Hi all , how about , first of all I would like to introduce myself as this is my first post . I've been reading this forum a while and I have decided to register to write this post . Forgive me if my English is not very good since I'm from Spain and it is not my native language and I'm using google translate : P .

My case is the following : Currently I have 28 years and a problem of skin and hair very very oily and acne that is difficult to control , which leads me anxiety, depression , discomfort , well now you know what I mean ... I took a course with isotretinoin as 13 years ago , can not remember the dose or time, but it helped me with acne because my face was very bad and still I have enough scars. However, my oily skin problem returned and have tried all kinds of treatment without success to fix it and nothing has worked , so I have considered re-taking isotretinoin . Anyway, I thought about taking it on my own for several reasons , if I go to a dermatologist may not prescribe and think my problem is not enough to take it, or give me a low dose over x months and then return back oil (my brother has done two courses of isotretinoin and has also failed to solve the problem) .i dont want to take a standard dose of 0.5 - 1mg / kg as I think it is a dose too toxic for the body.

I have read a lot about the low doses for a long time and I think it could be an interesting solution , but I asked a couple of dermatologists and they said that you can take for a long time , even years, but at some point would have to leave , then I think ,why to do this if my oil will come back? so my idea is to take isotretinoin indefinitely until: a) it solves my problem naturally with age b ) solve my problem is due to some kind of atrophy of the sebaceous glands produced by the drug c ) appear side effects and have to leave d ) some new remedy appears less dangerous .

Well , the fact is that I started taking , first was with 2.5 mg a day a few weeks , and now I'm with 5mg per day two weeks now . With 2.5 mg daily i saw something, it had better face and less fat , but with 5mg i have perfect skin , there are still some fat but much less , it's like less dense , and acne has disappeared. The truth is that I am delighted , but I continued to look for more information on the safety of this treatment.

Well , now comes the important thing . I've been looking very much information and many cases of people and experiences , until I found this: http://www.unboundmedicine.com/washingtonmanual/ub/citation/1626958/Skeletal_hyperostosis_in_patients_receiving_chronic_very_low_dose_isotretinoin_

Basically it is a study that is to say that some patients who took 0.14 mg / kg for 3 years was observed to increase the risk of hyperostosis . At this point I thought, well, maybe I should leave because taking doses as low (in my case and 70kg weight equivalent to 10mg a day is supposed to be a low dose ) increases the risk of these effects , so this therapy may be hazardous in the long term .

But at the same time I was looking for information on hypervitaminosis as isotretinoin is a derivative of the vitamin a. I was taking a multivitamin that contains vitamin A , so I was figuring to see if I could or not continue to take it or I could produce hypervitaminosis . The most is that I saw that the side effects of isotretinoin are similar or equal to those of the hiperviaminosis a , and calculate the equivalent amounts of isotretinoin comom if I take vitamin A , and note the following : chronic hypervitaminosis a is produced by taking an amount greater than or equal to 25,000 IU of vitamin A for long periods of time ( a year or more ) . Ui 25,000 equivalent to about 7.5 mg of vitamin.

If we consider that isotretinoin is a type of vitamin A, this means taking a daily dose of 7.5mg isotretinoin + Vitamin A = chronic hypervitaminosis, which means side effects such as bony changes (hyperostosis, etc. .. ).

So I started to calculate what dose might be "safe". If we consider that the diet gives us approximately the recommended daily amount of vitamin A are 0.8 mg (2666 IU approx). If we subtract 7.5 to 0.8 = 6.7 mg. From this it follows that taking at least 6.7 mg of isotretinoin per day carries a high risk of occurrence of a chronic hypervitaminosis. The maximum amount that I think could be considered safe would be around 5mg per day (16666ui) would be 16666 +2666 = 19332ui, leaving a safety margin of about 5000ui.

In my case I have the intention to be a year taking 5mg a day and then reduce it to 20mg a week. This dose of 20mg a week I have seen repeated in pretty places, including forums I've seen in my country that at least two people have been prescribed for life by dermatologists for chronic rosacea . This dose is equivalent to 2.8 mg per day ( 9333ui ) , and I think it offers a good compromise between performance / security .

This in my case would take 13.7 mg / kg / year, so that would have to be 8.7 years to take the equivalent of 120mg/kg treatment . This dose is within the recommended doses by dr. Plewig . [removed] This study also says that this dose is probably not produce side effects.

The effects in the liver , triglycerides , etc ... with these doses as low is very unlikely to occur any dangers , especially if it is a life and a healthy diet , it is also easy to control with blood tests every few months.

I also think it would be appropriate radiographs performed at least once a year to monitor the possible negative effects on bones.

Well these are the conclusions I have reached after much research and reading, I like to know that opinais about it and if anyone can bring something more to the issue .

Thank you very much !