Day 5:

I'm actually seeing improvement, which seems weird. Cysts are drying up, blackheads are starting to fall out. The purpley-redness is becoming less red. My lips are also drying out, as are my nasal passages--there is blood every time I blow my nose. Joints are starting to snap and crack when I move, which hasn't happened since I was on Spironolactone. Hands are dry, but so far nothing a little lotion doesn't fix.

Common to see improvement right away. There is usually an initial breakout on weeks 2-5, some people do not experience any initial breakout. Alot of people think it will be smooth sailing from day one, from what ive read, but then they will break out. Good luck!!

I'll be following your updates for sure! I'm just about to turn 30 and should be starting accutane in a couple of weeks if my bloodwork is all ok. I also have cystic acne - in fact, I've never even really had 'normal people acne'... all my life its only been giant painful everlasting cystic evilness! Hopefully I will end up being 2 or 3 weeks behind you - I know everyone reacts differently and on a different timeline, but it will be interesting to see how you're doing

Jones4545, you called it. In the last two days, what smallish pimples I did have have now turned into full-blown, painful cysts....and I have about 8 of them at the moment. I guess this is the famous initial breakout (I'm currently on day 8) (though I'm also a few days away from my period, which could also be the culprit...hard to tell). But overall my skin is still pretty dry and my lips cracked in one spot yesterday.

WittySock, I hear you. I've also always had cystic acne...never just the "normal people" acne. Nothing over the counter (or even topical prescriptions) ever worked. The only thing that ever made a difference was Spironolactone, but I knew I couldn't stay on that indefinitely, and when I did stop, the cysts came roaring back.

I've also noticed that I need to moisturize my entire body now, for the first time in my life. I have a lot of acne on my back, and it's starting to dry up and get itchy, which is great, but annoying. Seems like things are working, though, which is promising.

Everyone is different and it's all dose dependent also but I am 32, similar story to yours but just facial acne so here is my experience with IB..

At then end of October, I started on 20mg/day -  for the first 4 weeks.

First 3 weeks nothing was happening. I started to get a few big cysts around 3 weeks in.

Week 4 I went up to 40mg/day and that's when I really broke out.  

December was a bad month and most frustrating thing is, it clears a little and you think this is it, the big turnaround and then boom a fresh breakout!! People talk about the initial breakout but it's actually breakouts, plural.

About a week in to January it started to improve and I haven't had big breakout since.  It's been v slow progress and i was still getting a good few new spots but about two weeks ago I started seeing big improvements  2 months to go of treatment. 

Everyone is different but keep the faith though the breakouts!! They will clear in time and they are just spots, you will have dealt with similar before but at least yo know these should be the last breakouts you have - with some luck of course 

Thanks so much, Isogirl123. That's all helpful. I guess I should have mentioned that I'm on 40mg/day. And yes, I just keep holding onto the fact that the next few months should be the last time I have to deal with this, hopefully ever.

I'm on day 9 now, and my whole face hurts. Last night, everything felt very inflamed, and it hurt to even wash my face. I could tell that there were a bunch of under-the-surface zits waiting to come out. What hurt most was my nose. This morning I woke up to a ton of tiny whiteheads, including about 3 INSIDE each nostril. Normally I would think that this was a reaction to something I put on my face, but I haven't used any new products, and especially not inside my nose, so this must be the Absorica pushing stuff out.

I also have a large cyst right beside my eye--between the bridge of my nose and the corner of my eye. Super painful, and any time I touch my eye, I bump it, and wish I hadn't. I think it started when I wore my glasses last week--does anyone else get them there where glasses touch? And it's unfortunate because my contacts are annoying now that things are starting to get dry, but I can't wear glasses because, ouch.

I have probably 8 cysts total now, all of which popped up in the last 3 days. One on my cheek opened up, and I now have a lovely scab. It's embarrassing to have a giant scab on my cheek at work as a 34 year-old.

This morning I was running out of the house and didn't have time to eat anything when I took my pill...it's the first time I have done that, and even though it says that Absorica doesn't need to be taken with food, my derm told me to do it anyway, because it will help with absorption. I figure one pill without food shouldn't hurt too much.

1 hour ago, bigappleedubs said:

I also have a large cyst right beside my eye--between the bridge of my nose and the corner of my eye. Super painful, and any time I touch my eye, I bump it, and wish I hadn't. I think it started when I wore my glasses last week--does anyone else get them there where glasses touch? And it's unfortunate because my contacts are annoying now that things are starting to get dry, but I can't wear glasses because, ouch.

Uuggghhhh yep! I currently have 3 (!) cysts in a row across the bridge of my nose (they've almost formed into one, so now it almost just looks like I have a funny bumpy nose), and on one side its right where my glasses sit. I find my eyes are too dry to wear contacts in the winter (so I'm assuming they will be too dry for the duration of accutane as well), so I can't switch to them. Mine don't hurt much thank goodness but every time I shift my glasses up I'm really worried the pressure is going to cause a cyst to weep or bleed.... ugh the joys we go through
ps. I do wear my glasses a lot and I've never actually had a cyst right where these are before, so it could just be bad luck rather than irritation?

WittySock, ugh! Thank you for feeling the pain (literally)...but sorry you feel the pain. I've also had three in that area at various times (actually, I have two now, but the one on the side of my nose is a bit lower and going away) and I know what you mean about it looking like you just have a "funny bumpy nose." And I swear the ones there hurt more than most cysts, because the skin is so tight there and there's no fat to buffer. Sigh.

Update - The one beside my eye popped later this morning. I bled profusely. Good times.

Day 10-

More tiny whiteheads. It's like every zit my face thought about having recently said "Hey guys, c'mon! It's now or never!" I'm bumpy and sore all over my face. The inner-nostril ones are the worst. I joked to my boyfriend today that I look like Deadpool. He said I don't. I don't believe him.

Just thought I'd add a little note here cos I'm sure everyone wants to know... my 3 nose bridge cysts now have a new friend.... 4 now. 4! I'm running out of nose!
Lol let us all remember that underneath Deadpool is Ryan Reynolds. We should all be so lucky (man or woman) to be that pretty! 🙂

YESS! Someday soon, we will all be Ryan Reynolds! ...or something. 🙂

Awesome support thread!! Best of luck to all!! 🙂

Day 13:

All of me is flaking off. I have dandruff for the first time in my life. My cysts are forming hard crusts (sorry, I just grossed myself out there) rather than coming to any semblance of a head, and are seeping from underneath the crusts (again, sorry, just keeping it real). The smaller whiteheads continue to pop up every day, but they are mostly going away on their own, and then flaking off where they were. I have to moisturize everything immediately after getting out of the shower. My lips are doing ok, though...chapped, but not terribly. The inner-nostril breakout is gone, thank goodness. That was awful. Other than that, I just have a lot of red marks, but my active zits are just the remainders of the cysts from the start of the breakout.

I'm either growing a horn or getting a huuuuuge cyst on my forehead. I have never had a cyst on my forehead before. Ouch. I had to photograph this one. 

How is your horn doing? I had one that did that a couple of months ago, and I've had a couple do the same on my cheeks since then (boy, am I ready for accutane lol). Mine was swollen like that for just one or two days and then just kinda shrunk down overnight to a normal (read 'still pretty darn big but at least not actually ridiculous') cyst. Don't think it ever came to the surface.

Wittysock, mine did the same thing! It's virtually gone now. It went down to almost nothing by the next day. So strange. And I have another one now by my inner eyebrow that's doing the same...last night it was huge, now it's just kind of normal, will probably be gone by tomorrow. I'll never understand my face.

Day 20-

Breakout is mostly gone, now just red marks, but they actually cover nicely with makeup. Lips continue to be dry. I also notice that my gums are bleeding every time I brush my teeth or even if I just eat something at all irritating. Face is very dry, and I've been using my Clarisonic every few days, with the acne brush head and no cleanser, immediately after I shower, to try to clear it off. So far it works well and doesn't make me bleed. Started getting a very itchy patch on my left arm, despite moisturizing everything after I get out of the shower every day.

I had one minor nosebleed yesterday. I noticed a little bit of a backache, but could be unrelated.

I haven't posted my product routine, so here's what I'm doing, if anyone is interested (and this came out of a lot of research from this site):

Morning:
Cleanse with water only or Dove Sensitive Skin soap on face in shower, Olay Ultra Moisture body wash in shower
Follow with CeraVeAM moisturizer on face, whatever other lotion I have around or coconut oil on body
Aquaphor Healing ointment on insides of nostrils
Burts Beeswax lip balm immediately following shower...and like every 5 minutes thereafter.

Makeup:
Continuing to use Bare Minerals. It actually works well after the CeraVe AM moisturizer and stays on all day right now.
Fresh Sugar lip treatment in Honey if I want something other than Burts Bees on my lips

All day:
Burts Beeswax lip balm. Seriously, all day.
Hand cream usually 1-2x throughout the day

Evening:
Cleanse with Cetaphil or CeraVe Moisturizing cleanser
Follow with Cerave PM moisturizer, sometimes twice
More Burts Bees lip balm.
Added eye cream into the mix

Every couple of days:
Exfoliate with Clarisonic on low setting, no cleanser/water only, Acne brush head, just on the very dry spots.

Day 22 -

Gotta say, with makeup on to cover the red marks, I can pass as one of the non-acned right now. Also, makeup actually stays on my face now, all day long. I was shocked last night to see that I still had eye shadow on that I applied at 8am...usually my face eats makeup. I haven't had a new zit pop up on my face in days, which is huge progress, and the ones I did have are either almost gone or just a red mark. Things are feeling slightly less dry, which concerns me...dry to me means it was working...maybe I've just found a good moisturizer/lip balm routine? Hair is starting to get a little dandruffy, something I've never, ever experienced (I only have experience with oil slicks and having greasy hair by the end of the day). I think I will turn into one of those people who doesn't wash her hair everyday, and I'm very excited by that prospect.

Day 25-

Not a lot of change. I'm continuing to feel better and more confident. Things are dry, but manageable. I have had a sort of very low grade headache and a bit of a back ache for the last few days, but neither is terrible. I go back to my derm tomorrow for bloodwork and to get my 2nd prescription.

Hi there! Uniting for all of us in our 30s battling annoying skin issues! 

I've also had a lot of pressure headaches (only at the back of my head, which usually never happens) and a whole lot of joint pains. I feel your pain! I bought a foam roller that helps with balancing my spine/neck but PCP had to put me on Baclofen to help with overall muscle stiffness as well. It seems like I have to take a new pill for each new pill I hop on.

Have you considered using Ketoconozale shampoo for controlling dandruff and flakes? It was recommended to me by my dermatologist when he thought it would kill my forearm folliculitis. It seems to work better on my scap and I no longer have as many flakes as I used to.

Good luck! I wish you all the best. I'm on day 45 and things are VERY dry here as well. Lips and face being the worst offenders. Cetaphil, Vaseline and Burts Bees are doing a great job at helping out. 

On 03/03/2016 at 4:44 PM, bigappleedubs said:

I can pass as one of the non-acned right now

"Smug normals"??? Thinking Bridget Jones-esque

Hey, bigappledubs..

Wondering if your derm is increasing your dosage at any point during your treatment? I was on 40mg once a day for a month and a half and my derm increased me up to 80mg daily. I have seen a worse breakout now then my "initial breakout". So many cysts on my chin right now :/

Hey CravingClarity, yep, I was upped to 80 mg 6 days ago (at the start of month 2). He put me on 8 days of prednisone at the same time, to try to counteract a flare. So far, my skin is completely clear, so I'm hoping that the steroid worked/is working. So far my only symptom is that my lips are even drier, and I feel thirsty constantly.

And Wittysock, YES! Those smug normals and their normal skin or whatever. Heh. Love Bridget Jones!

BostonShore, glad you understand. Is the dryness getting any better?

Day 37ish (I'm losing track)-

Skin is actually super clear right now, which I think is likely more because of the Prednisone my derm put me on during my 40 to 80mg Accutane transition than anything. Even without makeup, the marks are only slightly red. This is a huge development. I do have a mega dry spot on my right hand, though...having never had dry patches of skin on my body, this is weird.

Not having any other side effects, really, aside from super dry lips. I've also started wearing my glasses more, because my contacts are getting to be annoying. The prednisone definitely made me feel like I needed to run a few marathons the first couple of days I took it, to the point that I was randomly doing jumping jacks and pushups in the kitchen before dinner just to get some of the energy out, but my dose has tapered down and I'm back to my normal, lazy self.

Also of note: (and sorry if this is TMI, but I think the ladies here will relate)...I'm 2 days away from getting my period, and I have NO acne right now, not even a little one, and haven't had a cyst in over a month.It's nothing short of miraculous, honestly.

One quick product PSA:

Agave Lip Mask by Bite Beauty

I got it in the clear version (which essentially looks and feel just like petroleum jelly, but it has no petroleum in it). This is the ONLY thing that is working at the moment. I put it on at night before I go to bed, and in the morning just after I get out of the shower. If I forget it either time, I feel it. I still have to supplement throughout the day with Burts Bees, but this stuff works the best of anything I've found so far and my lips literally peel off if I don't use this for a day.