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Accutane And Previous Scarring - Please Advise

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Hi board,

I am really having a hard time.

I've been on accutane for about 2 months now. Starting my 3rd month. It has really helped my acne.

I started at 10mg, then went up to 20mg. Now I'm on 40mg Claravis, once per day. I am male, 36, and weigh 145 pounds.

However, I have a facial scar from a previous surgery. I've had it since 1996. I had the scar filled with Artefill in 2011, and had a lot of problems with the Artefill. The scar became a reddish/bluish/purple. I tried several lasers, such as V-beam, YAG, and Sicton Profile BBL, to treat the discoloration. Each one helped for a little while, but the discoloration would always return within 3 months. The scar was still discolored when I stared Accutane at the end of July.

After starting Accutane, the scar seemed to heal miraculously. I felt over joyed. My acne was going away, my scar was healing. I felt so optimistic. The scar became covered with white skin, like a white scab almost, or a white film of healing, flaky skin. It looked like the scar was finally healing itself, covering itself with new healthy skin. The skin was very flaky. It had an "alligator" texture, looking like a lot of tiny squares of skin, but the skin was hanging on securely. I hoped that the skin would all come together, the little pieces would join, and it would be a solid new layer of skin. Parts of the scab looked like a solid, continuous sheet of skin, and I was very hopeful that the rest of the flakes would join together too.

I scratched some of the scab/flaky skin off a month or so ago, and felt very bad. I got some advice from this forum not to do that, and I made a commitment not to scratch any skin off. And I have been very good about that. I haven't scratched it at all since that one time, and was really proud of myself. However, over time, the skin over the scar flaked off on its own. I felt that was ok, at least I was letting it heal on its own. The area under the flaky skin would be red at first, then become more white, more normal colored. Last night, the last of the scab/flaky skin over the scar fell off. I still had a lot of the scar covered by this scab/flaky skin, and it all flaked off last night, so I am very scared now. The last of the scab is off, and I feel the scar has now lost its "protection".

I am terrified now. Most of the scar is much improved, white in color. But the area that just flaked off is still pinkish.

What really terrrifies me is that there is MORE scar tissue than there was before, and this scar tissue has no facial hair in it, leaving me with a large area only on one side of my chin that has no hair, which looks asymmetric and odd. The scar seems to have actually grown, almost expanding, growing into new areas. I don't know how to explain this without coming off as paranoid or kooky, but I swear there is actually more scare tissue than there was before. It isn't just that the scar has widened. it seems like areas of normal skin, adjacent to the scar, have somehow turned into scar tissue. Because hair doesn't grow in scar tissue, I've always had a small area where there was no hair growing because of my scar. However, because there scar seems to have grown, there is now a pretty large, noticeable area without any hair, on just one side of my chin. This looks very bad, and I feel sick to my stomach. I feel queasy.

Part of me wonders if the scar was always in a state of suspended healing, and once the accutane stopped the acne and the seborrheic dermatitis...all that inflammation stopped....that the scar was allowed to heal, and a much larger area than I thought was actually scar tissue.

But the other part of me sees it another, scarier way. I have seen areas of red swelling form around the scar, then the redness and swelling goes down, and the next day, instead of a red swollen bit of skin, there is a white scarred area with no hair. That is how the scar 'expanded'. I would notice areas right next to the scar that were red and swollen. I put hydrocortisone on them, and the next day the redness and swelling was gone, but in its place was dead white scar tissue with no hair growing in it.

I don't know what to think. I am scared to mention this to the dermatologist, because I do not want to stop Accutane. I feel caught between two unbearable options. The acne I had was making me extremely depressed, and nothing worked for me but Accutane. Once the Accutane starting working, I felt so happy. On the other hand, watching my facial scar seemingly grow before my very eyes, and watching my facial hair fall out in a very obvious way, is almost as bad.

I am really hoping someone has read this far, and knows what I'm talking about.

Has anyone else experienced anything similar with facial scars, where they form a "film" of skin over them, then the film falls off? Or did your scar "spread" forming new scar tissue around it?

I apologize for how long this email is, but I'm very scared and alone. I don't have any family support or anyone to talk to about this. My dermatologist is very nice, and is very pro Accutane, and for that, I really like them. But they didn't do the Artefill injections into the scar, and I haven't even pointed it out to them in the past, because I was just focusing on Accutane. I'm afraid to point it out to them now, because I don't want to give them a reason to stop Accutane. I'm really hoping to get some advice from someone on this forum who has experienced what I have. Hopefully everything turned out ok in the end. I just need to get some hope that it will be ok, because right now I feel very hopeless and scared, and don't have anyone to talk to about this.

thank you so much to anyone who has read this

joe

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