Hi everyone,
After lots of lurking, I figured it's time to introduce myself and start my own log. As my user name suggests, I am SO done with having acne. At 26 years old, I've now officially spent half of my life battling acne, and have seen something like 10 different dermatologists over the years, tried basically every Rx med on the market (and spent the equivalent of a down payment on a house on all those copays, plus all of the other over-the-counter solutions I've tried!)
My acne has always been classified as "mild to moderate," at times bordering on moderate/severe, and at a few (glorious, wonderful, heavenly) times, in complete remission. The story of my skin seems to be that something works for anywhere from 3 months to a year, and then quits on me. Apart from a brief, horrific stint with birth control pills, I've never had cystic acne - and for that I count my blessings.
Most recently, I was on a regime of Spiro (50mg), Duac (derms kept prescribing that, no matter how many times I told them it was worthless), and a now-discontinued sulfur cream at night. With that my acne was reduced to mild - maybe 4-6 active pimples on a given day - but then I moved abroad and no longer had access to Spiro, and my skin exploded. Until I started Accutane two weeks ago, my skin was a complete grease pit - I would seriously have to use 3 of those Clean and Clear oil blotter things at a time (and would soak them through - ewwwww) to get the oil off my face. Plus, I was breaking out like crazy - new postules every day, and a new outbreak of forehead acne, which I've never had before.
After two dermatologists refused to prescribe Spiro because it's "just not used for acne here" (I'm in Europe), I finally went to a terrific derm who a) was willing to prescribe Spiro but b) took a look at my face and the list of meds I've tried, and immediately suggested a low dose of Accutane.
So, here's the plan, according to that derm:
I will take 10mg a day for anywhere from 1 - 4 months. From then on, my dose will be reduced at regular intervals: first 10mg every other day, then 2 times a week, then once a week. They said it will likely take 6 months, and seemed certain that this would clear me once and for all.
I just took my 14th pill today. The first week was great - my skin actually improved, noticeably. Fewer new pimples and the old ones seemed to be healing. As of a few days ago, my skin is acting weird: basically, all of my pores suddenly look clogged, although they haven't developed into whiteheads of postules. When I squeeze the pores (this is gross, sorry), sebum comes out, and judging by how it looks, it seems like these are old clogs. I'm wondering if this could be the Accutane bringing all of this to the surface? If this is my IB, I'll take it, but I don't think I'll get away so easy.
On side effects, so far I've not really felt anything. Had a headache the first two days but then it went away, and had chapped lips one day. Otherwise I feel totally normal, even my lips no longer feel chapped. I've noticed that the oil is finally starting to dry up - today when I used a blotting sheet, I only soaked through half of one. Now that's progress.
Anyway, would be curious to hear if anyone is doing a similar regime, or if anyone has a hypothesis about all these weird clogged pores. It's not such a big deal, just makes the texture of my skin look quite odd. Also, should I squeeze these guys or let them be?
Ok, enough for now. Will post updates when I can! (But no pictures - way too shy for that!)
Day 16
Quick update for those who might be interested: this weird raised pore/mini whitehead phenomenon continues, and it does seem to be some kind of strange IB - it's like every place where I might have had a pimple in the next few months is now pushing the clog out. Luckily these spots aren't turning into real pimples, but the texture of my skin has never looked stranger!
I have been pushing the gunk out of those pores, but I no longer think that's a good idea - today when I tried, my skin reacted a lot (turned very raised and bumpy, which is quite unusual for it). Seems that my skin is already much more sensitive, and as much as I'm tempted to push the gunk out of those spots, I worry I may now be doing more harm than good. Will try not to touch my face and if the spots resolve without turning into pimples, then I'll stick with the hands-off approach.
Otherwise I am now experiencing slightly chapped lips (in the corner) and slightly dryer skin on my arms. Otherwise no side effects. My skin, because of the texture problem and some healing spots/marks, isn't looking very good at the moment, but it could be worse.
Ok, not sure if anyone is interested in my updates, but nonetheless here is the latest:
Day 20
Skin: Slight improvement, but overall not looking so great. Still a bunch of little bumps everywhere (IB?) and the old spots/red marks are definitely taking longer to heal. Good news is that there are no major new pimples. The other good news is that my oil production has probably been reduced by 85% at this point. I barely even need to use powder on my face anymore, which is frankly unbelievable! My skin is flaky wherever spots are healing, so that doesn't look too great. The skin is definitely more sensitive now too - whenever I unclog one of those small little clogged pores (which I do much less often now), it leaves a red mark from irritation for about an hour thereafter. This is definitely Accutane-related.
I purchased Avocado Oil and am considering using that as a moisturizer (I've heard good things), but I'm hesitant to start something new. Anyone have experience with this?
Side Effects: Nothing big. Lips are a bit dry but no longer chapped, and otherwise I feel very really thirsty all the time, so am drinking more water than usual.
Day 23
Skin: Still have lots of those clogged pores/small whitehead things from before, but I'm not getting new ones and I actually realized today that I haven't been getting any new pimples basically since I started Accutane (with a few exceptions). I continue to extract the clogs from those pores which is gross and makes my skin look crazy right after I do it, but everything is usually mostly normal by the next day or two, and my skin is a lot less bumpy when I do these extractions. Since I no longer seem to be getting many new of those clogs, I'm wondering if this might be the start of my clearing? Or maybe this is the calm before the storm, because I feel like I am getting off SO easy thus far with Accutane (no real IB yet, no serious side effects).
Otherwise my skin looks ok right now - you can see some red marks from the extractions which are easily covered with makeup and fade in a day or two, and I do have some old pimples which just will NOT go away (for whatever reason, my pimples just take ages to go away now that I'm on Accutane). My oil is now 5% of what is once was and I'm LOVING that. Still, need a full face of makeup before I go out, and am looking forward to the day when that's no longer necessary.
Side Effects:
Basically none, just slightly dry lips and am thirstier than usual.
Day 28
Not sure if anyone is following this blog, but I really benefitted from reading other blogs before starting, so hopefully this helps someone else too!
Went to the dermatologist today for my 1-month check-up - can't believe how quickly time is going by! We agreed that my skin seems to be responding well to Accutane, and he's keeping me on 10mg/day for another 2 months (the nice thing about being on Accutane in Germany, where I am, is that there aren't quite as many roadblocks to getting the pills, and I was able to get 2 months worth at once).
He didn't mention anything about reducing the dose, but perhaps we'll drop it down once I finish 3 months at 10mg/day. Not sure, but also not complaining - this is working really well for me so far.
Skin: Doing a lot better. I continue to extract those clogged pores which actually seems to be working quite well. Fewer and fewer new clogs are developing, and I haven't had a real pimple in some time now, which is actually a miracle given how frequently I was breaking out prior to Accutane. This is the least broken out my skin has been in a long time, certainly since moving to Germany/going off spiro, and I'm no longer oily, which is also amazing. The one problem is that wherever I extract a pore, the skin gets dry and flaky (almost peels off), but I'm hoping that once my skin is finally clear, I won't experience this dryness anymore because I won't be doing extractions anymore. I'm considering getting a facial (has anyone done this on Accutane??) to have the pores professionally extracted, but I'm not sure if this is a good idea. Also considering using the avocado oil I bought as a moisturizer, but am afraid it will break me out. If anyone has used it, please let me know!
Side Effects: Also fine - perhaps because my dose is so low? My lips are slightly dry but nothing extreme, and I'm much thirstier now than I used to be (I drink a lot more water, which is probably good for me anyway). That's it. I've been super lucky so far, and am only hoping that this good luck continues.
Hope everyone else is faring ok!
Day 38
Safe to say that I am loving Accutane, and that I've been exceptionally lucky with my experience. Still on 10mg and evidently everything was fine with my bloodwork, so will stay on this dose through the end of February (at least).
Skin: My skin is looking really good. I continue to extract pores and am somewhat amazed at how much gunk there was in my skin, but I'm rarely getting new clogs now and very, very rarely get any pimples. It is worth mentioning that few very old pimples are still sort of there (these ones are seriously from 6 weeks ago - how can they still be there?!) as tiny tiny little shriveled bumps, but only I can see them when I get up close to the mirror so it doesn't bother me, I just don't know why they're not getting away. The other thing is that the blackheads on my nose refuse to go away. Any ideas as to why? On a more positive note, though, my skin is no longer oily at all and also not unbearably dry. So overall, my skin looks great - definitely the best it's looked in a LONG time - getting to the point where I can be seen without makeup, which is something I've been able to do only a handful of times in the past few years.
Side Effects: Also very lucky here. My lips get dry but nothing crazy, and I've had what feels like a rash on the back of my neck (I feel tiny bumps and it itches), although when my boyfriend looked, he said there wasn't anything there. But otherwise that's it. For those who are interested, I did very, very cautiously get a bit of body waxing done today and my skin reacted just fine - it hurt a tiny bit more than usual but I didn't have any other adverse reaction. Still, I wouldn't risk doing it on my face.
hey thanks so much for this log! just read it for the first time today and it's so helpful!! I saw a dermatologist today. It was a private appointment, as on NHS (UK) it is so hard to get (I got it once before after pleading and they were so reluctant even though they agreed my skin was a mess). It helped a bit that time, but they made me stop after three months and everything returned to crap. Anyway, after 2 years of antibiotics, topicals and random drugs I have purchased off the internet, I am starting low dose Accutane on Monday. I am too afraid to get my hopes up and although your blog did give me hope, I quickly bashed it and told it to be quiet because acne has destroyed me since the age of 11. Many thanks for your log, I'll continue to read it with interest. Good luck with everything
Hi! Just found your blog - it'll be interesting to see how the low dose treats you, seems to be treating you pretty well as of now! I'm on 40mg/day for now, will probably bump up to 60mg/day next month, and I'm logging my progress. I, too, am SO DONE WITH ACNE! Best of luck in your course & keep updating frequently! 
Day 52
Well unfortunately I've had my first real setback on Accutane 
It's not a huge deal, but for some reason I got a breakout on the lower part of my right check / near my mouth last week that consisted of a few pimples. I did accidentally miss one dose of Accutane last weekend and then went out to a very smokey club that night (and didn't sleep much that whole weekend) which could have contributed, but it's hard to say. I also wonder if it could be caused by the Neosporin I put on a dry healing mark in that area? I think Neosporin ointment might cause me to break out, actually. Or it could just be a normal breakout and I've been lucky so far -- again, really hard to say.
In any case, the pimples are basically gone so I'm just left with some red marks in that area but they do require a nice coat of concealer to hide 'em. Just a bit frustrating to have this happen RIGHT before Christmas/the holidays after the past few weeks have been so good!
I continue to get a fair number of clogged pores which I find strange, but from today on I'm no longer going to extract them - mark my word. If they don't improve, I'll talk to my derm about it in January. Otherwise all is fine, skin is very dry wherever I picked/extracted which is why I'm no longer going to do this -- the marginal benefit of getting the gunk out doesn't seem worth the red, flakey spots that follow.
I did also try avocado oil on my face last night -- it seems to have really helped with the dryness/flakiness, so I might continue to use it at nights.
Hope everyone else is doing well!
Hey! I'm also on a fairly low dose of accutane also (20 mg/day) and I'm on day 48 (i think) so we're basically on the same journey!
That's so weird you had a breakout on your right lower right cheek by your mouth. Thats EXACTLY where I have been breaking out! Its the only place on my face where I get bigger pimples. I have tons of those clogged pores as well. They never get inflamed but they are small bumps that you can see and have gunk in them. I attempted using a blackhead extractor on a few and it just ripped the skin off of them so I was left with nasty red and raw spots on my face! Needless to say I am not going to pick at those anymore. If you talk to your derm and find out a way to treat them, let me know!
Good luck and I'll keep up with your posts!
Hi youngforever (and everyone else) -- sorry for the slow reply! Yeah, it's weird how my spots cluster, and how the location of the cluster changes. Never really understood that. How are you doing on your course?
Time for an update:
Day 71 (I think):
Skin: Doing pretty well. That breakout cleared up, although it did last over the holidays. You guys might appreciate this: I travelled to my boyfriend's family's house for Christmas, but somehow managed to forget my concealer. I NEVER forget my concealer, and of course I also had that nasty breakout. Making matters worse, all stores were closed here in Germany for 2 days, so I couldn't easily buy a replacement. I figured I'd borrow some of the makeup from my bf's mom, but her skin is probably 8 shades darker than mine. I ended up using some of her dark makeup and basically trying to blend it with my light powder so that I didn't look like a total alien. Didn't work so well -- I ended up looking like I was wearing a makeup mask, or maybe like a modern oompa loompa! But better than the no-makeup alternative given the breakouts! Sigh.
But since then, things have improved - skin is pretty much clear, however I still regularly get clogged pores, and the blackheads on my nose are as bad as ever. My old pimples also seem to linger forever. I'm seeing my derm next week and am going to ask him about this. I'm beginning to think I may actually need a higher dose (20 mg) to knock out these clogs? Any advice?
Side Effects: The skin on my body (especially legs) feels dry and a bit itchy, but moisturizer takes care of that. Otherwise no real side effects.
Hope everyone is doing well!
I think the higher the dose you have, the faster everything progresses overall, at least that seems to be the trend based on what I'm reading. So, maybe the clogs etc will take longer to come out because you're on such a low dose.
Traditionally and from what I've read, your daily dosage depends on your weight (it's supposed to be 0.5mg - 1mg per kg so if you weigh 50kgs your dosage should be anywhere from 25mg - 50mgs/day). Also, I've read that the "remission" (so to speak) of your acne is dependent on cumulative dose (should be 120mg per kg, so if you weigh 50kgs, the total amount of accutane taken throughout your course should be 6,000mgs).
Sounds like you're on a non-traditional dosage, so depending on the severity of your acne, you could be fine or you might need to be on it for longer than average (usually it's between 4-6 months depending on dose tolerance). Again, that's up to you and your derm.
Hey! My treatment is going pretty well. I am on day 65..I had to skip a few days to wait for my blood results to get back and my appointment was on a friday so that was an extra 2 more days I had to wait. This whole iPledge/blood-drawing system is so frustrating!!
Anyways...my derm bumped me up to 30mg a day and I have to say it helps SO much with getting those little tiny clogged pores up and OUT. There was the biggest and deepest blackhead on my forehead that had been there for a month. It wasn't raised like a pimple but it was definitely a visible black dot smack dab in the middle of my forehead (pretty!) It finally popped out today and let me tell you it was probably the most satisfying thing ever haha! My nose is looking a lot better too, most of the blackheads are just coming out on their own. I did have 2 little pimples pop up..probably due to the dosage increase, but they aren't big or anything compared to what they would get like before accutane. Both of which are in the same exact area as before, bottom right cheek! So annoying.
I am so sorry to hear about your forgotten make-up!! Trust me...I have had that same panic attack before. I actually left my make-up at home when I went back to college one time and I had to run to CVS to buy whatever I could find at that moment so I wouldn't be seen without make-up. Its the worst feeling having to rely on it that much, but soon enough we can go make-up free! I would definitely talk to your dermatologist about upping your dose. It will help speed along the process of everything. 20mg is not bad at all...once I was moved to 30mg I've noticed my skin is much drier and flaky. When I was on 20mg, the dryness was very manageable so you should be fine!
Sorry for the novel, but good luck!
