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u are on month 3 and only taking so little, so you gotta wait. it will take longer to work than traditional course.
how are your oil levels? does your skin seem dry? any tightness? it is highly important to keep your skin from being irritated and red.
the thing about low dosing is (from my experience so far), is that it is a marathon and a long term commitment. And when you do something like this for so long, your skin must be comfortable and babied (even if it means slower results!) otherwise everyday will feel like a grind. eat healthy, exercise, and keep your skin moisturized. those things will go a long way in helping you cope with the stress of acne. it's not just about a miracle pill, cuz it aint.
even if ur skin is oily, id rather you put on a good heavy cream to keep your face moist and smooth, rather than dry and flaky.
Hi.. seriously your skin looks fine?! You are being your own worst critic. Your skin looks normal with the odd blemish- like a normal person really! Even my hubby who is definitely not acne prone gets the odd 2 or 3 zits now and again. He doesn't even notice them,I do because that's what acne does, it makes you zone in on what nobody else would even notice or care about. The roaccutane will work. You hang in there. Just remember that everyone and I mean everyone will get the odd breakout. xx
Hey guys,
Thanks for the support, much appreciated. I am just trying to be patient. I am at day 106 now, 6 weeks till my next derm appointment. I am waiting it out till then.I have another largish inflamed pustule on my left cheek, about 5 or 6 actives total but they are healing up. I have had a couple of clogged pores/comedones that have been sitting on my skin for like months become inflamed so I am wondering if the dose increase is pushing clogs out now.
yunchang, my skin isn't too dry or tight. I used the regimen for many years and my skin is not as tight and dry as it was whilst using BP. I use cetaphil moisturiser which is pretty heavy and don't really have any problems with dry patches or flakes.
Well nothing for it but to be patient and positive and keep trucking along. My faith is being tested along the way, but it's still there 
Day 110
Inflamed angry red bump on right cheek now has a big yellowy head on it. Still big and painful. Got a new tiny papule near it. The spot on my left cheek healed up within a week without incident. Still got a couple of healing actives on my left cheek and left jawline from previous breakouts.
I also keep getting medium sized recurring papules right at the corner of my mouth on both sides. Might be cause this is an area that gets dry easily.
Day 117 (almost 4 months)
First off, thanks a bunch for the message and the support kim! It has been a long and difficult almost 4 months on the tane and I have often struggled going through this - it's heartening to know I am not alone.
My skin is still refusing to get totally clear - I am stuck in a cycle of 3 - 5 actives which take a week or two to heal by which point they will have been replaced by a new 3-5 actives. I'm also getting too many big inflamed pustules (that take 2 weeks or so to shrink) for my liking lately
Right now I have one healing big pustule near my right ear. The big angry bump on my right cheek has healed up a lot but is still there and will leave hyperpigmentation for a while (and prob a small scar).
Still got two of the largish inflamed papules on my left jawline healing up/pigmentation marks. In the last couple of days I've had 2 smallish inflamed papules spring up on my left cheek. I'm hoping and they should go away without too much of a problem. I have a large inflamed pustule with another beautiful big yellowy head near the left side of my chin and as of yesterday a new medium sized papule near my left sideburn.
I know that this stuff will all heal up in a week or so (red marks longer) but I am getting pretty frustrated as the breakouts just keep coming. I have now almost completed four months of Accutane and I had hoped I would have reached the stage of not breaking out by now. If it doesn't come in the next month I am starting to wonder if it will. I realise I am on a low dose, but having said that I have been on the drug for a fair while now.
Got my next derm appointment in just over 4 weeks at which point I will have been on Accutane for almost 5 months. If I am not clear at this point I guess I'll have to look at my options - hopefully it's just a matter of waiting it out a bit longer as I'm not that keen on increasing the dose. Be interested in what my derm has to say.
Day 134 (First day of week 20)
Haven't updated for a little while. The last 2 and a half weeks have been decent. I haven't had any of the big, inflamed nasty pustules and the ones I did have, have been healing up. The frequency and severity of my breaking out has definitely improved - I am hoping this continues. I have still been getting small comedonal and inflamed stuff, particularly along my jawline and around my chin. But nothing big and nasty that lasts weeks before it flattens out and would be obviously noticeable to somebody else. Got my 5 month follow up derm appointment in 2 weeks.
Day 149
Almost 5 months on Accutane now. Haven't been breaking out much. At the moment I have 1 large pustule healing up on the left side of my chin, and a smallish papule that has just cropped up today on the right side of my chin. This is my first pimple on the right side of my face for around 4 weeks. I continue to get 1-2 a week on the left hand side, including some nastier inflammatory stuff. Other than that my forehead seems to be getting bumpier, but it is non-inflamed stuff (or just a tiny bit inflamed).
Had my derm appointment on Monday. As I am still breaking out a little bit, he bumped my dosage up to 20mg/day to try and stop these breakouts in their tracks. He said I am going to be on Accutane for a good long while to really try and put it into remission, which I am happy about.
Hope everyone else on tane is going well. If anyone is interested in my side effects, they are very minor - just slightly dry lips and skin. Compared to my two previous courses (I took 60mg/day each time) they are much milder as well.
Day 158
Update about the same as last one. Large pustule on left side of chin has almost healed. I have 2 actives right now - a mediumish pustule has cropped up on the left side of my chin. It was a soft clogged pore for weeks and weeks so it was inevitably going to get inflamed I guess. I also have a small papule on the right side of my chin. My forehead is still bumpy but it is non-inflamed.
Getting a bit frustrated that I am still getting breakouts. I realise it has been a lower dose but it has been a fair amount of time now. I have now been on 20mg/day for 12 days.
How annoying. I wish I could come over there and tell your acne to go the heck away already. I am feeling frustrated, and I'm not even you! Sheesh. But, if this higher dose is bringing up some stuff that has been just sitting there for a while, maybe that is a good thing. Even 20mg a day is still a pretty low dose, but hopefully it will be the bit more you need. Did it take you a long time to clear up on your 'regular' courses? Do you know what your cumulative dose is up to this point? I am at about 6500 total at this point, on my way to my goal of 8400 (works out to about 130 mg/k for me. I am super tall so I weigh about 64 k).
Keep us updated with the new dose. Wishing you all the best.
Day 163
Got around 4 - 5 activies. The mediumish pustule got pretty big and inflamed and is just starting to settle down. I also have 2 or 3 smaller pustules nearby it. Just the one papule still on the right side of my chin. I think my forehead seems less bumpy so I am hoping the increased dosage is having an affect on the comedonal and non-inflamed stuff that is persisting there.
I have noticed my lips are definitely drier now that I am on 20mg/day. Hope this is a good sign.
Hey Kim, to be honest I can't really remember exactly how long I took to clear on my other courses. I am 32 now on this third course. I was 18 for my first course and 19 for my second course so it's a long time ago! I wasn't very knowledgeable about acne back then (I didn't even wash my face during the courses) and I didn't really monitor my skin during the course. I was pretty unhappy with my appearance (I had a face covered in inflammatory papules and pustules) at the time, so I basically never looked in the mirror, took my pills and waited for the time to go by. I was clear by the end of my courses which was about 5 months, I can't remember if I cleared up before this point.
As far as cumulative dose so far:
I took 60mg/week for the first 8 weeks = 480mg
I then took 100mg/week for the next 13 weeks = 1300mg
I have now been taking 20mg/day for 16 days = 320mg
So in total that is 2100mg. I am around 75kg. So far that works out to 28mg/kg. I don't think my derm is shooting for the 120-150mg/kg cumulative dose though. It's more about stopping the breakouts, rather than reaching a dose. He did say I'll be on tane for a good long time to really try and knock it out. The first step of stopping the breakouts would be nice though! My patience and faith are being tested.
Glad to read your course is still going well.
Day 165
Meh, got 2 new pimples above my lip of all places. I don't think I've had one there for around 2 months at least. One was a softish clogged pore that had been there for weeks and weeks. My razor got snagged on it whilst shaving on Tuesday, which was enough irritation to cause it to become inflamed. It's right on my lipline and is painful. The other one is just a tiny pustule right smack in the middle. Should die pretty quickly but still annoying (and puzzling).
Anytime these breakouts want to stop I would be much obliged.
Day 171
Skin still about the same. Decent enough but not completely clear and still breaking out. Pimples above lip have almost healed up as has the stuff on the left side of my chin. New breakouts along my jawline on both sides. Just the one pimple on the right side. 4 or 5 on the left. They are inflamed but not particularly big. Still annoying and frustrating that I'm still breaking out.
Day 186
A couple of days into month seven and just over 26 weeks down. Still not clear. Very frustrated and disheartened. Got around 7 actives/healing on my left jawline, 2 on my right. They're not too big or vicious but it's still acne. Wondering if it's going to happen for me and I just gotta wait a bit longer. How much longer though, past the 6 month point now?
Anybody got any ideas/reassurance as to why I still have not cleared up?
I might email my derm and ask whether I should be concerned to still be breaking out at this point.
Hi Kim,
Thanks for the reply. I started on 60mg/week for the first 8 weeks, then 100mg/week for the next 3 months and now 20mg/day for almost 6 weeks. Admittedly the doses are low but 6 months is a long time.
Are you only taking 60 mg a week? That may be why you are not seeing progress. It's such a low dose.
Hi Kim,
Thanks for the reply. I started on 60mg/week for the first 8 weeks, then 100mg/week for the next 3 months and now 20mg/day for almost 6 weeks. Admittedly the doses are low but 6 months is a long time.
Are you only taking 60 mg a week? That may be why you are not seeing progress. It's such a low dose.
hey JJ i kinda have good experience with low dosing. 60 mg a week for 6 months is a long time! you should be seeing some good effects.
the best way to tell if it's working is checking your oil levels and texture of your skin. if your oil levels are down and your skin is smooth, then it is working!
If long term accutane does not work for u, i suggest trying Retin A. It closes pores and increases skin renewal, and you can take it forever. It does nearly the same thing as accutane and what you and I are after. good luck in whatever course you take!
I started Retin A in hopes that i get more consistent results. With low dose accutane, it worked for me cuz it lowered my oil levels but I would still get breakouts now and then. hoping that this retin a stuff will give me 100%.
I think you should give it a little longer. It's not completely unusual, as you're not even taking half as much as a regular course, and it often takes 3-5 months to see real progress that way.
Otherwise I suppose you could try upping your dose, even if only until you clear up, and then lower it back down? Or you could introduce a topical if your skin isn't too dry - a tretinoin type thing or a BP type thing to add to your routine? I still think you should wait a bit longer to see what happens with what you're trying now.
Hoping for good news!
Hey guys. Thanks for the suggestions. I emailed my derm and he said to bump it up slightly. I will now be taking 20mg/day 4 days out of the week and 30mg/day 3 days out of the week. My skin is dry on tane I don't think it could handle a topical on top. If this doesn't work I'm not sure where to go. I put a lot of faith into the Accutane working so if it doesn't it feels pretty dire. My mood and optimism regarding my skin really is at rock bottom right now. Tretinoin or a different retinoid like tazorac would be probably the only thing left. I always thought Accutane was a more effective retinoid than them though, so if Accutane doesn't work I feel like they won't either. I have tried differin before with disastrous results.
Thanks for the support, means a lot.
Day 208
Almost at the 7 month mark. I have 20mg tablets so I've been taking 20mg/day 5 days of the week and 40mg/day 2 days of the week. My skin has been better and it seems like I've almost stopped breaking out. Although I've been at this point before so I'm still cautious. I'm getting less of the non-inflamed stuff on my forehead although I do have a couple there ATM. I am getting the occasional zit pop up on my cheeks or jawline but they tend to be either non-inflamed or only small and inflamed. The only real inflamed spot I have right now is a clogged pore right under my lip which had been clogged for weeks and now has finally got inflamed.
If I do stop breaking out completely, I will then have to see what the next step is. I would probably prefer to see if I can taper down to a low maintenance dose as I don't reckon I'll get remission.
As for side effects, dry lips and skin and my skin is fragile. I get scratches easily on my body.