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Hi all! I™m a 34 year old mom of three, just starting on Accutane. I™ve chosen the low dose, extended treatment time for a few reasons: first, I™m past childbearing, my husband has a vasectomy and I™m already on birth control (Yaz) so any birth defect issues are exceptionally unlikely. Second, I get terrible cold sores specifically when my lips get chapped or sunburned, so we are hoping the lower dose = a little bit less dryness of the lips. And 3rd, I almost never drink anyway, so abstaining from alcohol for an extended period of time is a non-issue for me.
I™ve had acne since my teens, though that could be classified as œnormal teen acne. After the birth of each of my children, my acne has gotten progressively worse. I have deep cystic acne that is completely unresponsive to abx. I have tried a few OTC regiments (Obajii, Proactive, The Ordinary) with success for about 4-6 months, then the acne will return, worse than ever. I wear either a mineral based (p¼r) or water based (The Ordinary) foundation. I have tried literally 100™s of different products from $$$$ to Walgreens and the makeup on my face rarely seems to make a difference, my acne is systemic.
I was recently prescribed Wellbutrin for depression, 300mg a day which put my skin into an absolute tailspin. 3 months later it still can™t recover and I™m now off of my most favorite and effective antidepressant I™ve ever taken : (
So here we are. My regiment includes:
simple brand micellar gel gel wash for dry/sensitive skin- twice daily wash
cure- exfoliant 2ce week, sometimes more if my face feels gross- This stuff is from the gods. It™s Japanese, and available on Amazon. I™m not sure if it will be too harsh to continue using through the Accutane use.
Olay- sensitive skin moisturizer
I™m including my baseline pics- you can see lots of hyperpigmentation, scarring both on the surface and ice pick, active comedones, Whiteheads, blackheads and of course cysts. The pics are not fantastic as my phone like to try to blur skin, but it™s what I™ve got.
Week 1 update.
Day 1- took the pill with a œheavy fat dinner and went to bed. Woke up and had a dull pounding headache all day.
Day 2- No s/e other than headache
Day 3- started to notice a weird little dry patch under my lip. No improvement in acne (obviously), but it™s not worse *shrug*
Day 4- I™ve been sucking down water, no more headaches, but noticed the crease of my right eyelid has a dry/raw patch (wtf? There?!)
Rest of the week was uneventful. I™ve been using the cure exfoliant on the dry patch and then slathering aquaphor on it at night, so it™s not gotten any worse (or better tbh).
Today on Day 7, some of the smaller Whitehead issues are gone and there is a bit more smoothness of the upper cheeks (not much at all, feels just like normal breakout healing) but the cysts on my right jawline/neck are ANGRY. They have gotten larger and itchy as they stretch the skin.
Left side- a bit clearer, no dryness 
Right side (6-7 large, deep cysts)
Red circled area is the dry patch (post exfoliating/aquaphor) Not I much lip dryness, but I™m taking the moisturizing very seriously. I™ve pre loaded the pockets of all my coats and all vehicles with lip balms to make sure I™ve always got one within arms reach.
Week 3 and things are still about the same. No more dry patches, but every few days I™ll have a joint that will just ache incessantly. It™s not unbearable, but it is a bit bizarre. No dryness in the lips and I don™t feel like my hair is any drier.
I™m continuing to supplement the Accutane with milk thistle for my liver, red rice yeast to help keep cholesterol down, glucosamine for the joint issues and licorice for the prevention of cold sores. I did have a weird cold sore/zit mess happen right by my nose ring, so I took it out and put the spacer in. It was not red/infected and it drained and has been healing just fine since that happened. Not sure if it™s Accutane related, but I thought I™d put it up there.
Still lots of really persistent cysts with new closed comedones arriving daily along my jawline. The texture in my cheeks is a complete nightmare.
So, not much improvement, but it™s not worse either.
Week 4 report is similar to week 3 with the exception that my hair looks and feels....sad? Dry? Dull? All of the above. I™m not losing any as of yet, but I™m adding some intense conditioning to my weekly routine.
This is my first period since going on the pill last month which is normally a skin disaster even when my skin is not at terror level orange, and things stayed about the same- maybe even a little better? There are a few very angry spots in these photos, but everything is covering with makeup much better than it was a few weeks ago, so, we™ll count it as a win.
Pics are crap because I forgot to take them while it was still light so no natural sunlight in these which makes everything look worse.
Week 5 and everything sucks lol. Going to consider upping to 40mg a day (still a comparatively œlow dose to the typical exam.
Acne is ridiculous on my neck. Absolutely no change in that in the last 4 weeks. Everything is huge and hard as a rock. My skin (where the acne is) gets quite dry by the end of the day, but it™s not peeling off all over the place. No new dry patches.
