Hey everyone! Update time: had my last derm appointment last night and got a prescription for 45 pills! This should take me through Nov. 17 or so and then I'm done! Woohoo! That means I'll have taken 10,800 mg of Accutane, putting my cumulative dose between 150-160 mg/kg. the derm said that since I was only moderate to begin with (although that's my self-diagnosis, as he never saw me to begin with) and I reached the turning point around the two month mark, I have less than a 30 percent chance of relapsing. I'm keeping my fingers crossed.

Side effects: headaches, joint pains (especially after running), fatigue, dry lips, dry eyes, dry nose, increased anger and anxiety (but no depression, and I can't guarantee this is due to accutane although I'm fairly confident it is), eczema on my upper body/neck, red face, some hair loss though that seems to have gone away. And I've also experienced an increase in cholesterol but it was so low to begin with it kind of doesn't matter. Jumped from 111 to 141. Certainly not anything to be alarmed about but something I should probably watch in the future to make sure it was accutane related and not happening naturally.

And the most annoying side effect: increased sweating. Ok, so I don't know if this is a side effect, but I hate it. I'm not sure if this is accutane or the fact that I moved from Minneapolis to a swampy climate, but yikes, it is super embarrassing. Really hoping it calms down once I'm off the tane, but then winter will be starting so I won't exactly know...

So with that, 31 more days! Let the countdown begin!

Terrific news! Four more weeks is a piece of cakeI'm thrilled for you!

Remind me: Were you on 40mg the entire time?

Congrats!!!

How did you calculate your chance of relapse?

Hey! I'm happy that Claravis worked for you and that you're almost out of the woods.

I know I am totally late to the game, but I wanted to say that I also got a huge cyst leading up to the GRE. It stuck around for two.damn.years. I dunno about where you took it, but we had to have a picture taken at the testing center (for identity fraud?) and that cyst was on center stage in that photo. Nothing like a big scary grad school test to make your skin freaque out.

Also, I read something on this forum recently about people sweating from Accutane. It was mostly facial sweating I think. Is that where yours is? Is it related to stress/any factors in your life? I am about to start Accutane, and I eat a ton of onions and garlic (yuuuuumm.) My sweat smells of these lovely aromatics, and it is hard enough already to keep myself from smelling like a delicious Italian treat. (Which, IRL, translates to a stinky chick.)

DawgDaze: I was on 40 mg for two weeks, and alternated 40/80 from that point on. I know, the log title is misleading as I haven't been on Claravis (was on amnesteem) nor was I really on 40 mg/day.

GetMeTheResults: I'm not sure how he calculated the relapse odds. He asked me my initial condition and said "moderate", and he asked when I saw a turning point and I can say without a doubt that was at the 60 day mark. That's when I remember I had a horrible breakout leading up to the end of month two, then it's like the real pimples just stopped. I've certainly had small things pop up since then but that was the end of the constant, new pimple every few days stage. Because of this he said I had a pretty normal course, so I'm assuming he just gave me a normal relapse rate (less than 30 percent). I'm not sure there was an exact science to it.

Hamdinger: ugh I had almost forgotten about that picture. Hopefully that won't be circulated ever...as for sweating, yes, to everything. Mostly facial sweating and absolutely related to increased stress in my life. New job, new city, new coworkers, it's brutal. I also think it could be partially related to the photosensitivity, as I was in a cab on Friday, 70 degrees with the windows cracked and as soon as the morning sun was concentrated on my I was getting really hot and my face just felt like it was burning up. Really annoying. I'm just hoping it goes away after I am off the tane.

Ugh, I have been in a three-day battle trying to get my prescription. My doc says they have sent it four times, my pharmacist says they haven't received it, and both claim it isn't their fault. I'm amazed at how ineffective the medical system is. Really, shouldn't we have a better system in place? Why does the burden fall on the patient--who is now taking a morning off my low-paying job--to sort this out? Going to try to pick up a paper Rx today but seriously, what the hell!? Getting a prescription to the pharmacy should not be this difficult. It's not like this is a trivial issue like my hot tub is broken or something. Doesn't help that the pharmacy doesn't answer their phone. This already-frustrating situation feels magnified by all the crap going on in my life and the tane, I nearly lost it last night at the pharmacist. Proud of me for keeping it together but one more "sorry we don't have anything, check with your doctor" and I may punch someone. And I am not ever a violent person.

So, day 2 of no tane.

Hitting roadblock after roadblock here. Finally got a written prescription from my derm yesterday morning, only to find out that two pharmacies are out and the one that has it says iPledge won't let them enter 45 pills (they say I need to go to my derm again and get a prescription for either 30 or 60 pills). Day three no tane, and at this point I can't imagine I will have it tomorrow either. I almost lost it in CVS last night.

ugh. I can't believe the troubles people have with this drug. Cigarettes, booze, sodasall a greater risk to our health, yet we can purchase THOSE at will. I'm sorry. This should be between a doctor and a patient. A doctor prescribes, a pharmacy fills. No middle man should be involved to muck things up.

I'm bumping up tomorrow (hopefully) and (hopefully) my pharmacy won't have a problem with that. I'm expecting a headache, though, because that's just how it goes on the 'tane.

Good luck!

Hoping you are able to get it. That's really annoying. I switched to a small private pharmacy for that reason. I hate walgreens and cvs. The big pharmacies will never lift a finger to help you because they don't care.

I have my 4 month checkup tomorrow. Wool half way through! I'm going on a trip to Denver this weekend which Im kind of nervous about haven't been back since we moved and I have a lot of bad memories from CO. I'm hoping it'll be good for me. I have been having a bit of anxiety about it though...I had a tiny clogged pore on my cheek that I scratched at and caused a small red mark. I haven't done anything like that in months...so I know some anxiety is brewing. Otherwise face is great. Lips have been soooo dry lately. Oh yea...and I've been having these weird night terrors if I take my pill at dinner. Pretty bizarre. You guys ever have any weird dreams on tane?

Got the meds last night! Most frustrating prescription saga ever but got them! And I got 60 pills instead of 45 so I basically have an extra 10 days of tane if I want to take them. Might as well. Missed 2.5 days total so I hope that doesn't present an issue. I don't imagine it would but it sucks to have broken up the course like that.

I'm doing a trip back to Minnesota next weekend, lifeinfaith! I don't have anxiety about it really because I now associate MN with a great time in my life (I didn't when I was there, but now going through a tough time here on the east coast, I've glorified the Midwest in my head). I am nervous for the plane ride. I've been getting horrible panic attacks in confined areas with poor ventilation that could cause dizziness (I.e., metro, cars I'm not driving). I've been getting better, especially if I'm on my own and don't have added social pressure, but four flights seems like a lot to take on. I should clarify that I never had these problems before accutane, but there have been a lot of other factors in my life that could be inducing it.

Which brings me to another point: I wouldn't be so quick to write off the mental health effects of accutane. I'm not saying this in a "I'm depressed this is awful no one should ever take this drug because it messes you up" kind of way. So far the benefits have outweighed the disadvantages, but I definitely have felt off. Not suicidal, but almost out of body-like. Things seem a little scarier or like I'm not fully present, and I definitely am snippier/angrier. Whether this is a mental health effect (a questionable side effect) or the fatigue and headaches (well-documented side effects), I'm not sure. But I know I thought I wouldn't have any issues with it and I was surprised how much it has hit me. Nothing too scary, but more interesting. Also, just an observation, it seems like the mental health issues seem to hit guys more than women? Not sure if there is anything to that.

Lifeinfaith: as for dreams, I don't remember having particularly scary dreams, but I do remember REMEMBERING more of my dreams fairly vividly (which is uncommon for me as I usually have no idea whether I even dreamed or not all night). Anxious to hear what others say!

Could use some opinions:

I made the mistake of venturing into the dark world of long term accutane problems when I researched facial flushing. People really seemed to be describing a lot of what I have been experiencing. The hotness, the sweating, the redness (I've never noticed if I get red. I definitely am when I walk half a mile into the wind in the mornings but I figured that was normal skin irritation). Anyway, I notice this almost whenever I meet someone or have to talk in a group setting and this NEVER happened to me before. I'm trying to get a perspective--not from doomsdayers--about whether this has been well documented and whether it is permanent.i got pretty freaked out while reading it, but reminded myself that no one goes on those forums months after accutane to say "everything went back to normal!" I did think it might have been a LITTLE less dramatic flushing when I was off the meds earlier this week, but that could be an imagination. Today felt pretty bad again (two days back on the tane).

So, tell my what you know about flushing...

I haven't experienced facial flushing. Facial sweating, yes, when I do even the smallest amount of exercise. but no flushing, except a redness of the skin on my upper chest, the part that would be exposed, say, in a V-neck sweater. Has been very red since beginning of my course. It doesn't itch, it's not a rash, it's just . . . red. I have always been diligent about sunscreen on this area, but it looks really bad. I assume that's a side effect. And, hopefully, will go away.

I think in our heads, we're rational enough to know that Accutane side effects are, by the vast majority of accounts, temporary. But in our guts, we get scared. While plenty of patients recover just fine, there is a body of people who report long-term side effects. Even if we account for liars, hysterics, and hypochondriacsand for the maxim that correlation does not imply causationthat does leave a percentage of people, however minute, that are living with long term effects of a very powerful drug.

How many? I'm not sure we know. I don't think proper research has been done because everyone's afraid of it. While individual doctors will tell you their experience after decades of prescribing Accutane is by and large positive, I don't think the medical establishment as a whole really wants to know one way or the other WHAT this drug does, including HOW it works.

So, in my head, I'm all, "I'll be glad when this is done and I go back to normal." But in my gut, I'm a bit scared. Scared that my joint pain and eye problems will be permanent. Both are really bad now, and while I can tolerate it for the short term, if these turn out to be long term side effects, I'm not sure what I'm going to do.

We just have to wait and see . . .

Hi BreakItOutNow

Just wanted to say that I stumbled across your account while trying to make my own decision about starting accutane...it's been extremely helpful and so I just wanted to thank you, and wish you so much luck. Seems like, all in all, things went fairly well for you and I think it takes a lot of courage to dictate every step of a relatively difficult journey, even if in this relatively anonymous format. It's really helped me out, and I'm sure countless others who were just reading along in secret (like me).

So happy for you that you're at the end of this whole mess--starting my first pill as I type.

Best of luck.

Thanks for the realistic perspective DawgDaze. I agree, in my gut I'm scared that this crumminess I've been dealing with will be permanent. I am grateful for the clear skin, and I don't necessarily regret taking accutane because I haven't seen which side effects will go away yet. But the sweating, the constant red tone, the flushing, the headaches, the fatigue and joint pains and subsequent reduction in my running times--it's all a lot to deal with.

I also think a lot of people expect to get off the meds and go back to normal in a month or so, so if there are residual side effects at that time they freak out. I think I need to give myself 3-6 months for a major reduction in side effects, and something like flushing could stay around for a year or so. I just think my outlook will be better once I'm off the meds and things start improving, rather than popping more pills and panicking about the next side effect.

Hey-

As for my side effects on the low dose, they seem to be increasing as time goes on. I'm wondering if it's because a higher amount is finally in my system. None of them are too noticeable except the lip peeling. I haven't noticed flushing but I have noticed my face taking on a pinkish hue from time to time almost like I've been in the sun when I haven't. After running sometimes I feel more sore than usual and I seem to pull muscles easier, not really joint pain though. My skin gets nicks and cuts super easily and seems to take longer to heal so I have to be cognisant of that when playing soccer or mtn biking. My mental health state is far better than it was pre tane when my acne caused me huge amounts of anxiety. On the accutane I feel like I'm finally back to my old healthy self pre acne. I went back to tsking the pill early morning and the night awakenings went away so it's definitely messing with something there. They weren't necessarily dreams but more I would wake up several times a night and sit up because I saw things in the room or what I thought were shadows coming towards the bed. Sometimes my husband would wake me or I would wake up and realize my eyes were open and I was staring at shadows in the corner of the room. I would calm down as soon as I was fully awake realizing that it was just another one of those....totally bizarre and only start up if I take the tane after 1 or 2 pm.

As for long term effects, if I could trade off the side effects currently for no pimples ever I would. I don't worry too much about long term because I know numerous ppl who have taken it and are great. My dad took it and has no long term effects even though he had super dry flaky skin during the course. One of my friends took it about 8 years ago and the only residual effects he had was drier lips than before. He said as the years went on it seemed like his skin got less and less dry so even if you do have some residual thing, it's probably not going to be permanent. I think those with lasting negative effects are the outlier and not the norm.

Just checking in to see how you're doing. You have about another month to go, is that correct?

Hey everyone, long time no update! In many ways, yes, that means there hasn't been much to update. I haven't had a real zit for nearly two months, though I had what I think whaa a whitehead earlier this week. It was on the corner of my lips in an area that has been SO irritated and I use aquaphor and moisturizer like crazy and I actually think it was inevitable to avoid a small zit there. It has been just such a mess there. Regardless, I don't really count it. It was small and disappeared very quickly and I don't even know if it was a zit. Everything else is clear. I get small red bumps on my face now in then but only as a result of much colder, drier air. They go away in a few hours with moisturizer. They are not acne, but not fun. Just need to keep up with moisturizing, especially in the winter.

I end my course Tuesday. I'm terrified. I think I am so convinced the acne will return thAt I've forgotten accutane is supposed to cause long term remission. I have had a textbook course--small initial breakout, dramatic improvement at the end of month two, pretty much flawless skin for the last 2-3 months. Dry lips were brutal, dry skin was there, rashes = check, headaches and fatigue were a go, red skin, joint pains, some mood swings all joined the party. I think if there was a side effect, I got it in some capacity. Some were certainly more obnoxious than others. I'm really hoping the facial sweating calms down after the tane. That has been the side effect I am most self-conscious about. Everything else I can handle, but I've been walking around with a tissue for probably the last two months just to make sure I can dab my face. Really not fun.

So, in short, I'm looking forward to seeing some things go back to normal, but I don't want one of those things to be acne. Like I said, I'm so convinced it will return (especially since I've read a lot saying guys relapse more than women, but then I've read other papers that directly contradict that) that I'm sort of just counting down the days until my skin is crummy again. I know, I'm quite the optimist.

Anyway, thanks for all the support on here. And MorningTV, I completely missed your message until today! Hope your course is going well and that you are past any initial breakout now. I'm glad the log could be of use and feel free to share more experiences on here.

DawgDaze, looks like we will be off the meds around the same time. Looking forward to sharing experiences with you about post-tane life and hoping for the best for both of us.

What didyour cumulative doses end up being? Question for all.

Lifeinfaith: my cumulative dose was 162-165 mg/kg depending on what I use for my weight, which tends to fluctuate. So I am well beyond the 120-150 mg/kg recommendation. I have every reason to think it will work, I just don't trust it.

I'm six days off a five-month course of 40mg per day, cumulative dose of 6000mg. My doc informed me that since this was my second course, cumulative dose is half of what the first course was. "Even though my first course was 15 years ago?" I asked. Yes, she assured me.

I seem to have also followed the classic Accutane pattern, which I remember from my first course as well: 2 to 3 weeks of an initial breakout, followed by dry everything, followed by clear skin, followed by a couple weeks of flu-like symptoms, followed by intense joint pain. Followed by fed up

And, if I also follow my first course in another important way, I'll enjoy a very long, perhaps lifelong, remission as well.

All fingers crossed for everyone!

BreakItOut Now, I think you can trust it. Your treatment was "classic," and from what I know of your age, your gender, your dose, and your response, your chances for a full remission are extremely high.

Keep checking in!

DawgDaze: posts like yours are why I am on these forums. Thanks for the encouragement. Your down-to-earth optimism really made my day.

I can't remember, are you doing anything for maintenance? I have an appointment with my derm in two weeks and I'm wondering if he will prescribe a retinoid or BP or nothing at all. Not sure, but I feel like doing nothing may be like waiting for disaster to strike.

Doc suggests a topical retinoid. Which would be Tazorac, since I filled my last script for it before my new insurance hit (it doesn't cover prescriptions). Script is always for two tubes, so I should use that since I have it. She doesn't believe there is much difference between how Retin A and Tazorac work, either for anti-aging or to keep acne at bay. But she wants me to wait 4-6 weeks before slowly introducing it back onto my skin.

I can start with BP at any time, but I still feel too irritated to do so all over my face. The only thing remaining on my face are these two really tiny lil cloggers on the front of my chin. I can't tell if they're breakouts or scar tissue. Am putting BP on those, will have her check them at our two-month check up.

Anyway, I think maintenance is always part of the follow up treatment, so I'm sure your doc will prescribe/advise something. My first go round I think I was on BP for a couple years until I just finally quit using it, I wasn't breaking out.

Let us know!

I used retin a micro and differin long term (at seperate times) and then tried to use Tazorac for about a month. Compared to the other two which I never got irritated from it felt like it was putting acid on my skin. It would literally turn bright red and burn and peel off. Maybe my skin just couldn't deal with Taz but in my opinion it was leaps stronger than the other two retinoids. Right before accutane and occasionally during I have used Finacea. It's azelaic acid and I found that it has a little more in the anti-inflammatory department but doesn't destroy your skin like BP and still exfoliates like a retinoid but is milder.

I'm hoping very little maintenance will be required post tane though. Here's to hoping!

Lifeinfaith: thanks for the input. I only ever used Differin, and I noticed pretty much no irritation while on that. I both would love to not have a lot of maintenance, and would also love to make sure the acne doesn't return, so I'm of two minds when it comes to post-tane skin care. I'll discuss with the derm on Thursday and see what he has to say. I personally hope he is for using a retinoid. It would be much easier to have a derm prescribe a retinoid and decide I don't want to use it than not have him prescribe it and not have a choice. We shall see.

Everything holding up well on the low-ish dose course? And DawgDaze, you out there? How's post-tane life treating you?

Yup, still here. Just posted an update on my log. Basically, still clear, with the exception of two tiny whiteheads that came and went in a flash last week. Hope you're doing well. Still achy? I am, and it's really frustrating!