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Little background: I'm a 22 y/o female in Canada and I've suffered with nodular acne since I was about 14. I did everything over the counter - clean and clear, neutrogrena, oxy, spectro and even Proactiv. Why I never saw a Dermatologist until this summer was beyond me... It took me 8 years to see one but I finally did and he put me on Accutane, immediately.
I AM ON 40MG
Right now I'm on Day 9:
I was my face with a Clean and Clear makeup remover/gentle cleanser every night and then moisturize before bed and in the morning with Cetaphil.
First thing that happened was a breakout on my face and my body (which I don't get acne on usually). I haven't gotten any nodular bumps thank goodness.. However, I have had generic pimples surfacing and that's new to me. All of my forehead, chin and cheek but they're starting to go down.
Side effects: My skin is ridiculously dry - mainly around my eyebrows, around my mouth and my nose. The skin is just peeling and my nose burns occasionally... My nose looks I've had a ridiculous cold and been blowing my nose too much. It's just red and raw and peeling.
My lips are dryer than normal and they feel tight. They're not painful and lip balm works. The corner of my mouth though are cracked and they're slightly sore when my mouth opens too much.
There is one thing that's driving me nuts: and it's my scalp. My scalp is ridiculously itchy, almost to an unbearable point and my skin is flaking like crazy. The itching is so bad I can't sleep.. even now it's driving me nuts.
I have had no other side effects... I take fish oil daily and a multi-vitamin (yeah I know, but I work out regularly so I need to) and the fish oil helps incredibly with any muscle fatigue.
Day 12
I actually found a solution to the ridiculous itching on my scalp.. Allergy medication. I pop a Claritin or Benadryl and the itching subsides.
The skin flaking is now just around my nose with the occasional bit on my upper chin. Corner of my mouth is still cracked but it's whatever and the lips chapping is slightly worse.
Other than that, my initial breakout is GONE. It's subsided and now my face looks like it normally does on a good day. So I'm happy. Fingers crossed this keeps going.
p.s. I should note - in the first week my face BURNED whenever I cleansed or moisturized it. It's fine now.
Day 19
I had a nodular breakout on my chin. Pretty brutal. However it's just about done and my cheeks are noticably clearing up so yay.
Skin is super dry. Only on my chin and nose. No matter how much I moisturize, it doesn't seem to help. At all. The skin just peels and peels and almost becomes raw. I use cetaphil however, I find that Spectro works much better for me. Lips aren't as chapped but the corners of ny mouth still crack.
Had a bad itchy scalp Episode twice. Woke me up. I found the solution was to jump in the shower and wash my hair. Solved the issue. I just bought head and shoulders for itchy scalp. Hopefully that works.
Also, a note for ladies. Revlon Colour Stay foundation for dry skin formula is an amazing drug store foundation. With the peeling and dryness from accutane, I found this foundation put on right after I washed and put moisturizer on my face went on like a dream and stayed on. My face didn't look cakey or obvs about the peeling.
Day 29
Now it's not so bad to deal with. Things have definitely gotten a lot easier lately and I'm hoping it lasts.
- peeling/dryness of chin - this has improved A LOT! My chin isn't as dry and while it does peel/flake off occasionally, it's not nearly as bed. Same with under my nose. The main spot is the corner of my lips. The skin outside it still peels... I pick it at it, which I shouldn't, which is probably why. Trying not to! Moisturizing 2-3x a day.
- cracked lip corners - not as bad, but still obvious. I can now open my mouth all the way without it hurting.
- Lips - my lips are peeling a bit more. It seems to be worse at night, or right when I wake up. Sometimes my lips end up bleeding but religiously apply chap stick helps quite a bit.
- breakouts - I have a minor recent one. Full on pimples on my forehead and a couple on my cheek and chin. Nothing too obvious with makeup on so I'm not sweating it.
I don't have an appointment to see my super busy derm until Wed... So that;s four days away. So, I've had to space out the last remaining doses of accutane to every second day. So I took it today and then I will on Monday and then Wednesday my new prescription. I've lost weight (not from the drug but from being a gym rat) so I'm curious as to what my dose will be for month 2.
It's supposed to get better after this right? I feel like if these last four weeks have been the worst, then I can handle it. Sometimes I HATE it and want to stop because of the peeling and flakiness or just the breakouts. But I know I'm 1/6th of the way there, and I can do it. Five more months of clean eating, gym days and accutane? i'm going to look like a whole new me, and that's what's keeping me going.
Day 33
So I've had to space out the last few pills but I saw my derm today and got my new month worth... and I'll be seeing him before they run out.
Anyway, I'm still on 40MG.. He was going to up my dosage, but I went out drinking ONE night for a friend's birthday and my blood work for my liver had a bit of a jump. He even guessed I had partied, but he wanted to be double sure it wasn't the medications my dosage is the same and then will be going up next month.
- peeling/dryness - still minor. My derm actually gave me this medicated moisturized sample... If I like it, he'll give me a prescription. The dryness isn't so bad though honestly.
- cracked lips - still a pain. no improvement but not getting worse either.
- lips - my lips aren't cracking.. but they are peeling lightly. which is weird but lots of chap stick helps.
- breakouts - nothing new in the last couple of days. let's hope it gets better.
Day 52
So I'm more than half way through my second month of accutane still on 40mg and it's getting easier.
Side affects - dryness is not as bad. My derm gave me this prescription moisturiser called EpicCream I believe and it works WONDERS. Like OMG. HEAVEN!
Lips are still dry but chap stick handles that. I used NIVEA hydro care.
My skin has definitely improved and noticeably as well. To the point where people I don't see regularly have noticed and commented.
The biggest improvement has been on my cheek area and chin. The nodules I had on my chin minus one have disappeared and most of the acne on my cheeks has dissipated (and disappeared completely on my left cheek).
I have gotten two new pimples since. One on my jaw and the other on my left temple, that lasted a couple days.
What's left on my cheek area on is redness and what I believe is 'scarring' or hyper pigmentation... Which hopefully will fade. Won't be able to tell for a few months. Same with the right side. My chin is also still very red. So I'm hoping it's hyper pigmentation that will fade and not horrible scarring.
But so far, so happy!!
Day 61
So, I'm now starting my THIRD month of Accutane.. Everything has come back normal and my dosage has finally be bumped up.
I am now on a 40/80MG. Every odd day I take one pill of 40mg, then every even day I take 2 40mg pill for a combined dosage of 80mg that day.
We'll see how it goes.
No significant improvement since my last post. The hyperpigmentation is still there and my dermatologist said it could take weeks or even months for them to fade. Luckily, he said from what he can see on my cheeks at least I have every minimal scarring. Like very minor pitting and that treatment would fix it. So thank GOD!
@birdsxfeathers - it totally sucks =( makes me feel like the acne is still there but I throw on some makeup (Revlon Colorstay) and BAM! You can't see it on my cheeks and my cheeks look clear.
p.s. The amazing moisturizer I use is called EpiCeram... Not EpiCream like my previous post. Apologies.
Thank you @Joy4ever 
Day 72
So because of the higher dosage, the dryness is worse. It's not like OMG bad but it's pretty bad... Mind you, it could be my own fault. Sometimes I get so tired I fall asleep at night and don't moisturize until the morning... So, I'm going to start doing it at night as well again and see what it does.
My lip dryness is getting out of control too =( wah. Any suggestions?
Other than that, the rare pimple but definite improvement. Love this stuff.
Day 96
The previous month's dosage was a complete nightmare. My skin was super dry and flaky, my lips where ravaged and then new side affects appeared:
- joint pain (all over my body. I couldn't workout for two weeks)
- accutane rash (as my derm calls it. I broke out in a rash all over my right hand and up my arm)
- bruising easier (I barely bruised, but ever since this new high dosage, I so much as bump something gently, I get a bruise. I have bruises all over my legs, my wrist, etc).
My blood work came back as well and my liver enzymes where more than double what they should be on Accutane. 160. 1 effing 60!! No alcohol, no tylenol...
So, I am back down to 20 mg and have changed from the Roche`s Accutane brand to Canadian Epirus. It's supposed to be better in regards to it's absorption into the body than Accutane.. So it looks like my road is going to be quite a few months longer than I anticipated.
Today, I'm going to buy milk thistle. Apparently it's amazing for your liver.. New Years is coming up, I'm 22.. I'm going clubbing LOL and so my nerves are getting the best of me in regards to drinking? A pharmacist suggested milk thistle, not taking the isotretinoin the day of and the day before so my liver enzymes don't spike. I'll wage that mental war for the next two weeks. -.- GAHHHH
Day 106
While it is a drag that I'm back down to 20mg on Epirus, the physical side effects have managed to be under control again. So I'm on the fence about is it worth it..
My skin is soft from only needing to moisturise ONCE a day. Yay! My lips aren't as chapped.. So physically, I look better and I'm happy about that.
HOWEVER, I've gotten very sick since switching brands.. I'm not sure if it's a reaction from the brand change, or if it's the holidays and I just happen to have a weakened immune system or if it's an allergic reaction. I'm going to the doctor's tomorrow to get treatment for it and when I see my derm in two and a half weeks, I'm hoping he has some answers.
But I've gotten headaches on and off... my left eye is continually swollen and sometimes blurry.. Been like that for two weeks and I now have what looks like pink eye? Then to top it off, I have a head cold with a huge cough.. body cramps, and finally, a yeast infection brought on from my weakened immune system. So, I'm miserable.
Life sucks right about now... -.-
Day 116
So my eye issues have resolved... Could have been from being sick.
However - the headaches are still there. They come and go and they're minor but annoying. I don't want to reply on Tylenol because that goes through your liver as well.
New symptom - drowsiness. I thought the drowsiness I was experiencing was from being sick but now as my body's basically recovered, I've noticed the drowsiness to onset about an hour or so after taking my daily dose. It's hard to focus on anything... i've taken a month off the gym so that I can allow my body to rest and recover, but I'm going back tonight with the aid of 200 mg of caffeine (pills). I'm hoping the gym will offset the drowsiness over time. We'll see...
Don't see my derm until next Tuesday.. So 8 days -.-