So I was not planning on doing a log during my Accutane journey, but so far my experience has been so positive that I want to at least make it available to those who are researching Accutane in an effort to decide whether to take it or not.
Background:
I've been dealing with acne since age 13. Yes, that makes sixteen years now, and I'm just fucking DONE. I've tried everything, and finally in my mid to late 20's got it mostly under control by 1) no longer using soap of any kind on my face and 2) BP cream twice a day accompanied by moisturizer. I would have periods where I was basically clear, but they would never last, and especially when I work out hard and sweat a lot, I'd break out again. Having to decide between a clear face and exercise is just ridiculous, especially now that I'm nearly thirty and working out is becoming more important than ever. I've gone into medicine and seeing the difference in my patients between people who exercise and people who don't is just insane. I never understood what a difference it makes until I started practicing. I can tell you the two big keys to staying young: EXERCISE, and DON'T SMOKE. This is the big secret! So needless to say, now that I am exercising all the time, my skin is breaking out more or less continuously and I just can't stand it anymore. Plus it is totally unprofessional to be wearing loads of makeup every day.
I went to a derm recently who was actually a complete bitch - I came in requesting Accutane and she took one look at me and basically said "no fucking way are you getting Accutane". Instead she wanted to put me on long-term erythromycin therapy with some kind of expensive mask treatment every two weeks. Then she gave me a long diatribe about the horrors of Accutane and how someone with skin like mine was being ridiculous by even considering it, and I couldn't possibly understand how terrible the side effects could be. She was horrible. I would never talk to my patient the way she talked to me. I had several problems with this: side effects of long term antibiotic therapy can be pretty brutal in themselves, and I find it depressing how infrequently these issues are addressed by medical professionals, not to mention that flagrant usage of antibiotics is exactly how we end up with strains of resistant bacteria. Don't really want to be part of that problem. Second, I am not a moronic child. I've done my research on Accutane and by the time I came into her office, it was on the tail end of literally a five-year decision process. She completely discounted the emotional anguish that has accompanied my 16-year struggle with acne, and the fact that at this point I am wiling to do anything. I don't want to pop a pill twice a day for the rest of my life. Nor do I want to slather BP all over my face every twelve hours into perpetuity. I am also a medical professional so I understand the risk I am assuming here.
Anyway, obviously I am still pretty pissed off about the treatment I received from this lady, I'll move on now. I called almost every derm in my city asking if there was anyone who prescribed Accutane for persistent, mild to moderate, treatment-resistant acne. Got an answer in the negative every time, but I was determined, so finally ended up ordering an entire course in one shipment from Canada. It took about two months to finally get to me (longest wait EVER). But I am so, so excited to finally be taking what will hopefully be the last step in my lifelong battle with acne.
State of my acne when beginning Accutane:
Mild to moderate. At any given time I probably have from 0 to 4 active pimples. The problem was that they seemed to be getting deeper lately, so even if they weren't huge and obvious to an observer, they were painful for me. Ouch. Easily covered with makeup, but I want to be able to wake up and look gorgeous, not spend 15 minutes in front of the mirror before looking gorgeous. And it seems like I finally had a few zits that left minor scars afterwards. Don't know if this is because I'm getting older but it was the last straw for me. I can deal with acne but not with scarring. My family freaked out when I told them I was putting myself on Accutane but as I told them, I would literally crawl through fucking lava at this point if it would cure my acne forever.
I am five foot seven, female, 60 kilos, and starting myself on 20 mg a day. I have enough Accutane to reach a final cumulative dose of 120mg/kg.
Days 1 to 6:
The first pill I swallowed was accompanied by a great deal of trepidation. I've read the logs, the horror stories, and was convinced that I would have splitting headaches, all my hair would fall out, I wouldn't be able to go running and my face would explode into a complete fucking mess for six months.
Two hours after my first pill I had a headache. I never, ever, ever get headaches so I know this was caused by Accutane. However, I was actually rather excited about it because it meant to me that the isotretinoin was working! And the headache was perfectly tolerable, really just a minor, dull ache. It lasted about four hours. So far, so good!
Day 2 was exactly the same. Minor four hour headache. My vision has been funky for the past two days. But that's it.
Day 3 was when the dry skin started. Yay! This must mean its working, right? I did notice on day 3 that I was already having some delayed healing. I had one open, active pimple when beginning my course and it is taking FOREVER to heal. Normally the ones along my jawline flake up and peel off in no time at all. But this one is taking its sweet time. Small price to pay though.
Day 4 - headaches have stopped. I notice at this point that I haven't gotten any new pimples since starting. I am still doing BP twice a day in an effort to circumvent any possible initial breakout. I am also super dry and moisturizing like crazy. There is one tiny bump starting on my chin but it's not like a normal pimple. It's very small and very slow growing.
Day 5 - no side effects to speak of except for dryness, which is welcome. No new pimples and my old ones are still healing.
Day 6:
Took my sixth pill today, and I know some will think I'm crazy but I can already see a difference in my skin. It just looks nicer. It's completely insane, but I haven't gotten a new pimple since I started. This is a big deal for me - six days without a zit? I did have a minor one on my chin, but its more like just a small bump, maybe just one third of a pimple. At this point I think there's a good chance that I might be one of the lucky few who have an immediate and positive response to Accutane. Side effects included headache and blurry vision, but only for the first two days, and are completely gone now. My skin is much drier than usual, but nothing that a little moisturizer and Chapstick can't fix! This is so much easier than I thought it would be. I am so happy and grateful, yet at the same time it's bittersweet. If it's this easy, why didn't I do it a decade ago? Or age 22? 27 even? WHY THE FUCK DID I LIVE WITH ACNE FOR SO LONG?!
So far all the horror stories I've read have nothing to do with my experience. I hope this isn't too good to be true, but I have high hopes.
Still continuing BP in case an IB pops up next week. In my opinion though, for many people the IB has more to do with discontinuing topicals before the positive effects of Accutane kick in. For this reason, I will be overlapping my topicals with my initial Accutane course. If I'm still zit-free at day 30, I'll up my dosage to 40mg/day. We will see!
So far I have nothing but positive things to say about Accutane. I just can't believe I haven't gotten a pimple in six days.
Wow.
DAY 9
Well I did end up getting two pimples on the left side over the past 2 days, one which will probably be gone by tomorrow, but one of those stinking painful ones deep under the skin along my jawline. Right side is clear, chin is clear, forehead is clear and nose is clear. If it wasn't for these two I would actually look amazing.
My face has been oilier the past couple days, this may be partly due to the fact that I scaled back from 5% BP to 2.5%. It's weird because it'll be super dry and flaky in the morning, but after a nine hour shift yesterday I looked like an oil slick.
HOWEVER, when I woke up this AM I noticed a definite, undeniable difference in the appearance of my skin. Not only does it look drier, it also looks tighter somehow. When I looked at my nose close up I noticed that there were some areas where the pores were so small that they weren't even visible.
Holy shit! I must have been 12 the last time that was true.
No bad side effects to speak of, although lips are getting drier. Vanilla Carmex is my new best friend. if this is as bad as it gets it's a SMALL price to pay!
Can't wait to see what my face looks like once these 2 suckers heal up.
Day 12:
Jeez my face is DRY!! I haven't really wanted to post the last couple days because I've been a bit depressed; I got two new pimples, one deep painful one along my right jaw and a smaller whitehead on my chin which I popped last night. In addition to the two I already had, my face was looking pretty rugged the past few days. Four nasty zits at once is pretty bad for me so I've been rather depressed. But today is finally starting to look a little better. My whole left side is healing at least, hopefully this will be the last bit of breaking out I have to deal with for awhile. Wondering if this could possibly be my IB? Normally my skin is only this bad right before my period, which right now is two weeks away. Hmm.
Anyway - DRYNESS!! Holy crap. I've had to stop using my AHA lotion because it freaking burns like hell when it touches my skin, and today I had to transition to using an additional layer of thick Skin Food moisturizer in the morning. My face looks like the Sahara when I wake up, and usually starts to flake by the end of the day at work. If I weren't so excited to be on accutane, it would be nasty, but right now I welcome and side effects that might mean things are actually working. I don't have any other negative effects, no headache or joint pain or anything.
Here's hoping my face will look better in a few days 
(
My face started to look great right after I started taking Accutane. I'm on my 8th day now, and BAM, hello zits! It's upsetting, but I guess it means the drug is working since apparently Accutane causes an initial breakout.
"My face looks like the Sahara when I wake up, and usually starts to flake by the end of the day at work."
I feel your pain! Three days of the week, I have 13 hour days - where I can't re-moisturize. I feel crusty, and just unpleasant. I don't even want to look at anyone by the end of the day. 
Hopefully the breakouts stop for both of us!
Hey kaydon! Thanks for posting ) sounds like we are in very similar boats. While I wouldn't wish this on anyone, it is nice to have a "comrade in arms", so to speak.
Today is....drum roll....
DAY 13:
This is definitely my IB. I have a weird pebbly band of pimples and clogged pores, but ONLY along my jawline, clear from one side to the other. It's something my skin has never done before. Very weird. I just keep telling myself that I CAN get through this! It seems like the deep pimples are done forming, at least temporarily. Mostly just healing lesions right now plus the bumpy clogged pores. I don't mind those nearly as much though as they don't leave red marks or scars.
I've had to add a heavy duty moisturizer (skin food) under my makeup in the morning...and I'm STILL flaky by the end of the day. Better than an oil slick though. Lips are roughly the equivalent of a scratchy cotton ball. Good thing I have no boyfriend to kiss, he would probably shrink away in terror from my alligator skin-face and sandpaper mouth. Tee hee. Side effects are really a breeze though, if at the end of all this I am clear!!
Day 17:
Well my IB is starting to clear up. I haven't gotten any new pimples in a few days, and everything on my face right now is healing, nothing active. My skin looks gorgeous from my mouth up: I can really see a difference in it. HOWEVER, all along my jawline is covered with healing pimples and clogged pores that are still resolving. It's bizarre, this one long linear breakout all along my mandible and chin from one side to the other. I haven't noticed that my jawline is particularly prone to breakouts before in the past, but then again I've never taken Accutane before either.
Side effects are definitely becoming more noticeable. My eyes are red and dry and painful, and my mom even commented that they looked like I had allergies. My skin is getting more sensitive and I've noticed some dry, lighter patches on my upper arms. Yesterday when I went running, simply the combination of sweat and friction in my armpits made the skin BURN. I've noticed that a lot - amounts of friction on my skin that are not usually painful REALLY REALLY hurt now. Weird. I can deal with it as long as I get clear in the end, which looks like might start to happen now that my IB is dying down (and really, it wasn't even all that bad, just annoying).
My nose is back to being full of blackheads, though. I wish that would go away.
Still on 20mg/day. I was planning on bumping it to 40mg at the end of month 1, but I don't think my IB will be fully healed by then and I definitely want to wait until it is before I switch things up, in case I get another breakout from the dose change.
Bah. I just hope this is truly the final nail in the coffin of the misery that acne has been for me for the past 16 years.
Day 19:
MY FACE IS SO FRIGGIN DRY!!!! If this is 20mg I am frightened to know what 40mg will be like.
I don't think I can continue with BP. By the end of the day my entire face is peeling/flaking off, especially around the mouth. It's like a beard of flake. I am flake Santa.
Gross.
Got two new (small) pimples on my chin today, and successfully squished them both. I have about 8 healing red marks/scabs. Countless clogged pores, along my jawline almost exclusively but spreading north up my cheeks a bit. My face is just a big ball of YUCK at this point. I'm visiting friends and I'm sure the combo of clogged pores + flakefest is making them wonder what the fuck my damage is.
IB, PLEASE BE OVER SOON!
Day 19:
MY FACE IS SO FRIGGIN DRY!!!! If this is 20mg I am frightened to know what 40mg will be like.
I don't think I can continue with BP. By the end of the day my entire face is peeling/flaking off, especially around the mouth. It's like a beard of flake. I am flake Santa.
Gross.
Got two new (small) pimples on my chin today, and successfully squished them both. I have about 8 healing red marks/scabs. Countless clogged pores, along my jawline almost exclusively but spreading north up my cheeks a bit. My face is just a big ball of YUCK at this point. I'm visiting friends and I'm sure the combo of clogged pores + flakefest is making them wonder what the fuck my damage is.
IB, PLEASE BE OVER SOON!
Hang in there! To help cope with the dry skin, it might be good to hold off on the BP or just put it on every other day. I've heard that others will also do a very gentle exfoliation once a week. Beyond that, moisturize like a fiend. I've heard Cerave cream (not the lotion) works very well. Also, many have spoken highly about Dr. Dan's lipbalm and Aquaphor. Good luck!
Your story sounds similar to mine. Derms seem to be reluctant to give it to us women of stereotypical childbearing age. I convinced my derm after 40 minutes that I was abstinent and would remain so during my course, nevertheless, he wouldn't prescribe unless I went on birth control. He wanted to try me on hormone fixing pills first but I have waited long enough and would stop at nothing to get Accutane (I'm 32).
I'm on my 3rd month. After 2 months I went from 20mg to 40mg. The first week my skin appeared tighter and the pores seemed smaller but it's steadily declined since.
The most annoying symptoms I experience is the disgusting painful acne all over my neck and under the jaw line. My mouth and eyes are forever dry and my lips peel and bleed a lot. I am also very edgy, anxious and easily upset. I wouldn't call it depression, more of a constant sadness and PMS.
So sick of looking in the mirror. Can't wait to be able to get fraxl, my scars are fucking horrid.
Hi Pilloo!!
Hang in there - I'm so sorry to hear its not working wonders for you yet, but I know it will soon. I believe month 3 is when things are supposed to really start looking up. Did you get an IB? If so, did you get another when you bumped up your dose??
Today is DAY 33.
Sorry I haven't posted for awhile, but shortly after my last one my IB ramped up so bad (and I thought it was going away last time I posted - HA! Not.) that I was outrageously depressed and wanted to hide from the entire world, message boards included. Haven't had a breakout that bad since high school, literally.
THE UPSIDE:
My skin now looks amazing. I haven't gotten any new pimples in more than 10 days, which blows my mind. My red marks are almost entirely gone thanks to neosporin. If you looked at the left side of my face you would never even know I had acne. Even without makeup! I still have about three faint red marks on my right cheek but that's it. It's so weird because one day I was having acne IB explosion and the next it was like BAM, no more pimples, everything healed up and I am ecstatic. I stopped using bp, stopped washing my face, stopped paying attention to it really. It's crazy how freeing that is. Being a slave to the BP really sucked. Now it's like...if I wanna go to sleep I just go to sleep, no creams to plaster all over myself first. I am LOVING it.
Still on 20mg. But here's the kicker! I am running out of 20mg pills and am terrified to bump my dose to 40mg for fear of another breakout like the first one, which was indeed absolutely horrible. I'm loving my skin so much right now that I just don't wanna mess with it. Also, going out of the country for a 3 week diving trip and I do NOT want to be breaking out during that. On the plus side, the ocean usually clears up my skin right away, but I think what I will do is bring both types of pills and bump my dose 1 week before the trip ends. Crossing my fingers I don't get an IB but if I do it will hopefully be the last breakout I ever get, because it's 40mg from here on out.
What have other people's experiences been with that?
Side effects = dry skin, but not horribly, and that's it. I have no idea what I was so scared of. I should have done this 10 years ago.
I <3 ACCUTANE!
Hi Pilloo!!
Hang in there - I'm so sorry to hear its not working wonders for you yet, but I know it will soon. I believe month 3 is when things are supposed to really start looking up. Did you get an IB? If so, did you get another when you bumped up your dose??
Today is DAY 33.
Sorry I haven't posted for awhile, but shortly after my last one my IB ramped up so bad (and I thought it was going away last time I posted - HA! Not.) that I was outrageously depressed and wanted to hide from the entire world, message boards included. Haven't had a breakout that bad since high school, literally.
THE UPSIDE:
My skin now looks amazing. I haven't gotten any new pimples in more than 10 days, which blows my mind. My red marks are almost entirely gone thanks to neosporin. If you looked at the left side of my face you would never even know I had acne. Even without makeup! I still have about three faint red marks on my right cheek but that's it. It's so weird because one day I was having acne IB explosion and the next it was like BAM, no more pimples, everything healed up and I am ecstatic. I stopped using bp, stopped washing my face, stopped paying attention to it really. It's crazy how freeing that is. Being a slave to the BP really sucked. Now it's like...if I wanna go to sleep I just go to sleep, no creams to plaster all over myself first. I am LOVING it.
Still on 20mg. But here's the kicker! I am running out of 20mg pills and am terrified to bump my dose to 40mg for fear of another breakout like the first one, which was indeed absolutely horrible. I'm loving my skin so much right now that I just don't wanna mess with it. Also, going out of the country for a 3 week diving trip and I do NOT want to be breaking out during that. On the plus side, the ocean usually clears up my skin right away, but I think what I will do is bring both types of pills and bump my dose 1 week before the trip ends. Crossing my fingers I don't get an IB but if I do it will hopefully be the last breakout I ever get, because it's 40mg from here on out.
What have other people's experiences been with that?
Side effects = dry skin, but not horribly, and that's it. I have no idea what I was so scared of. I should have done this 10 years ago.
I <3 ACCUTANE!
YAY! I'm glad things are going so good for you now!
I'm still waiting for my IB to go away. Every time I think it's about to be done, I get more pimples.
Oh, PS: I have been laying out, getting all brown and toasty, no problems there. Hopefully that won't change with the dosage increase either!
Thanks kaydon!! I really hope things clear up for you soon!! It's hard at times to have to make things worse before they get better but this will be so worth it when we look back some day and acne is a distant memory. What day are you on?
Oh, PS: I have been laying out, getting all brown and toasty, no problems there. Hopefully that won't change with the dosage increase either!
Thanks kaydon!! I really hope things clear up for you soon!! It's hard at times to have to make things worse before they get better but this will be so worth it when we look back some day and acne is a distant memory. What day are you on?
I completely agree! I am willing to deal with this shitty IB if in the long run I am cured of awful acne.
I am on day 29! Going right into month two!! 
Day 36:
I can see why people start these logs and then stop updating. Because there just isn't much to update about!! I haven't gotten a single pimple in almost two weeks. My concealer has been relegated to a bottom drawer.
I was standing in Whole Foods with a friend yesterday and he looked over at me and said, "god, you have really amazing skin. I've never really noticed that before. It's just beautiful." I literally wanted to cry/make out with him passionately. Okay, maybe I didn't really want to make out with him passionately, but you get the gist. I think most everyone here can agree that it is the single best compliment a person can give us. After dealing with the soul-crushing emotional tolls acne can take over years and years and years, hearing these simple words is like music.
On one hand, I can scarcely believe that I finally found the answer after all these years. And really, it's such a simple answer. I don't know what the hell people are talking about with the whole "suicidal thoughts" and "intolerable headaches" and "oh fuck now I'm blind at night and all my hair fell out and I'm bald and nobody will love me" propaganda that's out there. Do adverse side effects happen with accutane? Yes, just like with literally EVERY pharmaceutical we prescribe. Do some people tolerate it better than others? Yes, that too, and again this is true with any medication on the market today. But whenever a patient takes a pill they are agreeing to a certain level of assumed risk, and honestly I don't think accutane is somehow more problematic or any different than simvastatin, for example. (I can't even tell you how many patients I've had who cannot tolerate this drug because it causes such extreme muscle pain, and in some cases actual damage and breakdown of the major muscles, yet it is still the number one go-to drug that everyone prescribes for high cholesterol).
Anyway, what I'm trying to say is that I don't think all the hype about accutane being so dangerous is truly deserved. For most people the benefits will outweigh the risks. And any time you are taking a pill, you are ALWAYS taking a risk. The potential payoffs for this one are enormous, at least for me. Sometimes I just want to cry when I look in the mirror, I'm so happy. I'm so scared that the effects won't be permanent in the end.
If anyone is reading this and is on the fence about starting, I would encourage you to at least give it a try. It's been a freaking miracle for me at this point.
Still on 20mg, and besides needing eye drops and lots of Chapstick, side effects are not bad at all. I will be upping the dosage to 40mg on day 60. I'll also be out of the country for almost a month so it might be awhile before I update next.
Well, I finished my course a month ago.
The last 2 months were horrific as I eventually bumped up to 80mg/day just to get it over with. My eyes were like two red scratchy holes in my face and my lips were like sandpaper. I walked down the hall like an old lady with arthritis and I felt like I had rubber cement in my eyes whenever I woke up. But then one day I was done.
And now this:
Is it horrible to admit that I am already forgetting what it was like to have acne? I feel like this is my REAL skin, the skin I was always meant to have.
I can't say enough about how glad I am that I finally did it. Side effects are 100% gone.
LIFE CHANGING!
