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*Note: Sorry in advance for the length of this...these are my initial posts...I'm finally starting to figure out all this tech stuff!*

Day 10

A little background: I'm 32 years old, been suffering from varying forms of mild to moderate facial acne and extremely oily skin for 19 years. I've tried everything under the sun to try and get rid of it, including prescription and over the counter creams, gels, lotions, antibiotics, Retin-A...I must have spent thousands of dollars over the years! About 8 months ago, I started developing cystic acne along my jaw line, on my neck, my chin, and on my hairline next to my ears. A month or so ago, my derm finally told me that the only thing that would help at this point was Accutane. He gave me a bunch of pamphlets to read, told me to research it as much as possible on my own, and to get my first series of blood and urine tests done. After thinking seriously about it for a couple of weeks, I made a follow-up appointment to see him and he wrote me a prescription for 40mg/day.

A few things he told me: do not drink alcohol at all (not a problem for me), do not take Tylenol or any medication with Acetaminophen as it would be too rough on my liver (Advil is a good alternative), do not take any supplements containing Vitamin A, use Lypsyl 10-15 times a day even if my lips don't feel dry, use eye drops and saline nasal gel for dryness, and forget everything he's ever said about treating acne! That means washing my face at night with a very, very mild cleanser, applying tonnes of emollient moisturizer, only rinsing my face in the morning with warm water, applying more moisturizer, and not using any type of exfoliating scrubs, spot treatments, or lotions. I'm so used to having to use lots of different treatments on my face that this is a nice break (and time saver!).

So far, so good...


skin is less oilycysts and pimples are still there, but are healing much faster than beforeskin is smoother and pores are smaller on my forehead, nose, chinNegatives:skin on body is dry and itchyscalp is itchylots of small whiteheads are popping up on the sides of my chinsome mild nosebleedsface is red and sore (like a sunburn without the peeling) especially on my forehead and cheeksskin is more fragile- my hands are all scratched and I have random scrapes and scratches on my legs and armsI'll keep you all posted...

Day 12

Things are looking pretty good...from my neck up. Yesterday, I felt two new cysts developing on my neck, and now they've settled in quite nicely. My face is doing alright, except for a lot of under-the-skin white bumps popping up around my chin, my cheeks, and the sides of my face. I went out yesterday to buy some new lip balm- Ceralip- which is absolutely incredible. I had been starting to get small blisters on my lower lip from the dryness, but after less than one full day of using Ceralip, my lips are smooth and much more comfortable. It also doesn't leave a tonne of shine, more of a matte gloss.


no side effects, other than some dry skinface is much less red and sore than it was two days agoNegatives:
two huge cysts on my necklots of whiteheads coming outdry sinuses have caused a nice cold...I'm now using a lubricating saline nasal spray to try to prevent sinus pain

Day 17

I am finally getting over a fairly brutal head cold (thanks to saline nasal spray and Kleenex with lotion!), but woke up feeling pretty achy this morning for the first time since starting Accutane. I had some errands to run, and during the day, I noticed that the backs of my knees were pretty sore, and so were the muscles in my neck. Driving was kinda fun...trying to stay awake while driving was even more fun.

I saw my mom Christmas day, and didn't wear a ton of makeup for the first time in many, many years. I'm finding that I almost don't care how bad my face looks, since I know it's only temporary, and hopefully I'll soon not have to think about it anymore. One of the first things my mom mentioned was that one of the two cysts on my neck looked so, so painful, red, and huge. She also said that the skin around my chin on both sides was super bumpy and rough-looking. I can always count on Mom for her brutal honesty. On the other hand, when I saw her again this afternoon, she said that she's already noticing an improvement in the bumpiness, and that I looked "healthy". Hmmm...wonder if this is going to be a permanent thing.

The funny thing is that even though I feel that my skin is getting noticeably better, I'm just as self-conscious about it as I was when it was at its worst. Just wondering if this feeling of looking awful will fade just as quickly as the acne is fading...


Texture on my cheeks, nose, forehead is much betterBumps around my chin are slowly starting to go awayOne neck cyst has just about fully healedNegatives:Dry skin in and around my nose is starting to bother me a bitLips are still dryTwo small chin bumps have turned into two small pimples that are taking forever to go awayRemaining neck cyst seems to want to hang out a while longer...it just won't heal and looks like I've been shot. It's flatter than it was yesterday, but it's as if only a thin layer of really dry (and practically transparent) skin is preventing it from crawling out on its own. It's impossible to cover with makeup, and too high up for a turtleneck to hide. Gross.Exhaustion and aches finally decided to settle in today.

Day 21

Although all the little bumps on my chin seemed to be going down quite nicely, it appears as if they're back in full force! It feels like hundreds of them are covering my chin, my entire jawline, the lower half of my cheeks, and my neck. Most are small and white, but some are red. Out of curiosity, I tried popping one last night, and it acted more like a small blister than a pimple- fluid that came out was clear with just a bit of blood mixed in. Aside from the bumps, I have one really nice red active on my chin- I swear I will leave it alone!-, one just above my right eyebrow, one on my left temple, and a bunch of small cysts starting just in front of both ears. Nice, really nice.

I've switched to a new moisturizer that's working really well (La Roche-Posay Nutritic) and am using Bioderma Sensibio H2O as a cleanser. Both have saved me from walking around with a bright red face all day.

On a side note, did anyone else find their last blood test experience really difficult? I guess Accutane has dehydrated me more than I realized. Half way through drawing blood, my vein just stopped flowing, and the nurse had to switch arms and to give me a break just to get the full 4 vials. This has never happened to me before. Plus, I was left with huge bruises on both arms, and a rash when I removed the tape afterwards. Ouch!

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I just noticed the back itchiness after I read your post! Annoying!

My derm didn't say to avoid alcohol completely, just drink in moderation...

I only plan on having a few tonight & won't mix the drinks like I used to...

Keep the faith!!!

Peas'n'Luv - A

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Day 29

So things haven't been going all that smoothly as of day 21(?). I started breaking out pretty badly a week ago, and while I'm finding that my acne is healing so much faster than before, it's also way more painful and inflamed. I have about 9 new actives on my chin and sides of my cheeks near my ears, and my cheeks, chin, forehead, and neck are just about covered in whiteheads. Pretty, I tell ya.

I had an appointment with my derm yesterday afternoon, and he's bumping me up to 50mg/day (10mg in the morning, 40mg at night) as of tomorrow. He's a firm believer in dosing according to weight to achieve the best long-term results (I'm somewhere btw 45-48kg) rather than dosing based on the severity of acne. He also said that my course will run a maximum total of 4 months...the thought of clear skin by April is what's keeping me from getting too discouraged right now. He told me that my IB is looking like that of a typical Accutane IB (in places I normally don't get acne), and that it should clear completely in 2 weeks (best case) to 2 months (absolute worst case).

Side effects so far:

  • slightly dry eyes
  • dry lips
  • dry mouth (depsite drinking at least 10 glasses of water/day)
  • slightly increased cholesterol, but hdl ("good cholesterol") levels also increased, so it all balances out
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Hey aimless, just finished your log, thanks for sharing your story. I'm a bit behind you, almost 3 weeks in. Similar stories though, I feel your pain. I haven't hit my IB, in fact things look so great it's freaky (of course I just jinxed myself). Anyhow, just wanted to ask, your derm said no tylenol? First I've heard of that. I've been taking some tylenol PM before bed as I'm fighting a head cold that REALLY likes me and won't leave. Wondering if I should rethink that? Also, my derm said I could continue to take my multivitamin (with 100% recommended daily allowance of vit A), and yours said no vit A supplements? Wonder what's up with that? Anybody have any thoughts on those meds/supplements? Good luck aimless, you're not alone in the fight :)


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Hi nobodylives...

thanks for the words of encouragement! I PM'd you about the Tylenol issue- hope it helps clarify things a bit. hang in there!

Day 30

Today was my last day on 40mg, up to 50mg/day tomorrow morning. As much as this IB sucks, what amazes me is my new acne is clearing up so fast. I mean, seriously, 3 of the really, really painful actives I woke up with yesterday morning have almost completely dried up, and just look like small patches of dry, red skin. This never happens to me; it used to take any pimples/cysts weeks to heal. Now, I consider myself unlucky if they stick around longer than 3 days. I can deal with this...

I also love the fact that my makeup stays in place all day. I can actually look in the mirror once before I leave the house in the morning to make sure blemishes are as concealed as possible, and I don't have to keep running to the mirror at work to see if foundation/concealer have run off my face in an oily mess. Also, for the first time ever, my eye makeup lasts all day! I used to have oily eyelids, and eyeshadow/liner/mascara would just disappear or cake in my "fine lines". Amazing.

Side effects: much drier lips today, and my ear lobes are starting to itch and peel (must remember to moisturize those spots at night!).

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OMG, totally can relate about the make-up issue! I was just thinking that yesterday, it's amazing that my face looks the same before bed as it does in the morning right after I get all dolled up :) Love love love this side-effect, if only it could last forever. Thanks for the Tylenol info, guess I'll use ibuprof instead for the time being. Weird how every derm's got a different opinion, good thing we do our own homework :) Good luck to you..........nlf

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Day 33

I woke up this morning feeling completely discouraged. I don't know if it's a result of being bumped up to 50mg/day, but my skin looks terrible! I've got a bunch of new large, painful actives, one of which is of the type that I know will take forever to heal. My neck area, which had started to clear up pretty nicely last week has now broken out again (I don't know why I feel worse about getting acne on my neck as I do about getting it ony face), and my skin is starting to get flaky around my chin and mouth. The good news is that most of the blackhead on my nose have disappeared, and the skin on the parts of my face that aren't breaking out is starting to feel really soft. I know I need to patient, but I'm just getting frustrated at this point. The worst part of today is that I have to go in to work this afternoon, and I don't much feel like being around my coworkers with skin this angry looking. A colleague of mine asked me yesterday if I was more stressed than normal, or if I was starting to get sick, because my skin was looking bad. That was such a reality check for me, since I try so hard during the day to forget about my skin, and to maintain a certain level of confidence.

Side effects, though, are minimal, which is a great. I've just got to hang in there for 3 more months...

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Day 35

I don't want to get too optimistic at this point, but it seems as if things might be looking up. A lot of the new actives I had only two days ago have already dried up and have pretty much disappeared. I still have a lot of small whiteheads on my cheeks, chin, and near my ears, but they're minor compared to what I've been experiencing lately. I do, however, feel the start of a cyst coming out on my neck (just lovely!), and I have a patch of really dry scaly skin on my calf where my winter boots have been rubbing. I keep moisturizing the area, and applying cortisone cream, but nothing seems to be working. Any suggestions?

Side effects: dry lips and that's all!

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Day ???

I'm finally posting again after what feels like forever. The reason I haven't posted in the past few months is that I've been pretty discouraged with my (lack of) progress, and I didn't want to remind myself of it.

After 2 months on 40mg/day, my dose was upped to 50mg/day. I'm now half-way through my 4th month, and I'm still breaking out. I'm still only experiencing very mild side effects (dry lips and facial flushing on bad days), but I'm also still breaking out. My problem areas throughout my course have consistently been my neck and jawline, areas in which I never had acne prior to starting Accutane.

I saw the derm today, who told me he's never seen a patient resistent to Accutane before, but he thinks that may be the issue in my case. He was very surprised that I have yet to stop breaking out as I've been at the correct dosage for my weight for over 4 months. He also said he's never had a patient still breaking out after 3 months, but that he does rarely see relapses about a year after a first course. He gave me the choice of either extending my course by another 6 weeks, or just increasing my dose to 60mg/day for another 4 weeks. I chose to up the dose in hopes of kick starting some sort of reaction. I've now got 2 weeks left at 50mg/day, then another 4 at 60mg. He also wrote me a prescription for Differin, which he said I should start using even while on Accutane. Ah, back to the life of daily topicals!

One interesting point he brought up: there have been a very, very small number of reported cases where birth control pills have interfered with Accutane. He suggested that maybe my pills (Tri-cyclen) are causing Accutane to be less effective than it otherwise would be, and that I could try going off them or switching to another type a month after I complete my course. There is a risk, though, that coming off the pill, or switching brands could trigger an even worse case of acne, and that, if I am simply resistent to Accutane, it would not be treatable in any effective way. Has anyone else heard of this?

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