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So... day 48 (end of week 7) and I'm pondering on my treatment... My derm prescribed me pretty high dose accutane to start (60mg/day at 50kg weight) and I have either mild acne fulminans or pyoderma faciale according to both her and my second opinion doc, so per the internet it says its usually treated with prednisone and LOW dose accutane thats slowly ramped up... Maybe I would have been getting better results or not had such a severe IB had that been the course? I'm hoping I'm on the right treatment... Anyone else start that high with a similar condition or have a different treatment course than me with a similar condition? I'm hoping this is going to turn around soon. Old spots are better but still there and not going anywhere and still getting (small) cysts and several smaller whiteheads/pustules, some in the same old areas.... Back pain is very mininal now and only slightly achy after running, skin still really not very dry, scalp is staying dry like its been since week 1, lips are dry but not too bad, and only severe side effect is that my nose cracks and is sore if I don't apply vaseline twice a day.
HOW MUCH LONGER TO SEE NOTICEABLE RESULTS?! Grrrrrrrr............... 
Going on 4 months of looking like this now and I'm starting to get really pissed seeing this in the mirror every day! My husband says it doesn't bother him at all but I'm so tired of being an ugly wife.. I want my old face back so, so very bad.. Will I ever look the same again or will the remnants of this stay around forever? 
Just need a little encouragement and reassurance today...
I am in my thrid month and my face still breaks out in inflamed and small bumps with cysts every now and then. For you acne, it may take longer but for the most part, accutane should work for you to some extent. Keep your head up and try to stay positive. You are a beautiful soul with or without acne so don't allow your acne to let you think otherwise
Try not to get discouraged! It'll get there!! Maybe talk to your doctor at your next appointment to get his/her opinion on why he started you so high? I'm sure they had reasons to?
I understand about the 'ugly wife' thing. I say the same thing to my husband. But it will get better!
Yea I'm not sure why my derm said that, how can he go from "you're improving" to "well you'll probably be on this for a long time at double the high dose". And then they ask if I'm depressed! My mom who is a nurse said she used to see asshole drs like this all the time, no bedside manner and just goes with the worst possible outcome so that in a couple months they can say oh look how nicely you're doing now. I'm choosing to believe that he will not actually put me on this dose. I'm also wondering if I should seek out a new dermatologist :/
Soo... things look a little better today on day 52. I'm feeling a bit better about my acne, save the new twin cysts that popped up about 2-3 weeks ago on my right jawline that I made worse when I tried to squeeze. Just big, red, itchy, and going nowhere fast... Other stuff getting flatter, but not redder and not going away. I think I'm going to have major problems with lingering hyperpigmentations. Zits that went away a month ago still have very visible and very dark colored red marks... I only have 1 pimple on my forehead!!! Its a flatter cyst by my nose that's been there for a long time but appears to be getting a lot of dry skin on it. Good sign? Temple pimples (haha, I made a rhyme) are calming somewhat. Skin is still not that dry. Only dry areas are on the biggest and most active spots and the CeraVe cream moisturizer gets rid of it easily every time. Chapped lips a little worse and left corner of my mouth is slightly cracked. Chapstick and vaseline help but don't get rid of it. Nose is really dry and cracking with stuck, hard, cracking mucus (ewww, right?). I put vaseline in it with a Q-tip 2-3 times a day and it feels better for a long time, but it doesn't really ever go away completely. I get a little lower back pain when I exercise a lot but its totally tolerable. My arms and legs feel a little bit dry and itchy but not too bad and they don't look like it so I don't put on much lotion there and its fine. I'm thinking about asking to up my dosage from 60mg to see if I get more results. Would that make things get worse again (another IB)? Would it make the side effects a lot worse? Just wondering if I should ask to next time since not much dry too skin overall...
Day 70
Old spots continue to get better. As for side effects: Lips peeling worse and dry in corners. Lower back hurts right after I run, but tolerable. Very light dry skin on arms and back of hands. Dry, bloody boogers, but not as bad as before. Feel VERY tired some days. Still breaking out but they are smaller and seem to heal quicker. 2 HUGE cysts on my right jawline (not in pics) have been there since day 35 and continue on... The biggest is MASSIVE and recently drained. At its biggest, it took up more than a quarter in space and stuck out like 1/2 an inch (nasty, I know). Its a lot flatter (sticks up from face half as much as before) but still very large and kind of bruised looking now. I hope to be done with the continued breakouts soon. Not sure why I keep getting new ones and many in odd places where I wasn't breaking out before. I feel heartbroken every time I notice a new one... I'm hanging in there and trying to focus on the positive, like my old spots being so much better. I just need to see myself in the mirror again and not be hyper-focused on my skin! I might ask to go up to 70 or 80mg (60 now) if I don't see much improvement or am stilling breaking out when I go back in to the derm in 2 weeks. ANYONE who had/has severe, cystic, and/or nodular acne that has been, or is on accutane, please post! It's great to hear from those who have been through it on days when you get down in the dumps and think it might not work, or might take much, much longer than you expected...
Wow, breaking out again. 2 new cysts by left ear, 4 itchy and sore pustules, and 2 more little flesh colored spots (pin sized). I don't get it... It's day 73 by the way... The old spots are still there and haven't changed much in the last 2 weeks. What gives? Is this going to work? Going to the derm in a week, maybe its time to up my dosage to 70mg (still on 60 now at 110lbs.) ?...
Wow, breaking out again. 2 new cysts by left ear, 4 itchy and sore pustules, and 2 more little flesh colored spots (pin sized). I don't get it... It's day 73 by the way... The old spots are still there and haven't changed much in the last 2 weeks. What gives? Is this going to work? Going to the derm in a week, maybe its time to up my dosage to 70mg (still on 60 now at 110lbs.) ?...
Brownilocks, i am a little further ahead - Day 120 i think and i am still breaking out so don't stress it. Some people clear up closer to the end of their courses which i hope is the case for me. If your acne was pretty severe it will take time. Don't forget to breathe. If you ever want to vent or have general accutane questions, let me know (this is my 3rd time doing this)
Keep on keeping on
Day 91, starting to get really dry. Lips looks really weird all the time with little dry things hanging off everywhere. Can't keep nostrils clear of crusty soreness. Pimples still there, albeit smaller. Still cystic acne though. Back of hand rash is getting pretty bad. My general doctor took my blood recently and said cholesterol, HDL/LDL and triglycerides are all off. Wondering why my derm didn't tell me this? Going to call Monday to find out. Lesions looking dryer but getting sick of this! She told me 4-5 months to be completely clear so REALLY desperately hoping that that happens sooner rather than later.. It sucks having all the side effects and still not being clear. Starting week 13 tomorrow. When did others with severe cystic acne start seeing it clear up once and for all? Sorry to keep asking, just not getting many replies lately....
Beginning of month 5 and still not clear. Better than before but still have lots of old spots (bumps) and redness and still getting new ones... Derm said my acne is just very severe, cystic acne and sometimes people with it that bad take longer to clear. She said she has a male patient with similar acne who is on month 7/8 and just now clearing. I believe it will work and it looks pretty good with makeup over it (still bumpy texture though). Otherwise I am very dry, especially inside my nose and of course lips and skin (mainly my forehead and chin where acne is worse). Back gets sore after intensive exercise as well. Hope it gets totally clear soon, dang it!!
Hey- sorry its been so rough my doctor told me that everything that's left is a scar, even the bumpy ones! I didn't want to scare you which is why I didn't write back. I'm seeking a second opinion today because his attitude about it was just unacceptable "you should be glad it's not worse, you'll never look like you used to". Who the fuck says that to someone going through something as awful as us?! I am still getting some smaller ones, but my main concern is that my face doesn't seem to heal, even the smallest pimple just sticks around as a little bump so I really am worried I'm just producing scars with every pimple. Makes me so anxious for the future. I'm glad your derm is much nicer and hopeful for you. Where are you located? I wish I had your doctor!
Hey I just saw my new dermatologist, she agrees with yours, I might need to be on it longer than most but she thinks they will go away!
I had to put together pictures from the last 6 months so she could get an idea and it really put it in perspective for me...my face is so much better than it was.
I still hate it and it looks unacceptable to me, but it was so so bad before. She says I'm responding to the medication and so I should just put on my makeup and forget about it everyday. She was at least much nicer than my asshole derm from before so I am absolutely switching.
Beginning of month 5 and still not clear.
Better than before but still have lots of old spots (bumps) and redness and still getting new ones... Derm said my acne is just very severe, cystic acne and sometimes people with it that bad take longer to clear. She said she has a male patient with similar acne who is on month 7/8 and just now clearing. I believe it will work and it looks pretty good with makeup over it (still bumpy texture though). Otherwise I am very dry, especially inside my nose and of course lips and skin (mainly my forehead and chin where acne is worse). Back gets sore after intensive exercise as well. Hope it gets totally clear soon, dang it!!
Brownilocks, no worries. My acne is moderate so much milder than yours and in my 6th months, i still have acne but not as bad. Given more time, i whole heartedly believe you can clear your acne. Keep your head up.
Thanks guys! I do know that I look a lot better and I feel a lot better than at any time since this all started. There are only 2 real bad bumps at the moment and they are ones that have given me a rough time since the start. All the others are starting to heal, are much smaller than before, or if they are new, they are not as cystic. I think its just gonna have to take some time for some of the old ones to completely go down since they were so massive before. Only 1 is really noticeably bad with makeup on, another is somewhat noticeable and the others are not as bad unless out in direct sunlight, lol. Getting very dry all around the areas that have acne and the drier I get, the flatter they seem to get in that area, though very, very slowly. This medicine definitely requires patience and its more of a tortoise than a hare, haha!
Ugggh, I agree that looking at old pics help since the current result is not what our overall goal is. Keep your head up about the scarring, I see where I think I do have some scarring on my face (texture changes/indents) but it is minor in my eyes compared to the acne that was there before and my derm told me that some people do see the scars go away in time still. She said she's been very surprised by some really bad cases in the past and that there are options (laser) in 6 months if there is significant scarring (though it costs more since insurance doesn't cover it). The raised spots of mine still drain occasionally and are semi-active (used to drain daily now its like once every 3-4 weeks and they are smaller so less stuff, gross, I know). My face is still not at an acceptable state for me either, and I could never go out without makeup and concealer all over my face and feel comfortable, but if it all just gets flat soon I will be very happy. I know the red spots are going to take me forever cause even when I had mild acne they did, months...
Sasch, thanks for the encouragement as usual! At first I didn't want to believe it would take me several months to clear but you were definitely right! Its good to be gradually seeing improvement though and keeps me positive! I'm slowly getting my confidence back and doing more outside the house without worrying about it. I know you said you were on accutane more than once, was your acne ever cystic? Did it clear each time you took it and if so, when it came back was it less or more severe than before? How long did it take you to clear the last time you took it? Sorry for so many questions, I'm just ever curious about this whole skin thing and what to expect and what I can do to help it along.
Good luck to you both and also to add an update to my log, my cholesterol was a little high and my HDL was a little low last visit, but I haven't been eating very healthy lately. Going to add some coconut oil to my diet and see if that makes a difference!
No problem girl. We have to support each other. Accutane cleared me the first 2 times i took it and yes, before i took accutane the first time, my acne was cystic and moderate. Over the years, it has gotten better and worse but never to the level it was before my 2st course. it took a while to get completely clear too (around 3 + months), especially this time around. I have a few weeks left and still not clear but such is life i suppose.
If you have any other questions, feel free to PM me
Thanks Sasch! I am 4 months in starting the 5th and I think full improvement will eventually come, its just gonna take awhile since mine was/got so bad.
I have a none related general question for all who take/took accutane as well. I haven't really been worried about minor spots but I have some little whiteheads around my eyes (like 2) that have been there for like a year before the accutane/acne outbreak. Was wondering if accutane will get rid of these/this type of acne too or if I should just try to have them extracted?
Also, open to new makeup suggestions for those of you suffering with mod to severe and/or cystic acne with sensitive skin that is easily irritated by makeup. I like my Clinique city base cream to powder, but it just doesn't absorb well and sticks to the dry flakes a bit. I HAVE TO have something that doesn't contain irritants of any type or dries out the skin even more! Scared of mineral foundations too cause I have lots of trouble with powder causing acne (both loose and pressed). Thanks for your suggestions! 
End of month 5 and still getting new spots (though small) and still have old active spots. Things are better than ever but my acne is still there and noticeable. I could not go out without makeup on still and my skin is bumpy. I'm wondering if this is going to clear me all the way and when/if I will stop getting new ones? Derm says I'll be on accutane at least 2 more months... Also, my cholesterol is really high despite eating healthier over the last month. Any advice?
They can put you on a cholesterol medication if they are worried about it. I've never heard of a case of cholesterol not going back down, but I have heard of derms putting people on meds for it.
I'm sorry you're still dealing with this. I'm currently dealing with extreme atrophy from Dr A-hole overinjecting my face, and they aren't sure the one on my forehead is acne. Could need to be excised. Awesome.
Hey!
Thanks for the encouragement annetossy! Sometimes it just really helps to hear comforting words to push forward in what, at times, seems like a never ending journey. Are you still on Claravis? I see that you were/are on a similar dose as me. How is it/did it work for you? I'm wondering why the progress is in such slow motion!! Drives me nuts sometimes... Don't get me wrong, I'm thankful for ANY and ALL progress, but it just sucks always thinking "I should be clear in a couple more months" and then not being...
Ugghhh, I'm sorry to hear you are still dealing with this BS too. How are the lesions? Have they gone? I'm sure you've asked this but would laser treatments after being off the accutane about 6 months help in any way? My doc said for scarring they see pretty good results but then there's the wait which seems unbearable to me (I def have some texture changes, like ripply indents). She said sometimes the atrophy and other scarring can go away gradually in time after coming off accutane so keep your fingers crossed! I will definetely ask about the cholesterol meds. Can't change my diet much cause I eat pretty healthy, I think I'm just somewhat predisposed to it cause high cholesterol runs in my mostly thin and active family.
Laser would help for some of the scars, and my derm is hopeful that the atrophy will go away.... I'm not so sure. I will have to wait a year for the one on my forehead to get cut out, thats how long you should wait for surgery I was diagnosed with PTSD yesterday, will be going to therapy for a long long time because of this. I still have flashbacks to when it started and keep wondering what I could have done to stop it, I feel like I didn't treat it in time...