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New & Possible Accutane Rx

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Hey everyone!

I am new to the forums (well, as a poster, I have been a secret reader for a little bit now). I just had my second follow up appointment with my dermatologist and today, she stated that I should begin Accutane.

Let me give you a little backstory...

I am 32 years old, I have had acne since I could remember (in junior high, high school, as an adult). Sometimes it is bad, other times it is tolerable. My parents never took me to a derm ever, and I just got medications to try from my primary care physician.

I have tried doxy, the erythromycin, pledgets, etc., over the course of many, many years. Nothing ever really worked. Still acne prone now wth lots of scarring.

I initially went to the derm about a skin rash I had, but decided to speak with her about my acne.

As I have gotten older, my acne is primarily located around my chinline & neck. It's an awful and embarassing place to have it.

She gave me some Sulfur/Emu wash to use, followed by a Rx for Ziana, and then Keflex to take twice daily.

At first everything was working like a charm, I wasn't getting any new breakouts, just really oily skin in the AM when I woke up.

Last week, my skin took a turn for the worse. My neck, mainly on my right side of my face is awful. Huge, painful acne popped up. I have had it bad, but NEVER like this. I avoid the mirrors, camera phones, everything. I am really having a hard time with this right now emotionally.

(I guess I will have to post a picture to show the current state of my skin, which terrifies me greatly).

I am embarassed so much right now it isn't even funny. I am avoiding my husband like the plague because it is tearing me apart.

So, I saw the derm for my initial appointment on 8/18. I had a follow up today, 9/15, and I spoke about my problems with the recent, painful breakout. She immediately recommended Accutane.

Now, I have done a ton of reading and such, and everyone pretty much says that you should stay on Ziana for about 3 months or so and then go from there if it is not working. I mean, after a month, is the suggestion of going on Accutane really a valid one? Should I get a second opinion? Should I stick with the Ziana for longer and then take the new antibiotics she prescribed and go from there? (I am going from Keflex to Bactrim).

I am just at a loss. I have noticed some slight improvement in my cheerk area in regard to scarring, but my initial thoughts were that this chin thing was just a IB.

I'm hoping for a little guidance & light that you guys can shed on the situation.

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Hi and Welcome! It is not unusual to clear and breakout more later. Especially with a retinoid, you have to give it 3 months of everyday use to really judge if it is working for you. I would suggest give it 2 more months since you are a month in before trying accutane which is not a walk in the park or a cure all. I also think diet changes are the easiest thing you can do so why not give it a go for those 2 months (dairy and gluten free - essentially paleo. If at the end of 3 months there is not consistent improvement, by all means try accutane.

I too have suffered with acne since a teen and I am 31 so i feel your pain - still struggling actually but i just wanted you to know you're not alone.

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Thanks for responding and for your suggestions. I have started taking the Bactrim and we stopped the Sulfur/Emu face wash. I am now just washing my face with room temperature water, patting dry, then using my Ziana.

Maybe it was Bactrim, wishful thinking, or something else, but the chin breakout that has been awful and is still awful, did lessen in severity a little bit. It still is making me uberly self-conscious, but I put my hair up for the first time in about a week and went out in public like that. (I just used my 1.5 year old to block my face).

I am going to stick with the Ziana for the next two months and see what happens. I am trying to eat clean. I lift weights and I am looking to gain some muscle. I don't really indulge in a lot of diary and gluten really (I stick to some basic meal prep, not changing things up too much). I am also a water-holic. I try to down at least a gallon of water per day.

I hate feeling this way though. Now that I have lost a little weight, I want to feel complete and not be as self-conscious about my face.

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