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Hello. I kept a record here back in 2015 of my first accutane journey, and it was helpful to look back and document the progress and changes in my skin. Unfortunately I forgot the password to that account, so am posting here. I want to create a new log so I can document my journey with my skin.
I went on accutane for severe acne and facial/neck seb derm in 2015. 20mg first 2 months, 40mg for the rest. It cleared it. Afterwards I had a resurgence but epiduo cleared it up. I used epiduo for 6 years with clearance.
Unfortunately november 2021 I had a stressful time, and my skin suddenly got extremely oily. My face and neck started to break out a lot, and epiduo wasn;t controlling it. I was put onto low dose accutane (10mg a day) on 28th Dec.
I am starting week 13, day 80.
Since starting there have been no changes. My skin looks a lot worse. My acne was "mild" to begin with, but unfortunately it was worsened a lot since I started. I wake up with new bumps daily - but they never stop. I assumed accutane would have cleared this up fast, but unfortunately it hasn't. My face looks dreadful, and very sore, red and rough. The texture is now awful. It's to the point where I believe I need to stop the accutane, as it is just making things worse. My derm prescribed some glycolic acid to see if it would help.. .but my skin was too sensitive and it made everything really bad and irritated after a few days.
The problem is... I don't know what to do. I feel stuck. I can't just "go back" onto epiduo and my old routine as my skin is too sensitive, but also the accutane is not doing good and the side effects of dry eyes are effecting me a lot. I am also feeling suicidal over my skin (but this is not caused by the accutane, but can't be good either.) I feel I have exhausted all options. Retinoids. Acids. Accutane.I feel I will never wake up with clear skin, and the accutane is just damaging my skin further at this point.
I see my derm on the 28th. I will try to stick through until then. That will be the official start of my 4th month. I will talk to her about my concerns and explain how I believe I need to come off of the accutane. I don't know what the plan will be, likely to wean off of the accutane and slowly wean onto epiduo again (or tretinoin, but I feel epiduo is stronger)... but I feel scared. I miss my old life, my old face, my old routine of just putting on epiduo at night and feeling comfortable. Now I wake up and feel scared to look in the mirror and see what I'm dealing with today. Still... I don't feel accutane is for me. The acne isn't severe, but unresponsive, but now looks a lot worse since the accutane is making me dry, red and sore (even at a small dose, but I am only 8 stone and 5 foot 5. I am also older now, 30, so the effects are hitting me harder than when I was younger and took it when I was 23/24.)
I'm scared. I don't know what to do or how to get my skin back to a level I am comfortable. I am going to ask if maybe I could persue a chemical peel or laser... maybe that would help "smooth out" my skin, "reset" it almost - so I have a blank canvas to apply retinoids on... but I don't know if a chemical peel can even do that. I don't know if my face is even recoverable at this point.
So here we are. Day 80. 10mg a day. Soon to likely stop. I will keep this updated for my own records.
Hello. I have tried elimination diets many times in the past, with no luck (my skin was actually the best when I was eating extrmeely unhealthily and drinking a lot).
Hormones I haven't had tested - i am a guy though so I don't know if hormones are the cause of my acne (Although I guess all acne is technically hormonal as it is androgen related). I feel my main issue comes from stress... but the stress is caused by the acne which causes the stress. So it turns into a very bad cycle.
Day 81 10mg a day
Everything always seems calmer in the morning and then looks worse as the day goes on. It's like my skin is "plumper" in the morning, then really thins out as the day progresses. It really ends up showing a lot of my textural issues - which I don't think anything can ever fix. My skin is very thin so I don't think any peels or lasers or anything can help "thicken" it. I used epiduo for 6 years with an active retinoid, and it's just as thin. It makes me feel that this is just my skin, and it will always be like this.
The area around my nose on the cheeks is so shiny and bumpy and textured. It looks odd, and I don't remember it ever looking like this prior to accutane. It may be caused by dryness, but I don't know - I was using epiduo prior which was drying in itself, and I wouldn't say I'm insanely dry on low dose accutane either. I just am so confused and don't feel my skin will ever look normal. Moisturising is hard as it really shows every single bump and pore. I feel there is not a place on my face that is smooth.
I am currently just washing my face with water in the morning and using cetaphil gentle skin cleanser at night in an attempt to give my skin a break from products for a while and see how it goes. I have been doing this now for 6 days today. Sometimes it looks calmer, but then I will get more bumps.
I will start reapplying moisturiser from wednesday when I need to go into work.
Day 85
Went and got my haircut today. The guy was so heavy handed he cut two spots by my hairline and my neck is one massive rash. I am fed up of this - and fed up of this ridiculously sensitive skin. I always seem to get these little bumps by my hairline, which i never did before starting the accutane. My texture around my nose (on the cheek area) is awful.
I just want to stop the accutane - but also I feel that there's nothing I can do once I do that. If I stop I just go back to epiduo which stopped working after 6 years, and is too strong for my neck area anyway (where I get a lot of the issues).
Still. Maybe this 3 month break while being on the accutane and not taking epiduo is enough to "reset" it for me and make it work better... who knows. Either way I just don't think the accutane can do anymore. I don't think what I have is even "acne"... they're more like consistently irritated hair follicles or something..
But also... epiduo is too strong for my neck, so nothing can be done there.
I'm just feeling lost and scared.
I will be seeing my derm on monday and discussing - but I already know it will be lowering the dosage and incorporating epiduo or tretinoin. I feel inclined for the epiduo as, if they are irritated follicles, the BP will work faster - but then it is very drying...and I can't use it on my neck. My skin is also just so sensitive.
Maybe I just need to stop literally everything.
Sigh, I don't know. I hate waking up to new bumps every. fucking. day. I just wish there was a procedure that could rip my face off and I could grow a new one. I've even looked into co2 laser, but you can't have that done with active acne - and it would be months of a red face which I cant take... and it wouldn't stop the bumps from coming...
Day... doesn't matter.
Saw my derm on Monday and we agreed that what I have isn't neccessarily acne. It's more irritated follicles/folliculitis. This is likely why the Epiduo worked so well for 6 years after my last course and why my skin appeared to freak out when I stopped it and started the accutane. I feel the BP in the epiduo is what acts fast enough on the irritated follicles to stop them getting so inflamed.
We've decided to lower the accutane dosage. I am now taking 10mg every other day, so the equivelant of 5mg a day, to order to slowly wean me off and to continue hopefully dealing with the areas that are actually acne. On top of this I am back to using the Epiduo. She prescribed me Epiduo Forte (the 0.3% adapalene version instead of the regular Epiduo 0.1% version) and told me to use it every other day. However, there is a delay getting my prescription - so I have decided to use the regular Epiduo every single day, with today being my 6th consecutive night of Epiduo whilst taking the 10mg accutane every other day.
She said I could use it on my neck as well, but my neck is always very red and raw and sensitive, so I have not done that yet. That being said, my neck has been relatively calmer this week, so I am hoping it will stay this way. If it flares up again, I will try applying a small amount of epiduo and see how it goes.
The ideal goal would be the epiduo works and I stay on low dose accutane as a maintenance, and this combination clears me. In writing it seems like it should be the ideal combination... BP/Adapalene work on the top layer of the skin, whilst accutane works from within.
That being said... my skin is still a mess. It is a little tender today so I will watch how it goes, and I have a rough patch on my right temple area. It looks like a bunch of little spots, but I am pretty sure it is not acne and is just dryness. I am going to keep an eye on it and see how it goes, it may just be me readjusting to the epiduo...
I am also just getting daily bumps... always on my temples. They take like 4 days to go, and then when one goes 2 more appear. It's not acne, but little inflamed irritated follicles I believe.. and I just feel I will never not have them. I'm tired.
For now let's just see how this combination goes. My face is tender, but I hope it will adjust. I just feel I am never going to have smooth skin, I will always have daily bumps and it is exhausting. I'm really trying hard to get my life back, go gym, go work, etc... but it's just so, so hard... you try to be positive all day, then look in the mirror and see 5 more new ones and it's just...
I want it to end.
So.
The past few months have been an absolute mess. I stopped epiduo after 7 years of use to go on the accutane, and then my skin freaked. The first month was awful on 10mg a day, and then since then my panic overtook me and it all went to shit.
It turned into a plethora of 10mg every other day, then 10mg every day, then retrying a topical while on accutane, retrying epiduo, attempting glycolic acid, etc etc. It's been a disaster.
My derm has told me that what is best for me to do right now is stop everything. That includes the accutane. For 4 weeks. And then I can go back and we can reassess, and that 4 weeks will give my skin enough time to settle down and we can actually see what we're dealing with.
Now... this is so, so difficult. I think it's so hard because I KNOW I will end up on a topical like epiduo or accutane again, so my mind is like "well, why not just start now?!"... but I know that this is for the best. To see where my skin lands at baseline, and then reintroduce something. Properly. With no chopping and changing.
However... after 7 months of this now, I am at breaking point. I don't know if I can bare it getting any worse. And I know it will. It's been 2 days since I last took accutane (Was just taking every other day for a week before that), and my skin is starting to get very oily and breakout.
I think I know as well that... nothing can be done for my neck acne. My derm has said herself that this is irritated hair follicles and not acne, which is why no treatments work. She basically said that... I need to just deal with it. And that's very hard. Because it's one of my biggest concerns
But I know this is the right thing to do.. I just don't know if I can stick with it. I know that this is the smartest thing. My skin has been so chaotic and so up and down through this entire course and I haven't been consistent. I don't even know what is happening anymore.
This is the best thing to do so I can see my skin at baseline, as horrific as it is, and then go from there. It means that whatever treatment I DO restart (whether it be a topical, or accutane, or...) that I will have less doubts in my mind. I will have more confidence it is the right thing.
I just pray it doesn't get too unbearably out of control over the next 4 weeks. I pray so hard that it doesn't get unbearable.
I had hoped I'd be clear by now in December. Now I am back at square one. Deliberately doing nothing which will definitely make everything worse, physically and mentally. But I know these 4 weeks will help me figure out my skin for the rest of my life... hopefully...
But where I have been doubting if I am on the right path this entire time... I am hoping I am now taking the first step on the right path.