Hey!
I'm currently on a low dose treatment and have been for the past 2 months! I started a normal 5 month accutane course, taking one 40 mg pill a day. After my 5 months, my doctor told me to take one 40 mg pill a week for 6 months to maintain results 
Let me know if you have any questions!
I did my first two trials with Accutane about 20 years ago. Doctors would not prescribe it for my moderate acne -- "only for severe cystic acne", they said. No mail order pharmacies back then. I bought it in powder form from a chemical supply company that sold it as a dye for tunable dye lasers. Compounded it myself with vegetable oil. No alcohol, no tanning.
Did the first treatment for four months at 35mg per day -- the minimum dose recommended by the Physician Desk Reference. It worked great, but the drying was severe -- great patches of skin peeling off my face. In four months, however, I had skin like a baby. Alas, the acne came started coming back nearly as soon as I stopped treatment.
I tried again at 70mg per day. This time I moisturized my face with aloe vera gel, which took care of the peeling. The higher dose didn't work any better or any faster, but it did last longer. Still, the acne came back after a couple of years. After that I didn't want to try it again because it dried out my eyes too much to wear soft contact lenses. In retrospect, I should have stuck it out to get a higher cumulative dose, but 4 months is what the PDR was saying back then.
Anyway, I started a month ago with 5mg per day. Although it is available in 5mg capsules, the 10 mg capsules are the most economical, so I'm taking a single 10 mg capsule every second day. And it's working just as well and just as quickly as the higher doses. Accutane has a short half life, so I suppose a daily dose might be better, but since this is working fine I see no reason to bother with the extra hassle and expense. I plan to continue taking it until I reach a cumulative dose of 150mg/kg.
Side affects have been minimal. When you start on Accutane, the existing lesions become irritated and inflamed. Lesions that were buried and unnoticeable now become visible, so the acne APPEARs to temporarily worsen, but it really doesn't. This affect faded away after three weeks. No problem with contact lenses at this dose. No peeling. Slight dryness, controlled with Dove soap. Existing lesions did take longer to heal.
A word about the Dove soap. Skin is slightly acidic. Nearly all soaps are alkaline. When you wash your face with an alkaline soap, your skin produces extra sebum to restore the acid balance. So you might want to try a ph neutral soap. Dove is the only mass market soap I've been able to find that is pH neutral. Plus it already contains a moisturizer, saving the hassle of applying one separately. (Neutragena, despite the name, is no longer pH neutral. There are liquid cleaners that are pH neutral and even pH balanced to match skin acidity, but they are really detergents, not soaps, and detergents are drying in themselves.)
well, since ive done 3 full courses, the last one was a total of 19000 mg i think... 100mg/day for like 6 or 7 months////
i self treated with 40mg mon-wed-frid and was very happy... going to DERM tomorrow and hope she agrees to do the same for life or whatever!!!, OR i even want to start 20mg 3x week....
30yr old, acne SUCKS....
phats
5mg/day Accutane 60 Day Progress Report
I'm continuing with an average 5mg per day dosage -- one 10mg pill every second day. (0.07mg/kg body weight) I wash my face twice a day with lukewarm water and Dove soap. In the morning I apply aloe-vera gel as a moisturizer.
Results are good. I have not had a new pimple since November 20th. All my existing lesions are now healed over, leaving only small circles of new pink skin. Comedones are no longer forming on my forehead and chin. I'm still getting them on my nose and cheeks, but they are smaller.
Side affects: Slight dryness to my facial skin and lips. Existing lesions took a long time to heal -- the worst one took 6 weeks -- although they all healed eventually. I've read this is because Accutane decreases blood flow to the face. I believe it, as shaving nicks hardly bleed at all.
My hair became dry enough that I started using a conditioner.
well, since ive done 3 full courses, the last one was a total of 19000 mg i think... 100mg/day for like 6 or 7 months////
i self treated with 40mg mon-wed-frid and was very happy... going to DERM tomorrow and hope she agrees to do the same for life or whatever!!!, OR i even want to start 20mg 3x week....
30yr old, acne SUCKS....
phats
well, since ive done 3 full courses, the last one was a total of 19000 mg i think... 100mg/day for like 6 or 7 months////
i self treated with 40mg mon-wed-frid and was very happy... going to DERM tomorrow and hope she agrees to do the same for life or whatever!!!, OR i even want to start 20mg 3x week....
30yr old, acne SUCKS....
phats
well, since ive done 3 full courses, the last one was a total of 19000 mg i think... 100mg/day for like 6 or 7 months////
i self treated with 40mg mon-wed-frid and was very happy... going to DERM tomorrow and hope she agrees to do the same for life or whatever!!!, OR i even want to start 20mg 3x week....
30yr old, acne SUCKS....
phats
I'm way older than 30 and still get cysts {or used to) so yes I know the feeling..
I did 60mg/d from Jan to May( Iv'e been through this regime 3 times before). By July/Aug the cysts started up again. In September I began 20mg/d and had the odd minor,short lasting breakout. But it's worked well for me---> no excessive oiliness for one is a blessing; dry lips the only side effect. I'll continue until March on 20mg/d then reduce to 20mg/every other day.
After more than 3 months, I have to say that I feel good about this low dose regime. I was wondering if anybody has been on Accutane for 1 year or more. A couple of the people on this post http://www.ichthyosis.com/ubb/Forum3/HTML/000013.html say that they have been on Accutane for 10+ years and at high dosage. I would'nt want to chance that.
I have self prescribed myself a course of 20 mg daily, Im only on day 9 so not much to report yet. I was orignaly going to continue 20 mg daily for 60 weeks in order to hit my cummulative dose, Im now wondering weather to up my dose to 40 mg daily in about 8 or 9 weeks once Im clear. This could half my course and Id hit cummulative dose alot sooner.
Low dose or full whack dose...two different approaches and both possibly viable, depends on how bad your skin is and what you're looking for: an attempt (which is all it is) at permanent remission with a full dose OR a maintenance low dose. The former has much more chance of side effects (although these can be overblown considerably, especially on the net), the latter you have to keep taking....
I showed my doc the article and he said "Yes, people are doing low-dose but there's no end game, you're never finished." At least that's what he thinks.
Do you still have to do the iPledge thing on low-dose? I should think so.
Im on day 14 of 20mg daily and have seen nothing yet. No dry skin, no dry lips and no I.B.
Anyone who has done a low dose course when does something start to happen? Im thinking that maybe this is just to low dose as I weigh 75kg but my derm says 20mg is still really powerfull because this is such a strong drug and that it should be enough for me.
5mg/day 90 day progress report
About the same as last month. No new pimples. A few times pink spots would form and then fade away in a day or two without coming to a head. Comedone formation is nil on my forehead and chin. I'm still getting them on my nose and cheeks with no reduction from last month.
I have been doing something similar.
I have been on low dose Accutane, supervised by my Derm for just over 12 months. I did up to 10mg per day but spent a lot of time doing 10 every other day or 10-10-Nothing.
The only side effects were dry, swollen lips and my face being fatter and more bloated (lol, go figure). Occasional mild knee pain. Nothing else to report, which I have been happy with. I also got blood work checked bi-monthly and it stayed well within normal ranges.
I am 130 lbs (58 kgs) and have suffered from cystic scarring acne since I was 13. I am now 23. I can't believe its been a whole decade! I am male.
Recently, I stopped for about 3-4 weeks and the acne has returned. I have cysts on my chin and nasty inflammed whiteheads on my face. This is disappointing. An entire year on low dose and it has not produced remission.
My derm discussed this with me today and recommended that we ramp up the dosage to 20mg, then 30 and eventually the target of 40mg. I am quite hesitant about this. He is quite reluctant to let me keep continuing on low dosage long term (even though I am not experiencing any overt side effects) because he really doesn't know the implications. There haven't been any studies.
He says he wants to do a proper high dose and get it over with in one shot. I did try 40mg for several weeks years ago but found the side effects too much to handle. I'm not that eager to do it again.
I am completely at a loss about what to do.
Any of you been on low dose for longer than me? 12 months has been a long time. I am so disappointed that I don't have remission.
Any advice would be appreciated.
Wow, well with all this info I really can't see any reason to not start accutane. My doctor is an idiot however, so he won't do anything for my skin. I know where to get accutane online and will be starting a 20mg/day course as soon as I get back off holiday in June.
Wish me luck
don't use sources from 2003..naughty
and science isn't fun, trust me *cry* *bitter* *overworked*
And you aren't completely correct about Doctors not being aware of new studies unless they have just finished training. In science and medicine we have it drummed into our heads to practice EVIDENCE BASED science and EVIDENCE BASED medicine
It honestly depends on how good and thorough the Doctor is as to whether he/she updates their knowledge, also depends on which specialty...some areas are more research reliant than others.
But having said that I think its excellent to do your own research and go into your doctors office armed with some knowledge. Some Doctors are hopeless, especially GPs. I seriously had one the other month that didnt know what international units were I almost walked out.
But remember, biochemistry/physiology of the body is very complicated, a lot more complicated than some articles or reviews make out - to understand the significance and real implications of many of these articles you have to really understand the context i.e physiology and pathways and signalling and cellular architecture and genetics and blah blah blah. So its easy to take something out of context or misinterpret something or be swayed by a bad argument (not all studies are good) unless you have training in the field (and even then...)
so message - don't always trust doctors, but don't always trust articles or reviews, and don't always trust your own perception. What you need is a magic omnipotent computer that knows all. good luck!
An entire year on low dose and it has not produced remission.
Any advice would be appreciated.
SELF magazine (not sure what month but I have the actual page & page number) but I think was in 2007. The article said quote:
Page 116: Tried Ortho Tri-Cyclen, Tretinoin cream, oral antibotics? "NOT WORKING FOR YOU?"
"A near-cure. Most docs agree isotretinoin(or Accutane), which decreases oil production, is the answer to hard-to-treat acne. After 4 to 5 months on the drug, most patients go into permanent remission, says Sumayah Jamal,M.D., a dermatologist in NYC. Moderate acne can benefit too:"Instead of the typical dose of 50 to 80mg, I'll prescribe 10mg per day, then wean it to 10mg a week." Dr. Shultz says. But success has a price. Miscarriage and birth defects are risks. (Women on the drug must use two forms of birth control, plus take a pregnancy test each month). Sun Sensitivity is too, so a sunscreen with SPF30 is a must--a habit we should all follow anyway!"
Doses as low as 2.5 mg and even 1mg per day have been used on a continual basis to keep acne at bay.
Tell your doctors that:
1mg per day isn't enough. Studies so far indicate 10mg a week after 10mg per day for 1 to 3 months first works. 10mg a week is 1.42mg per day. No studies show that less than 1.42mg per day works.
1mg per day doesn't work. Hence, why the study at 2.5mg 3X per week didn't work. That was 7.5mg per week meaning 1.07mg per day.
But, I'd try various supplements to help combat the side effects of Accutane. Accutane is basically a mega-dose of vitamin A which depetes your Vitamin D making you feel weak & have potentially joint pain, etc. Also, I've read Accutane ups blood calcium which drops your magnesium. Magnesium is used for energy production.
Based on these 7 Medical Journal references:
1. Serum levels of Vitamin D drop significantly following Accutane treatment of acne. [Acta Derm Venereol 72: 217-219,1992]
2. Long term use of Accutane would increase the risk of cardiovascular disease. [New England J Med 313: 981-85,1985]
3. Among users of retinoids, omega-3 oils (fish oils) have been shown to reduce increases in triglycerides by 70%. [Human Toxicology 6: 219-22, 1987]
4. Accutane decreases biotinidase activity, the enzyme the recycles biotin, a B vitamin. [skin Pharmacol Applied Skin Physiology 12: 28-33, 1999] Deficiencies of biotin may result in skin rash & hair loss!
5. Quercetin inhibits the conversion of retinoic acid to other undesireable forms of vitamin A. [biochem Pharmacology 63:933-43,2002]
6. Quercetin blocks many of the enzymes that degrade skin collagen that increase lines & wrinkles. [Mutation Research 481: 269-76, 2001]
7. Magnesium inhibits the enzymes that breakdown collagen that increases lines & wrinkling of the skin. [Atherosclerosis 166: 271-77, 2003]
There are the 5 supplements I feel everyone should take on Accutane. To safeguard your health from any possible side effects from Accutane:
1. [swansonvitamins.com] Swansons EFAs Flaxseed oil with "Lignans." 200qty (980mg oil/20mg lignans) softgels. Take 4 per day. (2 softgels with first & last meals). Also, will help absorption of Accutane because provides some healthy fat.
2. [iherb.com-enter referral code:DUJ828 around the time the site asks for your credit card number. It gives you $5 off your first order. Get the same deal in the future by using the same code by starting a new account with a diffferent email address. Also, orders over $60 is free UPS ground shipping in the 48 US states] NOW Foods Vitamin D3 1,000IU & K2 45mcg . Take 1 Vcap per day. Take with 1st meal.
3. [iherb.com]NOW Foods Magnesium Malate 180 tablet bottle (150mg). Take 2 tablets per day. (1 tab with 1st & last meal).
4. [iherb.com] Natrol Take One "iron-free" multivitamin 60 tablet bottle. Take 1 tablet per day with first meal.
5. [iherb.com] NOW Foods Quercetin 500mg. Take 2 Vcaps per day. (1 Vcap with 1st & last meals).
(Only people under 18, women pregnant, or women with their monthly period should take the form with iron).
Otherwise, for every 1mg of iron you take, you increase your risk of heart disease by 5% [New England J Med 330:1152, 1994]