11 hours ago, azukiimochi said:

I was on Accutane around 4 years ago for moderate-severe acne and all was going amazingly until the beginning of this year. Ever since I got off accutane I've had really minor breakouts every now and then but they didn't bother me because they would resolve on their own after a week or so. But since the beginning of this year I've had some sort of breakout all the time and its slowly gotten worse over time. Recently I've been getting some cystswhich is also starting to concern me. Iwould say my acne is mild but if I can, I'd like to go on accutane to I guess reset my skin.

Is it possible to get on a second round of accutane for mild acne? Or do I have to go through all of the treatments that I did almost 5 years ago and failed to help first?

Please let me know of your experience! Thanks!

Have you got any gut/stomach/intestinal issues? The human immune system is in the gut. If there is a problem with the gut's immune system it can lead to skin and eye issues. There are 2 gut conditions known to cause skin and surface eye issues. Small Intestinal Bacterial Overgrowth (SIBO)and/or Small Intestinal Fungal Overgrowth (SIFO) have been shown to cause skin issues. Both SIBO and SIFO have the same symptoms. They may occur alone or together. Both are highly treatable, Most have symptoms but some are asymptomatic but will test positive for SIBO/SIFO.

You may not have acne. The visible skin surface conditionmay be Rosacea Subtype 2 with papules and pustules that looks like acne but isn't caused by bacteria or fungus. Rosacea Subtype 2 frequently gets misdiagnosed as bacterial acne in a visual exam, especially if the skin isn't very red. Rosacea Subtype 2 is frequentlycaused by the immune system in the gut being out of whack and allowing microscopic demodex skin mites to get overpopulated. Everyone has these mites, a few are normal. An overpopulation of demodex is not normal. Demodex skin mitescan cause large blackheads and acne like lesions that may show up and may appear on a cyclical basis. The mites eat skin oil. They live and die on a 2 to 3 week cycle. When they die,the mites may rise to the surface of the skin in a pustule - known as a die-off. As the mites spread, so do the skin issues. You may have some or all of the following symptoms: large blackheads, pustules, papules, folliculitis, red skin, itchy skin, body acne, scalp acne, ocular rosacea (aka Blepharitis demodex), etc.

Accutane may appear to work at first until a relapse occurs. Accutane shuts down most of the oil glands greatly reducing the oil the skin mites, bacteria or fungus may be feeding on. The reduction in oil can reduce the demodex skin mite population. Accutane does not kill the mites directly. However, after the Accutane is stopped the demodex population can eventually rebound. All Accutane is doing is treating the surface symptom, it isn't treating the real problem at all. Accutane also has a lot of serious side effects. The following medical paper shows a patient that was misdiagnosed for 3 years with bacterial acne, finally treated with Accutane. At first he appeared to be getting better. Once off Accutane, the skin condition returned. Finally got diagnosed with demodex skin mites. 2 week treatment, 2 once a week doses of Oral Ivermectin killed off the mites, still clear one year later.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489393/

The following 2 papers were published in medical journals.

The first paper is from May 2013 International Journal of Infectious Diseases. This medical studyfound that treating patients with demodex using acombined 2 drug, 2 week treatment was highly successful at clearing demodex overpopulations from their skin. The most successful treatment was using Oral Ivermectin once a week along with Oral Metronidazole 3 times daily for 2 weeks. The paper doesn't mention SIBO but Oral Metronidazole is highly effective at treating 2 bacteria (Bacterioides and Eggerthella Lenta)known to cause SIBO. I took this treatment after decades of being misdiagnosed with bacterial acne, allergic conjunctivitis and "it must have a bug or something you ate" gut issues. It was all SIBO. Still clear at 3.5+ years.

"Evaluation of the efficacy of oral ivermectin in comparison with ivermectinmetronidazole combined therapy in the treatment of ocular and skin lesions ofDemodex folliculorum"

https://www.sciencedirect.com/science/article/pii/S120197121201315X

The second paper is from the American Academyof Dermatology published as a letter in 2016. In this study, people with rosacea were also confirmed to have SIBO. Mostwere treated successfully with the very expensive antibiotic Rifaximin. Rifaximin is highly effective at treating E. Coli infections.E. Coli is one of the bacteria known to cause SIBO.

"Rosacea and small intestinal bacterial overgrowth: Prevalence and response to rifaximin"

https://www.jaad.org/article/S0190-9622(12)02330-4/fulltext

A 3hr SIBO breath test can be done to screen for SIBO. But the breath test doesn't identify the specific bacteria causing the problem. The breath test does not detect SIFO.. The gold standard test for SIBO and/or SIFO is the endoscope test. The endoscope is just a thin flexible tube inserted in the small intestine to collect fluid. The fluid is cultured to determine exactly what strain of bacteria and/or fungus is causing the overgrowth. That allows the doctor to select the most effective antibiotic and/or antifungal drug to treat the problem. Guessing and using the wrong drug will not fix the issue and may wipe out the wrong bacteria/fungus in the gut.

Before taking a second round of Accutane, it would be a good idea to explore any gut issues you might have. SIBO/SIFO can be cured in 2-3 weeks with the right drugs. Treatment with Accutane takes longer, has serious side effects and may only treat the surface symptoms without curing the real problem.

In all cases, eating a healthy well balanced diet, low in sugar and high in probiotics can lead to clearer healthier skin. Sugar causes more oil to be produced making the skin more tasty to demodex, bacteria and fungus.

.