Hi all.

Ive bee suffering from mild-severe acnes around my chin and neck for about 5 years.

Tried many different things like BP retinoid tetracycline and had enough with them...

So i went to see the derm and finally got the 1month perscription (40mg).

I was aware of common side effects but i wasnt quite aware of initial breakout which seems like the worst side effect of all.

Todays only my second day so im not noticing any difference yet but it seems like the most people are experiencing this and now im scared the s**tless.

i know i have to endure whats neccessary but im not sure if i can bear the thought of getting my entire face covered with acnes for months.

I donno if i should quit before entering into the point of no return...any tip or advise would be great...

 

Acne flare-ups have been documented in taking Isotretinoin, but it's very rare, happening in less than 1 in 10,000 cases and it depends how much you're taking and the other medications you're on. However, the possibility of simple coincidence can't be excluded as not all pimples are "born" at the same time.

Acne treatment does take time, especially for severe acne. Isotretinoin is the most effective drug available for severe acne and in the long run can prevent extensive and difficult to treat scarring. If you're still concerned about an "initial breakout", talk with your dermatologist to see if she or he will prescribe steroids or other topicals with your regimen.

Thank you for the information.

But that 1/10000 sounds more like 1/2 in this forums haha.

Well no pain no gain i guess...

You're welcome!

40 mg is the average dose for a medium-sized person; the worse side effects and the higher chance of a flare up would happen with a 150 mg/kg dosage. You can look at some dosing information here: http://www.skintherapyletter.com/toolbox/ad/accutane/dosing.html . Of course, you could ask your dermatologist to knock it down to 10 mg if you're that concerned about side effects.

Yes, it kind of does sound like the acne-flare up is more common in these forums. But it's easy to confuse correlation = causation and acne is after all a cyclical disease. For severe and resistant acne, keep in mind Isotretinoin is the best treatment and remission happens in about 70% to 80% from a single course.

Well the truth is that he actually prescribed me 60mg (40mg+10mg+10mg pills)

but I've been only taking 40mg pill after doing some research that 60 is considered high for start up

I'm guessing he gave me the amount based on my weight (130lbs)

but people who have nearly the same severity as me seem to start with 20mg or 40mg at the most.

I should talk to the dermatologist but I may just continue with 10mg.

Well the truth is that he actually prescribed me 60mg (40mg+10mg+10mg pills)

but I've been only taking 40mg pill after doing some research that 60 is considered high for start up

I'm guessing he gave me the amount based on my weight (130lbs)

but people who have nearly the same severity as me seem to start with 20mg or 40mg at the most.

I should talk to the dermatologist but I may just continue with 10mg.

 

i'd trust your derm before making assumptions form here. im sure a quick phone call would put your mind at ease

Well the truth is that he actually prescribed me 60mg (40mg+10mg+10mg pills)

but I've been only taking 40mg pill after doing some research that 60 is considered high for start up

I'm guessing he gave me the amount based on my weight (130lbs)

but people who have nearly the same severity as me seem to start with 20mg or 40mg at the most.

I should talk to the dermatologist but I may just continue with 10mg.

 

i'd trust your derm before making assumptions form here. im sure a quick phone call would put your mind at ease

 

I agree with this. You should speak to your dermatologist about the dose.

I do however completely understand how you are feeling, I know I spoke to my derm in great detail before starting and made her well aware I had concerns about taking this medication, she started me on 20mg, i'm 5 weeks in and now on 40mg per day.

Keep at it and stay strong, I keep positive by thinking of the end result. x

Thank you all for replying and yes i guess i should talk to the dermatologist first.

Luckyme24/ how was 20mg/day ? Any intial breakout/side effect?

Well the truth is that he actually prescribed me 60mg (40mg+10mg+10mg pills)

but I've been only taking 40mg pill after doing some research that 60 is considered high for start up

I'm guessing he gave me the amount based on my weight (130lbs)

but people who have nearly the same severity as me seem to start with 20mg or 40mg at the most.

I should talk to the dermatologist but I may just continue with 10mg.

 

i'd trust your derm before making assumptions form here. im sure a quick phone call would put your mind at ease

 

Agreed. If you clicked on the Isotretinoin dosing link earlier denisj, it did say they base it on your weight. But yes, if you feel unease about the dosage, do talk to your derm!

I wouldn't worry about the dosage being too high. I am an 110 pound (50kg) female and just started 4 days ago and am taking 60mg per day. I asked my doc if this was too high and she said its based both on weight AND severity/location of acne. The normal dosage is 1mg/kg so if you weigh 130 you are about 59 kg, so 60 mg would probably be pretty standard if you have moderate to severe acne. Of course you can take up to 2mg/kg safely in the course of treatment and my doc said I'll probably get uped each month if I don't have bad side effects. I also found that people who can tolerate and use higher dosages tend to have less chance of a relapse after ending treatment. I was sooooo depressed before I started, but I've been really happy since I began since I know that in time I will FINALLY get the skin I want (29 and have been battled acne with everything under the sun for the last 15 years, from OTC stuff to Rx creams and antibiotics)!