next weekend, so it will probably happen then....

On that happy note, hope everyone is doing well with their course!

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Breakitoutnow -

The major thing to make sure of when you are deciding on stopping it is that you have gotten your cumulative dose. You need 120-150 mg per kg you weigh....for instance I weigh 45 kg (your cumulative dose will be a lot more since you are male and most likely a lot bigger than petite me). My cumulative dose is around 5500-6000 mg. I am planning on taking a low dose (.5 mg/kg) for minimal side effects of 20mg a day, so that puts me at about 10 months. I know its longer, but there are newer studies and many dermatologists who believe the long low dose is a much better way to go as far as no side effects and better on your body. As long as you get your cumulative dose, the studies show it still provides long term remission. They are even thinking the cumulative doses should be lowered for mild to moderate acne. If you are taking a high dose, you will probably meet your cumulative dose around 5-6 months though, depending on your weight.

Since you are 6 weeks in now, I bet you don't have to worry about the IB too much. From what I have read, it happens in the first few weeks for most people...and your acne was not severe so less chance. At least...that is what I am hoping as well!!!

I know this is only day 3 for me, but so far the only thing I have noticed is mostly that my face is a little drier than usual at the end of the day. I woke up with a big pimple near my mouth the day after my first dose...but I doubt this could be from the tane so soon.

I noticed you talking about eczema, and this is something I get off and on as well. My whole life, I occasionally get little patches every now and then, mostly on my arms and trunk. How has the tane affected that for you?


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Hey lifeinfaith:

I thought the same thing about the cumulative dose (I feel like such a braniac on this drug. I was correcting the pharmacist the other day about iPledge when they told me I had to answer questions online. I'm pretty sure they didn't appreciate my attitude but oh well). I weigh 70 kg, and by my calculations of two weeks at 40 mg,a month and a half at 60 mg, and three months at 80 mg, I would be at 149 mg/kg by the end of a 5 month course. So going to a seven month course seems a little excessive to me. I will voice these concerns with the doctor I guess.

Anyway, I'm so glad you have finally started your course! Big thing to keep in mind is that even if things get rough, you are making progress and it's all a step in the right direction! I hope you are right about the IB (for both of us)! I'm just so scared to get optimistic on this stuff in the first few months. I agree, most of what I have read says it hits between weeks one and four, but I've read quite a few people saying they felt they were looking their worst around Day 35-40 and then there are always the logs about "Help me! It's day 127 and I have a massive breakout!" and those terrify me. Oh well, I'm just learning to enjoy the days when my skin looks good, and hope they become more frequent in the future.

As for eczema, I used to get it a little bit between my fingers on my right hand when I was like 12-13. I remember it being aggressive, angry, nasty and oozy, but really confined to that specific area (my dad has always had major problems with it). It comes back now and then as basically a patch of dry skin for like two weeks in the winter, but I noticed around week 3 on Accutane it flared up a little. Not awful and definitely not as nasty as it was when I was younger. It just looks like small blisters now. I've added my CeraVe facial moisturizer to it maybe three times this week and it is pretty much gone. That's one thing I will say for accutane: you get side effects that you think are going to get so much worse and wonder, "How will I live with this for 5 months!?" and then suddenly they are gone. That's not to say something doesn't take their place, but it keeps things interesting!

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Day 40:

Hey guys,

So at the risk of jinxing everything and ruining all my progress, I have to say it for the sake of honesty: my face looks really good. I've gone maybe three days without an active on my face and I only have maybe one or two noticeable red marks (one of which looks like it may be an ice pick scar but not sure yet). Other than that, it is RIDICULOUSLY smooth (I seriously spend a solid five minutes in the shower just feeling my face and wanting to cry tears of joy). Some parts of my skin actually look flawless. I am sure I will continue to break out, as I can't imagine the breakouts just ending and never starting up again, but hopefully things are more manageable from this point on.

I have been getting a few more actives on my back and back of my neck, which is a little weird since these areas cleared up really nicely in the first few weeks. But I haven't broken out badly on my back in years and this hasn't been bad at all. One or two that go away quickly. I noticed what felt like a pretty big whitehead or maybe even cyst on the back of my neck yesterday afternoon. I got home and picked at it a little and I think it popped (sorry if this is TMI, but TMI seems to go out the window when it comes to Accutane logs). I put a little spot treatment on it. I know you aren't supposed to but that area hasn't been very sensitive so I figured it couldn't hurt. Literally within two hours I couldn't feel it and I think it is gone this morning. Pretty awesome.

The unfortunate thing about getting really good skin on this stuff is you never know if it is going to last, and any little thing that could be a breakout sends you into frantic mode. I noticed a microscopic clogged pore on my right cheek last night (I'm not even sure I could call it that. It was more like a small bit of hardness under the skin). So naturally I started squeezing and pinching and messing around with it. I think it is gone now, but I probably made the area redder than necessary. Either way, hoping it doesn't turn into something in the future.

Side effects time! Dryness has REALLY set in over the past few days, which sort of sucks because it looks like I have dandruff on my face but I would rather deal with this than acne ANY day. I view the dryness as a good sign too, since I've read that it is usually an indication that breakouts are coming to an end (but that could be made up). I told my mom about the dryness on the phone and she was like, "Try a moisturizer!" I was like, "Seriously mom? What do you think I've been using?"Joint and muscle pains: check. I made the mistake of doing push ups the other day (which always hurt for me) and the next day I was super sore. I'm probably just weak (as a runner, upper body strength isn't exactly my forte) but I think the 'tane has something to do with it. Headaches are happening on and off. Dry eyes seem a little more present, but that probably has more to do with pushing three week contacts to three months. The eczema on my right hand has calmed down dramatically, but it doesn't seem to want to go away completely. I'm also noticing some redness on my upper arms, but nothing too bad and I think some are just mosquito bites. That's the Upper Midwest in June for you.

Overall, I love where my skin is at right now. It's not perfect, but it looks like it could get there. I also know it could still get worse, being only 5.5 weeks in and planning to up my dosage in about three weeks, but I'm really enjoying the nice skin now. I've got big events this weekend and the holiday next week (for those in the US) so I would love if this nice complexion could stick around for awhile! Fingers crossed, but either way, I think I'm getting a taste for what life could be like after acne and I LOVE IT!

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That's great it's going so well for you! I just finished week 1 (I started out taking 20 mg every other day, which I will do for 2-3 weeks to wean myself in then bump up to 20 every day as my dose for the rest of the course... Unless somehow I have 0 side effects on that and can bump up to 40 with no side effects but that's doubtful)

So far...absolutely no side effects except maybe that I feel I need a little more water. My face has gotten noticeably drier and clearer just in week 1 which kind of amazes me at such a low dose but I am pretty small and medicine sensitive. It still gets somewhat oily in the evening but overall it's producing less oil... I can touch parts of my face at 5 pm that would have been super moist and breakout prone before. In the past week I got 2 new pimples..both around my mouth. My clogged pores have been making an exit...they all seem to be coming to the surface faster and loosening up then either rubbing off in the shower or popping out with a small squeeze that so far hasn't left any marks....once I up dose I'll probably have to cut that out but hopefully I won't really have many clogged pores soon..My forehead has gotten the most clear...it's really strange that in a weeks it's smoother than it has been in months. It's my moist oily area...my T zone, and that area seems to have lessoned the most in oil. The chin cheeks and jaw area have broken out a lot more for me as an adult and they still have numerous clogged pores that will hopefully vacate with little convincing.

So...so far results seems pretty good, I know this is only week one but I'm hoping it stays on this trend.

Breakitoutnow - so did you go from having an abundance of clogged pores to only having one or two now? I try not to focus on those because I have really messed my face up in the past trying to get at them but they are looking super ready and easy lately. There was even one big one on my jaw that has seriously been there for 9 months that finally popped out and looks like it's finally healing correctly. Strange business.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Day 43 (start of week 7):
Starting week 7, and I know this week is going to go quickly since I'm busy with work, plus I'm traveling home for the 4th of July to spend it with some family. Very excited. Hard to believe that I'm a month and a half in already. In some ways it seems like it has been so fast, in other ways it seems like this has been the slowest journey EVER. The scarier thought is that I graduated from college a month and a half ago and I'm still job searching, but that's a different story entirely. Now, as far as skin goes...

Flawless skin days were short lived, but it's not THAT bad. I felt REALLY great about my skin on Friday probably, and really I just felt much more confident all of last week. Starting yesterday, I noticed a few small things popping up. I thought I got them taken care of and gone so quickly, but my skin is so fragile and dry that even if I don't notice any damage right away, a few hours later I will see the red spot. And they aren't really spots, they are big blotches. It sucks and it takes forever for them to heal. I've got a reasonably large one on my left cheek right in the middle of my face, a large one right in the middle of my forehead, and two pretty much in the exact same locations on my upper left and right cheek. They aren't bright read, but they look like dark marks and I just hate how long they take to fade. It sucks too because I've noticed on Accutane that these things seem to pop up out of NOWHERE. It's like I notice a dark mark in an area where I had a zit, then it seems not as noticeable, then it seems to come back with a vengeance. I can't really figure out how the skin healing works on Accutane. It's a little all over the board. My face is still so smooth though that that is a perk. I just love feeling it in the shower. My skin was SO great last week, that this is a little discouraging. It is still so much better than pre-Accutane, don't get me wrong. But I even went out this week and had an awesome time and I just felt like I knew what life without acne finally felt like. Everything looked so good earlier last week that I couldn't imagine that there was more to come up. But there was. Anyway, the stuff was very small, and if the breakouts stop for a few days the marks should be gone and I'll be back to feeling better. Fingers crossed!

My back went through quite the breakout this week though. I've never had bad back acne, at least not recently. But I had probably 5-6 spots pop up and that wasn't super fun. I'd rather it there than on my face, but it is swimsuit season and it's not particularly fun. Point is, acne sucks anywhere. Regardless, things seem to be slowing down a little back there and spots are fading quickly.

I think I said it last time, but HOLY DRYNESS! MUCH DRY! My face is really dry (finally invested in the CeraVe PM moisturizer and that helps). My lips are dry. My hair is dry. Everything is dry. One thing I have noticed is increased facial sweating. I'm not sure if this is even a side effect, but it seriously kind of sucks. I always sweat on runs obviously, especially when it is 85-90 out, but lately I'll get home and even after wiping down, my nose and upper lip is just RIDICULOUSLY sweaty! I'm wondering if this is more that sweat droplets that would usually flow off the skin are actually getting caught on the dry, brittle skin. I can stop talking about this now since it's sort of nasty...Other than that, headaches occasionally, joint pains occasionally (though these slowed down). That's about it.

I went out last night and drank a lot for the first time on Accutane. Definitely felt it in the morning, though not necessarily more than usual. Hoping this doesn't mess with my liver tests, but I'm certainly not making a habit of it. I was just so anxious to cap off a week of good skin, but I may have celebrated too early. Still waiting for an IB. I'm six weeks in and I've seen dramatic improvement, so I like to think it wouldn't get so bad after having gotten so much better, but I know it is a possibility. I'm also two weeks away from starting month 3, and I hear that is usually when people see major results, so I'm excited to get to that point!

All in all, a little down about the slight deterioration of skin condition, but I also know good skin days will return, and hopefully soon!

Lifeinfaith: I went from not even noticing clogged pores to suddenly noticing the four or five on each cheek I had. So I think pre-Accutane, I had so many clogged pores and my skin was just bumpy with them that I didn't even realize what a clogged pore was. Once I started accutane, those mostly went away and the ones remaining were a lot easier to spot. It was like a dramatic improvement in skin condition, so much so that I could really notice the flaws (clogged pores). Does that even make sense? And I cannot emphasize enough: do NOT go after those pores. Seriously even when you don't think you are doing damage, you are and it shows up a day or two later for me some time. I can see where I scraped off the top layer of skin and it's blotchy and ugly and takes forever to go away.

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Arggh you're right!! Last night I got to noticing 3-4 clogged pores on my right cheek and got too comfortable with how easily the clogged pores had been coming out...so I went after them and it did not turn out well. They were mostly ones that didn't do anything when I squeezed and now I have four red irritated spots on my right cheek that look like pimples. :( I havent had any actual pimples pop up in the past several days (except for two on my neck/hairline area which is random) and I was really feeling great at the end of last week...but now I know it will be several days of putting concealer on those spots and hoping they dont turn into anything. I dont know why we do this to ourselves. They were really tiny clogged pores too. I have this prevailing belief that if I don't take care of the clogged pores, they won't ever come out on their own or go away. But this is not the case on accutane right?


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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lifeinfaith: Sounds EXACTLY like my experience around Day 8 or Day 9. That spot where I had a battle with clogged pores is still a little discolored and it has been a month (not to scare you. It certainly looks so much better and no one would notice unless I pointed it out and they had a magnifying glass haha). But I keep doing the same thing. Small tiny whiteheads lurk under the skin, so I pick and pressure and get them to the surface, and then I'm left with two weeks of broken, red skin blotches that are like 4 times the size. Without concealer (yes, I'm a guy and I wear concealer. I gave up caring about the stereotypes a long time ago. It simply gives me the confidence to take on the day) my face looks pretty messy right now, which is such a bummer because it was nearly flawless last week (I'm not just talking clear here. It was smooth, it was even toned, I seriously felt like I could take on anything). Now I feel like I've got a solid week or two of healing to do until things look good again. But don't fear too much about the bad skin and the red marks. A) try not to pick (easier said than done) and B) my experience has been that healing takes awhile on Accutane and it gets super frustrating, and then like, overnight, things look so much better. I will have red marks that seem to be taking a week or two to fade at all, then one morning I'll wake up and they aren't so bad. The next day, they are gone. It's kind of insane, but I won't argue with it. And as my doc said, it's going to be up and down, but you should notice a positive trend. Hang in there!

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More power to you! I always wondered how guys made it through puberty without concealer.

The marks from yesterday are on their way to fading...thankfully my skin has always healed very fast. I'm getting a swollen bump on my chin and a small pimple under my nose. Looking forward to going a month without getting a pimple!


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Something weird happened yesterday. Monday night I noticed a really swollen spot on my chin...yesterday that spot had swelled to an area the size of a nickel by evening...like the most swollen pimple I have had since I was a teenager. It reminded me of what I used to get monthly as a teen....super freaked me out..I was thinking it was going to last forever and was hurting like crazy...so I gave it a little pressure just to see and wallah. A tiny plug flew out. I don't see how something that small caused such an inflammatory respond and it wasn't even deep...today the lump is like 30% of what it was and just a little tender. I am wondering if this is some IB because that was totally not the usual.

And my lips are dry all the time now.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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I upped to 20mg ever day now- the past few days face started flaking and lips are always chapped. This stuff is powerful I don't know how you guys do high doses! Those marks from squeezing last Monday are gone...but I am noticing one or two more scars/slight indents that I could never see before in places that I havent even touched recently. I've heard this can happen on accutane before they eventually get better? Have you experienced anything like this ?

The monster pimple is healing but left a lot of inflammation behind with it. I'm also getting one in between my eye brows. I think this is IB for sure.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Day 50:

Hey everyone. So today marks the start of week 8 and I'll be honest, I'm pretty down. My skin isn't the worst it has been (actually, I'm home with family for the weekend and they all say they see tremendous improvement). And they're right. My skin is so soft and the texture is just great. But I've been breaking out a fair amount this whole week. It started with your basic whiteheads here and there. They left marks and that was that. But last Tuesday I had my first cyst pop up on my chin. It only flared up really big (and not probably that noticeable, but it was painful) for maybe a day or two, but as it has been going away it's leaving a pretty big red mark. I don't mind it a ton because for whatever reason red marks on the chin just aren't AS noticeable, at least on me. It's kind of like the whole area has texture and shadows so it sort of just looks odd, but it isn't a huge blotch on my cheek or anything, so I'm grateful for that. But last night, I had a small something on my right cheek, up near my eye and off to the right side (thankfully it's not in the middle of my face). I picked too much and now it is a mess. Big broken skin and just a pain. I hope it will be gone in the next few days. My estimate is that if I can avoid any other kind of breakout on my face for the next few days, I will feel pretty good come Wednesday. But since I seem to be getting something new everyday, I'm not very optimistic. My back was also breaking out a ton lately, which is unusual for me. I really have no clue what was going on, but it seems to have slowed down at least a little.

Objectively, my skin is no worse than before Accutane and actually is better (and has had points of being MUCH better). But these breakouts are really bumming me out. I cleared up so nicely just last weekend, and it has been such a roller coaster ride since then. Once everything is clear, I keep wondering why other things form. Isn't everything gone already!? Anyway, I keep thinking I'm approaching month 3, but I still have a few weeks technically (I started May 18, so July 18 is still two weeks away). But if you measure by weeks, I'm getting close. I hear month 3 is where good things usually happen. I keep praying that once this breakout stops, that will be the end and it will be uphill from there. I'm sure I'm wrong, but that would be so nice. Truly, on days when I have good skin my confidence is through the roof. On days when it is bad, I just want to throw things. I'm sure everyone here can understand.

Side effects: Dryness has calmed down on my face, but my arms are dry and I'm getting eczema on my right hand again. It isn't bad. Just kind of a dry rash . Photosensitivity is real, folks. I never sunburn and I still haven't on the 'tane, but I run outside and I have a pretty fierce tan, which isn't doing anything for my red marks I'm sure. I put on SPF and everything and it kind of doesn't matter. I like it because I like the way I look tan, but I'm sure my derm will yell at me. I've been pretty depressed today, but that has more to do with the bad skin and the fact that my laptop screen broke on me than the 'tane. Also, lips (per usual), dry eyes, and some joint pain still. I just notice running is tougher, but I'm still keeping my mileage where I usually do, so no big issue there. Also, I think I've been fatigued. I always want to sleep, but like I said, I've been home all weekend and I tend to get that way when I come home.

Question for everyone: I rarely get cysts (knock on wood, knock on wood, KNOCK ON WOOD!) but when I've gotten them in the past I always squeezed them really hard and got just clear stuff out and it looked horrible. For the most part, I managed to avoid that with this thing on my chin. My question is, doesn't stuff have to come to the surface? Is this cyst just going to come back in a week or two? It seems like if I just let it die down the nasty stuff on the inside has to go somewhere...Does it just dry up and peel off with the skin? Any insight would be appreciated.

lifeinfaith: Sometimes I will look at my face in the mirror and see tons of scars and think my face looks a little ridiculous, and other times it looks flawless. I think Accutane messes with your skin texture a ton by dehydrating it (making the scars look much more noticeable) and then shrinking pores and facilitating skin turnover, making them look better. I also think it depends on what moisturizer I'm using. If I use a really thick PM one, it looks a lot worse. I'm grateful that I don't have a ton of indented scars, though I have maybe two or three that I can see.



***UPDATE***

Alright so after looking in the mirror, I realized my last post may have been dramatic. I have one bad red mark zit thingy that will probably look much better tomorrow, one red mark from the cyst on my chin that isn't great but is fading, and one very small red mark under my lower lip. That's all though. The rest of my skin looks very good. I only clarify because I told myself when I was starting this log that I would not exaggerate my experiences and scare potential Accutane users away. This is a roller coaster ride and I get really pissy about my skin, but it has been improving, even if it's not 100 percent clear. I have to remember that just because I'm really obsessive about my skin and it doesn't look flawless, it doesn't mean I'm not seeing results. I think I get more down about breakouts now because after making so much progress, it's a step backward. If you are considering Accutane, just do it. I had a taste of flawless skin last weekend and it was incredible. I know more of those days are on the way.

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Oh cysts, those terrible little things. I never got true cysts until a year ago while my husband and I were living in Colorado during the worst breakout of my life...brought on by extreme stress/crazy climate change and using oil on my face to try and moisturize.....anyways the things I used to always get and get occasionally now - like this week's monster chin zit which is healed now but still has inflamed tissue (stuff easily expelled from it but I think it kind of became a cyst type mass afterwards from all the inflammation it caused. You cant see it at all aside from the red mark, just feel it, but it doesn't hurt at all anymore ), are actually reallllly inflamed pustules that eventually come to a head and expel with squeezing. The things I got in Colorado however, never came to heads and would have resulted in massive tissue damage if I had squeezed the crap out of them. I went to a dermatologist and they told me not to touch them or it could cause major scarring and they actually injected one with cortisone which took it down in about a week (but left a dent in my chin for almost 2 months from atrophy).

You basically have to assess it to be able to tell...if you have normally been a cyst former then that's probably a good indication...but if yours always pop them maybe it isn't a real cyst. For me, I can tell by the fact that the poppable kind "progress". They get really swollen, then over the course of 2-3 days, get even more swollen to the point that they feel like the huge lump has moved to the surface and SUPER hurt. Sometimes they show a white head depending on how long you wait, sometimes not. These I used to lance with a needle and all the contents would come out with pressure. The cysts would never seen to progress...they would appear all inflamed...never seem to have a central feel..and I would go days hoping they would progress, but nothing would happen except them just sitting there being painful and swollen and ugly. I never squeezed those...I think the plug or infection started pretty far down and ruptured part of the sebaceous gland causing all the swelling and angryness mostly from the tissue itself and not the plug. Most of that content was probably clear fluid from the tissue and white blood cells, not solid stuff. They would last for about 2 weeks....then the red mark from them would hang around for about 1-2 months. After about a week they would finally stop being painful and then start shrinking and then finally disappear after maybe 2 weeks. Nothing ever came out of those, so I think the body just broke it down and absorbed it. Again, I don't think these kind have a huge plug, they just get super swollen and fluid filled from the damaged gland way down deep. So...if I were you I would inspect it and see what kind it might be. If it really is a cyst, I would definitely not try and pop it. The cysts I had at the time (I got maybe 5 in total) healed without leaving permanent marks.

It sounds to me like maybe you are finally having a bit of IB? I know I am...last night another zit showed up in between my eyes then this morning was huge and swollen. I worked out and took a long hot shower and it came to a head in the shower, and I popped it after. Now its healing flat...but I don't usually get this many large swollen ones this closely timed...and they also dont progress this fast. My derm told me that since my acne was not severe my IB would probably be a few more swollen ones than usual, not a ton of pimples like some get, so it seems to be doing that. Hopefully this only lasts a week or 2 and then I will be closer to clear skin. I pretty much haven't had any white heads since starting accutane (I didn't get a ton of these before) and most of the clogged pores that are left are on the sides of my chin, and a few near my mouth.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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lifeinfaith: Thanks for the description. I assumed this was a cyst because it felt SO deep and I could actually see/feel the bump under the skin (like a hard little ball) but it came and went within a matter of days (it's pretty much down to just a red mark now) so maybe it was just a big postule. Either way, I would love if it never came back. Sorry to hear that the IB is setting in for you. I'll cross my fingers that it clears quickly for you and you get on the path to clear skin soon! I'm not sure if I'm dealing with an IB or not. Like I said, this isn't worse than my breakouts were before Accutane and in many ways, the skin is so much better. But I'm just craving clear skin so much at this point. It's like it's almost in my grasp if these stupid breakouts would just stop. I'm also worried that in two weeks they are going to bump me up to 80 mg/day. I would love to clear up nicely and say I'm seeing great results, can I just stay on 60 mg? I hate the thought of suffering through an(other?) IB in month 3.

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Sounds like you've been doing really well, and I like your comments about trying not to obsess. I'm one week in on a second course of Accutane (second in 25 years), and I'm trying very hard not to make it the focus of my life. Not easy, though!

Also, like you, I'm a runner (although, several decades older, LOL), and I was ultra sensitive to the sun on my first course of Accutane, as well as on this one—if I'm out in the middle of the day, regardless of how much sunscreen I have on, I can just feel those rays pounding on me, and it gives me headaches, too. I have always been diligent about sunscreen use, but now I'm slathering on a 50 SPF whenever I leave the house, even if it's just to get in the car and go to a meeting. And when I'm on the trails, I add a hat and a long sleeve technical shirt to boot. And don't forget good eye protection, too. The sun is no joke, and it's doubly bad on this drug.


Best of luck and I hope you continue to enjoy your runs!

Edited by DawgDaze64

My regimen:

Completed a round of Amnesteem (my second in 25 years), 40mg per day for five months, on November 23, 2014

Mornings:

CeraVe Foaming Cleanser Normal to Oily Skin

Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)

Paula's Choice 2% BHA toner

Paula's Choice Skin Balancing Super Antioxidant Serum

If not wearing make up, then apply a thin layer of Paula's Choice 5% BP lotion

CeraVe AM Facial Moisturizing Lotion 30 SPF for Normal to Dry Skin

Evenings:

CeraVe Foaming Cleanser Normal to Oily Skin

Paula's Choice Skin Balancing Toner, Oily/Combination Skin (no alcohol, tons of antioxidants)

CeraVe PM Facial Moisturizing Lotion for Normal to Dry Skin

Thin layer of Tazorac

Make-Up (on the days I have to wear it for business, etc.):

Estee Lauder Double Wear or Almay TLC 16 hour foundation


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Day 52 (and story of the Mutant Zit from Hell):

So before all prospective Accutane users freak out that I'm on Day 52 and talking about a bad breakout, I should clarify: this is not a disaster, face-consuming, cystic breakout. I don't want to scare people here. My Accutane experience has been a roller coaster, but it has been largely positive. With that in mind...

This thing on my right cheekbone sucks. I seriously haven't had a zit like this before. The "cyst" on my chin and red marks are fading nicely. My face would actually look damn good if this thing weren't on it. For the record, this is what had me upset two days ago, and I don't really think it looks any better (actually, I think it looks worse). I've picked way too much to the point where I'm tempted to just take a knife to it. It isn't that big, but the red blotchiness from where I've picked is pretty significant (maybe penny-sized or a little smaller). But it is weird! I can't get it to pop, I think I've gotten some stuff out but now it looks like a big red blotch with a raised white surface. I've tried to open the white surface thinking it was a pus-filled and I didn't really get much out. So now the white surface looks like a donut. I don't think I can accurately describe this thing, other than it is very very weird and annoying. Maybe it was a small cyst that I just tried too hard to get rid of and it hardened into a scar? I have no idea, but I really really wish it weren't there. My chin isn't looking GREAT, but I could deal with that a lot better if I didn't have this thing. My only saving grace is that it is off to the far side of my right cheekbone and not in the middle of my face. But boy is it ugly…and not remotely concealable. I gave up trying.

Now that I have that rant out of the way, everything else is fine. Red marks on chin are fading nicely (although I can still see the bump under the skin from that chin cyst. I don't want that coming back). Dryness is setting in again, which is fine. I kind of wish my skin would just completely dry up and flake off and take the MZH (Mutant Zit from Hell - I've given it its own acronym, folks) with it. I'm hopeful that it will be significantly better by Friday morning, and maybe by the end of the weekend it won't be super noticeable. But who knows. This is new territory.

I'm 7.5 weeks in and I like my results, but I'm not to the point where I want to be yet. Side effects have been the same: dryness, arm/hand rash, photosensitivity (got very tan on my 11 hour drive yesterday. I'm not kidding). Depression is present but that is again due to poor skin, not Accutane. Lips are drying out even more (didn't know this was possible) and the right side has cracked. Kind of wish the left side would too just to make it even.

All in all, I hate the state of my skin, and yet I also love it. Chin and far right cheek (almost temple) have been hit really hard this week, but everywhere else is really nice. I'm getting labs done next Monday and have my two month check-in on July 18. I'm really hoping things look good at that point. A lot can change in just a day on this stuff, so a week and a half is an eternity.

DawgDaze: Glad to see another runner on here! I've noticed running is much tougher on the 'tane. My recovery time after runs is probably 3xs what it was pre-tane. I made the mistake of doing a fast 10-miler a week or two after starting and I think I'm STILL recovering (and that was over a month ago, mind you). The sun is intense, and thankfully I have a darker complexion to begin with or I would be a red lobster at this point. As for skin obsession, I haven't been so good about that this week. It was a lot easier for me to say "don't obsess" when I felt like my skin was on the up and up. As it has gone downhill this week, my obsession has set in again. I need to relax and just deal with it for a few days, then hopefully things will be uphill again. Month three is just around the corner, and you'll be there before you know it as well!

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I feel kind of similar to you except I'm not even a month in yet! The rest of my face is looking very nice (weird zit in between my eyebrows pretty much vanished after it popped this weekend) if not for my chin. The big pseudo cyst thing that popped had another pimple next to it a few days ago that I kept jacking with and last night I jacked with the cyst bump thing again hoping something else was still in there, but no, it's just a hard mass. This has happened to me when I was younger, and like yours, it just kind of becomes what almost seems like a scar due to all the inflammation and trauma. We really just have to stop messing with it and let it heal. Thinking back, those always got smaller and smaller after a few weeks if I just let them heal. Also, if you go to the Derm soon you could have them look at it and maybe get a cortisone shot if it hasn't improved? I really need to stop obsessing too. My skin has been my obsession for the past 2 years now and I'm just plain tired of it. I'm going to just put aquafor healing ointment on my chin the next few nights and try to completely ignore it.

I am really thinking my hair is drying out and it's starting to worry me. I couldn't even use shampoo this morning. I have really long hair so theres a lot of it. Going to put a filter on the shower head and use a heavier conditioner to see if it helps. I was considering bumping up to 30mg next month to shorten my time to 6 mo rather than 9 because I was thinking, how can I go for 9 months, but now I'm thinking, how can I increase side effects even more? Well see how it is end of month.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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lifeinfaith: If I could stop picking, my life would be so much better. I sometimes notice though that I don't even realize I'm doing it. I lean in close to the mirror and then, two minutes later, I've left a trail of devastation. So with this massive weird thing, I picked off all the scar tissue and scabby stuff. Now it is an indented red mess, but at east I feel like it is on its way to healing whereas before I couldn't even say that. I think by tomorrow or Friday it will be concealable and maybe early to mid next week it will be much less noticeable. Fingers crossed.

I got another microscopic whitehead last night that I popped and left a not-so-microscopic red mark. Ordinarily it wouldn't bother me because it's concealable and should be gone in two or three days but it's just adding to my frustration at the moment. My skin looks so good in parts, I just want to be like "How is there more stuff coming up!?"It is ridiculously smooth and it is so dry that I feel like it should be inhospitable to any kind of zit. But it's not. They just keep showing up. And even the smallest things leave a mark these days. I did manage to get a clogged pore in the middle of my right cheek last night that didn't really leave a mark and I was happy about that. Meanwhile, my right cheek and chin are looking pretty ugly. My left cheek and forehead and nose (knock on wood) are looking beautiful. I guess I'll just make sure that's the side I show off?

I keep feeling like maybe this is acne's last stand and that once these breakouts come to an end I'll be clear for good, but I sort of don't know if that's the case. I'm getting about one whitehead a day and contending with red marks, so it's not great news over here. I can also say it isn't any worse than pre-Accutane. But I'm two months in--I should be turning a corner, right? And I know people say "I didn't clear up until month 4" or "Some don't clear up until after their treatment" but I cleared up so well at the 5-6 week mark that I really thought I would be in better shape by now. Oh well, it's a marathon, not a sprint.

Also, scary moment last night. I took two pills (I do that every other day), one at breakfast and one at lunch, so only about 3 hours apart (which I have done before and my derm said is fine). I went for a run in the evening (about 6 miles, a typical distance for me). It wasn't real hot, very comfortable. After I showered I noticed I wasn't feeling great. I went to a friend's house for dinner and basically couldn't eat. Spent the whole evening on the couch, with a blanket. I felt like I had a fever, and I was nauseous and my friend said my eyes were really bloodshot. I took two Advil and pretty much fell into bed. Woke up this morning and I am fine. I'm attributing it to dehydration. Any other ideas?

So right now, feeling bummed. Really hopeful that things look better by this weekend. I can't expect this red mess on the right side of my face to go away real soon, but I think if the other marks (which look like they should be on their way out) disappear, I'll be content. Now if only I could stop anything else from coming….

Edited by BreakItOutNow

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Yea it sounds like dehydration. My Derm told me it's real easy to do on accutane so I try and chug water constantly. I have been scared to play soccer since I started and have just been working out in the gym. I'm going to this Sunday though, so hopefully I'll be ok. It's hot as hell here and I sprint a ton in soccer.

I keep thinking the same thing as you,if this would just be the last pimple, if theyde just stop coming - but I think that's flawed thinking because it might be months more until thst happens (like you said some say they don't totally clear until 4 months) or it might not ever happen. What might be "perfectly clear" to some might be a super annoying clogged pore to us. I have a friend who did 5 months of accutane and it cleared him tremendously (he had severe nodular cystic acne) but he told me he still gets a few pimples a month - to him this is amazing though. I don't want to set myself up for perfection because it isn't possible and I think if we do it might just be an endless pursuit. I have an extremely hard time not doing this though. I've been ok lately at not picking at clogged pores (since they are visible to no one but me) and only allowing myself to mess with swollen ones. My hope is that accutane stops me from getting swollen pimples except on occasion (and hopefully 0 cysts ever ) and majorely reduces my propensity for clogged pores.


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Day 54:

Hey everyone. So, day 54 and I am both loving and hating my skin, if that makes any sense. I love it because it is so smooth, and most of the residual red marks have faded. It looks pretty flawless everywhere, with the exception of two MAJOR flaws on my right cheek.

First is what is left of the Mutant Zit from Hell. It is now a bright red gash on my right cheekbone, just past the far corner of my right eye. It is seriously the ugliest thing I have ever had on my face (with the exception of a pretty big cyst that I tore apart on my nose one time. That was bad). I don't know if it was infected or what (I did so much to this thing that I wouldn't doubt I severely messed it up. I picked, I used a needle, I might as well have dropped hydrochloric acid on it, it is that bad). Question: has anyone every tried spot treating with neosporin/antibacterial ointment? I need something that will facilitate healing of this gash. Dealing with a red mark is one thing (and difficult enough), but dealing with what looks like someone took a knife to my cheek is a different story. I've been spot treating with Differin but that seems to be irritating more than helping. So, neosporin? Any thoughts?

I also had a new thing pop up yesterday. Yippee! It feels pretty deep, but it isn't blowing up into a noticeable bump. It is more just a big red mark. It's on the far side of my right cheek (near where sideburns would be if I had them) and I don't mind it as much. It's relatively easy to conceal, but it's taking everything I have not to pick away. It is kind of sore, which makes me think "cyst" but I'm not sure that is accurate. I think it could just be a really deep whitehead that hasn't come to a head yet? Time will tell.

If you would look at me from the front/left you would think my skin is flawless. If you would look at me from the right you would think "What happened to him!?" I think I have learned my lesson on picking, but probably not. This thing on my right cheek though is so ugly, I really need something to put on it. I have heard neosporin is comedogenic so that sort of sucks, but maybe if I'm real careful and just get it on the actual gash? I kind of don't care if it leaves an indented scar, I just want the bright red bloody (not as in the swear word…it's actually bleeding) thing off my face! I would feel a lot better too if I hadn't gotten this new thing on my right cheek.

Accutane has been a largely positive experience, but breakouts get me down a lot more now, especially since I thought I was moving to the point where they would be more manageable. I've noticed myself slipping into old habits, like not being able to get myself out of the car and take on the day, or wanting to cancel plans with friends. The funny thing is, my skin IS better! It really is. Lifeinfaith: I think you are right. I have built up the expectation of flawless skin and any time I get close and it goes away, I get really upset. I also have to say I have some expectation of perfection simply because the rest of my skin is nearly perfect! It really looks and feels so great, it's just these two or three BIG marks (ok, one BIG mark, two other relatively small marks) I get that are really getting me down. But you are right, I have to remember that Accutane isn't going to solve ALL my problems. It can (and probably will) seriously help my skin, but I'm not necessarily going to look in the mirror and love what I see, even if I have clear skin. I have a pretty significant history of body dysmorphic disorder and always hone in on a real/perceived imperfection. I did it with my weight until I was 17 and weighed 108 pounds (which, for a 5'10" guy is pretty darn thin), I've done it with my skin now. I have to stop chasing perfection, not just with skin but with my appearance in general. I know this is a lot of very personal information that is pretty tangential to my Accutane log, but it is something I felt the need to share. Basically, I think I'm a relatively sane individual, but my self-loathing when it comes to appearances has plagued me for half of my life. I have to remind myself that Accutane is helpful, but there are deeper issues here. I recognize them, I'm working on them with a mental health professional, and that's about the best I can do. Sorry. That was a lot. We can go back to talking about pretty skin now.

All that said, I'm fine with the odd zit every couple weeks. I would really love to not be getting them every day like I am right now though. In other news, I have a roommate who I believe did Accutane in high school and has always had very good skin. I've recently noticed he's using Clearasil products and new acne soaps. We never talk about skin care stuff, but I'm wondering if he is feeling a relapse? Either way, he is going on four or five years of very nice skin, and I think that seems worth it to me. Plus, I haven't noticed any blemishes on him recently, so maybe they have been small and he is just trying to get ahead of the game.

No dehydration issues yesterday after my run. Lifeinfaith: Don't worry about soccer. Keep your electrolytes up, but enjoy yourself. It's important to maintain a semblance of normal life on this drug. Soccer will be a good way to get your mind off Accutane and skin care and--literally and figuratively--"get back in the game." Have fun!

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I'm right there with you! Wonderfully said. I'm on day 63 and my face is so smooth with only a couple cysts still. I'm happy with my results so far however accutane is like a roller coaster so I try to keep in mind a new cyst could pop up any day.

I've read where people talked about using neosporin, I've tried it because Im a constant picker. Now that all cysts are shrinking I can see my needle holes I've made in them in the past. But its lessening more and more each day. I'd do anything that will make you feel better about them. I didn't notice much difference when I was using neosporin. Cortizone cream works best for me and I've noticed good results.

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Mandy: Glad someone is in the same boat as me. I think I am definitely going to use neosporin. This isn't a cyst anymore, it's an open wound. I'm so mad at myself for picking, but it was one of those things where it started out as no big deal, started picking, made it worse, figured I couldn't make it much worse, so I kept picking. False: YOU CAN ALWAYS MAKE IT WORSE! Anyway, I'm optimistic that maybe I'm turning a corner on Accutane soon. I can deal with the gash if it starts healing and if the breakouts slow down. I'm happy because (knock on wood) I haven't gotten anything (or anything significant) on the left half of my face for quite a few days (cue massive breakout on left cheek!)

Good luck to everyone on their course! Glad we've all got support here!

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Antibiotic ointment for sure. If you put differin on an open wound it will just irritate it, I've done it. The quickest way to heal a wound with minimal scarring is to keep it moist for as long as possible - even Vaseline or aquifor.

When I was breaking out terribly in Colorado I started seeing a mental health provider for almost a year. It was the first time in my life, but the acne was giving me such severe anxiety and I was getting depressed about it ...that's about when I developed the major picking/complexion fixation. They actually diagnosed me with mild ocd... Which body dysmorphia is in the same family as. They said it wasn't straight up body dysmorphia because it was the only time I've been fixated on something on my body but have been fixated on other "perfectionistic" type things in the past. I had just never talked to anyone about it before. I figure at least half the people on this website probably have ocd of some type... Or they wouldn't be on here lol. Seeing a therapist was one of the best things for me, they gave me tons of good tools and a better understanding of how my mind works and how to think about my thoughts - cognitive behavioral therapy. I am loads better than the low point I had gotten to 1.5 years ago. Before I stopped seeing my therapist, he knew I was going to take accutane , and thought that was fine. He thought perhaps it would enable me to minimize or eliminate this trigger to the point where I could easily train myself to not obsess over it...thst is, until I find the next thing to obsess over!

What have you been doing to moisturize your face? I have been using my normal oil free moisturuzer but my face is getting so flaky at the end of the day. Has this been a problem for you?


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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Lifeinfaith: As much as I hate hearing your struggles, it is nice to know I'm not the only one who has struggled mentally with this. And I know other people on this board have as well, but hearing a personal story like that is helpful. I have to say I'm amazed there isn't really a cure for acne at this point. With how much it really seems to destroy people's lives, you would think we would just have a shot or something that gets rid of it. I just graduated college and if my current career path doesn't work out, I'm heading to med school and may try to make it as a dermatologist. I certainly have the passion to help people through this by now. But oh well, that's a long way off.

Anyway, for moisturizing, I use CeraVe PM anytime I wash my face. During the day I also use the AM moisturizer for some added SPF protection. I still get flakey skin, but this regimen seems to be working well.

I started putting aquaphor on the wound yesterday per the recommendation of my derm's nurse (I need to buy that woman a gift card or something. She has been so accommodating). I think it is helping, but it hasn't been an "overnight transformation" or anything. Have a nasty but concealable dark mark on my far right cheek just below the nasty wound, but I think it should be gone in the next two or three days. I also peeled off some dead skin where that cyst on my chin was only to reveal a dark red mark yesterday, so I'm upset about that, but maybe in the next two or three days it will be gone as well. I'm still getting little things though. Had a small thing pop up between the eyes yesterday and it was no problem, I popped it easily and it was so small, it's gone now. But I'm getting discouraged anytime I get something new. I would feel like I'm making major strides if I could even go a day without some kind of zit, no matter how small.

Tomorrow is the end of week 8 and what I will call the end of Month 2. I've seen progress since starting, I know I have. I'm just hoping month 3 is when it really gets going!

UPDATE:

HOLY AQUAPHOR! I lied. I didn't think it was an overnight transformation because when I washed my face this morning and reapplied aquaphor, it wasn't. I just peeled some dead skin around the side off though and it tore off the whole top layer. It hurt like hell, but revealed fresh (albeit bloody) skin underneath. It is indented and will probably leave a nasty scar. I don't dare put concealer on it or anything, but I would say it looks 50% better. Seriously a huge huge difference. Incredible. Aquaphor is a miracle product. I am reapplying it now and will continue to do so throughout the day. With the improvement I just saw in less than 24 hours, I am excited to see what it may look like by the end of the weekend. Just wanted to update with some positive news for a change.

Edited by BreakItOutNow

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That's great! My husband used aquaphor ( I keeps speaking it wrong) when he had some moles biopsied and they healed well. I've been using it on my lips at night and so far no peeling.

So no active pimples right now..,little plugs are falling out of my face daily, it's pretty weird. Did this happen to you? Also, this week the skin on my cheeks has been getting weird and rough looking...like slightly bumpy and uneven. Any insight on whst could be going on there?


PM - Clean face with water and cotton rounds. Spot treat with Finacea.
AM- Wash face with Aveeno Gentle Foaming Cleanser and apply Sanitas Oil Free moisturizer
30mg Absorbica for 8 months


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