Hey secretsky, thanks for sharing your story!

If you want my opinion, definitely take the opportunity to do a lower dose course. To answer your questions:

- In terms of side effects, at that daily dosage, albeit lower than most courses, odds are that you will still see the same side effects as you did while on 40mg per day, just less severe. But, there are a few things you can do to lessen the side effects significantly, for example taking a hyaluronic acid supplement which all but eliminates the joint and lower back discomfort and even helps with the skin dryness (it is the same ingredient in the HydraPlenish that GatorsFan mentioned a couple posts up). Another thing you can do, which is common knowledge in my book, is drink a ton of water! Water helps with everything when it comes to moisture levels of the body, don't stop drinking the stuff all day! Also, vitamin E and vitamin K supplements help greatly to balance out the large amounts of vitamin A derivative in your body, thus again, reducing side effects.

- When it comes to how soon you should see results, just remember it varies greatly from person to person! Some people see significant results in 3 - 5 weeks, while others are left waiting until a few or more months in. One thing that has been documented in studies, though, is that the end result, around 6 or 7 months in, low dose accutane has shown about the same clearance percentage as higher dose courses, all with less side effects and a minimal initial purging, if any. If the studies are correct and the stories of people on this website hold true, mine included now, the route with less side effects should sound SIGNIFICANTLY better.

- Would it be quicker? Like I said above, everyone is different, but generally the end result between those on high dose and those on low dose is generally the same. That said, the beauty of low dose accutane is that the body responds so much better to a slow, gradual accumulation of the drug in your system.

Just an update on myself, now that I am around 4 months in, I rarely break out anymore and when I do have lingering flare ups, they heal relatively quickly! It's a nice feeling and I only look forward to having even better skin in another two months. The last remnants of comedogenic acne and minor clogged pores still need to make their exit!

Also, secretsky see if your dermatologist wouldn't mind prescribing a couple months of cephalexin antibiotic when you start your course. It was the one antibiotic that ever helped me get clear and fast! This was a beauty for me because it allowed me to get clear of inflamed acne in the beginning of the course and just let the accutane set in without worrying about any initial purging or anything of that matter! It may seem scary taking an antibiotic and accutane in the beginning, but I noticed no extra side effects except for increased happiness knowing my face was clearing right off the bat!

Take care and let me know what you decide!

Akanel

Thanks Akanel for your response! I appreciate that )

And Thanks for the tips that you gave me though! I have been taking vitamin E and Vitamin D with calcium (I have low vit D). I drink as much as I can. Whenever I can get a sip in. I use Cerave moisturizer and aquafor for my lips. So I got myself covered since I do have experience of some of the side effects from the last time I took it.

I have a few more questions though, if you don't mind.

When you started accutane how would you classify your acne? Are you under the supervision of a Dermatologist? I personally used to get 3-4 cysts (I mean huge ones) every so often when I first went on accutane. The reason why my derm put me on it was because it was persistent and nothing else worked. Plus I was going off of insurance and would no afford any sorts of medications in the future. Hense the first round of accutane of 40 mg for most of the time then 80 mg the last few months. I have recently moved overseas (Egypt) and things here are much different from what I am used too. I can actually walk in to the pharmacy and just get isotretinoin!! WOW, I was shocked. Nothing here is regulated but hey, in a way it works for me, right?! How ever I DID go to a derm here and he also prescribed it for me but at 20mg. But because its easy to get a 'pack of pills' I thought to just go back and get more to take my original dosage of 40 mg which was why I posted on this blog ) You see, also my acne is worse then it was when I first took my first round in the US. My whole left side of my face is FULL of cystic acne. I never had that before. I'm thinking that 20mg will barely break the acne plurge at this rate if 40mg didn't kick it out of me in the first place. You see what I mean?

I am 9 days into taking accutane. The first week I rotated between 20mg/day to 20mg twice a day (total of 30 mg in a day). Then yesterday I decided to just stick with teh 40mg since I've already gotten three new cystic buddies. So, are you saying that if I stick at a low dose I may not get the acne flare up that I already seem to be getting? Now I'm thinking to just stick to 20mg and see how it goes...hmmm. I'll have some thinking to do I guess.

I will say however that the acne that DID exist is no longer painful and are just bumps (kinds hard though). I haven't picked at anything even though I'm so damn tempted too but I'm worried about scaring. Why?! because some of my acne that did go away since starting still has a red mark even though pimple is gone. I NEVER had that before when my acne healed. So it seems that accutane has a longer 'healing' process as well, but I could be wrong. It just seems that way for me.

So how many mg do you take? Do you take it daily? When did you start to see a significant improvement in your acne? Do you have any tips for the red marks by any chance?

Well those are all the questions I can think of right now. Thanks again!

SecretSky

Sorry for this late response, Secretsky! Anyway, to answer your new questions:

- When I took my first course of Accutane back in 2010 (normal dosage course) I had moderate/moderately severe acne, characterized by inflamed pustules and papules with 3 or so cysts at a given time. All of the acne was located on my cheeks, so I was not plagued all over. Also, I have been lucky in my life to have a completely clear back and chest, which I have always been thankful for.

- Since my first course, yes I have been under the supervision of a dermatologist. She alone has been the one prescribing me medications and helping me in any way she can.

I am sorry to hear that your acne is worse now than it was before =[. My acne came back after the first course but was not as consistently bad as it was before and cysts were all but completely eliminated. I still had bad periodic breakout of inflamed acne, but they were not as severe as before.

When it comes down to how much you think you should take, it depends on whether you are looking for remission of your acne (which a lot of us "second coursers" know isn't always the case) or for long term clearance with long term low-dosing. Studies like that from Dr. Plewig HAVE shown that it doesn't matter whether you are taking 40mg or 10mg, or even less in some cases, clearance of your acne can be achieved around 6 - 8 months. However, it is during that time frame that high dose courses are ended and typically show permanent remission of one's acne. If you are like me and don't have confidence in your acne going into remission, I would keep it around 20mg a day or maybe 40mg every other day, and then once 6 months comes around and you see that you are clearing those final pores, drop it even lower maybe to 20mg twice, or even once, a week and continue on that road with clear skin as you see fit.

There are many people in the Acne.org community who have had amazing success with long term, low-dose Accutane. There are even instances on this site where individuals have taken 10mg a week for upwards of 5 years (gulp!) with no noticeable side effects. I am in no way advising that, but it just goes to note.

Now that I am at my 5 or so month mark (I've lost track a little) I too can say that I am - with the exemption of lingering comedones and the occasional pimple - acne free thanks to only 100mg a WEEK. So, basically, during a given week I may take it every day, I may take it every other day, it all depends on side effects for me. That's part of the beauty of a low dose course is that you can control it more. It took about the 4/5 month mark to really notice that I was not really breaking out anymore and for weeks now, I have been a happy camper.

As for my advice on the red marks, I would suggest using an alpha hydroxy product, like Dan's AHA+ which helps with the resurfacing of the very top layer of the skin. It could assist in speeding up the fading of those marks. If not that, believe it or not, anything that hydrates the skin, heals the skin, so drinking a lot of water and maybe even looking into the Hyaluronic Acid I talked about in an earlier post would help you!

Hope I could help again!

Akanel

I'm a 60kg girl, 25 years old. I've been taking it for 10 years.

My advice: tolerate the high dose, eventually your acne will reduce- it will take months (maybe 7 or 8). Roacctune is such a powerful drug and it dries up your oil glands. No acne can survive that. Just keep going on, at the high dose that you have been prescribed. Eventually you will notice that while you are still getting pustules and acne which LOOKS just as severe, the pressure may not been built up underneath those pimples. It will take months, but stick to the high dose and be stubborn. When your face is eventually clear (maybe after 7 months), THEN stay on the high dose. Keep it clear. Once your skin is stabilised and you can count on your face being clear, THEN go onto the lower dose.

My experience:

Since the age of 12 I have had severe cystic acne, mainly on my forehead, cheeks and then it progressed to my back.

The dermatologist put me on the contraception pill Diane, which only made me gain 13kg and didn't affect my acne.

When I was 15 I went on my first course of roacctune. I was taking 40mg a day for 9 months.

At about the 6 month mark i was completely clear.

As soon as I went off it the acne came back - just as bad.

I went on another course, finishing when I was 17.

After about 4 months it came back again.

This time I went on a higher dose of 60mg a day for about 9 months. But i realised I was running out so I rationed it a bit and made it last longer. It trickled down to a very low dose, maybe 40 or 60 mg per week. Then I ran out.

About 2 or 3 months later the acne came back.

This same cycle happened over and over again for 8 years.

When I was living in London the NHS wouldnt prescribe it to me. I was beside myself. I was going to fly home to australia to see my dermatologist just to get prescribed it, and then return to London. (I swear the pollution in london was making it worse).

I ended up going home and the next day I went straight to my derm who prescribed me 60 mg per day. But advised me to "take it how it works for you" so i ended up taking a lower dose, higher at the beginning until I got the acne under control and then slowly trickle it down to a low dose to maintain the clear skin.

I ran out, it started coming back. I moved cities but my derm referred me to a new derm and she was shocked and appalled that I had been on an official dose 60mg per day. She said thats what she would put a 100kg male on.

I hadn't had any side affects. Cracked lips were the worst it ever got, and I just needed Carmex lip balm for it. Once I had run out of Carmex for about 4 or 5 days and my lips became cracked and started bleeding. Nothing else would work on my lips.

Now that I'm on the lower dose, I just get dry lips, I take Carmex with me everywhere. I can go about 3 or 4 days without it, but I do need it (even on this low dose). Luckily you can buy it everywhere.

I am officially on a dose of 10mg per day now, but realistically I take somewhere between 120 - 200 mg a week. Just before my period I take about 40mg per day for a week.

I am worried what will happen when I run out of the roaccutane and have to take the normal dose I have been prescribed 10mg a day.

I am so grateful for accutane. I has saved my life. Far from leading to depression, it has saved me from depression. I now take pride in my appearance and I feel confident. It's the most horrible feeling in the world trying to hide and cover your face.

I cannot recommend it highly enough, this has turned my life around and changed me from being a shy, introverted child who hated herself, to a confident woman. I am able to stand up and be proud, in my workplace, at my uni, and in my social life. I am not afraid of what people will think of me, or how many pimples I will wake up with in the morning.

Thanks Akanel for responding.

Your situation seems very similar to mine. The acne I have is located on my cheeks and lower chin too. I mean, I wouldn't call it bad, but I just never use to have this many all at one time. It would just be about 4-5 every month over my face. Now its about 11ish, hence me saying its worse. I also don't have any acne anywhere else on my body except cheeks and lower jaw.

I did get the cephalexin though. It seems to be helping with the acne. The swelling has gone down some what and I only have one new buddy that seems to be disappearing quickly. I hope it continues to go this way honestly. Since I last talked to you, I only have two of the cysts that existed left (besides my new buddy).

Did you by any chance notice that while on accutane your cysts came to a head? Mine never did before, they were just hard painful bumps. I dont' know, this times acne episode just seems different from the last time I took accutane. As bad and disgusting as this sounds, I actually popped those pimples that came to a head. I normally don't do that, but they were just not going away and I really couldn't help myself. The other thing that's annoying me are these small white bumps. They seem to be getting a bit more to the surface so they look bigger. Any pointers on that? It doesn't seem like pimples honestly, it seems more like a case of milia. I wonder if accutane gets rid of milia or not?

I think the change in environment has significantly affected my acne. Which is why I have it a bit worse then I used too while in the US.

I have now, from your advise, gone down to 20mg/day along with cephalexin.

Hey, how long did you take cephalexin? Did you stop taking it already? I'm asking bcs I went out and got the cephalexin myself. Remember, things aren't regulated here. So I am just curious how long you stayed on it.

One more thing, you had mentioned a question of sexual dysfunction. I've also read people say they've lost total interest in sex. Since you've been on it for almost 5 months now, did you notice any difference? I'm just curious because I did notice that I'm much 'drier' then I normally am even though I'm not sexually active. And I thought it could be from the accutane. Plus, I'm in a relationship and we may go to the next level. So I'm just curious.

Thanks again for your responses. And please keep in touch! It's nice to talk with people who are in the same boat as you )

Catiecatie, thanks for your input. I appreciate that. I see your point of view and in some ways I do agree with it, but since I already took the FULL dose of accutane and it didn't really do much, I'm thinking a low dose may get rid of the acne I have and if I stay on it long term, then it will eventually stay away. Besides medically speaking its the total mg/kg that you take in the end that matters, whether you begin with 40 or 20. If you take 20mg then you'll just be taking the accutane for a longer period of time. You can goodle 'low dose accutane' and you will find that their have been many studies to prove that it is just as effective as a high dose. Except the side effects may not be as bad as with a regular dose.

Take care all, and thanks again!

I'm glad the cephalexin is helping with the inflammation, it definitely helped me until the accutane really kicked in. I took the cephalexin for about 2 and a half months. I probably could have stopped around the month and a half mark and been fine, but I was busy with school and didn't want to risk having a breakout. Once I stopped the cephalexin, it was clear that the Accutane was doing the majority of its job and I didn't need to take the antibiotic anymore. I would take the cephalexin for at least 2 months, if it continues to work for you, you should be happy camper with less acne!

I didn't really have any cysts come to a head. Any real cysts on my first course got larger at first and then simply sunk into the skin. Maybe what you believe are cysts are actually just extremely inflamed sub-surface pustules. But again, Accutane's effects can be different for everyone, so they may in fact be cysts that are coming to a head. In terms of the white bumps, I would assume that they are either tiny pustules coming the surface, or they are comedones that, again, are coming to the surface. Keep an eye on them, but I would suggest a delicate glycolic acid like Dan's AHA+ (that I had mentioned in my previous post) to help them purge faster.

Keep in mind that, yes, your environment can greatly affect your skin, acne, complexion, etc. And one of the larger causes of environmental effects of skin can be severe changes of climate. Give your system time to adjust to the new environment and it should calm down. I experienced this same thing when traveling to dry climates in Europe, like Greece, from Florida.

The sexual dysfunction issue I was having was merely something in my head, I have remedied it since the post about it. I was reading things online and had a bit of a hypochondriac moment thinking that something was actually happening to me. The male equivalent to being not as wet, is being not as "hard" (pardon the terminologies everyone). Literally ONE time I had less hard member than usual and I got myself all worked up about it, worrying that I was going to be a 19 year old male popping Cialis. This luckily was not the case and both my girlfriend and me are happy about that =P. Trust me when I say this, don't get worked up about being drier on occasion. If anything goes for fluids in the body it's drinking more water. Drink plenty, way more than you're used to and you should be fine! Also, I don't know if you are, but don't get yourself worked up about stuff like I did, it only makes it worse. Talk to someone about it if it's a problem, particulary the person you are in a relationship with, it helped me realize I was being crazy lol.

So, continue on the track that you're on and you will be a happy camper soon. You can only look forward to it!

Regards,

Alek

How much dosage are you currently taking?

How much dosage are you currently taking?

 

I'm currently on 20mg a day until the end of December. In January I will only be taking 20mg twice a week and continue on that course for another month, at which point I may drop to 20mg once a week for maintenance.

Thanks Akanel,

It's honestly nice to have someone to relate to going through my second course of Accutane. I appreciate it, a lot!

So, I've noticed that I'll wake up one day and see a 'good' face in front of me, and then another day its just HORRIBLE!! I got a few more bumps on my face, but they don't hurt at all, its weird.

Yeah, water is a big issue for me. Its a struggle to get a lot of water in my system with a busy schedule. But I'm trying my best.

Again, because of where I am now, my resources are limited. I do however have a face wash that has glycolic acid and I also have a lotion that is 3% glycolic acid. Do you think those would be ok to use while on accutane? Glycolic acid wasn't harsh on your skin? How many times a week did you use it?

I'm dieing for a clear face right about now. Blah, it just looks hidious its not even funny. All these bumps! I'm praying I see more improvement SOON!

Well, thanks again. And I hope we can stay in touch to share our progress )

~Secretsky )

No problem! I'm always willing to help. People with acne are like a family, we all empathize so greatly with each other that we do what we can to provide assistance!

In regards to the AHA (glycolic acid) I was able to use Dan's formula which has 10% glycolic acid with no problems. It actually helped to moisturize my face when it getting more dry. When I was using it, I would put it on every night in place of my Vanicream Lite lotion. I have incredibly sensitive skin and AHAs are nice because they are generally easy on an individuals skin.

Just stick with it! Once your face is clear you'll look back on those weeks where you felt like nothing was changing and be so happy that you stuck with it and fought on!

I hope only the best for you.

Currently on 40mg/day, but I'm hoping to go down in dosage to reduce side effects. Thanks for posting this.

Oh my god....woke up this morning with EIGHT cysts!!!! 4 on each side of my face ((( I can't believe this! I never used to get acne on my left cheek either ;-(( I am SOOO depressed today its not even funny ;-(( I'm starting a new job on Sunday too...boohoo. I usually don't wear makeup because I don't want to aggrevate my acne.

Words of encouragement will really help today!!

(

Man, I'm on birth control thats suppose to prevent acne for years now, on antibiotics, and accutane....why this mess?!!

Oh my god....woke up this morning with EIGHT cysts!!!! 4 on each side of my face ((( I can't believe this! I never used to get acne on my left cheek either ;-(( I am SOOO depressed today its not even funny ;-(( I'm starting a new job on Sunday too...boohoo. I usually don't wear makeup because I don't want to aggrevate my acne.

Words of encouragement will really help today!!

(

 

I feel for you, Secret =[. We have all, as acne sufferers, been there. There is nothing worse than looking in the mirror every night, not liking what you see, hoping for it to be better in the morning, only to have it look worse when you wake up. I'm sure everyone on this site has experienced this!

You just need to realize that, as far as we're concerned, there is no miracle cure for acne, yet. We all know that Accutane, the one drug destined to clear just about anyone, takes dreadful amounts of time. Sometimes, especially with Accutane, it can be one step forward and two steps back. Other times it may be 3 steps forward and no steps back!

You can only do a few things mentally right now:

1. One of the hardest things for us acne sufferers to do. You HAVE to realize that you analyze yourself far more critically than anyone in the public would ever. Odds are, the only people who REALLY notice your acne are other acne sufferers. I realize that with myself, I will take note of people with acne because, like I said earlier, we empathize with each other.

2. You must look forward and try to disregard the now (at least in terms of you skin). You will be so amazed once the Accutane kicks in and you already know that! You just need to fight through it, realize that this stage doesn't matter. Often, to cheer myself up, I would think about all the people I was around who saw me as an acne sufferer and imagine their reactions when my face cleared up! The positives far outweigh the negatives in the end result!

Thanks Akanel....I really needed those words of encouragement! Its funny though, I really don't remember this on my first try at accutane at all!

Some of the buggers actually came to a white head throughout the day and I was able to pop 4 of them because they were ready to come out. I know popping is a no no, and I normally don't but this batch or acne I've noticed that if I don't it just stays there and then will swell up again later on again even after it goes down. So I sterile the area, poke it and with a little push stuff just gushes out (I know disgusting, sorry for the graphics).

I thought with the antibiotics and birth control things should be under control, I guess I was wrong :-/

I'm trying to stay positive, but on days like this, its darn hard!

But again, I really am glad you were able to respond. Just made me feel a whole lot better.

Thank Akanel!

Take care,

Secretsky

Hi,

I took Accutane 12 years ago with great success, I have been pretty much acne free since, just a few pimples here and there. My biggest problem since then has been oily skin, I have never seen anyone with skin as oily as mine, I wash my face and 15 minutes later it is puddling on my face in the pores. I have spent literally thousands of dollars on products and vitamines that never work, the best product I have found is OC8, but it is a cover up and does nothing to help stop the oil, and it is very expensive and lasts about 2 hours for me. After giving up on fly by night products I have started taking Accutane, I am now taking 10mg a day and have been taking it for 3 weeks now and the oil is at least 80% gone, and my large pores and rosacea are all but gone ..This medication is amazing. I am going to take the 10mg a day for one month, at that time I will drop the intake to 10mg every 3 days for 2-3 weeks and hopefully drop down to 10mg once a week to 10 days depending on how the oil comes back. Taking the Ultra Low Dose has not caused much, if any side effects, only thing is a little flaking skin around my nose and dry lips. Taking this medication can be life changing for some people, I myself feel much more confident and it is great not having to blot my face with toilet paper 20 times a day and wash it 3 times a day. I am doing this on my own by getting the pills online, when I took Accutane 12 years ago I had zero problems with liver function and that was taking 40mg a day for 5 months so I feel very confident that 10mg will cause no problems, but I do plan to have blood work done in about 2 months. Those of you out there taking 40mg and even 60mg a day should really consider droping down to a lower dose and give it some time to work, it is a lot easier on your system. If anyone out there is currently taking this low of a dose or even lower please chime in and let me know how it has worked.

Hi Prowler Junky,

I'm glad the ultra low dose is working for you!. I'm still waiting for mine to kick in. I am however on 20 mg a day for persistent moderate to severe acne that doesn't want to go away. I've been on it for a month now with no change. In fact I have more acne now then i did when I started ( I took 40 - 80 mg a day a few years ago and was really clear, but it came back really bad ( Acne sucks. Its really depressing to even look in the mirror now a days. I've never been this soo depressed before about it.

Are you with a doctor or are you doing this independently?

I find it interesting that different parts of the world have different ways on giving this medication. I temporarily moved over seas and I can just go and ask for it...no questions asked. Where as when I was in the US I had to register with the iPledge program every month.

Anyhow, I hope that the medication continues to work for you.

Goodness, began week 5 and not much improvement except for the fact that the pimples that come (still 4-5 at a time) are smaller and come to a white head faster then they did before. Is that a good sign? How long after that should it just stop?!!! I know everyone is different, but sometimes knowing how others went through it would be helpful :-/

Just keep pushing through it, secret. Your case of acne seems just to be more difficult than mine so I fear my experience may not provide the best example. All I can tell you is that it will work! It just needs time =/. Keep this thread updated!

I will come out and say this.

I have been on low dose accutane since Nov 2005. That would mean that I have been on it for 7 years! Holy.. In the beginning, I took 2 20mg pills per week. I was clear within 3 weeks, save for the acne marks. With consistent use of tretinion cream, I almost had movie star flawless skin at the end of 6 months. Then, I weaned down to 1 20mg pill every 5 days, and now, 1 20mg pill per week.

I have been on 20mg/week for the past 4-5 years. I will have you know that I have no side effects whatsoever, save for dry lips, which i like to peel. I always had dry lips anyway so no difference. No joint pains, no back aches - I go to the gym 3 times a week. I'm a medical student, and I with the stress that that comes with, I never had any breakouts during the exam period. It was almost wonderful.

Almost....

My complexion before accutane was normal, had the usual teen acne every TOM, but other than that, pretty clear. Broke out bad in 2005, oily skin, improved a bit on AHAs. Long story short, I had no qualms on taking accutane.

Now, with the stress of clinical year, my skin still remained largely perfect, but i realized an increase in blacheads, closed comedones, and one cyst that I had stuck around for >3 months! It was pretty distressing for someone who walked around with flawless skin for 7 years. I stuck it out, used mandelic acid, which btw, GOD SENT.

This post is for the acne sufferers out there, who have SUFFERED ENOUGH, depressed and down about their complexion - TAKE IT.

Thanks Akanel.

I'm still pretty bad on the face. It's really kind of weird this time around on accutane. I'm starting to think that there's something bacterial that cephalexin isn't good for. It's just weird. I've stopped picking at my face and just use the accutane, moisturizer, and glycolic thing at night. But absolutely no improvement as far as acne reduction.

I still get many pimples at a time on one side of my face and once it begins to heal it comes out on the other side of my face. Plus that huge cyst thing that is still there. SO, not a happy camper. I am however going to go and see a new derm. I think the one I am with doesn't know much about persistent stubborn acne. I hope the new doc can figure something out. We shall see. But I will keep you posted.

Thanks again,

secretsky

Hey there, everyone!

Just checking in because I know it's been a while. College has kept me from updating or even checking in often. You forget things here! Just to update people, my face is doing excellent and that is on one 20mg pill twice a week: once on tuesday on once on friday. I take nothing other than the Accutane and apply nothing. I still wash my face with Purpose gentle cleanser and moisturize with the amazing Vanicream Lite lotion. I have no dryness at all, no unusual muscle soreness that I can think of (I crossfit everyday), no joint kinks or pains; everything seems to be in line.

I COULD NOT BE HAPPIER WITH MY DECISION TO TAKE LOW DOSE ACCUTANE. It has changed my life thus far. I no longer live in anxiety waking up each morning, wondering about my acne. It's amazing what clear skin can do for a person's quality of life.

Secretsky,

Please update on how you are doing! Did you stick with the Accutane? Are things better?

Any of you guys get clear from 20 mg of accutane 4-5 x a week?

Bump?

I was taking 40 mg's a day every 4 days. I was on that regimen for about 8 months when I developed Irritable Bowel Syndrome. Some days this is much worse then acne, because you feel bloated, sick to the stomach, and get sharp pains a lot of the time, and unlike acne, I will have this my entire life. So just remember to be careful of Accutane. Just do a search online and you can find thousands of people that have had links to it developing severe stomach issues such as IBS, Crohns Disease, and Bowel / Colon Cancer. Be careful !!