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Introduction

This is my first foray into openly (although anonymously) discussing my ongoing experiences with acne. While I am self-aware of my condition, I cannot help but remain in denial. This log will detail the more abstract symptoms of condition/experience as well as my current course of Accutane.

Here's a little bit about myself. I am in my very early twenties, male, Asian, and live in Northern California. I've been dealing with acne for about five to six years, though more seriously in the past three to four. I would categorize myself as moderate-severe to severe acne, nearly all of which are located on my face (cheeks, t-zone, and recently my chin). My struggle has been mostly psychological in nature. I've become semi-obsessed with researching over-the-counter products and regimens, and subsequently trying a whole slew of them throughout the years. I have even resorted to foundation and tinted moisturizers (the latter of which I still use to this day). (I blame this entirely on my brief stint in theater my last year of high school [which was ages ago in hindsight], without them I would have never discovered cover-up.) As a guy I don't find it outrageous to do what I do, but it's an enduring and embarrassing process day in and day out.

I think the cumulative effects of my denial over the years has taken a toll on my self-image. At my worst, I have consulted a dermatologist and chickened out due to being slightly belonephobic (fear of needles), and have also consulted a dermatologist for antibiotics and topical treatments. Mentally strained from the rigors of maintaining the false perception that my skin isn't nearly as bad as I imagine it in my mind, I recently committed to a full course of Accutane after recognizing the barriers this condition has created.

So, since this is a log, I will gradually continue and expand on the introduction over different posts to maintain concision.

Accutane and other fun pills

I began an (estimated) five month course of Claravis on January 05, 2009. My dosage is 40mg a day. I intend on trying to force my 128 lb. body the maximum dosage my dermatologist will allow me, so we'll see how far I can take it.

My dermatologist is one of those straight forward guys who, if asked to lance off a cyst, would spin you around and stab a needle in you without asking, then slice off the said cyst and ask "what's next?". He's also not much for bedside manner. The upside of his casual demeanor is that I skipped out on the initial blood test and went home the day of my appointment with a month's worth of pills. The downside is, I don't get to skip all the blood tests.

I am also taking the following vitamins daily just for shits, giggles, and overall gung-ho-ness:

  • 1 flaxseed oil gel tablet
  • 1 vitamin b-complex pill
  • 2 vitamin d3 pills (one day and one night)

Other regimen related things

As I previously mentioned, I've tried a lot of different products in the past. I may have a cost-value dilemma, but ultimately I've fallen in love with Kiehl's. Could it be the absorbent prices that make the products feel more amazing? The faux medical garb of the employees? Or the free samples? Who knows. Whatever crack they put in it, I'm sold. My credit card company loves that I love Kiehl's too. In the end, everyone's happy…sort of.

  • Kiehl's foaming non-detergent washable cleanser
  • Apple Cider Vinegar toner (with an ACV:water ratio of ~1:4)
  • Kiehl's ultra facial moisturizer
  • Jojoba oil additive for moisturizer
  • Kiehl's ultra facial tinted moisturizer

Etc.

I'm open to suggestions, questions, or other dialogue. In fact, I'd love to hear any stories you have to share about how you're practically half-crazy because of acne, or other things related to personal struggle. Reading a lot of the logs, I'm asking for audience participation since I find the psychology of this more scarring than anything else; it's often glossed over a bit too.

Oh, despite the repeated emphasis of possible severe depression and suicidal thoughts in the pamphlets, I find it humorous that since starting my Accutane course, I've begun watching Six Feet Under.

Sick, but oh so cathartic. Thanks for reading. I'll update as much as I can possibly can and look forward to any responses.

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The psychological affects are what affect me the most too, I developed acne-sociophobia which is basically an overwhelming fear of social situations because of the constant worry of looking bad and being judged negatively for having bad skin.

I'm 19 (closer to 20) and the last few years of my life I've barely left the house because I feel so inferior to everybody else. I'd say my acne is probably in the moderate range but obviously any level of acne seems much greater to the sufferer so it basically cripples me in situations other people wouldn't think about twice.

I've wondered about using cover up before and I'm a guy too. I don't think there's much I wouldn't try to hide, treat or 'cure' my acne.

I've found due to my situation I've been depressed for a long while but I didn't mention that to my dermatologist because I didn't want it to stand in the way of being able to take accutane, if anything since I've been on it I'm less depressed but there's probably no connection, I'm probably just becoming more numb as the years go by.

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Hey there, I just wanted to wish you good luck and hope that everything works out well for you. I started about a month before you, and slowly but surely my skin is improving (read my log for more info.)

I too have suffered quite badly psychologically. I used to be quite a confident person when I didn't have to worry about the way my skin was, but several years of acne changed me and only now am I starting to regain my confidence. I know what you mean when you say how tiring it is to kid yourself into thinking you have better skin. It would be so much easier to maintain that perception if people didn't constantly remind you by staring at it when you talk to them! Grrr!

I will continue to read your log until hopefully you and I along with all the other people on Accutane at the moment are acne-free! I have to say that you write very well, it's like reading a book.

Anyway, good luck, and remember that you'll be looking back at your log in a few months time with clear skin! :D

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I've wondered about using cover up before and I'm a guy too. I don't think there's much I wouldn't try to hide, treat or 'cure' my acne.

I've found due to my situation I've been depressed for a long while but I didn't mention that to my dermatologist because I didn't want it to stand in the way of being able to take accutane, if anything since I've been on it I'm less depressed but there's probably no connection, I'm probably just becoming more numb as the years go by.

Thanks for your reply, I really appreciate your candor.

For cover up, it really depends on your complexion. If you are very fair skinned and are prone to flushing or redness (though I suppose our skin condition is a lot of redness), it may look less natural since cover up will be a singular tone. For example, when I drink, my Asian skin flushes heavily, so if it's not applied properly, you will get discrepancies in facial tonality.

I use a tinted moisturizer by Kiehl's; it comes in light, medium, and dark, and it is also SPF15. I prefer this over actual cover up because despite what ingredients have shown, using product can and probably will clog your pores. Cover up is also not good for dryness, since flakiness will make it obvious you are wearing something. I chose the moisturizer because I prefer to look as natural as I can be, although I am admittedly very oily in appearance due to it.

On a good day, when there are no/minimal bumps on my skin, tinted moisturizer works amazingly well as an alternative cover up and I have just as much confidence as I would if I was drastically improved. In my opinion it's worth a try. I've been fortunate enough to have had girlfriends in the past who did not care enough about this to make any sort of problem out of it, so it's mostly in our heads (unless you have asshole friends who would make such remarks about you).

As for the depression, I haven't decided on what my self-diagnosis is, but I definitely do not feel that this will negatively impact me any worse than the many years of torture I've put myself through.

I too have suffered quite badly psychologically. I used to be quite a confident person when I didn't have to worry about the way my skin was, but several years of acne changed me and only now am I starting to regain my confidence. I know what you mean when you say how tiring it is to kid yourself into thinking you have better skin. It would be so much easier to maintain that perception if people didn't constantly remind you by staring at it when you talk to them! Grrr!

Thanks for the kind words. I hope you enjoy all the rambling that's to come in this log. I've subscribed to yours and will be keeping tabs on it as much as possible.

I think we're all affected in some way, because this notion that everyone is looking at us seems to be always present. In real reality, I think we end up inadvertently putting more attention on our faces than necessary. At the dinner with friends, I am always concerned with the lighting and how it will affect my appearance (since flat or dim lighting means I look kind of normal), and always using gestures or arm/hand positioning to cover parts of my cheek or face. It's a horrific experience, I don't know how my friends deal with it, especially since I can't look them in their eyes.

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Day 1 - 4

January 5th, 2009 - January 8th, 2009

Initial breakout seemed to start within 48 hours of the first pill. I suspect, despite my lack of scientific knowledge of this whatsoever, that my 5'11 and 128 lb. frame alongside my through-the-roof metabolism has skipped all the pleasantries of a grace period with this drug and has gone straight to breaking me out. Near my mouth and through my jawline have been small bumps, but since then has come out completely as whiteheads. My right side (my good side) has been taking one for the team this week. Last week it was the left side that was the culprit, but they're congregating across my face like it's the trek to Mecca. I'm guilty for carefully and neatly removing the whiteheads when they become scrapable. (Mind you, I really don't have a good side. Years of this has given me red marks all across my cheeks and while some have faded it's painfully obvious.)

No side effects as of yet. I remain mostly on the oily side from moisturizing so I don't expect it to be a problem. I do look forward to waking up soon and not feeling icky.

Apple cider vinegar toner has helped immensely with keeping it things under control, though the pimples fluctuate in condition throughout the day. Sometimes I feel fine, while other times I feel bloated and pulsating, like a walking blob of lava.

Did some math for all the veteran pill poppers out there. My current Claravis intake in regards to my body weight is 0.69mg/kg. When does that ratio become unsafe?

-----

Etc.

The second day of my course, I was very productive. I woke up at 6 A.M. and I forced myself to get ready. It didn't take so long this time since I had a photo shoot at 10 A.M. so I had to rush out to get my errands done. Bought film, dropped off film to be developed, finished my photo shoot, went back to the lab to drop off film, had lunch with a friend, went to the bank, came home, rode my bicycle for half an hour and did some stretching to cool down. Overall, more productive than I've been in the past few months. It felt great. I'm going to try and repeat this more often. It breaks the monotony and cumulative effect of being agoraphobic and unable to act on impulse.

Took a day off the next day and slept-in. Bad idea. Wanted to do things but ended up moping around the house. My friend wanted to meet for dinner, so I ended up staying in the house until I really had to leave. Original plan was 7 P.M. pickup, of course I procrastinated and didn't get myself ready in time so I arrived at 7:30 instead. I hate being constantly late because I can't bear to deal with covering up my face every time I want to go out. Other times I just have to ignore the internal thoughts and just do it. I got through college like that, but now things are different.

A little bit more of the same today. Watched a lot of Six Feet Under. I'm on season two now, and it's absolutely amazing. I left the house, finally, at 4 P.M. to pick up my film from the lab. Then I did some scanning and editing, and I think the portraits turned out alright.

All in all, I'm still struggling to straddle the line between complete recluse and functioning human in society. More soon!

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Day 7 - 9

January 11th, 2009 - January 13th, 2009

Initial breakout has decided to become a permanent part of my red bump collection. There was this gnarly cyst-bump-ma-bob growing on the back of my right ear, where the ear meets the head, and I thought it was some sort of maligned tumor or some sort of small fetus-child. Thankfully it's been reduced to a pea sized bump. A lot more of these cyst babies have been popping up around the back of my neck and in random places, but they don't really show much so it hasn't been an issue.

Nothing fantastic to report. My left side is definitely having a better week. Fuck you right side.

Side effects

I've been shedding a couple hairs every morning in the shower, but I'm not worried. I have a head full of thick, robust, and utterly boring straight Asian hair that could use some thinning. As long as I don't get an unsightly receding hairline, I should be okay with some thinning.

My hands are particularly achy today. I'm a compulsive knuckle cracker, but today there seems to be a lingering soreness.

Haven't experienced any night blindness, though my eyes have been strained a bit. Must be all the television watching. I am up to the last season of Six Feet Under.

Dry lips are starting to kick in but I've been using Kiehl's lip balm. Waiting for the dryness to really kick in.

I really think my weight to Accutane ratio is really making my medicine extra toxic.

-----

Etc.

Less crazy this past few days. Some friends were in town and went out. They all got completely pitted and mashed, but I stayed stone cold sober the whole night. My line was "I'm on medication, if I drink I might die." It seemed to work, but they could have just been too drunk to notice anything off.

Super B-complex vitamins taste, and smell, like smeared doo doo flies. Fluorescent neon lime-green pee is a fun upside, though.

I'm working on getting more sleep. Crazy dreams about friends, ex-girlfriends, and possible Freudian slips.

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Day 10 - 12

January 14th, 2009 - January 16th, 2009

Everything is going into hyperspeed. Yesterday the right side of my face was having a bad day, now today it's the left side. I'M GOING CRAZY.

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Day 16

January 20th, 2009

Side effects are kicking in much stronger, and the Initial Breakout is still continuing to wreak havoc on my face. I'm taking it like a trooper. The pores on my nose are being sucked dry I suppose, since for the first time I can feel all my blackheads just by touch. It's kind of a weird sensation but gross at the same time. The new developments from the Claravis are more painful, but I trust that they'll subside shortly.

My hands have been über dry, and so has my upper neck. Kiehl's moisturizer aplenty. Also, jojoba oil is doing wonders for my lips. A godsend.

That's all for now.

Etc.

Mr. Obama, welcome to the Black House.

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Day 31

February 4th, 2009

One month down. My blood test was interesting. Requested the smallest butterfly needle and it didn't end up being as awful as I imagined it. My doctor brought the heat and wanted to bump me up to 80mg, but once I told him my weight, he prescribed me a 40/80mg regimen for the upcoming month. I hope all goes well and I can go the full 80mg by next month and start kicking some ass.

Nothing new to report. Skin is much drier, but it's a good thing. I'm over-moisturized so I'm not feeling any of the ill effects of the dryness, except for the lips. Using a lot of jojoba oil and Kiehl's lip balm moisturizer…it's doing the trick for now.

My skin itself hasn't improved. Still having a few new developments on my right side. The inactive parts seem to be sealing up, but there is still tons of redness and a lot of work. My skin seems more consistent, which makes it easier to put on the tinted moisturizer before I go out.

Etc.

I'm terrible with the vitamins. Trying to take them daily…but I need to wake up on time or else I feel less motivated to do so.

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Day 33

February 6, 2009

Almost forgot to add, a week or two ago, the pores on my nose were definitely wide open and all the blackheads were being pushed out. I could feel the texture of it if I brushed my fingers against the skin. Fast forward to now, it's incredibly smooth now, and I think that is healing.

There is a tiny active pimple smack dab in the middle of my face, in between my brows/eyes/above the bridge on my nose.

Despite a slow first 30 days, I'm still enthusiastic about the course. Doing some math since reading the "All About Accutane" section of the front page.

The majority of people who take it see their acne effectively cured, experiencing long term remission of acne symptoms. Studies show an average relapse rate of 25%, and in these cases sometimes a second course is given. This relapse rate is dose dependent. Patients who receive a cumulative dose of 100-120mg/kg see the best results and lowest relapse rates. Patients who receive a lower dose relapse more frequently. Depending on how much the patient weighs, .5mg - 2mg/kg is usually prescribed per day.

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Day 42

February 15, 2009

Can't believe it's already been at least 40 days of treatment. It's gone by quite quickly now that I've eased into accepting the course for what it is. Less anxiety about the meds, so now I mostly deal with the regular day-to-day anxieties and sociophobia.

It seems as though I am nearing the end of the initial breakout. It took a week or two for it to really get started, and now that I'm nearing a month and a half, it looks as though the left side of my face has settled down, and any previous actives are now mellowed out and there haven't been any new activity. Latest ones on the left side are underneath my jaw and around the cheek area. In the morning, the left side actually looks as though the red marks have become less red.

The right side seems to be following along slowly. Small actives on the upper cheek closer toward the ear, they are whiteheads that aren't painful like cysts, so I'm in the clear. Hopefully in a week or so it'll die down, but I'm hoping sooner since the strong 40/80mg routine is ramping up the turnaround time. Some days bumps will mellow out within 12 hours, while others take no longer than a few days to become much more subdued.

Other than this, I am staying ultra-moisturized with the jojoba oil to compliment my Kiehl's ultra facial moisturizer. Very liberal applications have been used, though now I am very careful around the eye area because of increased sensitivity to wind. It's annoying as hell having to tear up from the moisturizer being too close to the eyes.

Hopefully there will be more good news to report later. I'll consider putting up photographs, though I am extremely wary about it.

Until next time.

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Day 113

April 27, 2009

Two months later.

In comparison to my second month, the entire consistency of my skin has altered. My four months of Accutane has placated 85% of my acne and has subdued the remaining actives. Since my initial breakout ended, I would say that there have been a total of 6-8 new actives since, none of which have behaved in a manner similar to what my acne was like prior to Accutane. They are deeper, more solid, bumps that do not hurt. They don't come to a head like overactive acne seems to do when it's out of your control. These new spots are easily mitigated and disappear slowly when I ignore them, but they seem to fade without damaging the skin.

Right now, I still use tinted moisturizer, but my face feels flush and the only thing I have to live with is the scarring and redness. The healing process is my next concern.

I've switched from Kiehl's daily moisturizer to Cetaphil moisturizing cream with jojoba oil. I've heard great things about this product and I am going to test it out. This might save me a huge chunk of cash per annum considering the amount of money I spend on moisturizers and facial cleansers.

Side effects have been progressively worse as far as eye strain goes. There have been mild cases of depression, but I don't find them to be altogether debilitating. I could imagine it being a very dangerous side effect if one were to be susceptible to the mood swings of depression, but I seem to take it in stride and just sleep on it. It sucks but it fluctuates and seems to be an echoing effect. Once I leave the house and get my mind off of it, the depression-ish side effects subside dramatically.

--

Last bit of news.

The doc prescribed 80mg/day and I am contemplating continuing my 40/80mg dosage instead. I've looked into the low dosage Accutane studies and am curious as to whether or not it's best to say 'fuck it' and go the full 80mg/day for my last month.

Part of me wants to scale back to 40mg a day to maximize the time I'll be on Accutane, just in case my body needs to live with the drug some more. I'm afraid that once I run out, I'm done and it'll come back. It's kind of irrational, but I'm leaning toward going the full 80mg and fighting through the increased side effects.

---

I'll update this once I'm finished. So far, I'm very happy and wish I had done this sooner.

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Glad to hear that your skin's getting clearer :) And I'm guessing it's even better now as it's been a month since your last post. Don't feel depressed ;):catdance:

I think I get the bumps under the skin you mention, the ones that before Accutane used to come to a head. I have an area on one side of my chin where I can feel them, but they don't seem to be going away! I'm worried that it will start coming out when I stop Accutane. Do yours go away? I thought maybe it's the skin damaged underneath? Or do you think it is kind of like 'dormant' acne? I'm probably just being paranoid as usual :D

Anyway good luck with the rest of your course, hope you're doing alright.

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Glad to hear that your skin's getting clearer :) And I'm guessing it's even better now as it's been a month since your last post. Don't feel depressed ;):catdance:

I think I get the bumps under the skin you mention, the ones that before Accutane used to come to a head. I have an area on one side of my chin where I can feel them, but they don't seem to be going away! I'm worried that it will start coming out when I stop Accutane. Do yours go away? I thought maybe it's the skin damaged underneath? Or do you think it is kind of like 'dormant' acne? I'm probably just being paranoid as usual :D

Anyway good luck with the rest of your course, hope you're doing alright.

Sorry for not checking up on this thread as often as I should.

The bumps for me are just fading with time. Unfortunately the dermatologist I saw had a very swift approach so I didn't get a thorough run through on issues such as that. I don't fear it will change much after I'm off Accutane since I can feel the lack of oil on my face when I wake up.

What I can feel is what remains after my treatment. The skin is undoubtedly scarred and damaged, and will take some time to heal. How many years that will take I'm not sure.

Thanks for the support and I hope your journey is going smoothly as well.

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