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valo_123

how to avoid initial breakout

I haven't been on this site in quite some time because I'm currently ending my accutane course and haven't had a breakout since after week one on accutane.

I'm gonna make this short and sweet and if people have questions i'll do my best to answer them. So basically I've tried just about everything from accutane in the past to extreme diet restrictions and nothing has worked. I actually got off accutane when i was about 17 after 2 months because the terrible initial breakout it caused.

So fast forward (from original course) to about 7 months ago when i decided to give another shot at accutane. Basically i was terrified of getting another initial breakout, which in the past, caused scarring. My acne was pretty bad, I was so oily and flaky all the time that pores were always blocked and I always had at least 10 little pimples on my face with one or 2 decent sized ones.

Thinking back on my previous course on accutane I realized that when starting with 20 mg i had no initial breakout. I was late to my derm appt. for the second month and they made me reschedule for a month later...so i was off accutane for a month and everything came back. So to catch me up they started me at 40mg, which resulted in a bad initial breakout about 2 weeks after starting. I then stayed on it for about 3 more weeks, all the while breaking out all over the place. At this point I stopped taking it.

So with that in mind i concluded that starting at 40mg caused it and the IB could be prevented by starting at a lower dose and hopefully working my way up. BTW i'm 5'10" and 140 lbs. So I suggested this plan to my derm, who i've had since the first course and before, and she was happy to do whatever I wanted. As long as I ended up with the appropriate accumulated dose. So I started at 10mg, stayed on it for 2 months, then went up to 20mg on month 3, 30mg month 4, 40mg month 5, and I've been on 40mg since. She came to the conclusion that I'd have to be on it a few months longer, which, to avoid a huge breakout was totally worth it in my book.

Since 1 or 2 weeks after starting 10mg I've probably had 4 or 5 TINY pimples come up in all these months. They say the initial breakout is a result of the skin purging. I was scared to death i would breakout like crazy because of all the clogged pores (white bumps under the skin and blackheads) i had. I wish i would have done this a long time ago. I feel it's safer because you're not bombarding your body with crazy ass doses (60mg 80mg) in the first few months.

People might have the notion that a crazy dose is necessary to kill the oil glands. I couldn't argue that point because I'm not a chemist or a doctor. But it makes more sense to me that slowly disabling the oil glands, and for a longer amount of time, would increase the likely hood of them not turning back on. I read a few blogs on the internet awhile back of guys using very small doses (10mg the whole course) and it having a lasting affect.

Good luck

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I avoided the initial breakout by starting off with a high dose in my very first month of 80mg

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Were you using any prescription topicals when you started the accutane at 10mg???

Thanks for you inspiring story! I am glad it worked for you

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Im on day 6 of 60mg of accutane and my skin is looking great , not one single spot since day 2 and for the first time in 4 years my black heads on my nose are vanishing before my eyes =] Although of course this does not mean that I wont have an IB, ive heard lots of stuff being said about it going great untill week 3 and then BAM! Huge IB... But my derm said starting of high is the best way around avoiding an IB.

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To start people high is the normal thing derms do. The initial breakout is expected in the majority of normal accutane cases. That's not to say there won't be some exceptions. I feel my story has merit because I tried starting high (40mg was high for my weight at the time) and got a bad IB around the 2nd or 3rd week. Then I started low (10mg) and experienced no breakout, just a consistent decrease in oil and then pimples.

I was using finacea on and off before starting treatment on accutane. I don't feel that contributed to the lack of an IB. However, i would recommend using it after treatment to maintain results because it doesn't irritate the skin and diminishes red marks. Also, I exercise regularly and have a pretty good diet. My good diet has gotten worse since the results of accutane started kicking in. I still keep sweet stuff to a minimal though.

I can't say whether it has an effect or not, but I'd recommend keeping the sweets and carbs to a minimum during the expected IB period.

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To start people high is the normal thing derms do. The initial breakout is expected in the majority of normal accutane cases. That's not to say there won't be some exceptions. I feel my story has merit because I tried starting high (40mg was high for my weight at the time) and got a bad IB around the 2nd or 3rd week. Then I started low (10mg) and experienced no breakout, just a consistent decrease in oil and then pimples.

I was using finacea on and off before starting treatment on accutane. I don't feel that contributed to the lack of an IB. However, i would recommend using it after treatment to maintain results because it doesn't irritate the skin and diminishes red marks. Also, I exercise regularly and have a pretty good diet. My good diet has gotten worse since the results of accutane started kicking in. I still keep sweet stuff to a minimal though.

I can't say whether it has an effect or not, but I'd recommend keeping the sweets and carbs to a minimum during the expected IB period.

i can understand why you say the IB is normal, but you must realise for a lot of people that causes a lot of scarring e.g. redness and the pitting of the skin. increasingly dermatologists are starting people on lower doses to prevent this. getting rid of the acne is easy on accutane, its preventing the possibility of scarring, which is so much more costly to deal with.

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To start people high is the normal thing derms do. The initial breakout is expected in the majority of normal accutane cases. That's not to say there won't be some exceptions. I feel my story has merit because I tried starting high (40mg was high for my weight at the time) and got a bad IB around the 2nd or 3rd week. Then I started low (10mg) and experienced no breakout, just a consistent decrease in oil and then pimples.

I was using finacea on and off before starting treatment on accutane. I don't feel that contributed to the lack of an IB. However, i would recommend using it after treatment to maintain results because it doesn't irritate the skin and diminishes red marks. Also, I exercise regularly and have a pretty good diet. My good diet has gotten worse since the results of accutane started kicking in. I still keep sweet stuff to a minimal though.

I can't say whether it has an effect or not, but I'd recommend keeping the sweets and carbs to a minimum during the expected IB period.

i can understand why you say the IB is normal, but you must realise for a lot of people that causes a lot of scarring e.g. redness and the pitting of the skin. increasingly dermatologists are starting people on lower doses to prevent this. getting rid of the acne is easy on accutane, its preventing the possibility of scarring, which is so much more costly to deal with.

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Is there any research available that backs this assertion up (that starting on a low dosage is more beneficial/effective than starting on a high dosage)?

From the posts on this thread, it seems like people are hearing different things from their doctors.

**EDIT (to my question above)**

Have any clinical studies been conducted regarding the IB/potential scarring/overall effectiveness of accutane/rate of relapse when a low dosage vs a high dosage is used at the beginning of the treatment plan?

Edited by JHN3445

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Is there any research available that backs this assertion up (that starting on a low dosage is more beneficial/effective than starting on a high dosage)?

From the posts on this thread, it seems like people are hearing different things from their doctors.

**EDIT (to my question above)**

Have any clinical studies been conducted regarding the IB/potential scarring/overall effectiveness of accutane/rate of relapse when a low dosage vs a high dosage is used at the beginning of the treatment plan?

id say starting on the higher dose would prevent the possibility of relapse (thats my personal opinion). the idea of starting on a low dose stopping the IB and preventing scarring is based on my derm (whose been using the drug for 20 years) and the many people in the scarring forums who say the IB destroyed their lives. i know when i break out i scar (thats just me) so any possibility of preventing that is great. research is great, though understanding how your own skin works (from experience) appears to be so much more important. if you know your skin will react in a certain way, you need too obey that.

oh also :) lol sorry for the incredibly long reply. my breakouts seem to be declining a lot lately. most of which i contribute to the antibiotic gel im using with the accutane. my derm says its likely not to be helping...though i think it does. i put it on a red pimple and its not as red the next day !

Edited by cartwheeling_monkey

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To start people high is the normal thing derms do. The initial breakout is expected in the majority of normal accutane cases. That's not to say there won't be some exceptions. I feel my story has merit because I tried starting high (40mg was high for my weight at the time) and got a bad IB around the 2nd or 3rd week. Then I started low (10mg) and experienced no breakout, just a consistent decrease in oil and then pimples.

I was using finacea on and off before starting treatment on accutane. I don't feel that contributed to the lack of an IB. However, i would recommend using it after treatment to maintain results because it doesn't irritate the skin and diminishes red marks. Also, I exercise regularly and have a pretty good diet. My good diet has gotten worse since the results of accutane started kicking in. I still keep sweet stuff to a minimal though.

I can't say whether it has an effect or not, but I'd recommend keeping the sweets and carbs to a minimum during the expected IB period.

i can understand why you say the IB is normal, but you must realise for a lot of people that causes a lot of scarring e.g. redness and the pitting of the skin. increasingly dermatologists are starting people on lower doses to prevent this. getting rid of the acne is easy on accutane, its preventing the possibility of scarring, which is so much more costly to deal with.

I'm not sure I follow what you're saying. Are you agreeing with me?? To restate, I got an initial breakout while starting with 40mg, this scared me greatly. I avoided an initial breakout while starting with 10mg.

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Is there any research available that backs this assertion up (that starting on a low dosage is more beneficial/effective than starting on a high dosage)?

From the posts on this thread, it seems like people are hearing different things from their doctors.

**EDIT (to my question above)**

Have any clinical studies been conducted regarding the IB/potential scarring/overall effectiveness of accutane/rate of relapse when a low dosage vs a high dosage is used at the beginning of the treatment plan?

I didn't state whether or not it was more effective in the long run. Like I said, I'm not possitive either way. As far as the derm told me, it's all about the cumulative dose.

Because I got a bad IB while starting on 40mg, and I didn't get one while starting on 10mg, I concluded that the likelihood of an IB is reduced if the initial dose is smaller.

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I'm just curious if there is some sort of trend among dermatologists to start patients on lower dosages in order to reduce the IB -- ie: the benefits of reducing the IB outweigh the benefits of starting off on a high dosage (and if this is the case, is there any research that it stems from). My derm started me on 60 mg/day. I was just starting the IB at my one month check-up, but she kept me at 60 mg for the second month as well.

Is there any research available that backs this assertion up (that starting on a low dosage is more beneficial/effective than starting on a high dosage)?

From the posts on this thread, it seems like people are hearing different things from their doctors.

**EDIT (to my question above)**

Have any clinical studies been conducted regarding the IB/potential scarring/overall effectiveness of accutane/rate of relapse when a low dosage vs a high dosage is used at the beginning of the treatment plan?

I didn't state whether or not it was more effective in the long run. Like I said, I'm not possitive either way. As far as the derm told me, it's all about the cumulative dose.

Because I got a bad IB while starting on 40mg, and I didn't get one while starting on 10mg, I concluded that the likelihood of an IB is reduced if the initial dose is smaller.

Edited by JHN3445

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