Hey there guys,
so as the title of this blog suggests, I'm going to be documenting my journey and experiences during the first leg of my treatment with isotretinoin. My dermatologist has me on 3 months to start, and then at that point I'll head into the office again where I assume we'll see what my progress is and determine whether or not I need to or should continue treatment, maybe at a different dosage. Right now I'm on a lower dose, only 20 mg. My dermatologist didn't want to start me on anything heavier than that because I'm quite a petite person. I know 40 mg is by far the most common dosage you see and is what a lot of people posting here have taken, so I hope that for anyone else who is in the minority and taking 20 mg that maybe my posts will give you a better idea of the results you can expect. So… here's a little background on my skin:
I've really only had chronic acne for about a year, so I am really lucky in that sense because I've seen people who have struggled with acne for several years before they ever find a solution. I don't know how some of you do it, because one year in and I'm already at my wits end. I'll admit, I probably don't have a lot of patience compared to other people dealing with acne but I won't ever apologize for wanting to get this problem dealt with as swiftly and surely as I possibly can. My dermatologist readily agreed with me that my acne seemed quite aggressive and when I told him all the different things I had tried including topical treatments, chemical peels, prescription creams, birth control pills, and even dietary changes, he could see that I had already grown so frustrated and exhausted most of my options so isotretinoin had to be the next step.
Right now, my skin actually isn't as bad as it's been in the past but it's a far cry from being normal, passable skin. I have a little bit of active acne and the pimples I get are always stubborn and take so long to heal, but thankfully I haven't had any new breakouts in a while. I went on birth control in February and I was able to stay in the habit of taking it daily for a while, but come May I was pretty irregular with taking it and even stopped entirely for a couple weeks. That seemed to throw my hormones badly out of whack, as literally overnight I had several dozen little hard skin colored bumps crop up alllllllllll over my jaw area. A few days after that horrific breakout, I got my period (which I actually hadn't gotten at all in the two months which I had been on the pill), and that's when it clicked in my head that my hormones were getting confused by being on the pill and then going off of it and that must be what was causing my breakouts. So I've been a lot more committed to taking the pill regularly since that one terrible breakout. My body has had an interesting time adjusting to it. For the next two months, I got really bad breakouts that occurred around the same time of month as that crazy one I had in May. I didn't get my period after starting the pill again but I'd still get the breakouts around what would have been my time of month. It was always concentrated around my jaw, mouth, and chin, and the pimples themselves were small in surface area, but very firm and raised, and there were always a LOT of them. The breakouts would come really suddenly but for the most part clear up fast as well. Now, ever since September, I haven't had a bad breakout like the ones I'd get every month. Earlier this month, I even got my period for the first time while also being on birth control regularly, and while I got it, I was amazed thinking "Wow, why haven't I broken out yet?!" I wasn't using any special products on my skin at the time because I feel like no matter what I put on my face it really hasn't made a difference (but I will get into my routine in a bit) … So I'm not really sure what it was that's been doing the trick, but if I had to take a stab at it I'd say it's probably a combination of the birth control finally doing it's thing in regulating my hormones now that I've been taking it consistently for about 4 months, and a result of healthier habits including my switch to a vegan diet.
Now, another big problem area for me is my cheeks. In fact all of my acne is totally local to the lower half of my face, while my nose and forehead are 100% clear, which I find really strange. ANYWAYS, like I said, the blemishes along my jaw and chin are smaller, a little more raised, and seemingly more surface level, but the acne on my cheeks seem deeper and the blemishes are much larger. They're flatter, but have a larger surface area and take a while to come to a head unlike the ones on my lower face which pop up out of nowhere but disappear in a couple weeks once theyve reached their peak. The blemishes on my cheeks take forever to heal, are often very painful and inflamed, and leave bad scars in their wake. I have active acne on both my cheeks, kind of in a small cluster, not really on the apples of my cheeks but closer to the sides of my nose. There's some small active pimples on my upper jaw area along with my chin and some pretty bad scarring in that area too, as I have a very fair complexion that scars easily. There's actually one really noticeable one from a pimple on my chin that was particularly bad, it’s left a scar that's noticeable from a distance and even makeup doesn't fully disguise it. I can't tell exactly how bad the scarring is on my cheeks because I'm still dealing with a lot of active acne in that area and my pimples there tend to be flatter so it's hard to distinguish what's active acne and what's leftover pigmentation. I'm hoping the isotretinoin will help with both.
Anyways, that's the current state of my skin right now. I should also note my skin type is quite normal, I wouldn't describe it as particularly oily, in fact it can be very dry in the winter time which is actually around when I started breaking out last year. My skin is a real mystery eh….
So, the routine I was following for the last few months was washing with a salicylic acid cleanser and, morning and night, and actually in September I got a cleansing device, specifically the Foreo Luna Mini 2 for my birthday, and I really enjoy it so far cause I feel like you get a deeper clean in less time and it leaves my skin feeling smooth, fresh, and stimulated. After that I use diluted apple cider vinegar as an astringent. Then, in the mornings, I'd put on a light moisturizing gel with hyaluronic acid, and at night I'd use a bit of a heavier cream, it's a beta hydroxy complex, which is supposed to help improve skin texture and appearance of pores, lines, and pigmentation. Then I'd spot treat with tea tree oil every night, just dabbing some on my more inflamed and angry pimples. That routine had been going pretty okay for me, my acne certainly wasn't getting worse, but over time, and I mean just in the past couple weeks, right after my visit to the dermatologist where they issued my blood tests for isotretinoin, I noticed I was starting to get dry, scaly patches on part of my face. I'm assuming it was the drying from the salicylic acid and tea tree oil, also with me living in northwestern Canada, we have a very dry, arid climate, and going into October it already is quite cold here and the conditions can be harsh on your skin. I was thinking to myself, "yikes, my skin is already drying up and I haven't even started the drugs yet?" So I figured I'd have to start amending my routine. I've already made some changes and the dry patches on my skin have indeed disappeared so yay! I'm gonna continue with this routine and see how it goes and of course update you guys, but as of right now, I plan to wash my face only once a day, at night, in order to get my makeup off, using a gentle, natural cleanser from Origins. I'm going to use my Foreo but on the lowest vibration setting cause I found using it turned up all the way like I had before was painful on the parts of my skin that were kind of chapped and raw. In the morning I just splash some water over my face, let it air dry, then go right to applying the astringent. I diluted the apple cider vinegar even more and added chamomile and green tea for their soothing benefits, and a bit of jojoba oil just to help rejuvenate. I recently started using a new daytime moisturizer cause I ran out of the last one, this one is glycolic acid based and I don’t know if it will be quite as hydrating is the hyaluronic acid but I think it will be good for scarring. I'll see how much my skin dries out and adjust accordingly, but I've already armed myself with Aquaphor in preparation for the dry and chapped skin and along with my rich night cream I'm hoping that will be good enough.
Well guys I guess that's about all there is to say! (I say that as if I didn't just write 3 giant paragraphs) I’m going to post weekly updates to talk about my side effects, progress, just any changes I'm noticing in my skin. I imagine the first couple weeks might be pretty uneventful so some updates might be much lengthier than others. I also plan to get up some photos of my skin in it's current state maybe tomorrow, and I'm gonna dig around to see if I can find even more photos of my skin from before but I'm thinking that won't turn up much cause I really tried to avoid photos when my skin was bad.
I hope some of you guys decide to follow my updates and progress! I apologize because I know sometimes I go into excessively long explanations and ramble, I'll try really hard to be more concise in my future updates.
For now, because I know this introductory post had a lot to read and a lot of people probably won't take the time to go through it all (if you do however, just know I appreciate you) I'll post a little tl;dr down below:
- Suffered from hormonal acne for the last year that would fluctuate in severity but was still persistent
- Acne is deep, persistent, nodular on the cheeks, and papular/pustular along the jaw and chin. Extensive scarring is present where acne used to be present on the jaw and chin, though it is mostly clear of active acne.
- Birth control and diet have helped calm down those occasional flare ups, but I'm still looking for that extra something to deal with the aggressive acne on my cheeks
- Following a simple skin care routine using natural and gentle products, avoiding agitation
And again, I'll be on isotretinoin 20 mg, from the brand Epuris which I believe is exclusive to Canada, but it's essentially just a generic form of Accutane, and I'll be on it for 3 months until I meet with my dermatologist again and then we'll determine what the next step is.
Today was actually my second day on the medication, I took my first dose yesterday on Wednesday, so I'll most likely post an update Wednesday of next week. Keep an eye out for it and follow this blog if you're interested and want to find out what results a lower dose of isotretinoin will yield. Thanks a bunch for reading!