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anon000

Isotretinoin log

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I'm male, 23 years old, weight 73kg (161lbs). Acne started at the "usual time", around 13/14 i think. I've been though three courses of antibiotics, with pretty much no effect. I've been very afraid of the long-term effects on the brain, that's why I waited so (too!) long for the Isotretinoin. But since I am now only 1-2 years away from finishing university and my acne is still my defining attribute, I think it's appropriate.

It's hard to tell how much the acne has restrained my life. When it all began, I withdrawed from life, making me an outsider in school. Since then I have "waited" for the acne to go away, leaving me a socially awkward wreck. No need to say I have never had any real contact to girls (leave alone having a girlfriend). This is not only a burden, more like driving me to the brink of madness.

I'm currently on day 14 of my therapy, using 30mg of Isotretinoin. I'm from germany, so it's called Aknenormin instead of Accutane. Side effects so far are nose bleeding (~2 daily) and dry lips - nothing compared to the acne.

After reading most of the published scientific work on Isotretinoin, I know that my dose is much to low and i will need ~50mg to achieve the magic 120mg/kg after my 6 months. I'll visit my derm on Tuesday again to negotiate a higher dose. If that fails, I plan to get the missing dose by myself (yay for the internets!). I envy the people here who have so much higher doses, but the doses in germany are much lower unfortunately.

Photos:

For the obvious anonymity reasons I can only post pictures of my back. Acne severity on the breast is slightly lighter, as is my neck, arms and face. The back is obviously scarred to death, and I know that the scars will last forever.

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day 23

Side effects have changed. still dry lips, but less nose bleeding. Instead: moderate headaches and dizziness when standing and especially when moving my head. No effects on the acne so far. Fresh photo at the bottom.

Bad news: My blood is OK, but my derm doesn't want to go above 30mg. So I will take matters into my own hands and get the Iso online (additional 20mg per day to reach the usual cumulative dose).

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I hope that you can get your dosage upped. I weigh 123 lbs and started off at 60 mg daily. I am actually a little worried that it is too high.

I understand how acne can leave your social life a bit of a mess, or obliterate it all-together. My advice is to just focus on this treatment for now. Also, worrying about the girl issue is useless. I can tell you that the majority of them are not worth it anyway. I am one, so I'm a bit of an expert. I promise that whatever you need to get out of life is something you already have. I think the fog just needs to left (meaning the acne) to let you see that.

Good luck and keep going! We're all rooting for you!

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Germany? Awesome! I love German guys. ;) Haha, just picking. Anyways, for the girl thing, I know a lot of people hear this all the time, but soon enough the right girl will come along. I will keep reading your log and seeing your updates/progress. Keep hanging in there! Good luck!

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day 29

Hey there, thanks for the replies. While I appreciate your advice, it's not so easy to forget about the girl issue. Even in the acne forums there are 15yo people who had 3gfs this year alone, which is a bit humiliating to hear.

My derm won't increase the dose, so I've uhm "acquired" more ISO from abroad. It should arrive tomorrow, I'll then increase from 30 to 50mg on my own. I wish I could get those 60mg like Enemy on a legal way, but that's rare here :(

side effects include the usual dry lips and skin in my face. Nosebleed ~2 times a day. Moderate Headaches and increasingly worse dizziness now even when sitting. And since some days, my right hand is shaking all the time. Sounds not so great, but it's nothing compared to the acne. Photos from yesterday:

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day 42

acne on face is improving, so is it on my back. I've done a quick before/after mouseover:

before/day 42 mouseover

Mouse over picture: after

Mouse next to picture: before

Side effects are no big deal: dry lips, nosebleeds, rash on both hands, dizzyness and headaches

edit: oh and i'm on 50mg since day 33

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day 124 / over 4 months

long time since the last update, on 60mg per day for quite some time now. Good news: My face is completely clear. Bad news: My back/chest has improved next to nothing. I've attached two photos from the end of may.

To be honest: I'm disappointed. Although I know it can take some time for those areas to improve, it's not easy to cope with. The planned duration of the therapy was 6 months, which leaves less than 2 months for a miracle. But I have no intention to drop off the Iso until there is a significant improvement.

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day 124 / over 4 months

long time since the last update, on 60mg per day for quite some time now. Good news: My face is completely clear. Bad news: My back/chest has improved next to nothing. I've attached two photos from the end of may.

To be honest: I'm disappointed. Although I know it can take some time for those areas to improve, it's not easy to cope with. The planned duration of the therapy was 6 months, which leaves less than 2 months for a miracle. But I have no intention to drop off the Iso until there is a significant improvement.

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I'm so sorry to hear that man. Since for guys like you and me with body acne Accutane often seems like the last hope. My worst fear is that it won't work.

I really hope you get clear, keep us updated!

God bless you!

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duuude, getting accutane yourself is a baaaaad idea.

the pills you recieved may be defective/have different ingredients in them/etc.

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day 124 / over 4 months

long time since the last update, on 60mg per day for quite some time now. Good news: My face is completely clear. Bad news: My back/chest has improved next to nothing. I've attached two photos from the end of may.

To be honest: I'm disappointed. Although I know it can take some time for those areas to improve, it's not easy to cope with. The planned duration of the therapy was 6 months, which leaves less than 2 months for a miracle. But I have no intention to drop off the Iso until there is a significant improvement.

It may still happen within those two months, anon. Keep the faith. May I ask, have you ever used Head & Shoulders shampoo on your back? I used it and it literally cleared up my back - which was just as bad if not worse than yours - up within three to four weeks. It was incredible.

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cool, replies :D. Hokay some things to clear up:

1. I don't want to spoil my source, but I can assure you that the accutane pills were original. But I don't use them anymore.. found another dermatologist who gives me the full dose. I know a lot about this drug, read almost all published scientific work on it - far more than both of the dermatologists, believe me. I know such a high dose is needed to lower the risk of relapse - don't want to take any chances.

2. Yes I tried a lot.. Head & Shoulders/other forms of zinc (also systematic), B5, Taurine, DIM, lowcarb/nocarb (over months!), lactose/gluten-free, .. pretty much every trend that swept this site plus all the other medications like antibiotics (topical and systematic - worked one time, resistant now :evil: ) and topical acids

3. saint3meg3rlfc... agreed on the number :D yet it is the ultimate exception for a 23year old to have absolutely 0 experience in that area - something that is not easy to change in my situation

4. I'm a godless atheist.. whether "god blesses me", or I "keep faith" won't help here. But thanks for the efforts ;)

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136 days / 4.5 months / 89mg/kg

Hmm... 4.5 months. A very sad milestone :(. I've made a comparison between now and the first day of the therapy + another fresh photo. As you can see there is no improvement to speak of. The old photo actually looks better, although that might be because of slightly different lighting. No unusual side effects... don't really know what else to say. ;(

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136 days / 4.5 months / 89mg/kg

Hmm... 4.5 months. A very sad milestone :(. I've made a comparison between now and the first day of the therapy + another fresh photo. As you can see there is no improvement to speak of. The old photo actually looks better, although that might be because of slightly different lighting. No unusual side effects... don't really know what else to say. ;(

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That sucks man and also I think it's very strange that Accutane hasn't cleared you up at all. That kind of back acne I thought was the kind that usually responds well to Accutane. I would be eager to suggest that you might have something like Folliculitis, but from the pictures it looks a lot more like acne.

Has your face cleared up?

What is your derms explanation?

Keep your head up high and don't give up.

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Yup, face cleared up from moderate acne to clear in ~2 months - only scars and red marks left. But my back doesn't seem to improve at all. I'm getting multiple inflammations every day.

The derms here are incompetent. I've seen 4, only 2 even looked at my back. My current derm is also incompetent, but at least he's willing to give me 60mg/day. Maybe I'll visit him again next week to see if i can get to 80mg.

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Yup, face cleared up from moderate acne to clear in ~2 months - only scars and red marks left. But my back doesn't seem to improve at all. I'm getting multiple inflammations every day.

The derms here are incompetent. I've seen 4, only 2 even looked at my back. My current derm is also incompetent, but at least he's willing to give me 60mg/day. Maybe I'll visit him again next week to see if i can get to 80mg.

The derms here are excactly like that. My current derm doesn't even bother to look at my body acne to see the progress. Also he just rambles about me being perfectly healthy etc. even though I raise conserns regarding side effects. I hate those fuckers.

Im in the middle of my accutane course and my face cleared up very fast, but my body acne hasn't improved much. It often itches and I'm not really sure if it's acne or Pityrosporum folliculitis, but my derm was convinced it was acne due to the lesions being pretty deep. Does your body acne sometimes itch? Since Accutane hasn't cleared you up I would go to the derm and demand a biopsy done! Since antibiotics didn't help you at all it could be that it's fungal....

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146 days | 4.8 months | 97mg/kg

No progress at all. Face still clear, back still a disaster. On sunday it will be 5 months... :cry:. But I'll probably get on 80mg/day at the end of next week + my derm seems semi-cooperative about the therapy duration... so no fixed end at the 6 months mark (which would be in ~4 weeks already :cry:).

This is ridiculous.. my dose is already far higher than what most other people get here in germany - without any effect on my back. If everything goes according to plan, I'll reach the magical 120mg/kg at the end of this month.

Hmm... I'm not an impatient person (I've already lived 10 years with it), but the possibility that it won't help at all scares the hell out of me

@White Fox

I've thought about it not being acne, but I don't think so. It looks exactly like my face and neck looked like, just more severe. Also: It's continuous.. there is no border between neck and back acne. Plus there were at least 3 doctors + 4 derms who said it is acne.

Oh and I made photos... but they always look the same, so I don't think they're interesting.

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hey man, cheer up:) it is good news to hear that ur face is clear after like 2 months. anyway, the face is more important than the body after all, since it cant be covered by clothes. anyway i hope ur back clears up fast.

im taking 30 mg daily(one 20 mg and one 10 mg pill) i dont know if i should take one at night and one in the morning or both together. i understand u used to take 30 mg before?

oh and u mentioned that 120mg/kg is the target dose. im weighing 61 kilos so it works out to be 7200 mg in six months but at my current dose of 30 mg daily i wont be able to reach that in the time period. is it really that important in that aspect in clearing acne.

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im taking 30 mg daily(one 20 mg and one 10 mg pill) i dont know if i should take one at night and one in the morning or both together. i understand u used to take 30 mg before?

I don't think it really matters with that dose, but the half-life of Isotretinoin is ~21 hours, which means that your peak concentration will be significantly lower if you you don't take them together. That may help to weaken the side effects.

oh and u mentioned that 120mg/kg is the target dose. im weighing 61 kilos so it works out to be 7200 mg in six months but at my current dose of 30 mg daily i wont be able to reach that in the time period. is it really that important in that aspect in clearing acne.

There have been some studies which investigated the relapse rate of people who took Isotretinoin in different doses. The result was that the rate depends much more on the cumulative dose than on the daily dose, which means it doesn't matter if you take much for a short time, or less for a longer time.

The quantitative results were, that a higher cumulative dose helps to reduce the relapse rate. The upper dose above which no improvement could be statistically determined was between 120 and 150mg/kg. Because of that, the usual recommendation is the 120mg/kg. Neither does that dose guarantee a complete remission, nor does a lower dose guarantee a relapse. There are some risk factors (high severity, body acne) and in the end it's all statistics. I personally want to be on the safe side, and accept the higher side effects.

With your 30mg such a dose will take long... my derm wanted to do the same - I switched 3 times to finally get someone who does give the higher doses.

In the other news... no change... surprise surprise :cry:

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wow that is really helpful! thanks.

i guess i will take them at different timings, 10 mg in the morning and 20 mg in the night. ive been having headache , back pain, and discomfort after upping to 30 mg.

all the best once again!

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