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inuk

24/F, 60mg Accutane (roche) 23 September 2009 (Pics)

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So, I know I am starting the log a bit late. I guess the first few weeks are pretty uneventful anyways so here I begin with a brief summary of what has happened until now.

I am 23 and will be 24 in 5 weeks.

Quick background

Got acne at around 20-21. I usually have 1-4 small-medium nodules at any given time and a few healing. Sometimes more. Sometimes a few pustules in addition. My face - especially my cheeks - is pretty crowded with red marks so without makeup I look pretty bad.

For the first year or so, I took only minocycline and topicals, which did not really work. Then at 22 and 23 I really became desperate and I tried everything - including spironolactone (did not work), every antibiotic and topical and home remedy. I sometimes worry that I have put to much rubbish in my body.

My acne remained mild-moderate and persistent.

I wish that my doctors had agreed to give me accutane sooner. I know there are many who have more severe acne than I do. Nonetheless, I has been pretty bad at times and it was absolutely devastating this past year when it reached its peak.

My dosage is an average of 60mg a day, alternating 40 and 80 every other day. That is a total of about 45 40mg pills per month.

Month 1- up and down, not miraculous but I looked better than i did before. There would be times that I thought " this WILL be my last pimple, and it will all be healing from now on". Not so.

I am now on month 2 and have about 19 more pills before my next pack. and I did slow down my dosage for a while just because I became paranoid that my joints were hurting. They are fine now so I should finish my meds this month on time with the proper average dosage. I don't know if I will have slowed down my possible results, I never took less than 40 a day (other than for three days between filling my script).

My doc told me to get two topicals, one is neo-medrol and the other is a custom compound involving a few things (antibiotics mainly). They have been good I think, I have not gotten another pustile since starting the compound; the neo-medrol helps keep the red nodules from becoming really red and inflamed.

SO

DAY 52

My overall tone is pretty good. Two or three days ago I got one papule/nodule on my jawline which may or may not stick around as long as its twin on the other side of my face. Its very strange how my pimples are usually concentrated on either side of my face at any given time and that they seem to crop up in similar places. I also have one hard nodule on my cheek which I am not at all happy about. Other than these two actives, I have some small healing pimples around my face.

Side effects: dry lips (whatever), mild headaches. I don't know if they are related or if I should be concerned.

I really hope the pimples I have now don't last forever, as they usually do, and that I dont get more! Still, I think I am doing better than I have on anything else I have tried. I like that you can actually feel accutane at work.

I have been reading all of your logs for ages and thought I would jump in! Been wishing you all well! :D

Edited by inuk

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Hey girl. Good luck with the tane. I am starting my 6th month tomorrow and am comletely clear. I saw that you took spiro and it didn't work. What was ur dose and how long were u on it. I am thinking about goig on it after tane to stop the hormonal breakouts from coming back. Accutane can't really keep those away forever.

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Hey girl. Good luck with the tane. I am starting my 6th month tomorrow and am comletely clear. I saw that you took spiro and it didn't work. What was ur dose and how long were u on it. I am thinking about goig on it after tane to stop the hormonal breakouts from coming back. Accutane can't really keep those away forever.

hey !

I took 100-150/day for 6-7 months so I def tried.

I thought about that too but I am not sure, I might be more inclined to stick with b/c and hope that works!

I was convinced that spiro would work if I took enough for long enough but I was so so disappointed. It did help slightly but it wasn't enough. At some point I was taking spiro, yasmin+ antibiotics to try to keep the acne at bay. I felt like I was treating a serious chronic disease. It sucked.

I am glad you are doing so well! after how long did you stop getting new pimples?

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It's hard to say how long until I didn't get any new breakouts. I can tell u I

never got an ib!! My skin immediTely started getting drier. No oil!!! And slowly broke out less and less. I think around the end o month three is when I really noticed a difference. I haven't had any significant breakouts in like 2 months. I mean little red bumps once in a while but rarely and they never turned into whiteheads and went away very quickly!!!

Keep us posted on ur progress.

I might put up some pics of mine. The results are pretty amazing.

My derm is totally cool with putting e on it again if I need it in the future. He said it's rare for anyone to need a second course but it's good to know I can do it if I need to!

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DAY 53

These two actives on my left side are a bit of a bummer. They are pretty red and inflamed. The neo-medrol seemed to work yesterday but the effect seems to have worn off so I am hoping that another application and a nights sleep will bring some relief. I feel so close to clear skin but these certainly feel like a major setback. They are the kind that stick around for a while.

Hoping that my bloodwork this month was ok and that I can continue! If not I don't know what I will do.

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Day 54

My liver enzymes are around 3X what they were when I began 7 weeks ago, which was devastating. I even slowed down the accutane a bit during that period of time.

The doc gave me another month so hopefully within a month I will be clear enough that if I have to stop it will be ok.

I am concerned about this. I really don't want to stop but I also like my liver and don't want any problems with it. Obviously.

For now the two actives have responded a bit to the neomedrol and hopefully will continue to shrink in the days to come.

Has anyone else had liver enzyme elevations?

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Day 55

Well no news. The two nodules are up and down, depending on how much neo-medrol I slather them with. Good think I work at home and dont have to see people with a thick crust over two big red spots.

I dont really feel anything else coming in but you never know.

I started a new pack of Diane-35. I previously took Yasmin but decided to try the Diane. Yasmin does tend to give me muscle twitches so maybe its a good idea to switch.

I noticed a wrinkle I under one eye, i cant believe I have one but then again, its not that weird to start seeing smile lines in your mid-20s. Lame. I don't think its related but I think the general dryness makes it look worse. I really have felt tempted to use retin-a or taz.

I gave in and used a bit today. I really want to peel a bit, my skin looks dull and kinda crappy. I also have that custom compound I was prescribed, which seems to work on pustules and things but doesn't prevent these long lasting deep ones that come from below and stick around for god knows how long. Bleh.

I know I am basically only dealing with 2 pimples right now but let me tell you, they feel like setback. That side of my face had been clear for so long!

I am really hoping that my liver enzymes don't continue to rise next month. Thus far, the rise has been linear so I must pray that my liver gets used to it. I am tempted to take a break for a week or something maybe in two weeks time to see how quickly the enzymes drop. If I do have to stop, I pray that by the end of month 3 I will be clear enough that stopping wont feel like such a dissapointment.

Yeah today I am mixed. I hope it works, I hope my liver is fine, I hope my red marks fade in the next month when I am visiting friends overseas.

Wish me luck all.

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Day 56

Well the two actives are starting to calm down. They are surrounded by flaking skin thanks to the neomedrol- win some, lose some.

I have pretty much no side effects. Thats a bit weird. My lips are a bit dry but I only need to put balm or aquaphor on them twice a day. The "dont go anywhere without chapstick" thing has not been a problem for me lately, though it was at first.

Otherwise I am fine, by skin is less sensitive than it was. At some point, towards week 4 ish i guess, even toothpaste around the mouth area was irritating- I had to be careful. Now I am fine. I don't know if that is a good or bad sign, probably a good one. My eyes are a bit dry I guess. Headaches gone, they may have been period related.

I don't feel anything coming up. Lets hope that by the 2 month mark I will only have to worry about healing these red marks!

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Day 56

Well the two actives are starting to calm down. They are surrounded by flaking skin thanks to the neomedrol- win some, lose some.

I have pretty much no side effects. Thats a bit weird. My lips are a bit dry but I only need to put balm or aquaphor on them twice a day. The "dont go anywhere without chapstick" thing has not been a problem for me lately, though it was at first.

Otherwise I am fine, by skin is less sensitive than it was. At some point, towards week 4 ish i guess, even toothpaste around the mouth area was irritating- I had to be careful. Now I am fine. I don't know if that is a good or bad sign, probably a good one. My eyes are a bit dry I guess. Headaches gone, they may have been period related.

I don't feel anything coming up. Lets hope that by the 2 month mark I will only have to worry about healing these red marks!

good luck to you. im on the same path. my right side of my face is beautiful and clear i got 1 on my forehead and 2 on my left cheek. and the rest marks!!!

i hate them marks cuz it makes it look worse! its like a reminder of the crap we been through

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I don't have a camera at the moment! the one on my comp doesn't really capture details.

Soon I hope!

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DAY 57

Yesterday when I was washing my face, I noticed the aforementioned peeling around the actives I had treated with neomedrol and decided (rather stupidly) to try to help them along. I did realize how deeply the neomedrol had penetrated so i now have a red mark where I inadvertently peeled off a good amount of skin too early. nothing crazy and it doesn't hurt but ick. its not even on the pimple. i put aquaphor on it so lets hope it resolves shortly

nothing new coming in.

i notice when I put aquaphor on my face, any actives I do have (even those that are healing) become more inflamed. Its a catch 22 i think because I know that lesions kept moist heal faster. So I don't know.

Lets hope that progress continues!

I have been taking 80 mg a day, but I think that I will finish my monthly batch just right since I skipped a few days in the last month.

No real side effects really, I did become PRETTY nauseous at the gym today when I tried to do some challenging stuff. I think that this was attributable, however, to not having eaten or had enough water today.

I am also in the process of losing some weight, btw, I don't know how relevant it is but sometimes I think that my lower fat intake may compromise the extent to which the accutane is absorbed. I do try to address this by taking the accutane with something like nuts, peanut butter, something with oil, etc. I actually am having my triglycerides measured for the first time in a few weeks so I don't have a baseline (not sure what happened with my doc there). I have certainly cut down on my intake of animal fats (and animal products in general) so I hope I am moving in the right direction.

My goal is to emerge from this course the way I was before I got acne and gained some weight. I am also quitting smoking. I hope that my general transformation brings about the boost in self-esteem that should come from within but hasn't.

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It is admirable that you're trying to change the things about yourself that you do not like instead of simply complaining about them. Good luck with the weight loss and even more so with the smoking.

You're kinda lucky if you're not really having side effects, lol. Wish I could say the same. The dryness of my skin knows no bounds right now.

I'll continue reading your updates. Take care.

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Month 1- up and down, not miraculous but I looked better than i did before. There would be times that I thought " this WILL be my last pimple, and it will all be healing from now on". Not so.

:D This is exactly what I've been thinking for the past 2 and a half months. Let's hope that soon it will be true.

I hope your liver enzymes stop rising. But you shouldn't be that worried, your derm agreed to continue the course. If you are healthy overall, your liver enzymes will get back to normal very soon once you've finished.

Best of luck :)

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Hi Guys, thanks so much for your responses! It is nice having a space to share this with anyone else who cares.

Day 58

Same as yesterday skin wise.

I didn't sleep much last night and when I tried to get up this morning I had MAJOR NAUSEA. It was not good and really very frightening. I had a banana and went back to sleep and woke up and felt ok.

I haven't felt great all day though, a bit lethargic and ALMOST nauseous but only very vaguely so. I just feel a bit crappy today. It might be the Diane, its so hard to tell. I am hesitant to take the meds today, maybe my body is telling me to chill out. I don't know!! I don't know if I am experiencing side effects from accutane, Diane, or just feel under the weather today.

I guess I will know as time goes on.

Thanks again to all the people who responded, I have been reading your logs with great interest as well! :razz:

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Thanks jon.

Today there is nothing interesting to report. I haven't taken any accutane for 2 days because my stomach was feeling not great and I just wanted to give myself a mini break. I just had the feeling that I wanted to. I wouldn't say I am clogged up but I don't feel as good as usual. I am sure many of you are having worse side effects but yea. I should resume tomorrow.

The two actives are drying up.

I've noticed some tiny red marks- probably mini papules- coming up on both sides (3) but have been putting the custom compound (mainly antibiotic/bacterial) on them and I hope they will be ok. We will see.

Have not been as motivated to work out lately, probably a bad thing. Just not feeling as energetic as usual but then again, its probably more about my mental state than about my physical one.

:|

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Hey babe!

Sorry you're feeling so nauseous. How long have you been on BC? My first three months on BC I was puking at least a few times a week. And then the ENTIRE time I was on BC after that (7 years) I was nauseous all the time unless I had something to snack on. I now have a copper IUD which I'm in love with. Some people's bodies just can't handle BC-- mine was one of them. My intuition tells me it's your BC, but obviously I don't know for sure b/c I'm not your doc. ;)

Are you sexually active? If not, I honestly might stop taking the BC and see if it gets better. If you are in a committed relationship, I'd recommend looking into the Mirena IUD (with hormones-- but WAY less than BC) or the Paragard copper IUD (that's the one I have--no hormones). They are covered by insurance or Planned Parenthood. The Mirena lasts 5 years and the Paragard lasts 10. I see you're in Canada, so I'm sure your system works way differently than ours... which is probably a good thing in that case. ;) If you're in the middle-- sexually active but not committed-- birth control or abstinence is your best option while on Accutane. :( Neither are that attractive of options!

Update me and let me know what you decide! xoxo

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DAY 69

Hi everyone, been over a week since I wrote.

Nothing interesting has happened. The same two actives are still there (I thought they would be) but they are better. I had a brief whitehead but it resolves quickly enough.

Other than that, I am looking pretty clear. Still, I am cautious.

That's all my news, I suppose its pretty good!

I don't have many new side effects- I am a bit lazy but I can't necessarily blame that on the accutane.

Lips have been particularly dry but I can deal!

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DAY 76

So, I am going for my blood work tomorrow and really am hoping my liver is doing ok. My elevation was significant from baseline but not high enough for my doc to feel that i must be urgently taken off. So hopefully I will be ok enough to be able to finish my course. I have lowered my dosage to an average of about 40 a day so maybe that will make a difference.

Skin: No much different. Its amazing how long the pimples I do have are taking to heal. I hate acne (don't we all?). No new ones since these two nodules I got a few weeks ago, which are still there but are pretty small. The neomedrol is great in that it has prevented them from being super red so when it does fade i don't think the mark will be as significant as it otherwise may have been. Also, there may be less potential for scarring because the inflammation was reduced.

I just really wish i could use retinoids and aha's regularly to start to try to improve my skin. I do think I could tolerate it actually: I am responding pretty well to the accutane. (My liver, not so much). I don't know if topicals are a problem if you can handle them on accutane. I don't want to risk it but I admit I have used them maybe once a week. Probably silly and without use. Oh well

Lips have been dry, I should really bring my aquaphor everywhere. Skin looks a big dry but nothing significant. Still no major side effects.

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day 80

Things are going OK skin wise, BUT I did wakeup with an ACTIVE this morning. It is small and is on my forehead near the hairline- not somewhere I often get pimples.

I am not too worried about this one, I think it will go away shortly. Or at least I really hope it does.

otherwise, my skin looks pretty damn good.

hoping red marks and other leftovers will fade soon!

Edited by inuk

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DAY 81

Blood work was better!

I feel up and down about the active I have on my forehead. Sometimes I feel like "FU**! This is not working!!!" other times I realize that small zits every few weeks are not a big deal. It looks pretty red but its not very big when you feel it so hopefully it will be gone in a few days!

I have been slathering it with neomedrol, maybe that will at least remove the redness.

I look forward to seeing how things go over the next month.

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Day 107

well, things are looking pretty damn good.

I did have a mild flare about two weeks ago, when I got one annoying pustule and another tiny, short lasting one.

Also, I STILLLLLLLLLLLL have a tiny bump left from the large nodule I got over a month ago. It seems like anything I get on my cheeks sticks around for a very, very very long time. Its very minor though and its not too bad.

Other than that, I am clear!

My red marks are still hanging out, and it looks like I have some minor scarring, though not too bad. It is my hope that within a few months of tazorac 0.1% gel my skin will be acceptably resurfaced.

Thats my update, I am pretty happy-

Also, I should note, I have reduced my dosage a bit and am taking an average of 40 mg/day vs. the 60 I was taking before.

I did this to try to reduce the strain on my liver and to possibly prevent worse side effects. I have not had any significant ones so I feel good about the decision. I will still aim to take a cumulative dose of 120/mg/kg so yeah.

I think its really interesting that several ppl have mentioned pain in their heels

how many of you are having that?

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