Hi! This is my first post in this forum and here is my story..
Background info:
I started to get acne when I was about 13 years old. I'm 23 now and I feel like i've had acne my entire life. First I started out with over-the-counter creams and stuff and also just washing my face excessively. Nothing worked ofcourse and it just got worse and worse over the years. It wasn't until I was about 18 years old and having the craziest breakout of all times that I talked to my dad and finally got to see a dermatologist. My dad also had pretty bad acne so he fully understood my situation.
My derm prescribed antibiotics for me (Oxytetral) and also Differin to go with it.. It helped a bit at first, but after a few months it just didn't help enough, so he put me on roaccutane. I was relieved to hear that this was supposed to "cure" me permanently for acne and the side-effects would be nothing compared to the increased life quality I would have with a clear face. I've only ever had facial acne btw, nothing on the body. I only weight 130pounds and he put me on a 40mg dose. I had a terrible initial breakout and that period was the worst of my life. I totally isolated myself and it was even painful to open my mouth to eat. It got better after a while and my complexion improved and the new pustules healed quicker. My only side effects were extremely dry skin and lips and kinda red-ish skin. I followed through and after 7 months or so I had finished my treatment. My skin was completely clear except for some red marks and some scars. I was delighted and my life was great!
After about 6 months i started to break out again. Nothing major, just the odd whitehead and pustule. I started antibiotics treatment again and I have pretty much been on antibiotics ever since. I've pretty much kept in in chess, but never been fully satisfied and it's always on my mind and affects my social life and self esteem.
About a month ago I suddently got this HUGE breakout! Even my acne got acne! That happened when i tried to go without antibiotics for not more then a week. It was summetime and I had a hard time getting new pills. After about 5 days of pure hell, i got some new antibiotics. It started to calm down, but I decided that this couldn't continue. Antibiotics doesn't help me anymore, except for maybe fixing random chlamydia issues 
So I got an appointment with my derm and I told him that I wanted to take another course with roaccutane, but that I wanted a longer treatment-period and a smaller dose. I really wanted to stay clear of the initial breakout and also minimize the dryness. My skin is very dry to begin with..
So, now I'm on day4 with only 20mg per/day. Already I have started to break out 
I have about 3-4 pustules on my right chin just next to my mouth, and the area is very red and irritated. I have 3 papules on my left chin right next to my mouth and also 2 whiteheads. They are very much concentrated around my mouth area. My chin below the mouth is clear, as is my upperlip, my nose and the cheeks. Problem-area has always been the mouth-area. Forehead is also clear. My skin feels very tight and I've already started flaking on my cheeks. The skin is pretty "rough" and the whiteheads are almost connecting if you understand? I really didn't expect the skin to tighten up this quick nor the aggressive flare-up on such a small dose. My lips are still normal and there are no other side-effects so far. I might kick up the dose to 40mg after a while, but I might also take 20mg every second day if the flareups and side-effects gets too bad. Is that a good or bad idea?
Here are some recent pictures of my chin:
I also wonder which topical treatment I should use while on roaccutane? I have a tube of differin gel and also a tube of Skinoren cream (Acid. azelaic 20%). Which is better to calm down the redness and skin irritation? I've never actually liked either of them. Differin dissolves acne pretty good, but results in flaking and skinoren doesn't even seem to have any effect at all. I've been using differin at night and skinoren during the day the last month or so...
My current regimen: Please critique or comment!!!
Morning:
Wash with Vaseline intensive care mild cleansing mousse (foamy)
Apply Skinoren cream
L'oreal moisturizing Balm for sensitive skin
Day: 20mg Roaccutane
Night:
Wash with Vaseline intensive care mild cleansing mousse
Apply Differin to affected areas ( I avoid unblemished areas, as it only irritates already dry skin)
L'oreal moisturizing Balm for sensitive skin
Even though I'm a guy, I also sometimes use a foundation cream to cover up the most red and aggressive areas and acne. Dunno how badly this affects the healing process though. I feel like if I don't I wouldn't even be able to go outside the house
I really really hope that this second course will finally "cure" my acne problems permanently and that it's no longer something that occupies my mind 24/7!!
Any comments or insights would be highly appreciated. Thanks for reading my loong post 
Cheers
oh my lord, i know exactly how you feel. EXACTLY. i actually have a derm appointment tomorrow morning to discuss a second course of accutane. i took my first course from aug 2000 until feb 2001. (40 mg twice a day) and i was completely clear up until the beginning of this year (so clear for over 5 years) which was the best time of my life. i know my acne is hormonal and that is why as soon as i had my son the beginning of this year, that is when the acne started and it's just been getting worse since then. my acne used to be more inflammed and red and hurt but now i have more (smaller, flatter) pimples than i used to. oh, it's so depressing i don't even want to go anywhere or do anything just stay inside and hibernate. it sucks so bad!!
i remember using aquaphor alot on my lips and inside my nose when i was on the tane last. it worked so well and was thicker and less greasy feeling to me than vaseline. and i just washed with cetaphil bar soap and used cetaphil lotion. and that is what i plan on doing again if i get accutane (i better get it). i just want to enjoy my life like i did those last years. i don't even feel like myself when i have acne.
hmmm. so why only 20 mg a day?? i would think 40 mg a day would be pretty low dosage. i have no clue what you weigh, but that doesn't seem like much to me...
best of luck, at least you've been through this before so you know what to expect as far as the side effects and that go.
heidi
p.s. i don't think using a bit of foundation is going to affect your skin from healing.
hmmm. so why only 20 mg a day?? i would think 40 mg a day would be pretty low dosage. i have no clue what you weigh, but that doesn't seem like much to me...
Thanks for the reply. Yeah, I know it's a small dose. It's basically to minimize the side-effects, especially the initial breakout. I had it real bad last time, and unfortunately it's not looking good this time either Seems like there is a lot of crap under the surface that are wanting to come out
I weigh approx. 130 pounds, so I'm very light. I might kick up the dose after a while, but i'd rather just be on tane longer than having to deal with the extreme dryness of skin and lips.
Did you use any topical treatment while on accutane? My acne itches so bad atm and it's very innflammable.. The whiteheads are no longer soft, but hard. That makes them really hard to pop.
Good luck on getting a second course!! How old are you btw? When did you start getting acne?
no, i did not use ANYTHING on my face when i was taking accutane. i mean, except for cetaphil lotion, cetaphil bar soap when i washed my face and vaseline or aquaphor i put on the really dry dry yucky patches. if my doctor will prescribe me another course, this is exactly what i'll be using again. i really wouldn't recommend using any other meds while on accutane either. accutane is so strong in itself and will get the job done. any other products are probably just going to dry you out more and accutane does a good enough job of that as you know. i think you are right when you said that all the gunk from under your skins surface is just being pushed out. that's what my skin did on accutane the first time too. the initial breakout was the accutane getting rid of all the yuck underneath and as soon as all that crap was pushed out, my skin only got smoother and softer. i remember every single blackhead on my nose also disappearing because they were getting pushed out.
patience patience patience. i know it is hard with acne but accutane will do it's thing and it'll go by faster than you think!!
oh, by the way, i am 26 in a few weeks and i've had acne since about 14. so i've been battling this crap for a long time (other than the last few years between my first dose of accutane and when i got pregnant).
so, you're still having extremely dry skin and lips with this small doseage too??
well, thanks for the good luck on getting accutane again, hopefully this derm tomorrow isn't a jerk and will give it to me no problem, seeing as it's the ONLY thing that has ever improved my skin!!
heidi
p.s. do NNOOOOTTTTTTTTTTT pick!! i repeat do not pick. i know it's addicting, but what good is it going to do?? unless you want more scars and more bacteria to be spread around!! believe me, i know from experience!!
also, i remember my face being sooooooo itchy (mostly around my chin and jawline where most of my acne is) and my scalp too. oh god, it was the worst itchiness i've ever had!! i used to get a piece of paper and use the edge of it to scratch my jawline and it soaked up some of the grease too. i know that sounds so weird, but it worked good and i hate my face touched, even with my own hands, i'm soooo paranoid. i never touch my face, even when it was crystal clear and i didn't even worry about breaking out!!
Day5:
When I woke up this morning my skin was extremely tight and all the red marks on my right chin had developed huge whiteheads. It seems like roaccutane makes the active acne develop faster, kinda like it excellerates the process. They "mature" quicker. I have new zits in the corners of my mouth, which makes it painfull to talk and eat. I'm afraid that the corners might crack soon.
I think I will try to avoid using any topicals. My skin is already harsh and red and I think it will only make it worse. I need another moisturizer though. The one i bought yeasterday was terrible. I had to apply 3 times after washing my face today and it still felt tight. My lips have started to dry up. I haven't bought anything to soothe them yet, but I will tomorrow.
I took 2 pills of 20mg today. I'm going to try to alternate between 20 and 40mg's every other day.
I can't remember that I got the initial breakout this soon the last time I was on tane. And all the other IB stories i've read mentions that the IB came after a few weeks. Does this mean that i'm likely to have yet another breakout later in the course?!? I hope that this is just the tane pushing out the crap from under my skin and that it starts to clear up straight away.
Starting to get very dry eyes aswell. No other side effects except from a crappy mood and unwillingness to go outside.
Did you get a second course siccamaro?
Day6:
Please kill me now When i woke up this morning i counted over 20 whiteheads on my chins. My face hurts, itches and it's very tight. I can't remember having an outbreak like this since my last time on tane. I don't know what to do anymore. Didn't think i would react this badly on a second course. Especially since my face was pretty much "clear" just before starting on tane.
When i went to bed last night, I used BP on the spots. Clearly a bad idea. Areas around my chin is like one giant red spot with many many big and small whiteheads. I took another 40mg's today. Trying to just burn through this with as much tane in my body as possible.
These are even after popping some big ones :/
I don't wanna go outside. Not even outside my room to see my roommates. I have a lot of stuff that has to be done, but all i want to do is stay in my room until this all goes away. I have to go to work in a few hours and I'm dreading it soo much.
Should I stop talking the pills for a few days or will that result in the IB taking longer to go away? How long is the initial breakout supposed to last? I can't remember from my last time..
I'm in lack of a good moisturizer that can soothe and calm the redness. No way in hell am i going out shopping like this.
At this point, i don't know what to do. I have totally isolated myself the last few days. And I'm supposed to host a party in 3 days
I hate my life right now!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
first off, don't stop taking the pills. you know that accutane will make your face clear. the hardest part is at first. but it will get better and you'll be so happy that you won't even remember *how horrible* it was. believe me, i've been right there in your exact spot. if i were there, i would hang out with you and play video games or whatever because i don't want to go outside either!! in fact, your problem area looks like mine. my chin, on each side by the corners of my mouth and my jawline. i actually have a gazillion tiny pimples on my forehead too and a few other normal sized ones like on my cheeks. so i'm not looking too pretty right now. this crap is so depressing. just try and remember you're not the only one going through this hell though. alot of other people are suffering with the exact thing. (me included)....
well, no, i didn't get an accutane prescription at my appointment yesterday. the derm i saw was okay. but he is very convinced that i have rosacea (whatever the fuck that is). i guess it's like adult acne with redness of the skin. my skin is barely red, but does have a pinkish tint to it. especially under my eyes. it's not too noticeable i just always thought that my complexion was uneven and blotchy looking, but when i wear makeup (which is rarely) you can't even tell. but he said rosacea can sprout up pimples too, they are less red, less inflammed and a bit flatter than regular acne alot of people get in their teens. he looked at pics of me from last time i took accutane and said that my acne was definitely more inflammed and bumpy then. i have acne again but it's different than before. so, he put me on finacea (cream to apply 2x a day) and doxycycline (antibiotic) just to speed up the process. he wants me to try this for 6 weeks. then i have another appointment with him. he said that if i'm not happy and there is not much improvement by then (he is very sure there will be it sounded like) well then, he'll put me on accutane because it worked for me before and can help with rosacea and rosacea acne. so, he gave me the ipledge binder yesterday, i have to fill all the crap out and read a bunch of stuff, but he said just give this other medicine 6 weeks, i've had great results on it with other patients and it's not harsh like accutane. but, if you're not happy with it, we can do the accutane because i can tell in your eyes that you really want it and it worked on you before. so, in 2 weeks i have to go get my blood test, so that at my next appointment, he can prescribe me accutane if i want it. i feel happy that at least accutane is an option again if this other stuff doesn't work. i know accutane does work and i just want my life back. but, i had a crazy, crazy day yesterday!!
talk to you soon!!
heidi
