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This has been a really up and down year for me. While pregnant my previously non existant acne (had a breakout or two over the years but overall very nice skin) got worse, and worse and worse. After my baby was born it just exploded (not sure if from stress or hormones)- cysts, nodules (really hard lumps along my jaw/neck and two on my chin) and then just war all over my face. I finally went to see a dr and she pleaded that I go on doxycycline to get it under control which meant I had to stop breastfeeding. I'm on my 4th week of that but when I saw another derm and she said while it's looking a lot better, the only approved drug for nodulocystic acne is accutane and that I was a really good candidate. I have been researching the crap out of it for 3 weeks and while I did get started on ipledge (would go on it Nov 19th) I'm terrified of what it's going to do to my face. Will these nodules get bigger? My first derm shrugged off the possibility of an initial breakout - you must be joking. My second derm said they could put me on prednisone for the first two weeks to keep it under control but what will that really do? It's gotta come out right? They (he and the nurse practitioner both said since I'm responding so well to the doxy for the rest of my acne that I will probably only get better. I find this really hard to believe and that they are being nice to not scare me. These nodules are just really hard lumps, some so far deep into my skin you can't even see them I can just feel them. I've never had this before and they scare the crap out of me. My first derm said they're really just inflammation and will die down? Or are they going to become humongous masses on my face while the accutane does it's "magic"? You can see my face from my previous posts, it doesn't look much better now but a lot of it is just PIH at least on my chin. But the nodules have been there for 10 weeks now.

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Not everyone gets an initial breakout. I'd say there's a 50 - 60% chance based on what I've read. Your acne may just as well start improving right away. You never know. Either way, if you don't get put on a really low dose, your acne might even be gone after only a month :)

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I have been trying to find information on it but I really think those that do not suffer from the IB don't have severe acne. With deep cysts, would they just go down or get pushed out? I wish I could find more info on this!

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It's not like cysts have anywhere to go but up... lol but AFAIK it depends because some people get lots of whiteheads, some people get lots of cysts, and others get a mix. IMO there's no telling whether you'll get an IB or what kind of IB it would be if you did get it. I've heard of people with severe cystic acne getting only whiteheads and vice versa.

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It seems like I can't even find anyone with my type of acne on here :( I just wish I could see a log where someone had to deal with this, its mostly people with moderate acne. The psychological effects of this have been devastating, I feel like this isn't even my body...

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I hate what acne has done to me, too.... Recently it got so bad that it was all I could think about. And I hated going out. I wanted to hide from people. I just started a course of Accutane and I already feel better about my face, being in public, and everything. I don't know why, but I already feel a lot more confident even though it's only been a couple days :S I guess it's because I *know* it'll go away this time. My acne's different from yours. I have LOTS of red marks but no cysts at the moment. Just whiteheads / inflamed whiteheads. But I also have acne in my hair, esp. on the back and sides, on my chest, on my back, and I often get zits in my ears.

Try the blogs: http://www.acne.org/...ndex.php/blogs/

Edited by inndem

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Hi, first off, i am soooo sorry that you are going through this. When i first took accuane years ago i had moderate acne that was literally ALL over - cysts on chin/jaw area.

The IB wasn't as devastating as i had imagined it to be.

Either way, if you are going to take accutane, you need to come to peace with 2 things

1 whether or not you have an IB is going to be determined by your body so try not to stress over what you don't have control over

2 accutane may or may not be a cure all, especially if your acne is hormonal. I tell people this as i have been on this drug 3 times and i still have acne.

You may want to try SPIRO or birth control first and in conjunction with that, look at the holistic boards. I decided to give accutane a go again (currently on my 3rd course) after a year and a few months of trying dietary changes, holistic practitioners, supplements and an all natural routine.

Will my acne come back after this? Very likely but i have to take it one step at a time

Good Luck

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Hey Sasch - we talked a month ago when I first realized this wasn't going away. I am on spiro, but my derm said my acne is too severe and that the only approved treatment is accutane - which startled me but I've never even seen acne like this before. I thought I had acne fulminans or conglobata for a while because the cysts are getting so big. My cheek drained for weeks before I finally got on antibiotics which has thankfully calmed it down but I'm going to scar which has never happened to me before. I am back on bcp (same one as before pregnancy since I was clear then, not yaz though). Every derm I've seen told me I need to be on accutane so I feel like this wont end unless I do. I heard if it comes back it shouldnt be as severe - I really hope so.

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Hey Sasch - we talked a month ago when I first realized this wasn't going away. I am on spiro, but my derm said my acne is too severe and that the only approved treatment is accutane - which startled me but I've never even seen acne like this before. I thought I had acne fulminans or conglobata for a while because the cysts are getting so big. My cheek drained for weeks before I finally got on antibiotics which has thankfully calmed it down but I'm going to scar which has never happened to me before. I am back on bcp (same one as before pregnancy since I was clear then, not yaz though). Every derm I've seen told me I need to be on accutane so I feel like this wont end unless I do. I heard if it comes back it shouldnt be as severe - I really hope so.

Things will work out. Accutane is rough in the beginning but it can seriously give you your life and skin back. If you have tried other things then accutane really is a viable option. I do encourage you though to look into dietary changes for your health at least.

Good Luck and know you are not alone.

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I was so scared too and it's good that you are concerned about what you are putting in to your body. A lot of people don't care, as long as they have clear skin! I researched accutane for years and flat out refused it even though it was recommended to me at least 5 times and I was told I was making a huge mistake by not taking it.

If your acne is as bad as you think it is I would not worry about an IB. I feel like most who are worried about an IB are the people who have persistent mild acne where an IB would be very noticeable. My derm told me usually the more severe the acne the less likely you are to get an IB, but it's all luck of the draw really. Everyone responds different to this drug and you won't know till you try. You have to ask yourself, can I live a quality life with my skin being the way it is now? I finally reached that point in my life where I could not go another day waking up slathering pounds of makeup on my face and being insecure every time I wanted to go swimming camping sleeping over at someone's house. Not to mention just holding eye contact with people became difficult because I was obsessing over my skin.

So I've tried to stay positive since my course started... I'm on day 22 or 23 and so far so good. Most people have their IB by now and I did not have one. I had one day that I had 3 pimple come up but since then everything has been fine.

Weigh your pros and cons. If to you it's not worth the risk don't do it. If you feel like this is really affecting your quality of life I would strongly consider it.

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It absolutely is affecting my life, I'm actually scared of my skin now. I can't even go to the grocery store because I'm sure people think I have a disease. I'm supposed to go to work next week to show off the baby for halloween and I am freaking out. I'm actually thinking of going as a zombie so that my lesions will look like makeup haha! I was put on anti anxiety meds this week and it has helped tremendously, I'm reading logs and trying to keep some humor about just how bad this is going to get, but that there is a light at the end of this horrible tunnel. I'm also going to consult an endocrinologist at the end of this, to see if maybe I had masked symptoms of PCOS, or if I'm just highly sensitive to androgens. Many things happened during this pregnancy that were related to elevated testosterone which is kinda weird. I'm trying to to keep a positive attitude that this was just an extreme outbreak and that I can go back to normal one day.

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I'm not sure if the accutane will help your situation or make it worse, but I can comment on Prednizone. I have mild acne that has responded to NOTHING. It's on my face, chest and back. Again, not severe, just extremely pesky and persistent. Before my wedding I tried everything. Nothing changed it. My derm put me on prednizone about a week before my wedding and my skin has never looked so flawless. I had the kind of skin I have always dreamed about. So maybe that will help with the initial breakout - if you were even to get one.

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