I'm a 40yo female with cystic/nodular acne. I've tried differin gel, loads of different tricyclic antibiotics, a water pill, topical retinoids, Obagi skincare, and Solodyn (minocycline) to name a few. The minocycline was the only thing that made a small difference-it reduced the frequency but not the severity of the outbreaks.

Eighteen days ago I started Amnesteem, 40mg (1x/day). Since I tend to have odd reactions to several meds, the derm suggested starting slow at a low dose would lessen the chance and/or severity of side effects. I also had a 6 month period of situational depression which I was on medication for about 10 years ago, so we are keeping a close eye on mood changes.

The first 10 days of Amnesteem I didn't really notice many changes. Around day 8-10 I woke up one morning with the skin in the creases of my nose cracking, and it burned like FIRE. Really brought tears to my eyes! It was raw like that for two days but I kept applying Olay sensitive skin moisturizer. That is the only time that has happened, which is odd....Somewhere between day 10-14 I noticed my lips getting a bit drier. My derm gave me tons of samples of lip balms. Aquaphor is my favorite so far. Dan's was awful! It left this really weird, chemical-like taste in the back of my throat.

Around day 16 I noticed a couple new cysts forming deep in the skin around my chin and jawline. Prior to that I had one or two moderate cysts that came to the surface and popped but went away quickly.

Now on day 18 I have about 5 fairly large cysts on my chin/jawline, one small one on the side of my nose, one VERY painful one deep in my left cheek, and a small one on my forehead. Only 1 of them is red and angry looking, but its right on my chin Fortunately, the rest are inflamed but only slightly pink. I feel like I could cover them with mineral makeup but we all know you can still see the lumps and bumps under makeup and sometimes that makes things look even worse. I also have loads of blackheads, and I've noticed they are coming to the surface and starting to work their way out

I am TRYING not to freak out too bad. I keep reminding myself of the goal - the journey just sucks along the way sometimes! Lol

My derm prescribed Ampicillan to help lessen the cysts faster...has anyone else had a similar experience? I am also considering getting a Kenalog injection into the severe cysts on my chin...any thoughts on this procedure?

Also today I have a really bad headache. NOT fun. I am hoping perhaps it is from dehydration, as the Aleve hasn't helped.

I'm still pretty oily, but it looks as if my skin is just starting to dry out a bit around the edges of my nose and the crease of my chin. I haven't started moisturizing yet, because the makeup I wear to work every day is a tinted moisturizer so I feel like its enough at this point.

The only other side effect I have noticed is weird body aches and pains here and there. For two days now it has been a deep ache in my lower back, which is only really noticeable when I try to sleep...silly me, trying to sleep! Yesterday my calf muscles both seized up on me, as if I had worked out really hard. (A little history here- I am normally an every day runner, 1-2 miles a day, but my derm suggested I just rest and take it easy while on this course of treatment. Which sucks because I don't run because I love to, I run because I love to eat!)

I'm rambling, so ill wrap it up here. I'm hoping these cysts go down SOON without becoming too gnarly looking, so if anyone has any tips for reducing cysts fast, please share!!

One more thing I want to mention: the BEST piece of advice I have read on here so far, for me, is to STAY OUT OF THE MIRROR FOR A WHILE, lol....this is REALLY hard for me, as I tend to obsess over every new lump or bump, but really, it's true...the more I obsess the more tempted I am to pick or try to pop and make things worse. I wish I could remember who said that and give credit where credit is due, but whomever you are thank you, and I will pass it along!!

 

I'm not sure what a Kenalog injection is but whenever I've had a very bad cyst that just isn't going away I have my dermatologist give me a cortisone injection ino it. Some people are wary of doing that though because if it goes down too quickly it could leave an indention but I've never had that problem. That medication you're taking, Amnesteem, from reading the side effects sounds very scary. Have you tried doing something drastic with your diet?

Some dermatologist prefer corisone shot or prednisone take orraly ,it's basacly the same thing.

Yea the course does suck sometimes , I had a terrible inital breakout when I stared(took prednisone) , now I don't have cystic acne anymore ,just red marks from the inital break out .

Stay out of the mirror , and remeber time files , your course will be done before you know it!

Hi Melle! Thanks for your input I have made some changes in my diet; cutting out caffeine and ALL dairy, gluten, soy, banana, kiwi, all types of melon and all products containing Latex, after I had allergy testing done and found out I was allergic. Unfortunately, this made no difference whatsoever with my acne. I agree the side effects are scary, however for someone who is desparate for a cure and who has informed themselves of the risk and what to watch out for, I feel it is worth trying.

Andrew, thanks for the encouragement!

I am curious, did you stop the course and start antibiotics and prednisone because your IB was so bad or for some other reason?

The derm is considering stopping and starting my course because I am having bad headaches.

DAY 21

On Friday (day 19) I had to go see my derm for a checkup, since I was having severe headaches for two days. He advised me to back off my dose and only take a pill every other day to see if that helps. If not, he's going to drop me down to 20mg once a day to start out. I'm kinda bummed because I was starting to see some results The blackheads were starting to work their way to the surface and the overall oiliness was definitely getting better. I ended up having to get injections in seven active cysts and they're already gone today! Yay!

I now only have one active cyst and it is very small so I'm hoping the IB is over.

Hopefully the lower dose will still work and help with the headaches. This is the only treatment that has really helped and I really don't want to have to stop taking it.

My lips are still a little dry but Aquaphor helps a LOT. I definitely need to drink more water!!

I've also noticed I'm a little more emotional than normal. I don't know if its the Amnesteem or the roller coaster of this crazy skin of mine! lol

If not, he's going to drop me down to 20mg once a day to start out. I'm kinda bummed because I was starting to see some results

I now only have one active cyst and it is very small so I'm hoping the IB is over.

Hopefully the lower dose will still work and help with the headaches. This is the only treatment that has really helped and I really don't want to have to stop taking it.

I've also noticed I'm a little more emotional than normal. I don't know if its the Amnesteem or the roller coaster of this crazy skin of mine! lol

 

Hey with the emotional part you can experience mood swings on Accutane, also you could become more emotional if you've had to give up so form of stress release (while on Accutane). For example I had to give up my Muay Thai, Thai Kickboxing, and as a result I lost a form of stress release that I was using four to five times a week. If this could be what's happening to you, try and find something to replace your previous form of stress relief. If it's just due to mood swings, try and just do something you enjoy when the mood swings take place. Lastly with how you said it could be 'the roller coaster of this crazy skin of mine', that is still part of the Accutane experience, meaning it's a result of the medication you're on (not that it isn't important), and as you originally said just try and keep in mind the long term goal and others peoples success with the medication.

As for the dose I actually spent three months on 20mg/day and it minimised my initial breakout. I definitely was getting improvements from this dose, so if you do get put on this dose, for a bit, hopefully this will put your mind at ease. If you want I can give a link to my log and you can see the improvements I've made, considering I spent the first three months on 20mg/day. Also there was someone around my age who spent their whole course on 20mg/day and she is happy with the results she gained. By the way she was around 45 kilograms, just so you have something to compare against.