Hey all. Started my Isotretinoin treatment at the start of the new year, so am now onto day 43.
I've had extremely severe acne since about 2005 (at the time I was 17, now I'm 25) - for the first few years I tried the usual suspects to try and tame it - clerasil, proactive, various facial washes and finally antibiotics/zinc tablets etc. With nothing so much as making it slighlty better I got dishearted and figured nothing would help and didn't bother with anything for a couple years until the end of 2013. That was when I heard about Isotretinoin (I live in switzerland and they use a different brand of drug to Accutane) and decided it couldnt hurt to try.
Anyway backstory over, as I said, I'm now 43 days into the treatment and figured I would start to take notes of how things are progressing - partly for others in order to see how effective it is for people with terrible skin problems and also partly for myself so i can get it out somewhere (i'm horrifically self conscious so don't really like discussing it with loved ones / friends).
For the first month my derm prescribed me 40mg per day. I didnt really notice much of a difference in skin quality for January - just the usual fluctuation between 'bad' and 'terrible'. Each time it seemed like it may be clearing up it just flared up again a few days later. Towards the end of the first month I really started to notice the dryness side effects as well as the so-called Initial Breakout really coming to a head.
R.E. side effects: dry flaky skin and extremely dry lips were the two big ones. Not really anything dramatic and fairly easily managed with chapstick and moisturising cream. The only other thing I noticed was that my left nostril (not my right, literally just the left) is extremely dried out and constantly crusting up / scabbing with dried blood, not to mention fairly painful to touch. This problem comes with a nosebleed perhaps every 2 weeks but I've had nosebleed problems most of my life (though usually only one every 4 or 5 weeks up until now) so that doesnt bother me too much.
As I said - now on day 43 and my skin (except for my forehead where three big, angry looking red spots have popped up a couple days ago) is probably the best it's been in about 8 or 9 years. Yes i have a cyst of my neck and one below my left ear but both are fairly old problems (a week or two since they appeared) and seem to be healing.
For the second month i've been upped to 50 mg/day, so hoping it will start to clear up soon. Genuinely dunno what to do if after the treatment is 'over' my skin is still a mess - but shall cross that bridge when i get to it.
Please feel free to leave any feedback, advice or personal stories as I'd be happy to know what people feel personally about the drug / its treatment - especially any success stories from people who, like me, have fairly severe acne.
I'll try to update this 'diary' as often as possible for any people interested, and if anyone has any questions then please fire away 
Cheers to anyone who had the patience to read this far haha
Si
Day 48 - noticed the skin on my arms is getting to be really dry now - have a number of red patches where the skin has completely dried out and started to scab over. Nothing dramatic but extremely itchy. Trying to not itch them is hell haha
As for the rest, mostly all the same. The spots on my forehead are healing but still red blotches. The cysts are considerably better but still big red marks, and one of them started bleeding profously all of a sudden. Other than that my skin generally looks better acne-wise, just very dry and flaky unless i moisturise. My lips are the worst though, very dry and peeling and bleeding occasionally.
Day 56 - daring to think that maybe things are getting better - not one new spot / cyst since the last post, and the ones i did have then are definitely healing and getting smaller. Dryness has reached epic proportions though, i feel like a raisin and my lips are constantly cracked. My skin is manageable with moisturising cream/lotion but so far i've yet to find anything that really helps with lips. Got another derm apmnt. next week so might see if they have any suggestions and/or products. After a pretty rough first month (where tbh i was constantly afraid that this too wouldn't help me) i'm feeling optimistic and - dryness aside - this is literally the best my skin has been in about 8 years or so.
Hurrah for isotretinoin!
Day 56 - daring to think that maybe things are getting better - not one new spot / cyst since the last post, and the ones i did have then are definitely healing and getting smaller. Dryness has reached epic proportions though, i feel like a raisin and my lips are constantly cracked. My skin is manageable with moisturising cream/lotion but so far i've yet to find anything that really helps with lips. Got another derm apmnt. next week so might see if they have any suggestions and/or products. After a pretty rough first month (where tbh i was constantly afraid that this too wouldn't help me) i'm feeling optimistic and - dryness aside - this is literally the best my skin has been in about 8 years or so.
Hurrah for isotretinoin!
Do you have Chapstick Ultra 30 on hand? Heavy and waxy/greasy, but good.
I live in switzerland so we have this 'chapstick' called labello. The normal one was pretty much useless but now i use the moisture-boosting one which is slightly better. I'll ask the derm for suggestions, there must be something that they can prescribe that works better than anything over-the-counter.
I dont suppose you know of anything that might work on my nose? The insides of both nostrils are now permantly red / scabby / painful and nosebleeds are more and more frequent - completely ruined my pillow after i had one in the middle of the night the other day. Any help greatly appreciated
I live in switzerland so we have this 'chapstick' called labello. The normal one was pretty much useless but now i use the moisture-boosting one which is slightly better. I'll ask the derm for suggestions, there must be something that they can prescribe that works better than anything over-the-counter.
I dont suppose you know of anything that might work on my nose? The insides of both nostrils are now permantly red / scabby / painful and nosebleeds are more and more frequent - completely ruined my pillow after i had one in the middle of the night the other day. Any help greatly appreciated
I have the same probles as you with my nose. Sesame oil nose-spray is a necessity in regards to that! Drugstore/pharmacy will probably have that. Just don't use it the second before you go out as it is oil, and you might want to wipe a tissue under your nose after a few minutes.
Day 62 - (was away so missed about a week of meds and only got to the derm for a topup the other day).
Two words: miracle drug!
I can't believe how my skin looks atm, havent had a single spot (big or small) breakout in a while and the red marks are slowly but surely fading. I've genuinely not felt this happy with the way i look in about 10 years which is such an amazing feeling.
The only place that still isnt quite there yet is my back, which was always the worst. (Though because i could just wear a tshirt - though never a white one - it didnt bother me like the acne on my face). There are no active spots but loads of red marks and weird white lumps under the skin. But compared to before the treatment started it's almost night and day and seeing as i'm only done with 2 months i'm holding out hope that after month 4/5 that too will be pretty much gone & normal. Time will tell 
Basically for anyone with moderate to severe acne - PLEASE start isotretinoin...the dried skin/lips/nostrils are annoying but the difference you'll see in your skin is more than worth it!
Day 66 - that spot disappeared really fast and is now just a fading red mark.
Dry, peeling skin came back with a vengance though. Thinking i ought to carry a small mirror around everywhere just so i can keep checking how bad it looks. Lips and nostrils are still horrible but i'm willing to power through it since acne-wise my skin is so much better. Looking forward to when the red marks fade for good though
Day 71 - my lips are absolutely killing me...just yawning / stretching my mouth wide is stupidly painful. They're constantly cracked and or bleeding, despite using the cream recommended. Happily take that over acne ridden skin but it's still frustrating. Same goes for the constantly peeling skin. Keep having to run and wash my face so that it looks normal for a couple hours (until it creeps up on me again.).....then with my hayfaver my nose is just a mess; nosebleed every few days, constantly dry but also constantly running (which shouldn't make any sense but there you go). Basically can't wait to finish the treatment since it's done wonders for my acne yet still isn't exactly what i'd call a great experience.
Na stayed at 50 - because I'm skinny / not very heavt that was the highest the dermatoligist recommended going. But I feel that 50 is the perfect dose for me based on the results it has had in 2 and a half month.
On to day 74 (i think) now. Had a couple spots break out the other day - one on the back of my neck the other under my chin - but they're pretty small and i can already see them starting to fade. Lips are still completely dry and cracked though, and the isotret mixed with my hayfever is doing a number on my nose....but it's not so bad that I can bear it.
You're a few weeks ahead of me so i'm happy to read your latest posts that things are improving! I can't wait to catch up 😉
At the moment I have a big red angry pimple on my cheek but it's been there about a week and doesn't look like it's going anywhere anytime soon.
Did you do anything else with the spots (ie spot treatments or home remedies) you had or just letting it take its course?
I don't do anything to them - no creams / antibiotics etc. Just use nivea shower gel that isn't oily twice a day to wash and that's it. Also don't EVER pick them anymore, which i used to do before starting this course. Took some willpower but i now see why people say to never pick them haha
Day 76 now, pretty much the same as the last post skin and spots-wise, except the one on my neck has gotten a little redder.
Day 77 (missed a day coz i was constantly busy and didnt get home). Huge spot on the back of my neck (big / red / swollen / painful) 
Then a couple of other small ones, all of which are on my neck. Face is clear and lips are alot less dry than before. No clue why though. About halfway through the 5 month treatment (give or take) and def noticed an improvement. Hoping it keeps up and by the end of month 5 it'll all be cleared up
Day 81 - acne wise pretty good. The aforementioned spots on my neck are all fading fast and no new ones have surfaced.
But holy hell my nose is killing me...constantly dry and crusty with dried snot / blood. More so in my right nostril than my left. Tried vaseline / moisturising cream and also this crazy expensive cream that is "the best thing for it" that I got from the pharmacy. Absolutely killing me but ah well gonna have to stick it out for another couple months and hopefully it'll be back to normal post-isotret.
If anyone has any miracle cures for the nose crap then please let me know
Day 89, just about to finish the 3rd month. Acne is almost perfect, just the odd small spot on my back. Genuinely can't believe the difference it has made within 90 days, never would've thought it could happen. Dry skin / nose / lips is still a problem but i assume within a few months of finishing the treatment they'll be back to normal. Got 2 months left now and hopefully there'll be no new flare ups in that time and the remaining leftover marks will have disappeared