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Vitruvian

Vitruvian's Isotretinoin Log

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Diagnosis: Concomitant peri-oral acne, papulopustular/ocular rosacea

Primary symptoms: Facial erythema (flushing), non-transient erythema, papules and pustules, nasal and malar telangiectasia, burning, stinging, dryness, greasiness, comedones. Ocular redness of bulbar and palpebral conjunctivae, telangiectasia of conjunctiva and lid margin, inflammation of the meibomian glands, dryness, burning, stinging, light sensitivity, decreased visual acuity

Loads of fun, fun, fun.

Treatment: Oral Isotretinoin (Accutane)

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First day with the little pink pills. I'm going to take them at lunch since that's usually my biggest meal of the day. I'm hoping that taking them with a bigger meal will minimize any possible tummy upsets.

Isotretinoin is fat soluble and I've read from other people on the forum that it's best to take with a meal that is high in fats. So I planned for a meal with some nice healthy fats. Cajun salmon sandwiches and a huge garden salad with cumin vinaigrette made with hemp seed oil. Lots of omega 3, omega 6 and GLA in there!

I have a long history of health crusades which I wage against my own body in an effort to keep myself healthy and banish my acne and rosacea forever. None of the diet adjustments or supplements ever made a difference. My attempt to take tablespoonfuls of flax seed oil and hemp seed oil didn't last long. I couldn't stand the taste or the feel of it in my mouth - bleah. So for the sake of my tastebuds, I started to look for recipes that had those oils in them.

Here's the recipe for the Cumin Vinaigrette:

Ingredients:

1/4 cup Hemp Seed Oil

1/4 cup fresh lime juice

1/3 cup red wine or apple cider vinegar

1 Tbs Dijon or honey mustard

2 tsp ground cumin

Directions: Combine all ingredients in bowl and whisk till mixed. Chill until served.

And.. no tummy upset so far..

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Since this is only my first week on isotretinoin (Accutane) it's difficult to know what symptoms to blame on the isotretinoin, i.e. which are "normal" and which are just me being paranoid. :wacko:

The first day was fine. Nothing out of the ordinary. The second, my face was a little pinker than usual (which is pretty pink, not pretty and pink!) By the third day I looked like I'd been skiing in the Himalayas with Michael Palin. (Hey, I've got the ski mask to prove it!) And by the fourth day, well, I'm breaking out and on fire! Ahh! Put it out, put it out! It's hot hot hot! :blush:

But I can't blame all of it on the isotretinoin. It's tempting but no, it's THAT time of the month when hormones conspire to turn everything normal inside out and on its head. Every month I think to myself, if this is my body's last ditch effort to obey the call of the wild and perpetuate the species then getting bloated, zitty, achy and angry is not the most constructive way of going about it!

So at least some of the responsibility for this IB has to go to my own hormonal cycle. And although it seemed that the symptoms I would usually experience were more aggravated (like water retention oomph) I hesitate to attribute that to the Accutane after only one cycle. I'll keep notes and compare in the coming months.

Now that I'm a little further into the course I am definitely experiencing one of the cardinal symptoms everyone gets: Dry Skin. Ooo. The thicker the layer of vaseline on my lips right now the better. And I mean thick. A thinner layer still feels dry. Funny. They look all swollen and pouty and a lot redder than usual. So this is what it must feel like to have Jolie lips! Minus the burning sensation of course.

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Well, it's been a few months!

The initial break out was no fun but it's settled down finally. When the IB first started I was okay, I was smooth, I thought to myself: "I can handle this." By the fourth day I was upset - really, really upset.

But thanks to the wiser and more experienced users on this forum who have already been through this I knew chances were good that I'd survive.

I did - and better. Much better. :boogie:

Isotretinoin is a miracle. A God send. Thank you Hoffmann-La Roche!

The process is amazing and the transformation is equally amazing. It's as though the isotretinoin forces the skin to resurface and regenerate itself. The problem skin is steadily sloughing and I can see areas of healthy, normal skin for the first time in... far too long.

It's wonderful! I'm jubilant! I wish I'd done this five years ago.. No, ten years ago... before things ever got so horrible!

Yes, there are the side effects. But I don't care. I couldn't give a flying fig for the side effects. I told my Dermatologist I would be gladly learn to walk on my hands over hot coals if he thought it would help.

Compared to that, isotretinoin is a cake walk. In fact, compared to life with acne rosacea, isotretinoin has been a cake walk with lots and lots and lots of icing.

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On good days, I've got braggadocio to spare and the 'side' effects of the treatment don't faze me. (Not even the hair loss.)

On bad days ... I have to remind myself over and over that no matter how bad it gets (even the hair loss) none of it is as bad as acne rosacea. It's socially acceptable to wear a wig, but not to wear a mask. :shifty2:

On bad days ... I keep very close to my heart the understanding that all of these side effects (even the hair loss) are part of a wonderful healing process that will return me to my self.

And most important,

On bad days ... I remind myself that these side effects are (in the majority of cases) temporary and will pass (eventually).

Effects experienced so far:

Dry skin -

Where: Everywhere! From tip to toe.

This of course, is the rule. I'm using Complex-15 all over to manage it. It's a water based moisturiser that was recommended by my Dermatologist. He's a smart cookie.

Dry lips -

I found most lip products are pretty waxy. Manufacturers need the waxy ingredients to keep the product in a solid state but it makes them difficult (and painful) to spread across uber dry lips. Especially if its cold.

I couldn't find anything thick enough to work that still had a nice gloss. Eventually I started making my own lip balm. A little bit of peppermint in the mix really helps to increase the circulation and has a nice cooling, soothing effect.

Dry rash -

Where: Top of hands from just above the wrist joint to the second joint of each finger. Top of feet below the ankles. And on the lower, weight-bearing part of my tush. Yep - my tush. :blink:

Another forum poster (ThereIsHope) has referred to this as dragon hands, which gives a nice metaphorical visual of the scaly look the affected parts acquire. The right side of my tush was worse than the left. It cracked and got weepy which forced me to keep off it for a few days. I now apply extra coats of moisturiser to the area every day.

It's not just flaky, dry skin. There is an inflammatory component to it, which contributes to the scaliness. It took a long time but the scales eventually darkened and peeled away. It's drive you nuts itchy, but don't scratch and don't pick! It only makes the process take longer and ickyer.

Stupid me, I tried to loofah it, it was sooo itchy. Of course, it got worse and the rash spread up past my wrists where the loofah touched. I don't think this means it's contagious per se. I'd really like to understand this process better.

Dry eyes -

This is an important one, especially for anyone who wears contact lenses. Rosacea compounds the problem since the eyes are dry even before treatment begins. I found out the hard way so I've promised myself I'm going to write a comprehensive post about this since the consequences of not looking after the eyes can be so very serious.

Dry Hair -

It's frizzy and fly away and breaks very easily. Even the little hairs on my arms have gotten frizzy.

Hair Loss -

This is the biggie. Why can't it be my body hair that I lose? I'd love to go without shaving!

My hair is approximately 50% thinner than it was before starting treatment. I noticed an increase in hair lying around in the bathroom between cleaning. Not exactly attractive. Anyway, I started measuring the thickness of my braid to keep track. It seems to be levelling off. I'll be very grateful if I don't lose much more. Of all the side effects, this is the one that has bothered me most. It will grow back, it will grow back.

Facial flushing -

This is a symptom of rosacea as well, but initially the isotretinoin worsens it - a lot. But it has calmed down and is so much better than it was before beginning treatment.

Appetite Suppression and Stomach Upset

I'm less interested in food and eating in general and consequently not eating as much.

Sometimes, not all the time, I get nauseous after taking the isotretinoin. I haven't been able to pinpoint whether this happens with a particular food or not. I also experience a sensation I can only describe as mild burning in the lower digestive tract.

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Today, when my dermatologist opened the door to the examination room to see me, he actually did a double take! One quick glance over his notes, then a second longer look, and then ... a big smile.

I smiled back. :D

It was so fantastic to enjoy that moment of recognition for the progress I've made. :dance:

He asked how I was doing. He isn't happy about the severity of the side effects but I reassured him that I'm managing well so far.

The results of my blood tests were stellar and make up for the lousy side effects. He said my lipid profile was the envy of every middle aged man in the building including himself and my liver enzymes haven't risen so much as a smidgen.

I hope things look just as good in another two months! ;)

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Hi -

I saw your post Acne and Rosacea and thought gotta read!

I have mild Rosacea (pink cheeks and nose) and mild acne (mainly chin acne which is hormonal). I occassionally get other minor acne near my nose or forehead. I've been on antibiotics a short time to help but the acne comes back. My Derm. suggested low dose Accutane (10 mg day) which may help with the inflammation of Rosacea and help with the acne. I started last Friday but still am a little skeptical.

I'm nervous of the side effects (dry everything, hair loss, etc.) and also because my acne is more hormonal. I read Accutane can be a wonder drug, but for hormonal acne, it may not be as successful. Anyway, would love to hear more about your success and advice while on Accutane.

Are you male or female? What is your dose and how long do you plan to take? Is your acne fairly mild? Was your IB bad, more so than any acne you've ever had? How long did it last? Did it leave marks, and if so, have they started to fade? When did you notice sebum pushing out or blackheads clearing? How is your Rosacea, are you less red or more red? It sounds like you are pleased with the results so far? Feel free to PM me if better.

Thanks much.

Yvette

Today, when my dermatologist opened the door to the examination room to see me, he actually did a double take! One quick glance over his notes, then a second longer look, and then ... a big smile.

I smiled back. :D

It was so fantastic to enjoy that moment of recognition for the progress I've made. :dance:

He asked how I was doing. He isn't happy about the severity of the side effects but I reassured him that I'm managing well so far.

The results of my blood tests were stellar and make up for the lousy side effects. He said my lipid profile was the envy of every middle aged man in the building including himself and my liver enzymes haven't risen so much as a smidgen.

I hope things look just as good in another two months! ;)

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Hi Yvette,

I understand why you'd be nervous about Isotretinoin. I was too. In fact - I resisted going on Accutane for years. I'd heard all about the horrible, horrible side effects and thought the worst. I was determined to try absolutely everything before Accutane. And I mean everything - both conventional and alternative. Someday I'll type out a summary of the journal of all the nonsense I put my poor self through.

Now, I deeply regret not having made Isotretinoin my first line treatment instead of my last.

It would have saved me the scarring and the premature ageing of my skin caused by so many dead ends. :cry:

I'd love to help. You can ask me anything - anything at all. And I really mean that.

Are you male or female?

Female. I tried the hormone treatment route for three years without success.

What is your dose and how long do you plan to take?

20mg/day. My dermatologist recommends an initial course of six to eight months. If symptoms recur another course will follow.

Is your acne fairly mild?

It wasn't - no. But it is now! :boogie:

Was your IB bad, more so than any acne you've ever had?

It was bad. Very bad. All symptoms of acne and rosacea worsened.

How long did it last?

The IB started within the first week of starting the course. It peaked approximately three weeks in. Since then, there have been a few relapses, but on the whole it's gotten better and better and better.

Did it leave marks, and if so, have they started to fade?

No. The lovely white scars and mild pitting I have came courtesy of the acne and my own stupidity. I also had chemical burning all over my face from a mad facial peel wielding aesthetician. I don't know if I will ever, ever be able to forgive that woman. My skin looked like it had a sheet of plastic wrap glued onto it for close to a year. You could see the crinkles where the tight damaged skin tugged on the healthier skin around my eyes, mouth and nostrils. It never healed properly on its own.

During the IB any scarring already present looked much redder and angrier. In fact, it seems that any skin that has sustained past damage seems to react on Isotretinoin. I find this process fascinating - especially since the results have been so positive! So far, the white scars and pitting are still there but the increased cell turnover the Isotretinoin stimulates has helped the chemical burn immensely.

When did you notice sebum pushing out or blackheads clearing?

Ha ha ha! Yes, first, the blackheads start to stand out even more! That started to happen just recently. There is general swelling of the dermis too.

How is your Rosacea, are you less red or more red?

Less red now after the IB. I used to be red and burning all the time and the accompanying ocular symptoms were ludicrous to cope with. It's not gone. It still flares up. But the difference from when I started is vast.

It sounds like you are pleased with the results so far?

Very, very, very pleased.

Feel free to PM me if better.

I will if/when I figure out how. ;)

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Hey there -

Thanks for your input. I will try to PM you too. I'm fairly new here, so hope it will work.

Glad all is going good and you are pleased with the results so far.

Yvette

Hi Yvette,

I understand why you'd be nervous about Isotretinoin. I was too. In fact - I resisted going on Accutane for years. I'd heard all about the horrible, horrible side effects and thought the worst. I was determined to try absolutely everything before Accutane. And I mean everything - both conventional and alternative. Someday I'll type out a summary of the journal of all the nonsense I put my poor self through.

Now, I deeply regret not having made Isotretinoin my first line treatment instead of my last.

It would have saved me the scarring and the premature ageing of my skin caused by so many dead ends. :cry:

I'd love to help. You can ask me anything - anything at all. And I really mean that.

Are you male or female?

Female. I tried the hormone treatment route for three years without success.

What is your dose and how long do you plan to take?

20mg/day. My dermatologist recommends an initial course of six to eight months. If symptoms recur another course will follow.

Is your acne fairly mild?

It wasn't - no. But it is now! :boogie:

Was your IB bad, more so than any acne you've ever had?

It was bad. Very bad. All symptoms of acne and rosacea worsened.

How long did it last?

The IB started within the first week of starting the course. It peaked approximately three weeks in. Since then, there have been a few relapses, but on the whole it's gotten better and better and better.

Did it leave marks, and if so, have they started to fade?

No. The lovely white scars and mild pitting I have came courtesy of the acne and my own stupidity. I also had chemical burning all over my face from a mad facial peel wielding aesthetician. I don't know if I will ever, ever be able to forgive that woman. My skin looked like it had a sheet of plastic wrap glued onto it for close to a year. You could see the crinkles where the tight damaged skin tugged on the healthier skin around my eyes, mouth and nostrils. It never healed properly on its own.

During the IB any scarring already present looked much redder and angrier. In fact, it seems that any skin that has sustained past damage seems to react on Isotretinoin. I find this process fascinating - especially since the results have been so positive! So far, the white scars and pitting are still there but the increased cell turnover the Isotretinoin stimulates has helped the chemical burn immensely.

When did you notice sebum pushing out or blackheads clearing?

Ha ha ha! Yes, first, the blackheads start to stand out even more! That started to happen just recently. There is general swelling of the dermis too.

How is your Rosacea, are you less red or more red?

Less red now after the IB. I used to be red and burning all the time and the accompanying ocular symptoms were ludicrous to cope with. It's not gone. It still flares up. But the difference from when I started is vast.

It sounds like you are pleased with the results so far?

Very, very, very pleased.

Feel free to PM me if better.

I will if/when I figure out how. ;)

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