When I was doing my eyebrows today, which of course you have to do really close to a mirror, I noticed that my blackheads on my nose, chin, and forehead are all gone, bar maybe 3 stray ones. This is an absolute miracle for me. I've had blackheads in every pore of my nose and between my eyebrows since I was probably eleven along with some really deep and impossible to clean ones in the crevice between my lower lip and chin. I really can't believe it even when I look at it because I'm so used to all those pores being black and clogged and horrible looking and now they look perfect after just over a month of Accutane. This stuff works wonders.
Today I took the last dosage of my first month, so I had my appointment for getting the new prescription today. My triglycerides pre-Accutane were at 153, which is a little high, but high triglycerides are a genetic thing with my family. With the most recent bloodwork, they were up to 348. As a result, for the next month I'll be taking 40mg of Claravis instead of 80mg. I can't say I'm upset about the change because I have had some very frustrating side effects, mainly the rashes on my forearms that came as a result of a rope burn and haven't been able to heal because I rest my forearms on desks in class. They're tender and disgusting to look at.
Here were a few things we discussed:
Dry, itchy scalp. The guy said it was pretty common and not to worry about it. I kind of wish he would've given me something for it, but I've found that it helps if I don't wash my hair every day. When I take a shower, I usually just either put my hair up and don't rinse it at all or I rinse with water for a while and just use conditioner. I did find a shampoo and conditioner I've been liking a lot, though. It's by Alaffia and is called Neem & Shea Scalp Recovery. It takes a little to get used to the smell of it, but I quite like it now.
Severely cracked lips. I can count 4 places on my lips where my skin has fully cracked and bled. My lips also have been inflamed and red. I was given some Dr. Dan's and am hoping that will help since I've used every major brand of lip treatments.
Rashes. Initially due to rope burns and then worsened by leaning my arms on desks. My dermatologist said he had seen the kind of rash I got in Accutane patients before and that it's common enough. I got prescribed triamcinolone acetonide cream (.1%), which is used for treatment of rashes and skin irritations due to psoriasis and eczema mainly, along with not otherwise specified rashes. I'm meant to use it twice a day for 10 days.
Infected/rejecting/unhappy piercings. I got some piercings about a month before starting Accutane and I tend to be a very slow healer with piercings. We're not sure yet if it's still just healing or rejecting. Regardless, due to the Accutane, the healing process is going even slower and one of my piercings is actually two holes and they're both swollen and tender, so I got some samples so I use Altabax (or, generically, reapamulin) twice a day for five days. Hopefully that'll help.
Stretch marks. I'm annoyed to say I'm having a problem with these again since I haven't had any new ones since I was about 11, which is also when I stopped growing for the most part. I've had about 5 new ones pop up since starting and I haven't gained any weight. The dermatologist said it's possible that since your skin gets so dried out and thinned out that your skin is more susceptible to things such as stretch marks. He said there's not really much you can do about already developed stretch marks while on Accutane except to keep them moisturized.
I'm nearing the end of my first month, finally. I'm hoping that this is as bad as my side effects will get, because it's pretty intense right now. I've definitely been having dry, chapped, and cracked lips accompanied by flaky skin, which I was expecting, but I didn't really expect the intensity of some other things. For my lips, I've used Aquaphor and some chapstick by Bliss, both of which I love and will be using for the next few months. My scalp has been dry, itchy, and flaky as ever and absolutely nothing has helped it but some organic shampoo with neem in it and scalp oil. Anything else anywhere near it makes it a flaky mess. My skin has been very prone to getting rashes and those rashes heal painfully slowly. I got some rope burn two weeks ago that still hasn't healed. Also, I was wearing shorts and all around where the hem was on my thighs is rashes. It's pretty disgusting to look at, but doesn't hurt. The inside of my nose has been consistently filled with dry blood. I haven't gotten a full-on nose bleed yet, just dried blood in my nostrils. My neck and lower back have been pretty sore, but ibuprofen fixes it easily enough. Photosensitivity should also be taken seriously with Accutane. After 45 minutes in the sun with SPF 15, I looked like I had been out on the beach for hours with absolutely no sunscreen on. Covering up is the best way to get around this, and I can't wait until it starts getting cooler so I don't feel like I'm overheating.
As far as my routine goes, I'm washing once a day with a gentle, mild, and fragrance-free face wash, switching off between CeraVe, Neutrogena, Cetaphil, and Purpose to see which I like best. I haven't been able to use my Clarisonic, which has been really frustrating because I know it'd help get the dead skin off. Pre-Accutane, I used the "roughest" brush on the 2nd lowest speed setting for double time, and now I can't handle using it with the most gentle brush, lowest speed, and for the regular time. I've been trying to use a scrub from Korres every two weeks just to get some of the dead skin off, but it hurts horribly. I found a moisturizer by Dermalogica that has given me really nice results. I think it's called Intensive Moisture Balance or something along those lines. It smells a little funny, but it works wonders. I also got some Omega 3-6-9 oil for your face from Philosophy that also smells a little funny, but has helped on my nose and chin, where it's been most dry. For daily supplements, I've been taking Vitamin E and Fish Oil with my Accutane. Fish Oil is generally good, but it can help keep your skin hydrated and Vitamin E also helps combat some of the dryness from Accutane.
As far as my acne goes, I definitely had an initial breakout where I had about 5 big cysts on my face all at the same time (oh joy), but since that, nothing too bad. On my shoulders and chest, there hasn't really been anything, but my back has been breaking out with cysts all over. It's probably the worst my back has been in a while. Hopes are still high, though.
Today I took my 4th dose, so it's my 3rd full day of being on Claravis. As far as side effects go, I've had some headaches that have gone away pretty easily with ibuprofen. My lips have been a little chapped, but they're always a bit chapped, so I suppose they're normal. My scalp tends to be dry and a bit itchy, but it seems to have increased in the last few days. My legs have also been a bit dry, but not bad by any means. The only really bothersome side effect so far has been that I have been absolutely exhausted, but I'm hoping that's just my body getting used to the medicine and that it'll go away. My eyes also were quite bloodshot as a result of being tired. My sleep schedule didn't really change, so I'm pretty sure it's a side effect. There hasn't really been a change in my acne, but I don't expect any changes for a few months.
So the iPledge program entirely screwed up and I'm only starting Accutane today despite the fact I was supposed to start over a month ago. The book, as far as I could tell, didn't say that you needed to turn in all of your consent forms and whatnot after a blood test without birth control and a month before you start birth control. Don't make the same mistake I did, because it sucked. In addition, someone entered my birthday and birth control methods wrong into the iPledge program, so I had to wait another day. I'm so glad I finally got my prescription today, though.
I'm going to be going to the dermatologist sometime today to get my first prescription of Accutane. I've already got an arsenal ready of chapstick, lotion, eye drops, nose drops, and bandages ready in a little bag.
I've been on topicals and antibiotics for the last 2-3 years. I used Duac and Tazorac and rotated through antibiotics (Doxy, Solodyn, and another one I don't remember the name of) as quickly as was safe. While the topicals helped get rid of existing acne, they helped little in preventing further problems. The antibiotics only work while you're on them, and they're not safe to be on for very long. I've finally gotten to the point where I'm tired of hearing people say that I would be prettier if I didn't have acne and sick of being in pain with all the cystic acne, so I'm starting Accutane in hopes that it will provide a long-term solution. I have high hopes and hope that I won't be thrown too many setbacks with initial breakouts and side effects.