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Day 1 - Isotretinoin



this is my DAY1 on isotretinoin, my starting doasge is 30mg Claravis, 2 pills a day with food, i plan on taking right after breakfast and dinner.

this is an elaborate log/description with titles for each paragraphs, so if you dont want to read some topics you can skip thru'. this description explains my path to isotretinoin, and my acne history, etc. I will post more as the days/weeks move forward and when I make some progress.

Conditions that i am treated for:

(1) acne, one or two cystic spots on my face, a few more whiteheads and blackheads also on my face.

(2) scalp folliculitis, about 10 spots on my scalp all around my scalp and not specific to one location on scalp, this would be of cystic severity, so i feel uncomfortable sleeping, these cysts would press against the pillow and cause pain, but not as embarrassing as facial acne, its not visible.

(3) sebaceous hyperplasia, bumps all over my face, more so around the mouth, nose and the shaving line, less concentration on cheeks, forehead and other areas. They look like a larger white head, but when i touch it, it does not pain and this adds up the appearance of the face in a bad way.

Background info about me: I am a 26 years old male, combination skin type (some parts of my skin are very oily, other parts are dry), active social lifestyle, single, work at a desk job with people and computers, so occasionally stressful job, i wear contacts for my vision correction, i workout almost 5 days a week, workouts are not intense, i am a social drinker, i drink alcohol during the weekends, not every weekend though, i do not smoke, i have a average sports/outdoor lifestyle (this is for sun exposure). I live near DC. I am not sure how much of this is relevant, but this should paint a baseline picture about me:)

My acne history and past treatments (this has sub-paragraphs with titles):

Started with home/OTC treatments: I started getting acne when i was about 15 years old, at that the severity was very mild, few white heads in face area. like anyone else, i started with home treatments like 'wash face more often, rub a slice of lemon on my face, salicylic acid, benzoyl perozide, blackhead extraction with comedone extractor device, etc. At this point i kinda self-prescribed these treatments without going to a doctor or a derm. These treatments helped but not quite complete. for example, if i had 10 spots, these treatments would reduce them to like 5 spots, but i still had 5 spots sporadically. As i got older like 17/18 years, i started getting more acne lesions. I also used to believe in acne myths like diet, masturbation, dairy, aspartame in diet soda, etc, so i made adjustments in lifestyle to adapt, but that did not change anything, not even a placebo effect. So i continue to treat myself because that helped partially and i did not want to goto a doctor for something as simple and common as acne, in other words i was quite ignorant. When i was about 20 years old, i started getting scalp acne, for which i got shampoo that treats scalp acne, which also only worked out partially.

antibiotic #1 (minocycline+benzaclin in am+tretinoin before bed time): when i was about 22 years old, i decided enough is enough with acne & home treatments, i seeked medical treatments, mainly because of acne scarring. i went to a general physician and not a derm, he prescribed me minocycline 100 mg, twice a day, it worked, so my doctor told me to taper down the doasge, when i did that, my acne started coming back, so i went to a derm this time, my derm put me back on starting dosage for mino and this time he gave topical medication like benzaclin in am and tretinoin before bed. this worked, so my derm told me to taper the dose down for mino while keeping the topical medications unchanged. I did that, the acne strated to come back. i was on this roller coaster ride of going back and forth with the dosage for about 4 years now. I decided that this only works when i am on full dosage, and i cannot take antibiotics for years, so for second opinion, i went to another derm, and he wanted to change medication. Also in this four years, i started developing a condition called sebaceous hyperplasia.

antibiotic #2 (bactrim+benzaclin in am+tazorac before bed time): this combo worked, and it even worked after tapering the dose down from 2 pills a day to one pill a day, so i finally thought this might it. these treatments only helped acne on face and scalp, not the hyperplasia. my derm said, if i continue using tazorac, over time, hyperplasia would slowly go away, i did not see any signs of that during my 4 month course, but may be it takes longer, who knows. finally my derm wanted me to taper the dosage down to zero. it was good until two weeks after i stopped the pill, then i started getting acne again. i felt bad, because after spending so much time and money, i am now back to square one.

isotretinon: All along i was aware of isotretinoin/accutane, and how dramatic the results were, i was very reluctant to jump into it because of the side-effect warnings. But now that I have tried everything else, and i have persistent acne, i have nothing but isotretinoin to try. I went up to my derm, same as the one who prescribed tazorac, and asked for isotretinoin, we went thru' all the possible side-effects, and I had to sign a consent form and i get an iPledge ID card. the process is pain-staking, i got my blood work done few days back and my derm ok'd for prescription. I picked it up yesterday and i started my first pill today morning, DAY 1. I am looking forward to the results, not so much for the side-effects...lol.

few articles that gave me the confidence to proceed with isotretinoin (despite the side effects scare):

these links allow me to relax a little bit, esp. because the way it was written, they say even though the side effects are more popular than the drug itself, in other words the drug is very controversial, they say most of the serious side effects occur only in very small percentage of the folks, which lets me think more rational, i hope this helps you too, if you are looking for articles to tell you this might be ok.



my expectations from isotretinoin: I think the sebaceous hyperplasia will return once i complete the isotretinoin, atleast i expect long term remission from the facial and scalp acne, also not so oily face and scalp:). also i have a few blackheads which i am hoping to get pushed out. Usually to retain the results of isotretinoin treatment, dermatologists prescribe either a low does isotretinoin or a retin-A kinda topical after the isotretinoin, i hope something like that would keep the hyperplasia from coming back. though i am not quite positive about all that, and also i dont want to get too ahead of myself, lets see how this all plays out for me.

P.S: although i used brand names for medications in my blog, i always got the generic ones, generic ones have longer names, and i am lazy, so i used the brand names to make my drafting easier...lol.

thanks for patiently reading thru' my thought process, more updates to come.

I welcome any comments and constructive criticism.


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