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26M - First Time On Accutane - Mild Persistent Acne

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Hey all,

I've been lurking around these forums for a while and decided to start my own log. For the benefit of others and for myself so I can have a journal of my experience, which I think is important, because one day I may be feeling awful about my skin and look back and say hey it was much worse before we started this regimen.

I've struggled throughout my high school years and early into college with some pretty persistent acne. Then it pretty much went away in my early 20's. Then at 24 I got pneumonia and maybe it something in my body was changing, but at that point my acne started coming back and was probably worse than when I had it in my teenage years. During school I didn't care about it as much, but now for it to appear while I'm an adult and working an office job, it became unbearably embarrassing. I would get pimples pretty much every other day, and they would leave red marks long after the pimples went away. At this point, I resorted to finding some makeup solutions to provide a temporary solution to my shame. I discovered tinted moisturizer; specifically I discovered Bobbi Brown's oil-free tinted moisturizer. It was a god-send, because otherwise I don't know how I could have endured going to work every day with a red inflamed face. But this did not solve my underlying issue of persistent acne.

So for about a year I tried everything under the sun to get rid of my problem, from antibiotics, Stridex, Tazorac, different daily washes, etc. At the end I'll say that tetracycline (antibiotic), Stridex (the red box, which my derm recommended I stopped in favor of Tazorac), and Neutrogena Oil Free Acne Wash (Salicylic Acid 2%) helped the most. However, I'd still get about a large new pimple every 2-3 days, after following the regimen for about 2-3 months.

I'd been contemplating taking Accutane for almost half a year now, but I decided if I was going to take it I'd do it near the end of winter, because of the common side-effect of dryness while on the drug. So I finally bit the bullet and asked my derm to put me on the drug. He has started me on 40mg a day and I received from the pharmacy the Amnesteem (Isotretinoin Capsules) variety of the drug.

The day I started Isotret also had an appointment with the dermatologist office's local esthetician for a facial with extractions. I've seen her a couple of times in the past, and became comfortable with her seeing my naked face because she had seen my condition with many other patients at the office.

Days 1-4

I mention the facial, because it was also the first day I took Isotret. Normally after facials you develop a few new pimples during the following two-three days. As expected I developed these new pimples and as expected they went away after two days. What I didn't expect was for my face to be pimple free for the first time in a long time by the 4th day on Isotret. I don't attribute my existing acne to going away to Isotret, this early in the program, but I do attribute Isotret from preventing new acne from developing.

I did get a terrible headache the morning after I took my first pill. I took an aspirin and it went away. I will speak with my derm whether taking aspirin or similar drugs should be taken while on Isotret.

I should also mention that from the beginning I've moisturized my face with Cerave PM Facial Moisturizing Lotion after each wash, and put on top of it, when I go out, the Bobbi Brown Oil-Free Tinted Moisturizer (I'll probably switch to the non-Oil-Free one soon, as the Oil-Free one can be pretty drying. Hopefully I can stop using tinted moisturizer as soon as the redness goes away). And I wash my face with the Neutrogena Oil Free Acne Wash (which I may also have to switch to a gentler wash if my skin starts to dry out too much). For the lips I've been using Aquaphor Healing Ointment - Advanced Therapy. I've stopped all other products since I've started Isotret.

Day 5

Received my first nose bleed since started the program. I don't remember the last time I even had one. It wasn't bad, and luckily my nose didn't start bleeding until after I washed my face in the morning and before I got dressed.

Today I also developed my first pimple, since I've started Isotret on my cheek. It's fairly big.

Days 6-7

Still no other side-effects. I have noticed that after washing my face if I don't put moisturizer on my face, it will start to tighten up and feel dry. This is why I've been moisturizing my face and lips from the start, to prevent my skin to get too dry and start flaking. That being said, the dryness feels very very mild.

The large pimple I have on my cheek doesn't seem to be going away and also doesn't want to pop (no puss showing, just all under the skin). I've resorted to using this product, Rite Aid first aid blister care (http://shop.riteaid.com/Rite-Aid-Blister-Care/dp/B005006LAI#.Uy9A5YW0tzU) which is a cheaper alternative to those Nexcare Acne Patches. I've used this in the past - basically you place them on a pimple that is about to pop, or even post-pop, so that the patch will suck up all the puss, or remaining puss, and the spot will heal faster. What I was trying to accomplish with this pimple, was getting the puss out and prevent it from sitting there for a week or two, as I've read that this happens to some people while on Isotret. It seems to be working as the patch turns white when puss gets sucked out, and the pimple is getting smaller. It definitely cannot be popped so I'll continue to use these patches, unless I develop other pimples that are very stubborn. At which point I'll probably have them injected with cortisone.

I also developed some weird bumps on my skin, around my jaw, on Day 7. They were also fairly large, but they didn't hurt at the touch and weren't red or inflammed.

Day 8

Those weird bumps disappeared in the morning. So weird. Maybe Isotret is working its magic.

Nothing else new to report. Should also mention that since starting this program I've been drinking much more water and tea than I normally do to try and prevent any side effects as long as possible. And I've been taking my pill during dinner.

Edited by ct210
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Days 9 and 10

Nothing else new to report. Defintely feeling the effects of dryness on my lips now. Still not bad, but when I open wide the sides of my lips hurt, due to the dryness and what I assume are cracks on the sides.

On day 10, the big pimple finally opened up and I'm expecting it to go away soon. Other than that, I have one new small pimple on my cheek on the same side. So far so good! Hope it stays like this the rest of the way, though I'm sure I'll start developing more dryness on my face and lips by the end of the week.

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Day 12

Developed this weird rash on top of both my hands yesterday. Little small red bumps all over, covering about 1/3 of the top side on both hands. I've had dry skin there before, taking anti biotics, but this is the first time I've experienced a rash like this. I've been moisturizing them, and I'll see what happens. If it doesn't subside soon, I'll have to bump up my monthly derm visit.

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Day 14

Got two new pimples yesterday, one by my sideburns and one on my forehead. They're not large and looks like they'll probably go away in a day or so. Total of new pimples since starting isotret = 3. So far so good.

Did a little research on the rash that developed on my hands. Looks like it's eczema caused by the isotret. Bought some Aveeno Eczema Moisturizer and it seems to be working, at least they are not as red and itchy as they were the day before.

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Day 18

The Aveeno Eczema Moisturizer looks like it definitely helped. The rash went away after three to four days of use, and my hands are 95% percent back to normal.

So far so good. At this point the only side effect that is affecting me is the dry lips. I aways have to be in hands reach of Aquaphor. I lick my lips often and drinking anything causes my lips to get dry and start to throb after 10+ minutes. Every three-four days the sides of my lips hurt, but I apply Aquaphor liberally on those spots throughout the day and then are fine the next morning. Aquaphor is a must people. I tried applying regular chapstick the other day when I didn't have Aquaphor on hand and it gave me little to no relief.

I'm really happy that since I started this program I have had only one pimple on my cheeks. Whenever I got pimples in the past, the cheek/nose area were always the most embarrassing. I have been breaking out a bit more lately, specifally around the jaw area, where I was having issues before I started Isotret. The breakouts aren't bad, as I only have two active ones right now

Next week I'll have my blood draw and then a follow-up. I'm not so sure I want to up my dosage at this point, since I have gotten 6 new pimples since I've started, and have only had dry lips. I'll inform my derm and see what he says.

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hey! your story sounds exactly like mine including the type of acne and the age/gender we are! We are also around the same timeline for accutane. Today is day 22 for me.

I've also experienced the weird red bumps on the back of the hand which I suspect is eczema. It's nice to know that someone else has had it too. haha

Good luck and i'll be following along.

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Thanks skk3! I hope your routine is going well.

I haven't posted in a while, because of work and school, but mainly because of laziness!

So it's Day 60 now.

Derm upped me from 40mg to 60mg at the 30 day mark.

My skin has been doing very well lately. Since my last post, I've gotten maybe one or two pimples that lingered for a couple of days but that's it. Can't really complain, compared to pre-isotret when I had a new pimple every 3 days. I do get some tiny pimples on my neck but they are tolerable, they can be extracted but the redness lingers for a bit, which has always been an issue with my face except for the forehead.

As for the eczema on my hands.. yeah they're not going away permanently anytime soon. I have to make sure to moisturize them with the Aveeno oatmeal moistruzing cream in the mornings and at night, otherwise the ezcema returns with force. Once I got lazy and didnt put them moisturizer on for two days and both my hands were stinging and full of red angry eczema bumps.

Everything else seems to be going well. Lips are still dry, and Aquaphor still works like a charm.

I am noticing some more dryness around the shoulders and my hip area. Nothing bad, just gotta moisturize at night. Otherwise they just get very midly itchy.

Noticed some peeling of the face recently, but tolerable. Sometimes I may rub my chin area and I get that rope burn feel. I just have moisturizer on all the time, so dryness on my face is nothing crazy. Speaking of which, I still use Bobbi Brown SPF 15 tinted moisturizer over Cerave PM facial moisturizing. I tried switching to Bobbi Brown's SPF 30 tinted moisturizer but for whatever reason moisturizers with SPF 30+ don't mix well with my face right now. I know I should have strong SPF on, especially to avoid making the red spots darker, but my confidence is still not at the point where I can go on without the tinted moisturizer. Just gotta avoid staying in the sun!

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