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mfg

mfg's Accutane Log - 80 mg/day

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OK, so first off, let me say that I don't know what I'd do without these forums. It's a really comforting feeling to have a whole community of people who understand exactly what you're going through.

I'm about to go on Accutane for the third time. I had the first course when I was 19, the second when I was 24, and I'm 30 now. The first course, my acne was mostly cystic, and I cleared really fast without much of an initial breakout. The second course, my acne was mostly non-inflammatory (almost all comedones), and I cleared really slowly and broke out like mad for three-quarters of the course, which really sucked.

Anyways, after the second course, my oil returned (I'm crazy oily, like any pictures of me using a flash are blinding) almost immediately after I stopped taking the pills, but I was relatively clear for 3 years or so. After that, I just got worse and worse, and today, my face is mess of hundreds of small bumps, which you can't see unless you're close, and irritated places where I've picked, which you can see from a mile away. It's not a pretty sight, and I often feel embarassed just leaving the house.

So after trying basically every acne medication under the sun over the last few years (Differin, Retin-A Micro, multiple strengths of Tazorac, all types of BP, a few oral antibiotics), I went to the doctor's office this morning, and he suggested a third course. Assuming my bloodwork is ok, I should be starting 80 mg/day tomorrow. I can't remember what my dosages were for the first two courses, but 80 mg right off the bat seems like a lot from what I've read. I weigh nearly 200 pounds though, so maybe that's why I'm taking so much.

So anyway, thanks everybody for being there, and I'd be glad to answer anybody's questions about any medication, since I've basically taken every single one. I'm going to try to update this log daily, but I get pretty busy at times, so it might not happen.

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Weolcome mfg,

This forum is definitely helpful, especially when you realize so many people are having the same side effects, problems, etc. As for your 80mg dosage to start, don't be concerned. I don't have very severe acne, but my doc started me on 80mg for the first month. I'm 26 years old and weigh 210 pounds. I'm currently on month 3 and am up to 100mg per day. My doc's idea behind the high dosage is to do one cycle and be done with it. I still have good days and bad, but there's definitely improvement.

Good luck to ya and hopefully the thrid time's a charm!

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Thanks, Bateman. I think my doctor is also planning to be aggressive with the dosages, especially since he told me my first course was probably too short. One weird thing, though -- he told me to take both pills at dinnertime with my meal. In the previous two courses, I took the pills separately. I wonder what the effect will be, if any. I'll find out soon.

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mfg,

That is interesting about your dosage. Since I'm doing 100 mg, I take 60mg in the morning (1 40mg pill and 1 20mg pill) and then take 1 40mg pill with dinner. I wonder if taking all 100 at once would make a difference too. Maybe I'll ask her at my next appointment.

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So this is weird, apparently I'm not supposed to go fill my prescription until I talk to my doctor because my cholesterol came back at 207, which is pretty high. That's higher than it's ever been for me, although I haven't measured it in a while. In the past, I've been in the low 100s. I wonder if the fish oil I've been taking is affecting my cholesterol. I was taking a tablespoon in the morning and a tablespoon at night, but I just stopped in anticipation of going on Accutane.

So it looks like I won't be starting today, which is making me feel a little bit conflicted, because on one hand I don't like losing a day, but on the other, I'm not quite ready for the breakouts to begin. We'll see what the doctor has to say tomorrow.

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Good luck Mfg! I hope this is the last time for you. I know that Accutane is such an annoying process, but it pays off in the end!

and I can definately relate, I am going to be going on Accutane for a 4th time next week. Can't wait to see some updates!

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Thanks, Caryn. Good luck with your fourth time. If you don't mind my asking, what happened the previous three times? Did the acne come back as bad as before?

My doctor left a message this morning saying it was ok to fill my prescription. He didn't mention my cholesterol at all, which I thought was weird. So I'll be starting tonight. Let the fun begin.

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The first two times it came back it wasn't quite as severe, but my derm wanted to put me on it again. Now after the 3rd time my acne is back to being pretty bad, but it took about a year and a half to start getting bad again. I can't wait to have clear skin again!

hopefully your cholesterol doesn't pose a problem for you. good luck!

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I hear you, Caryn, I can't wait to be able to look at myself in the mirror again without cringing.

Day One

I just took my first two pills with dinner. Obviously, I'm not feeling anything yet. I'm a little apprehensive about doing this again, but hopefully I'll look back in five months and think this was a good decision. I have a feeling this IB is going to be pretty nasty, since I have a lot more bumps under my skin than when the second course started, and the IB for that course was brutal.

Instead of Accutane, the drugstore gave me Amnesteem. I don't know if there's a difference, but generics sure are cheaper for me under my insurance plan. Last time I took Accutane, I continued to take my vitamins, which at the time consisted of a multivitamin and B5. I could just be making this up, but I felt that maybe these vitamins actually diminshed the effect of the Accutane, because the side effects weren't as severe as they were on my first course. Like I said, it could be all in my head, but this time, I'm not taking any other pills besides Accutane.

I'm also getting prepared way early this time. I already ran out to the drugstore and got a tub of Aquaphor, as well as the Eucerin Redness Relief Daily Perfecting Lotion and Soothing Cleanser. I think I recall reading on here that those products are good. I've already tried the lotion, and it leaves this weird green film all over my face, which is not that cool. So I gotta mess with that a little bit to figure out how to put it on better.

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Day Two

Not much to report today. I went out to eat tonight with my wife and ended up having to bring my pills with me. I don't have a convenient way to do that, so I just stuck the two pills in a bit of saran wrap. I guess I should probably get a pillbox or something. This time around, I'm trying to be very careful to take my pills with full meals instead of on an empty stomach or with small snacks. I really want to maximize the absorption this time. That said, I swallowed the pills with a couple of sips of beer, which is probably not the best method. I figure if I drink in moderation, I'll be ok. Hopefully my liver tests in a month will agree. Not feeling anything yet.

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i usually wrap my pills inside a nakpkin when i go out to eat, no big deal. You know what they say, third time's the charm, good luck on accutane.

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Thanks, Toast. If this round doesn't get rid of my acne permanently, I'm just gonna have to be resigned to the fact that I wasn't meant to have great skin. Oh well, it wouldn't be the end of the world.

Day Three

Went out to eat again, and drank some more beer. Still haven't felt any effects really, except that my eyes were pretty bloodshot today. I'm not sure if it's because of the Accutane, but it was bad enough that my wife noticed. I looked like I was a bit high. In my previous rounds, I've been able to wear contacts the whole time, but that may not be the case this time.

As I mentioned before, I have tons of little bumps all over my face. Some of the ones on my chin are starting to become tiny whiteheads that eventually disappear if I rub them off with a towel after a shower or scratch them off with my fingernails. They're not too noticeable yet, so I can't complain. I would love it if those were all the IB consisted of, but I'm pretty sure the worst is yet to come.

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Day Four

I think my IB is beginning for real. Like I said yesterday, most of it is superficial acne that ends up forming little whiteheads. There are also a couple of bigger bumps that are slightly tender, which means they're probably going to get ugly. I look like shiot now, but I'm sure in a few weeks I'm going to wish I looked this good.

A buddy of mine that did two rounds of Accutane very close together told me about a little trick with Aquaphor. For whatever reason, they don't make a convenient small tube of Aquaphor to carry around (or if they do, I haven't seen it). So he took a tube of Chapstick, cranked all of the Chapstick out, and refilled the tube with Aquaphor. He kept refilling it from a tub of Aquaphor whenever he ran out. I tried it today, and it seems to work pretty well. I used a butter knife to scoop the Aquaphor out of the tub into the empty tube.

I also emptied my entire bathroom drawer of topicals into a bag to put into the closet. It was kind of liberating, actually. You wouldn't believe how much shit I've tried over the last five years. I literally had Differin, Retin-A Micro, two different strengths of Tazorac, four different types of moisturizer, Duac, Clindamycin, two different strengths of Mandelic, Paula's Choice 2% BHA Gel AND liquid, jojoba oil, and a couple of facial brushes. It was absurd. I really gotta stop reading this forum so much.

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Day 5

Not much new to report. My skin is oilier than ever, my lips aren't dry at all yet, and a ton of whiteheads are coming out where there used to be small red bumps. I have a fancy comedone extractor similar to the ones they use at the dermatologist's office:

http://www.spaequip.com/Extractor-Schamber...mp;category=182

and I've been going crazy with it. I admire anybody that has the patience to let whiteheads sit there, but I've never been able to do it. I have to get it out immediately. Anyway, the extractor works great if the comedone is ready. If not, you can end up doing a ton of unnecessary damage to your skin.

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Day 6

So whiteheads are slowly taking over the center of my face. My cheeks are fine and have never been a big problem, but my forehead, areas next to my nose (not the nose itself), and my chin are covered in bumps, some small and not inflamed, and others slightly inflamed and red. It's really a nice look. But considering so many other people are dealing with deep, cystic acne, I'm not gonna complain.

Other than that, nothing to report. I'm still crazy oily (maybe more so than before, if that's even possible), and my lips aren't dry at all yet. I swear, the day they figure out how to run cars on sebum, I'm going to be a very rich man.

Also, I'm pretty sure the way I got into this mess (with hundreds of these little bumps) is by over-irritating my skin. I'd been using Benziq wash (BP) in the morning and Tazorac 0.1% gel at night. My skin was always slightly irritated (dry and flaky, especially right under my eyes), but I survived until I started taking 2 tablespoons of fish oil a day. The fish oil definitely made me less oily, but as a result, my topicals started irritating me more, causing all of these little comedones. At least that's what I think happened.

Moral of the story is that when I finish this round of Accutane, I'm going to make sure that any topicals I use are as gentle as possible. I think there's a point at which being too aggressive with topicals actually causes acne.

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Day 7

One week down . . . twenty-some weeks to go. Whiteheads are still coming out, as well as an underground bump between my eyes. Could be my imagination, but I'm starting to feel a little less oily, though not dry by any means. Lips are normal, and I haven't started turning red yet, but those should be coming soon. I have noticed that my eyes seem more bloodshot all the time now, even when I wake up. I don't recall that this was a side effect of my previous courses, but who knows, I might not have been looking closely enough.

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Day 8

Pretty much the same again. I did have a slightly red bump on my forehead that was a bit tender. Since I'm pretty experienced with popping zits (not really a skill I wanted, but whatever), and since I generally don't get cystic acne, I went ahead and popped it out. There was enough white stuff in it that it actually made a popping sound, which in some sick way is really satisfying. Then a ton of blood came out of it. Sorry everybody if this is too graphic. Anyway, that was my excitement for the day. I'm not sure which comedones decide to turn into these crazy bloody zits, but I'm sure I'm going to have more. Good times.

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Days 9-13

I've been really busy lately, so I haven't been very good about updating. I'm still having the attack of the little bumps. Everyday, two or three of these little, skin-colored bumps decides to become a whitehead. So far, they haven't been to hard to remove, so as long as they develop in limited numbers, I'm ok with it. I'm also getting big bumps here and there. I currently have a nice big one on my chin that I decided to mess with because I'm stupid. Now it's a big bump with a scab on top. Luckily, it's kind of on the underside of my chin, so it's not too too visible.

Otherwise, I'm drying up pretty quickly. My forehead and nose, which were previously oil slicks an hour after washing my face, now stay dry the whole day. My nose is so dry now that the tip is starting to get rough, and I can see little flakes of skin if I don't moisturize. I gotta say, moisturizing my forehead and nose is a whole new concept to me. Lips are starting to get dry, and I'm being crazy preemptive with the Aquaphor. I haven't gotten to the point where chunks of my lips are falling off yet. Scalp is really itchy now, which must mean that it's getting dry too. Finally, the worst side effect so far is my red eyes, which seriously make me look like I smoke weed all day. I've used moisture drops in my eyes a couple of times, but I'm not sure if it's helping or not. I think i have to be a little more disciplined about using the eyedrops every couple of hours if I want to truly solve my red eye problem.

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Days 14-15

It's incredible how fast the side effects are kicking in now. I need lip balm at all times. Putting on Aquaphor at night is a lifesaver. I'm also starting to develop a mild rash on my forearms. The hundreds of little bumps are still pushing out, and I find myself popping 3-4 small whiteheads every day. They actually don't leave much of a mark usually, so I don't consider it a big problem.

Still have the red eye problem, which only happens if I wear contacts. Today I wore glasses the whole day, and my eyes are fine. Still working out four times a week (combination of lifting and running), and I'm not experiencing any added soreness at all.

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Days 16-17

The skin on my cheeks is so dry right now that washing my face hurts a little. I'm also developing eczema on parts of my neck and arms. Lovely. I still feel fine physically, I just look like a freak. Oh well, as long as it's working.

It seems like this time, the side effects are a bit more severe than in previous courses. I think this is probably because I'm not sleeping as much this time (due to being busy with work and school), I'm older, so my skin doesn't seem as resilient, and I'm being very conscientous to take my pills with large meals only.

Anyway, it looks like this is gonna be a long five months. I'm just trying to hang in there.

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Days 18-19

My initial breakout is definitely in full swing. I'm finding at least one, maybe two inflamed zits popping up everyday, in addition to clusters of red bumps and whiteheads. This is probably the worst my acne has ever been, but I've learned to be patient, so I'm not too stressed out about it. I actually think it's a good thing that I'm learning to control my anxiety and hang-ups about being seen looking like this.

This is kind of morbid, but I sometimes wonder what would happen if I got into a bad car accident and was disfigured. Am I really so vain that my life would be over? How do all these other people you see with deformities or really severe acne deal with their lives? Are they really doomed to lives of unhappiness? I worry that a lot of us here, me included, are imprisoned by our own standards of beauty. And yet I'm on Accutane, and I know how much I'll enjoy the clear skin that results. But I'm trying to figure out how to use this experience to make myself grow mentally and emotionally, so that I become less reliant on physical appearances when I interact with people.

Anyways, I had my first nosebleed a couple of days ago, which, sadly, I consider an Accutane milestone. The skin all over my arms and hands is getting really dry, which means I have to slather on moisturizer right when I get out of the shower. I'm using the Aveeno Daily Moisturizer for both my face and my body, and I like it a lot. Body feels about the same, not especially sore.

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Days 20-24

Sorry I haven't been good about updating the log. Not much has changed. I'm still right in the middle of my IB, and I'm looking pretty bad. I have a bunch of people, including my parents-in-law coming over to my house for a July 4 barbecue. I'm hoping not to look completely horrible that day. We'll see how my luck holds up.

I also have my liver tests on Thursday afternoon, the day after I drink tons of beer and eat a bunch of unhealthy food. That should be interesting. As I said, during my previous courses of Accutane, I never had a problem with the tests no matter what I ate or drank. But I'm older now, so I'm wondering if that'll still be true this time. I'll keep you guys posted.

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Days 25-33

July 4th turned out pretty well actually. I definitely wasn't looking great, but I got lucky and didn't look insanely bad, just kind of bad. I probably drank 7 or 8 beers, ate a burger, a hot dog, and some coconut cake. The next afternoon I went to my derm's office for my monthly blood test. Turns out everything is fine, although my triglycerides, at 190, are "a little high" in the words of my derm. I AM NOT RECOMMENDING THAT ANYBODY COPY MY BEHAVIOR. If you do what I do, you could very well get taken off Accutane. It's just that for whatever reason, my body has always tolerated Accutane very well, so my lab tests have never been very bad.

Anyway, since I was busy, I didn't get my prescription filled until Saturday. Bad idea. Turns out my derm wrote the prescription wrong -- he had me taking 80 mg twice a day, which the pharmacist said could be lethal, so they weren't allowed to fill it. Since the derm's office isn't open on the weekend, they couldn't do anything until Monday. I was a little disappointed, but what's two days in five months? I figure it wasn't a huge deal. Might have worked out well for me anyway because I went out with some friends I haven't seen in ages and drank a ton. Again, probably a stupid thing to do on Accutane, but I did it anyway.

Got my next month's prescription today, and they filled it with Claravis. I have to admit, the packaging and the pills look cheaper and lower quality than Amnesteem, but I don't care as long as it works. I actually asked my derm if there was any difference whatsoever, and if he'd prefer I stay on a single generic. He said it doesn't make any difference at all. So despite other things I've read on this board, I'm just going to take whatever the pharmacist gives me.

Skin is still looking extremely bad. I feel subjectively like my IB is peaking and hasn't gotten worse in the last few days or so. I know I'm nowhere close to being done with it because I can see all the little bumps under my skin, all of which have to turn into full-on pimples to come out, it seems. I haven't been too lucky with the bumps clearing without becoming red and inflamed.

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Days 34-40

Well, I'm still not improving yet. It looks like I'm not the only person who's still having trouble despite already being on Accutane for over a month. My theory is that my type of acne, which typically consists of small, non-inflamed bumps, takes longer to clear than other types. I really wish some of this stuff could turn over without becoming inflamed, but it doesn't look like that's going to happen. It looks like literally every small bump has to become red and angry before it resolves. I have a ton of them, so I've been having a tough time lately. I've done this before though, and I know it works, so that makes it easier to be patient. But it is definitely getting old.

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Days 41-47

It looks like I might be turning the corner a little. I'm starting to break out less frequently, and I can actually count the number of bumps remaining. I think I might actually look ok in a month or so. It's really weird not having any oil on my face, even after an entire day.

The only side effect I'm having a real problem with is dry eyes. My coworker actually asked me if I'd smoked weed at lunch today. So it must be pretty bad. I'm not sure what to do about this. I'm using Genteal eye gel at night and Theratears eye drops during the day, and I still look like a stoner. I think I'm going to have to wear glasses mostly until I finish my course.

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