Hello,

firstly I would like to say, that I have had issues with acne or oily skin for more than 10 years already. Over the years I have tried many different products and also changed a lot of dermatologists. I have tried topical stuff like Differin (adapalene), tretinoin, other retinoids and retinols, Niacinamide, Jojoba oil, Zineryt, duac gel, benzoyl peroxide, Sudocream, then large doses of vitamin B5, vitamin A, D, K zinc, clay masks etc. In the last 4 years my main problem is oily skin. I can wash my face in the morning and 1 hour later I can see small droplets on my nose and forehead. In 2-3 hours I have completely oily face. I am usually using Azelaic acid suspension from The Ordinary, which is mattifying cream. This helps me keep my face relatively oil free for like 3-4 hours, then it succumbs to oil. I believe I have read almost all literature on oily skin and tried a lot of different suggestions like adapalene, OCM, green tea, moisturizers, clay masks, BHA exfoliation, cleansers for oily skin (Cerave, Cetaphil, Bioderma ...) etc.

On September 6 this year I was finally prescriped low dose of isotretinoin (10 mg) which should reduce the oil. I started the next day, but 2 days in I could already start to feel the side effects. My throat became very dry and over the week I was drinking 6 liters of tea and was still thirsty. I was waking up each night with really dry throat and was using tablets for sore throat. Then I started to cough, which I never do, I had to buy some syrups, otherwise I could not fall asleep. I also started to have problems with my stomach and had bad diarrhea. Then 1 week in I passed out at home and went to emergency, where they did some tests, but could not find anything wrong (CT + rontgen, blood tests, ECG). I am sure this was caused by isotretinoin, because I never had such problems before. After about 9 days I stopped taking the pill because of these side effects. I have also completely lost my voice and could not even talk for couple of days. Again something that I have never experienced before. After stopping the pill, the side effects are slowly getting better, my throat is not so dry anymore, and my voice is getting better. Other then this I had chopped lips, but this was very mild and I expected this. As far as my oil issue I could see after about 9-10 days that I had slightly less oil on my nose and forehead, but at a what terrible cost. It's been now 4 days since I stopped isotretinoin I am starting to feel much better. The question is whether I should continue with taking the 10 mg pill very mildly (for example 1-2x a week) or whether I should stop completely and stay away from that stuff. The sad part is that it is probably the only drug that can really help me with oily skin, I could start to see some slight effects only after those 9-10 days, but I guess the oil will quickly return after stopping. I can talk to the dermatologist, but he basically leave it to me, whether I want to continue with the medication.

What would you advise? I was reading a lot about the possible side effects, but extremely dry throat was listed as very rare side effect.