I am a sophomore rower at an Ivy League school, and recently I've been wondering about how Accutane has been affecting my athletic performance, in specific, my rowing. The lack of research/information on this topic lead me to want to share my story with those who may be in the same situation as me. I'll begin by describing my experience with acne/Accutane, and then transition into how this has impacted my rowing. Some backstory:
I am 19 years old, 6'2 and 185 lbs.
Acne runs in my family, on my father's side. My late grandfather had numerous scars on his back and shoulders from cysts, and my father also had acne into his 20s.
July 19th: Began first month of Accutane at 40 mg/day. Multiple, large cysts on chest and back.
August 19th: Began second month of Accutane, 60 mg/day. Some progress on drying out chest, cysts still present.
September 19th: Began third month of Accutane, 80 mg/day. Mosts cysts gone, several small ones on chest here and there.
October 19th: Began fourth month of Accutane, 80 mg/day. One or two cysts left, still getting some whiteheads, moderate/severe scarring in sternum region from major cysts.
My acne began in eighth grade, at which point it was very mild. I would breakout occasionally, nothing atypical of teenagers beginning puberty. Freshman and sophomore year were no different than eighth grade, as benzoyl peroxide and other over-the-counter medications effectively got rid of small patches of acne. Junior and senior year were tougher on my skin, and as my acne became more and more rampant I regularly saw a dermatologist and began Minocycline. This helped dry out my skin, however, a side effect of this medication is skin discoloration (purplish spots) where acne previously was, and to this day I am still dealing with this side effect on my chest/face. My acne fluctuated greatly over these years. I would have periods of moderate/severe acne and then periods where my skin was completely clear. In the end, I escaped high school without extreme scarring, generally satisfied with the state of my skin and how treatments had worked for me over those four years.
Fall of 2011 I matriculated into college, optimistic and with relatively clear skin. One fateful day during freshman orientation I found varsity rowers and two crew coaches who were looking to recruit freshman to row, and after a quick 5 minute conversation I agreed to give it a try. Little did I know that on that day I was making one of the most important decisions of my college career. School began, and I quickly saw my time being consumed by rowing and my schoolwork. After working out for two hours each day for 40+ days, I began to break out again. The acne on my chest, face and back was moderate, and I began to take more precautions, showering more frequently and beginning a four-part acne kit that I used morning and night. This acne never subsided, and by January I did not feel comfortable taking my shirt off in public. I worked out in a tee shirt throughout the winter and spring terms, and by this time cysts had been developing on my chest. I toughed out the year, thinking to myself that being in a less stressful environment and getting a lot of sun over the summer would help dry up my acne. I spent the month of June getting brutally painful extractions and trying desperately to get rid of my acne, however, I realized that what I was doing simply wasn't enough. I did research, read up about Accutane, and talked to my dermatologist about it. July 19th I took my first pill, beginning what was to be a brutal yet effective course.
High School Athletics:
I was very involved in sports in high school. While I never played a sport at the varsity level I played soccer through my junior year, skied recreationally in the winter, and played lacrosse through sophomore year. I played tennis on the side as well. Aside from these sports, I was an avid cyclist/triathlete. I completed my first Olympic triathlon the summer before my junior year, and worked my way up to completing the Providence Half-Ironman in the summer of 2011. I began cycling in 2007, and completed three century rides (100 milers) for the Jimmy Fund in the years 2007-2009. All in all, I completed two Olympic triathlons and one half-ironman in high school, as well as many hundreds of miles from training rides or cycling competitions. Having this aerobic base truly helped me when I began to row, as my fitness initially made up for my lack of technique.
I should begin by saying that I had no clue what rowing was before college. I knew of rowing as a collegiate sport and I could've told you what the Head of the Charles was, but not having rowed in high school, I wasn't aware of the discipline that such a sport entails. Freshman fall was spent learning said discipline. The enormous amount of time spent running, lifting weights, training on the ergometer and on the water in eights was nothing like the training I had done in high school. Training consumed me; while I cherished getting stronger and fitter, there were days were I questioned my motivation and my ability to continue; however, that year I set many records for myself that I still haven't touched. For instance, my team did all of our 30' tests rate capped at stroke rate 20, and my best average split was 1:50 for that piece. My first 6k in November was remarkable for two reasons; one, I found myself in the hurt locker to the point where I stopped rowing twice (the anger that the recruited freshman rowers displayed was enough to get me back on), and two, my time for that piece, despite stopping twice, was 21:09, better than half of the recruited rowers in my class. I sat two seat in the 1F for our freshman regatta in the fall, and our boat placed 1st, beating the second place crew by 30+ seconds over 3.2 miles. At some point in the fall (the weekend of the Princeton Chase, I believe) several freshman rowers who also walked on to the team and I stayed home, as we were not racing that weekend. We were told to pull a 2k that Saturday, and our only instruction was to "pace yourselves." To this day, I still ask myself how I managed to pull a 6:36 (1:39 average, my 2k PR) on that piece.
The winter months were bleak, gray, and uneventful. Through an intensive weight lifting routine I became much stronger; I maintained my fitness pretty well through these months, all went well. In the last few weeks of the term (early march) we had a boathouse-wide 2k test, on which I pulled a 6:38, two seconds slower than my fall time.
Spring came around, and I found myself seat racing for a spot in the 1F. After many grueling erg pieces (10x500m, etc.) and 5' pieces on the water, I found myself sitting 2 seat in the 1F. Our first race at Colombia turned out to be the only race that we would win that spring, however, the feeling of winning my first 2k dual race was like no other. We raced well at Eastern Sprints, placing into the petit final, and two or three weeks later we placed into the petit final at the IRA.
This past summer I was determined to return to college stronger and with better technique than I had finished the 2011-2012 year with. I joined a local rowing club, and practiced five days a week at 5:45 in the morning in a single/double/four. The rowing that I did that summer was truly beneficial, and I was enjoying my progress. My coach that summer wanted me to do a 6k in July, and on July 14th, five days before I began Accutane, I set a PR for myself with a time of 21:06. After multiple disappointing 6k tests, I finally beat the time I set back in fall of 2011! I was overjoyed, truly pleased with my performance and myself.
I soon after began my Accutane treatment, and noticed that after 1 week I wasn't experiencing the typical side effects: chapped lips, cracked skin, etc. Later on that month my body started to dry up, and I found that Aquaphor and similar ointments/salves were my best friends. I continued rowing, noticing pain in my joints (lower back and knees, in particular), but the pain wasn't enough to keep me from rowing. This period was marked by a general tiredness and soreness, as my body was adjusting to this new medication. I pulled a second 6k in late August (after I begun my second month), and blew up on the erg. I was so set on breaking 21 minutes that I started out at 1:44 for 2k and absolutely died. I noticed that I felt more tired than usual warming up on the erg, and the lactic acid build up came very quickly that day. I was crushed, shocked that I didn't do better after a month of training five days a week.
The time soon came for me to head back to school, and practice began the first day of classes. My weekly schedule:
Monday: 7:45 am heavy lift (front squat, bench press, box jumps, pull ups, core, etc.), 4:15 pm pre-row (30 minute erg workout), 4:45-6:45 pm row
Tuesday: 4:15 pm pre-row, 4:45-6:45 pm row
Wednesday: 6-7:15 am row (racing pieces; i.e. 3x2 miles, big seat racing day)
Thursday: 7:45 am endurance lift, 4:15 pm pre-row, 4:45-6:45 pm row
Friday: 4:15 pm pre-row, 4:45-6:45 pm row
Saturday: 9:15 am row (racing pieces, usually 2x3 miles)
I am about to start week 7 of this training regime, and I am quite happy that I have avoided injury and sickness thus far (knock on wood); however, I believe that Accutane has been impacting my training. Front squats and back exercises leave me with an aching back for 15-30 seconds after I complete a set of that exercise. I have been noticing more and more how sore my lower back has been when rowing, and while this soreness does not necessitate taking time off, I can't help but notice it most every row. We had a boathouse wide 6k test the last week of September, and I had a dreadful piece (1:47.5 average). Nothing worked well; even holding a conservative 1:47 split I felt exhausted after 1.5k. I have another 6k test this Tuesday. Hopefully it will go better than the last one.
So where am I going with this? Well, I can say with some certainty that Accutane has affected my rowing performance. The muscle fatigue has lead me to be more conservative in the weight room, and I don't recall the last time I've felt this sluggish on the erg. I understand that there could be other factors involved besides the Accutane, but the way I see it is that all this lifting has made me stronger than ever, and my fitness never drastically fluctuates. So, why is it that I haven't been performing at the level that I am capable of? It could be mental weakness (not wanting to push myself harder), as rowing is an incredibly mental sport; no, I believe that Accutane is the cause for the change in my training/results. Unfortunately, there is no scientific way to prove this. I will end by saying that the last four months that I have been on Accutane have been incredibly difficult (as I'm sure every Accutane patient would agree); however, I would trade a few bad erg pieces for a lifetime of clear skin in a heartbeat. If there is any patient who'd like to share their story with me (rower or not) I'd be happy to listen. For everyone out there dealing with acne, as my family and friends tell me, keep your head up and keep being yourself. Don't let your acne define or confine you. As a patient who has enjoyed what Accutane has done for my acne, I'd recommend it to anyone thinking about taking the next step and making the commitment to get rid of your acne for once and for all.