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matureacne

10 years on....second course of accutane

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Hi all. I'm new to this board, although not new to acne. A little bit about me: I suffered from cystic acne from about age 16 to age 27, during which time I was prescribed anti-androgens, birth control, antibiotics, topicals like differin and clindatech etc etc. Nothing worked until I was put on accutane for 6 months. My side effects were manageable and the drug gave me flawless, perfect skin for almost 10 years!! I was so happy :) Anyway, over the last year or so my skin has become oily again and the cysts have come back. Now that I'm older (I'm 37 now) the scarring is worse, so I found myself back at the derm today and she has prescribed accutane again.

I wonder if there are others around here who are older like me and who had such a long remission? How was your second course of accutane? I would consider my acne to be quite moderate and really all I get is cysts, almost never any regular pimples. My derm talked about putting me on a lower dose for a longer period, but she seemed to think that this might result in the cysts coming back once I go off the accutane. Whereas, a stronger dose over a shorter period might result in a longer or permanent remission. Any thoughts on this?

I have lurked here for many years, and only now feel as if I'm "qualified" to post! hehehe I would appreciate any advice/experiences/thoughts!

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Im sorry to hear about the acne making a return especially after such a long period of time and aww bless you for fainting im sure you'lll get better with the blood tests. Im sure this course will be easy going considering you reacted well to it the first time but maybe someone else whos done a second course be more helpful. Good luck. :D

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Guest tofupup

I'm almost exactly like you-- I had regualr teenage acne, then I had hormonal crap acne in my late 20s, at which point I took my first round of accutane. My skin was perfect for about 8 or 9 years and then I started getting cysts, so I started using proactiv, but that only helped for so long. By the time you're in your mid-late 30s acne sucks even more because your scars don't heal as well, if ever. So I went for round 2 in my late 30s.

I don't know if long vs. short term would be better or what; all i know is that the 2nd time around I took it for about 6 (or 7?) months, at 40 mg/day. I think the last month the derm decreased my dose to 30 mg/day (I alternated days of taking one 20 mg pill one day and 2 pills the next).

The most notable thing about taking accutane in my late 30s vs. 20s is that since my skin has aged, I feel it was harder on my skin. For instance, my skin became so paper-thin that I couldn't excerise at all becuase any friction whatsoever (like of the sports bra) caused horrible blisters. Also, I swear that it made my wrinkles deeper (even though it's supposed to the do the opposite), but I could very well be imagining it because I'm just generally obsessed about wrinkles anyway and regret deeply not wearing sunblock in my 20s.

I asked me derm about the wrinkle thing and he said it only looked that way because my skin was drier, and it would return to normal soon. He said that in only one case did he see accutane make a woman's face more wrinkly forever, but she was like in her 50s and past menopause so it was to be expected(?)

Well, it's been over a year and my wrinkles look the same to me, even though I'm using Retin-A. I dunno. I can't tell if it was worth it because I honestly don't know if the wrinkles are all in my head of what. Oh, and it also messed w/ my period the 2nd time around and made me panick that I was having early menopause.

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matureacne....you are not alone! I am 35 (female) and just started Amnesteem this week. My first course was in 2001 when I was in my late 20's. After my first course, I was clear for years. I just started slowly breaking out more and more last year and it got progressively worse. I tried antibiotics and Retin A but it just wasn't working. The first time I took Accutane I took 80 mg right off the bat and stayed at 80 for the full 5 months. This time my Derm started me at 40 mg and says she thinks a lower dose for a longer period of time will be more beneficial. She also won't start anyone at 80 mg though. After reading many posts, I think the dosage depends on the doctor. My Derm thinks I will be successful this time around (for good). Mostly due to my age. I'm praying she's right!!

Any way, keep us posted on your progress.

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Hey, thanks so much for your supportive comments!

tofupup, I'm a little worried about your report of increased wrinkles!! I don't look my age anyway (which I'm happy about), and I'm in no hurry to catch up :rolleyes: Perhaps it is just that your skin is drier? I know that when my skin is dry, it can look aged. Has anyone close to you commented on this? I know that sometimes we can be our own worst critics and perhaps no one else thinks you look more wrinkly?

srod, how are your side effects this time? The same? Worse? Better than before? Interesting about the dosage. My derm was quite keen on low doses for longer periods in her more mature patients. I'm not keen on doing this drug for a long time and just want to get it over and done with. Anyway, my prescription will come next week and then I'll be starting on 20mg per day for the first couple of weeks.

I think I will start to blog this, as I do find other people's experiences very helpful! It is nice to know that there are other people out there like me (although I wouldn't wish this on anyone!!).

Btw, I have a huge painful cyst on my forehead right now :( Just thought I'd share that...

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hey sorry this is kind of offtopic, but did you have to go on any maintenance topicals or something after your first accutane course? Something like retina, for those 10yrs you were clear? I finished accutane a week ago, and my derm said I dont need to apply anything. 10yrs remission would be good lol, though obviously permanent better.

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Hi brandish. No, I did not need to do anything for those years. I had the most perfect skin, no blackheads even! I just moisturized as normal and never even had to wear makeup. Honestly, total strangers would comment on how lovely my skin was :redface: It was an EXCELLENT 10 years! I hope I'll get that again.

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