Hi Guys!

I'm a 26 year old female and I've muddled through having acne for the better part of 15 years. Like many of you, I've tried every over the counter product along with nearly every kind of dermatologist prescribed medication (Tazorac, Azalex, Clindamycin, Doxycycline, Minocycline, sulfur masks, birth control just for the sake of it's skin-clearing properties, I've had my testosterone levels checked, and I've even had blue light laser therapy) but NOTHING has worked. During and after college, I just got fed up with trying so I resigned myself to slapping on makeup every day and trying to believe it'll go away "soon." Well, now I have a good job and INSURANCE (!!!) and a little while ago I had an epiphany that I'm an adult and I can go try to get an isotretinoin prescription if I want to! (haha). When I was a teenager I tried to convince my parents to get me put on it after the lasers didn't work but they were too gun-shy of the side effects so that was a flop.

There were a couple years that my acne was truly really bad (think many cysts on my face and back to the point where it made my skin hurt, realizing that I had gone all day with a shirt that had dried blood spots on the back because something on my back had popped at some point, and skin SO GREASY that I would come home from middle school and my mom would ask me if I didn't wipe my chin off after I ate a slice of pizza or something ) . It was bad. It had kinda tapered off since graduating college but now it's to the point were it's still PERSISTENT and I was just so sick of it, and my skin was still a grease factory. Like, I'll get to work at 7 am in the northeast of the U.S. (where it's cold as heck right now so it's not like heat is playing any part of it) and by 9 am my face will have a sheen of grease.

So, like I said, I finally got an isotretinoin prescription. My first month was for 30 mg (I weigh 120lbs) of Claravis. I could feel the side effects, but also the benefits nearly right away. The skin on my nose and the skin between my eyebrows would flake off and after about the first two weeks, I could see my blackheads on my nose, chin, and the sides of my nose/under my eyes pushing towards the surface and the skin there would feel almost...prickly...as they were pushing themselves out. For the first time, the skin on my cheeks was free of tiny bumps and I could go for more than like 8 hours without my hair totally greasing out. It was great. Yes, my lips, skin, and eyes were dry but I was taking it with a smile because for the first time since I was probably 10 years old my skin was GREASE FREE...for a whole day!!! It felt nothing short of miraculous, even with annoying side effects.

However, I am 10 days into month 2 now, and my dermatologist bumped me up to 40 mg of Myorisan. I was mentally preparing myself for the side effects to get more intense, but I was ready to welcome them if it meant that I would see an increased improvement in the clarity of my skin. I'm disappointed though...for the past 3ish days I've had at least one new cyst every day (two on the tip of my chin, one on the apple of my cheek, one on my opposite cheekbone, and I keep getting pimples on my upper arms (below my shoulders...think right where the cuff of a t-shirt ends). And my skin flaking has stopped, which is worrying me a little...shouldn't the medication keep drying out my skin, especially if I've been bumped up another 10mgs a day? Has anyone experienced this kind of fluctuation in the side effects? If so, when did you start getting better again? Is 40 days into the treatment too late to be seeing the "initial breakout"? Is this just not going to work for me?

I stopped trying to do something about my acne in college in part because I was just so sick of the emotional rollercoaster of getting my hopes up for what always turned out to be nothing. This is literally my last chance at finding something that may actually work, but I'm worried now. I don't want to go through this again.

My derm said that as long as I tolerate 40mg well, he'd bump me up to 60mg for the remainder of my 5/6 month treatment. I know this seems odd and hypocritical to say, but I find it a little worrying that almost all my side effects seem to have disappeared after 30 days (except dry lips...but that could just be the 0 degree weather that I'm out in for hours every day as well...my lips get chapped every winter all on their own). I'm also breaking out more now, and it's not like it's just concentrated to one area.

Any experience/advice/input would be SO appreciated. Thank you!!