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That part about giving someone "large enough doses of DHT" is interesting speculation, but that's all it is. Speculation.
It's not speculation. DHT is just one of many androgens that stimulate oil glands. Try DHEAS which increases during puberty.
Again, its not speculation that women in their 30's & 40's that never had acne before often suffer from an ovarian or adrenal tumor which creates excess androgens. Hence, maybe not enough to cause oily skin but causes acne.
Just as anabolic steriods do at high enough doses.
Babies under 6 months old don't have oily skin but the hormone surge at birth sometimes causes breakout up to their first 6 months of life.
Daniel J said:bryan said:That part about giving someone "large enough doses of DHT" is interesting speculation, but that's all it is. Speculation.It's not speculation. DHT is just one of many androgens that stimulate oil glands. Try DHEAS which increases during puberty.
Again, its not speculation that women in their 30's & 40's that never had acne before often suffer from an ovarian or adrenal tumor which creates excess androgens. Hence, maybe not enough to cause oily skin but causes acne.
Just as anabolic steriods do at high enough doses.
Babies under 6 months old don't have oily skin but the hormone surge at birth sometimes causes breakout up to their first 6 months of life.
Bryan you should do more reading big guy:
Again, "Acne can not occur without sebum, which serves as a nutrient source for Propionibacterium acnes." As quoted in this EDU link:
[Removed link]
http://en.wikipedia.org/wiki/Dihydrotestosterone
which states:
"DHT is also known to participate in the development in some cases of acne."
Just because the FDA-approved BPH drug dutatsteride doesn't stop acne doesn't mean DHT isn't involved in acne. There is more than just DHT that causes oil glands to enlarge. Like IGF-1, HGH, & DHEAS. DHT is 3 times stronger than testosterone & testosterone is at least 5 times stronger than adrenal androgens.
Genetically some people's oil glands make androgens within the oil gland like DHEAS. Hence, why the person's blood levels read normal on everything but might have the most severe form of acne being acne conglobata.
Men with acne actually have a lower risk of heart disease later in life. Makes since because it is an avenue at which your body expels cholesterol & triglycerides. Two ingredients in human sebum. Hence, why Accutane ups triglyceride levels unless you take fish oil with it.
It's not speculation. DHT is just one of many androgens that stimulate oil glands.
Hey, that's a really peculiar thing for you to say, considering that just a short while ago, you made the following statement in plain English: "It's not testosterone but DHT that ups the size of oil glands." 🙂
Again, its not speculation that women in their 30's & 40's that never had acne before often suffer from an ovarian or adrenal tumor which creates excess androgens. Hence, maybe not enough to cause oily skin but causes acne.
Sure, but so what? As I've pointed out numerous times before, Kligman et al found that significant oral supplements of testosterone did NOT increase sebum production in men, but they did do that to a variable extent in women (some women had extra sebum production, some didn't). But another critical issue here which you haven't acknowledged is the specific mechanism by which much larger amounts of androgens cause acne in certain women. Is it because of an increase in sebum production, or is it because of some other factor or factors? Or all of those factors together?
BTW, there's a rather obvious possible explanation (obvious to me, anyway) why extra testosterone given to men wouldn't have any effect on their sebum production. Can you think of it, yourself? 🙂
Babies under 6 months old don't have oily skin but the hormone surge at birth sometimes causes breakout up to their first 6 months of life.
There ya go! You just answered your own question! 🙂
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Daniel J said:Bryan you should do more reading big guy:
Again, "Acne can not occur without sebum, which serves as a nutrient source for Propionibacterium acnes." As quoted in this EDU link:
[Removed link]
I don't really particularly doubt that acne cannot occur without sebum; the only problem with that is that it's not saying very much. It's like pointing out that androgen is known to be a necessary prerequisite for common balding, but I don't think anybody would seriously suggest CASTRATION as a means to stop balding! 😯 See what I'm saying? I'm sure one could prevent or cure acne if there were a safe and reliable way to sufficiently and continuously suppress sebum, but there's no way (yet) to do that. In the meantime, we have other very important questions to ponder: why do some people who have even considerable levels of sebum production not have acne at all?
Daniel J said:Just because the FDA-approved BPH drug dutatsteride doesn't stop acne doesn't mean DHT isn't involved in acne.
Dutasteride has never been tested for acne. The drug that was used was MK386, which is Merck's experimental specific type 1 5a-reductase inhibitor.
Daniel J said:There is more than just DHT that causes oil glands to enlarge. Like IGF-1, HGH, & DHEAS.
Agreed. And you need to keep in mind the other possible important influences of those other hormones and cytokines.
Daniel J said:Men with acne actually have a lower risk of heart disease later in life. Makes since because it is an avenue at which your body expels cholesterol & triglycerides. Two ingredients in human sebum.
Let's not get TOO carried away! 
.
Where is that thread about masturbation making somebody's skin oily...
Probably shouldn't have gone there but ya never know!
DEFINITELY take fish oil EVERY DAY.
Fish oil is the go-to supplement for all kinds of skin problems, including dryness, eczema, psoriasis, etc.
In my opinion this is the absolute NUMBER ONE thing you should be doing. Buy Carlson's brand -- it has no fishy taste/aftertaste. It tastes like lemon. And go for the liquid, not the capsules. And take a decent amount of it -- 1 - 2 teaspoons per day.
For the liquid form I've heard that even after the bottle is opened and kept in refrigerator it could be spoiled and that it should be added some potent antioxidants like BHT but they are problematic for one's health. Wouldn't the capsule preserve the fish oil better? Should capsules be depositet in the refrigerator as well. As for the rancidity you could smash the capsules with your teeth.
For the liquid form I've heard that even after the bottle is opened and kept in refrigerator it could be spoiled and that it should be added some potent antioxidants like BHT but they are problematic for one's health. Wouldn't the capsule preserve the fish oil better? Should capsules be depositet in the refrigerator as well. As for the rancidity you could smash the capsules with your teeth.
Liquid fish oil doesn't go rancid for three months as long as it's kept refrigerated.
I am also on Accutane, and it is crazy how dry it can make you--and itchy (I wake up to myself scratching my face--which can't be good for the acne). I have lately been taking two capsules of Flaxseed oil and vitamin E and also using the moisterizer you can get here at acne.org. It has Jojoba oil and I also add a few drop of jojoba oil to it (can also get through here). So far hasn't broken me out and I have no dry skin flakes on my face (which can be just as embarrassing as the acne). I can only use it at night--as it is oil and I actually look oily if I use it during the day.
It's cheap and works good:)
It's cheaper, and you don't have to worry about fillers that are present in the capsules.Yes AND it's less likely to be rancid.. and if it is rancid, you'll know, whereas you could take a rancid fish oil capsule and have no idea because you aren't tasting it.
Well, a good quality fish oil like Natrol Fish oil is lemon flavored softgels with vitamin E added to prevent the oil from going rancid. The lemon to to prevent nasty tasting fishy burps. Also, long-term fish oil lowers vitamin E levels so vitamin E added serves two purposes.
I prefer veggie source omega-3 fats like Flaxseed oil softgels with "lignans." Problem is most companies put too little of a dose of lignans per softgel. I buy Swanson's brand at www.swansonvitamins.com it's like $6.49 per bottle of 200 softgels.
It has a whopping 20mg per softgel. You cannot find a better deal, since flaxseed oil without lignans is worthless. Any studies ever against flaxseed oil was without lignans. It's like taking fiber out of whole grains. I take 4 softgels per day (two with my first & last meal). 50+mg or more of flaxseed lignans per day lowers women's risk of breast cancer and helps prevent baldness in men. The latter has been proven by a study!
OP, I have this problem.
I took Accutane 5 years ago. My forehead and cheeks are still dry, leathery, rough, like wood. My pores look huge and "dried up." The hair along my "hairline" (neck, above eyes, etc.) is like straw. The hair away from my hairline (top of my head) is completely different -- soft, shiny, healthy. I even tried growing my hair out, wondering if it was just the cutting that was affecting the hair's oil level.
My skin feels dead. I feel like my wrinkels are coming in way fast. I don't even think wrinkles are that bad, but with my dried up skin, the folds really show how the skin has lost its retention.
My face FEELS dry -- almost like when you have a sunburn.
My dermatologists have always just said "use lotion." But the skin doesn't even absorb the lotion. Everywhere else on my body, my skin is very smooth, moist, and healthy. If i have some dryness/flakeyness on, say, my arm. I can apply lotion, and after a couple applications, voila, its perfect again. But my face is totally different. I am convinced it was the Accutane.
I know other people argue that the Accutane cannot permanently damage your glands, but I think some people, like the OP and I, might be more vulnerable. My father's side of the family all have very "bad" skin. Based on personal anecdotes/experiences, I think Irish skin might be more vulnerable to this than, say, Medditerranean skin.
I am 23, and I never had any acne after Accutane. Hardly even a pimple. But I really think this rough, leather, dead skin is far worse. Far worse. I sometimes fantasize about getting a skin transplant or somethign. Or stem cells. It really bothers me.
I had been so busy with school and work the past few years, that I sort of avoided it, and people always assured "after Accutane, you oil will kick back in, you just need to wait". Well that never happened, and I think I'm in a point in my life when I'm ready to confront it as aggressively as possibly. Or atleast figure out exactly what happened, rather than just avoiding it and saying "it's fine" or "its not that bad."
One thing I stumbled upon was Peroxisome Proliferator-Activated Receptors. they are supposed to stimulate Sebum production, and some treatments for diabetics have shown this. I will post a couple articles below. But I really am not an expert on this. I am seeing a dermatologist next week, and I am going to mention this. Even if it isn't the answer, I hope I will atleast express the "urgency" and magnitude of my interest in fixing or treating it.
Any thoughts? I'm wondering if I should see an Internal Medicine...person...or do they call them internists?...or an Endocrinologist or something. Perhaps this is just beyond the domain of the average dermatologist, since I've seen about 4 over the past few years, and gotten nothing but apathy and shrugs of the shoulders.
I had some redness/rash around my nose a couple winters ago, and I was prescribed some cream for it. the cream quickly fixed the redness/rash. I tried it around my forehead/cheeks, and it had no effect at all on the dryness and what not. It seems completely separate from any common skin disease or rash...I feel like my sebaceous glands are just fried 
(
I tried a lot of basic remedies -- Fish Oil, eating more fats, I actually eat a lot of fish anyway, I drink lots of water, I tried totally avoiding the sun...I even found a supplement that has help my scalp (I used to have bad dandruff), but my face has not improved, and it feels like its getting worse.
Strangely, however, the damage is only on my face (cheeks and forehead mostly). However, on Accutane, I had developed terrible cystic acne on my neck. But my neck feels rather moist and healthy. So I guess Accutane affects multiple glands, but the ones that are permanently damage are the ones on my face itself (cheeks/forehead mostly). I don't know exactly where the sebaceous glands are distributed, but if they are most in those areas, then that answers that.
Also, I started taking adderall about a year ago for ADHD. It makes my nose EXTREMELY oily...but my cheeks/forehead are as dry as the desert still. So it is pretty alarming that my face is so dry that even a stimulant that makes other people break out and get oily does absolutely nothing in my cheeks/forehead.
Please offer any insights as I am trying to really research this and get the necessary medical treatment. Even if this is considered cosmetic, it bothers me enough that I would pay for treatment even if considered non-urgent.
ARTICLES:
Peroxisome Proliferator-Activated Receptors Increase
Human Sebum Production
Nishit R. Trivedi1,6, Zhaoyuan Cong1,6, Amanda M. Nelson1, Adam J. Albert2, Lorraine L. Rosamilia3,
Surendra Sivarajah4, Kathryn L. Gilliland1, Wenlei Liu5, David T. Mauger5, Robert A. Gabbay4 and
Diane M. Thiboutot1,3
Peroxisome proliferator-activated receptors (PPARs) in skin health, repair and disease
Liliane Michalik, a, and Walter Wahli, a,
aCenter for Integrative Genomics, National Research Center Frontiers in Genetics, University of Lausanne, Genopode Building, CH-1015 Lausanne, Switzerland
So I am posting about this issue on the Mind/Muscle forums...and I post this on the thread there. So I am adding it here, b/c there are a couple more details relevant to this thread, too. And I don't feel like retyping those details.
Many people suggest taking Biotin for the long-term Accutane side effects. Krazyj, I believe that Accutane does cause permanent changes to the glands, as its marketed by dermatologists as a "cure" to acne. Personally, I think this drug should be banned. Do you notice any other side effects? Libido? If you don't want to post it you can PM me if you want.
It's ironic you suggested Biotin, because I recently started taking that for my scalp. It does wonders for my scalp (I had bad dandruff) but my face, and the "straw-like" hair around my hairline (neck, above the ears) is still...straw-like.
I currently used Aveeno moisturizer. I have used Dove, Eucerine, Cetaphil in the past. I used Desonide cream for the redness/rash around my nose, and I was impressed with how effective it was. I tried the Desonide cream on my cheeks/forehead (areas dried out by Accutane) and it had no effect at all. I have also tried some relatively expensive lotions/moisturizers/serums from Sephora by the brand Cosmedicine. The serum and the "matte" lotion actually made for a good "band aid" solution...that would last for like an hour.
I would even try putting straight up vegetable or olive oil on my face sometimes...sort of out of desperation...but it wouldn't help.
The straw-like hair is a telling symptom. I have tried lots of deep conditioners and what not, to not avail.
I also have issues peeing -- when I drink something, it needs to come out almost immediately after. I also "leak." I feel like this is connected...I'm sure a lot of the cells involved with urination are connected in some ways to those in my face...epithethial cells? I also get chap lips pretty easily, and relatively low saliva production (dry mouth). However, my Adderall usage makes the dry mouth and chap lips considerable worse. However, I'm pretty sure these were below average BEFORE I started taking Adderall last year.
When I take showers, my face gets extremely red. Yes, I know this happens to everyone. But before vs. after adderall, the redness I would experience was like 10x worse.
So in reading one of the articles I mentioned...it seems like the oral treatments that function as agonists of PPAR and increase sebum were:
Thiazolidinedione: 1) Pioglitazone; 2) Rosiglitazone
Fibrate: 1) Gemfibrizol; 2) Fenofibrate
The Fibrate group increased sebum by 77% (vs. 37% w/ Thiazolidinedione). Incidentally, I read on Wiki, however, that Thiazolidinedione is only approved for Diabetes treatment.
I also saw that there is a sebum measure machine called Sebumeter SM 810. That would be nice, to quantify the abnormality in some what, instead of just qualitatively describing it.
For the liquid form I've heard that even after the bottle is opened and kept in refrigerator it could be spoiled and that it should be added some potent antioxidants like BHT but they are problematic for one's health.
Oh my goodness....if you think a little BHT is "problematic" for your health, wait until you find out how "problematic" rancid and oxidized fats are. Such rancid fats are atherogenic, thrombogenic, mutagenic, and carcinogenic. Is THAT "problematic" enough for you? 🙂
Wouldn't the capsule preserve the fish oil better?
Maybe a little better. But oxygen can definitely still diffuse throught the walls of gelatin capsules.
Should capsules be depositet in the refrigerator as well.
Yes. I certainly would.
Well, a good quality fish oil like Natrol Fish oil is lemon flavored softgels with vitamin E added to prevent the oil from going rancid.
By no means is vitamin E a strong enough antioxidiant to completely stop highly unsaturated lipids like fish oils from going rancid. You need something a LOT stronger than just vitamin E. I recommend BHT for that purpose.
I had been so busy with school and work the past few years, that I sort of avoided it, and people always assured "after Accutane, you oil will kick back in, you just need to wait". Well that never happened, and I think I'm in a point in my life when I'm ready to confront it as aggressively as possibly. Or atleast figure out exactly what happened, rather than just avoiding it and saying "it's fine" or "its not that bad."
I'm rather confused by your post. I can certainly appreciate the problem you're describing with your extremely dry skin ("dry" as in MOISTURE-dry), but why on earth would you want your sebum to come back?? You seem to be assuming that the lack of moisture in your skin is linked somehow to the lack of sebum, but that's not the case. I hope the moisture in your facial skin eventually comes back, but at the very least, you can be glad the sebum is much reduced.
I also saw that there is a sebum measure machine called Sebumeter SM 810. That would be nice, to quantify the abnormality in some what, instead of just qualitatively describing it.
Sebumeters are nice, but you could also use Sebutape test-strips to measure the sebum on your skin. A roll of 100 Sebutape Skin Indicators costs about $40, which is a lot cheaper than a Sebumeter! 🙂
There's a thread I started on the Acne Research forum (you can find it with the Search function) titled: "If you stop washing, do you get MORE oily, or do you get LESS oily??". I provided scans of the actual Sebutape test-strips that I used to prove that I got more oily over a 12-day period of not washing. You could get some of those same Sebutape test-strips yourself, and directly compare YOUR results to mine! 🙂
The OP was a long time ago, Id like to know how things are now.
Anyway i found this thread by chance on google. I have almost the exact smae problem and have had so for 18months. However I've never used Accutance. I did use B5 very briefly (5mg a day for 2 weeks) 2 years ago but I dont think its connected.
One thing I suspect (and Im sure many will disagree) is Omega-3. I started taking 2000mg of MorEPA (look it up) in June 2006. and stopped about 7 months ago. I strongly feel that this suplement has caused my "lack of sebum" as you call it. I feel the same way, that softness seems to have been replaced by coarseness, and my hair does seem more stringy, straw-like as you said.
Its frustrating becasue my skin used to be soft, supple and smooth to touch (expecially the face). But now it is very dry, very uncomfortable and my skin lacks that "youthful glow". Anyway the only thing I have done is to stop the Omega-3 supplement, as its the only thing that seems to be related to the timing.
If my glands/skin has been damaged by it I hope the body is capable of eventually correcting this. Its hard to say whether things are gradually improving becasue I have days that are worse than others, its a bit unpredictable.
What's the difference between Moisture and Sebum?
I admit I am new to all this, so I don't know dermatology very well.
I never had dry skin before Accutane...and the rest of my body's skin (other than my cheeks/forehead) is extremely moist and supply and soft and healthy. As I understand, sebaceous glands are specific to these particular areas, so that is why I am focused on the Sebum.
I was actually about to go out and buy a bottle of "Super Omega-3 EPA/DHA with Sesame Lignans & Olive Fruit Extract (Molecularly Distilled)" so it is a bit discouraging that you were displeased by Omega 3. I currently take Omega 3-6-9, but it was suggested to me that I up my intake of OMega 3 specifically, and the sesame is supposed to further augment the effects.
The claim of sebum moisturizing and extending skin's youth holds no truth, at least in my case.
Extremely oily and developed creases on my forehead since late teens. Add enlarged pores and I'm looking like a 30 year old.
Sebum's main role is to waterproof the skin, keep the moisture in and environment factors out. Excess sebum suffocates the skin and leads to inflammation and things like hair loss.
I think in your case it's Accutane and not B5. Retinoids are very potent. Your sebaceous glands must be fried by now and I'm not sure if there's anything that can revive them.
Perhaps try finding other Accutane users and see if there's anything that helps them.
What's the difference between Moisture and Sebum?
Moisture refers to WATER. Sebum is an oily substancy consisting of various fatty acids and other lipids that are secreted by the sebaceous glands onto the surface of skin.
I never had dry skin before Accutane...and the rest of my body's skin (other than my cheeks/forehead) is extremely moist and supply and soft and healthy. As I understand, sebaceous glands are specific to these particular areas, so that is why I am focused on the Sebum.
You can stop stop worrying and beating yourself up over your relative lack of sebum, because it doesn't have anything to do with the lack of moisture in your skin. Read the following excerpt from a medical journal article:
Journal of Investigative Dermatology. 1987 Mar;88(3 Suppl):2s-6s.
"Skin lipids: an update"
Downing DT, Stewart ME, Wertz PW, Colton SW, Abraham W, Strauss JS.
(excerpt from this study follows below, including the references...)
Sebum and Dry Skin "...skin can be healthy and have charming cosmetic properties in the virtual absence of sebum." (14)
Kligman drew attention to prepubertal children, who produce almost no sebum, to support his thesis that skin does not depend upon sebum for maintaining its barrier to water loss: "...there can be no doubt of the insignificance of sebum as a waterproofing material." (14) Our recent studies at the other end of the human age spectrum have supported this conviction. In a survey of sebum secretion rates and the incidence of dry skin among subjects aged 65 to 97, no correlation was found between sebaceous gland activity and the presence or severity of dry skin (34). Kligman recognized that sebum could mask the scaliness of dry skin without producing any actual change in the condition: "Sebum, like any oil, has some emollient or smoothing effect when a sufficient quantity is rubbed into dry, scaling skin." (14) In spite of the clear inference to be drawn from the cutaneous characteristics of children and the experimental data obtained from the elderly, it remains difficult to dispel the myth that low sebum secretion rates cause dry skin. It is a rare individual who realizes that "dry" is not the obverse of "oily".
(14) Kligman AM: The uses of sebum. Br J Dermatol 75: 307-319, 1963.
(34) Frantz RA, Kinney CK, Downing DT: A study of skin dryness in the elderly. Nursing Res 35: 98-100, 1986.