I can't say I've been an avid reader of these blogs for a very long period of time, but lately things have changed and I've really been inspired to track my progress on Accutane.
I will start taking the Drug in early July, around July 2nd, and I'll let you guys know why.
So a little about me:
I am a 22 year old male in school. I started having acne when I was in high school; the same kind that my elder brother had, just on my forehead and it was very typical of the hormonal acne. Past Grade 10, my acne really subsided and I would get very few pimples here and there (once a week or so) but they weren't very big at all and were very easily manageable. My brother cleared up in University early on.
When I started University, my acne remained the same, but near the end of first year, stress took its toll on me, and I started having flare ups of acne which I only used OTC products for like Clean & Clear and things along those lines. My acne subsided; it was still there but it was manageable.
The acne got quite a bit worse in my second year of University, and being the idiot I am, I continued using OTC products and never even considered seeing a dermatologist. Any who, it was not pleasant, but I lived with it for another couple years. The acne started coming on my cheeks and this point. And I would have good and bad days; on the good days you could barely tell I had acne, but on the bad days.... well you know! So I always classified myself as having mild to moderate acne because of the cycles I went through.
In my fourth year, I finally decided to go see a dermatologist and he, in his infinite wisdom, prescribed me fucidin cream and said it would take a very LONG time to see results. I trusted him and went on the fucidin and saw him every 8 weeks. It got better, but I still had flare ups every now and then. A few months later, he prescribed an 8 week course of Minocycline (I can't remember the dose) but it didn't do much for the acne on my face. It helped the acne on my back completely subside, but it came back after my course of treatment stopped, and I continued on the Fucidin cream.
After finishing fourth year at University, I moved to a new city for Grad School and the Fucidin really controlled my acne well. I would have a few breakouts every now and then, but nothing major. I decided I would go to a clinic and get a referral to a dermatologist just to make sure I was on the right course of treatment. The GP I saw there said my skin was really nice and I should stop the Fucidin (she said she'd only refer me to a Dermatologist if she couldn't control it) ... I did stop it and the acne came back. It was just more break outs, which is to be expected really...
A few months later, I went to another Doctor and he referred me to a dermatologist and prescribed me Fucidin for the time being which helped, but my acne really hasn't gotten any better. I have very minor ice-pick scarring (three of four - not very noticeable) but I almost always have an active pimple and they are ALWAYS filled with pus. I even have some acne underneath my skin. The areas where there were pustules before are slightly hyperpigmented, very red, and so on and so forth... you get the gist.
So I finally saw this dermatologist a few weeks ago and he suggested a couple of treatments for me: one involved going on antibiotics again and trying some topical retinoids which may or may not work, would take a REALLY long time, and the chance of complete remission would be low, or I could go on accutane. He really sold me on the stuff but told me to read about it after giving me a package.
So I read about accutane and the side-effects. I honestly feel like I can deal with the side-effects if it means I can go outside without having to be self-conscious all the time, if I can look people in the eye and not be self-conscious, if I can walk past a mirror and not be worrying about how bad my acne is... So yeah, emotionally jarring stuff but you guys know all about it!!!!!!
Plus, I KNOW loads of people have it worse than me but I'd still like my acne to be gone... as it really has taken over my life.
So the BIG thing I was worried about with accutane other than the well known side effects was the initial breakout. I'm in school and I'm managing my acne so it's not always visible (using cover-up... yes it sucks being a guy and having to use cover up: sometimes it take over 20-25 minutes - this is just ridiculous. I just wanna wake up one day and just leave my house without having to worry about this stuff and fix my face). It looks like depending on your dose of accutane (mine is 80mg/day and I weight about 175lbs [so it's about 1mg/kg body weight which is normal]), the initial breakout begins around the end of week 2 and typically lasts till week 5 to week 6, and the majority of people begin to see results around week 8 and beyond. So yeah... BUT there will always be outliers!
I had the option of starting earlier this month but my school ends in the end of June so I decided I'll start the accutane in July, avoid showing face for 2 months, and then go back to school with my acne not being SO BAD. Of course, my IB could last a lot longer and be terrible so who knows these things. Also my 2 months won't really be off; I'll be working but at least I won't be seeing my classmates and friends on a regular basis... saves me the embarrassment... I know it's a little silly but what can I say... I'm only human!
Also as a note, the accutane doesn't actually cause you to have more acne. What it does is that it "leads to shrinkage of sebaceous glands and a marked attenuation of sebum secretion. The decrease in sebum results in the inhibition of the sebum-dependent bacterium Propionibacterium acnes (P. acnes), which is a key promoter of inflammation in acne vulgaris. Oral isotretinoin also inhibits comedogenesis by fostering keratinocyte differentiation and by normalizing desquamation." So as it shrinks the sebaceous glands (sweat glands/pores), the acne that was already down there and about to come out, comes out really fast! That's the only reason why you get an initial break out! The people who don't get an initial breakout don't have as much acne about to come out at the time being.
And I'm taking two 40mg pills with my dinner. Dinner is usually my largest meal, so it'll increase Accutane's absorption by a LOT! No Alcohol drinking, excess Vitamin A, or any processed foods, or any other systemic medications; Accutane takes a toll on the liver (which is why we have to get blood work done every month) so you want to avoid putting an excess workload on your liver.
Realistically, I don't think I'll be going to a higher dose ever throughout my course of treatment. The goal of the therapy is to have a maintenance dose of 120-150 mg/kg body weight. So if I stay on my treatment of 80 mg/day (1mg/kg/day), I should reach the maintenance dose in 4-5 months. Who knows, I might have my dosage lowered and the duration of treatment increased to 6 months.
So I plan to update this blog as often as I can and I hope I get great results and can help people in the future looking at these forums for information.
I honestly am not brave enough to post my pictures online. I will take pictures of myself everyday and keep them... and if one day, I become brave enough, I might even decide to post them!
So after talking to my Dermatologist and reading all this stuff online, this is how I'm preparing for the inevitable side-effects:
Aquaphor Lip Therapy (I just bought a lot of this stuff from ebay - 6 tubes for 25 dollars)
Burts Bees Medicated Lip Balm (It's not greasy so I can have this chapstick with me and use it all the time; I plan on keeping this stuff everywhere!) - I got a 6 pack from ebay; I'll see how it works and if I like it, I'll buy some more. This was around 20 bucks after shipping.
I bought an Aveeno moisturizer. I already moisturize with Nivea cream but I heard good things about Aveeno; I might use them both; one in the morning, and one at night.
I plan on buying vaseline to keep the inside of my nose hydrated and to make sure I don't get cracks on the outside of my nose
I'm also planning on getting nasal drips just to keep with me for work; I don't wanna have random nose bleeds; I'm also getting a humidifier for my bedroom
I bought my dermatologist recommended sunscreen for my body (Oubrelle SPF50) and I'm going to get the Aveeno sunscreen for my face
I've already been using a Clean & Clear face wash but the Cetaphil one comes highly recommended so I'm going to switch over in the coming days
That's pretty much it!
And advice would be greatly appreciated! If you have any questions, I'll try my best to answer them.
ALSO, sorry for the GIGANTIC POST! I'll try to keep them short if you guys want! I just happen to be a very verbose person with acne!