So, I started Accutane on 2014 december 4th.

My dosage is 30mg/day so far (my weight is 68 kg, and I'm 178 cm). The brand I take is Inerta (not sure if it's sold outside of Hungary, but I don't think there's a big difference between brands.)
I will do skin updates weekly.

Week 1

So a week has passed. I was so scared of Accutane, I thought that all the side effects were going to happen to me. But as far, basically I feel nothing special, but I don't know if this is a good thing or not. Maybe the dosage is too low for me, but I have to wait 3 more weeks to go back to the dermatologist.

I don't feel like I'm as dry as I thought, I had one day when my lips got really chapped but it's back to normal. They feel like they were exfoliated too much, if you know that feeling, but not chapped right now. I'm using Neutrogena Norwegian Formula chap stick.

My face is a bit less oily, but not sure about that either. I have a few new breakouts escpecially on my chin, and I have more breakouts on the side which was the better side:( The other side is pretty good now. I'm not sure if this is the initial breakout stage, if it is, I'm glad because I don't have golf ball sized cysts and stuff like that. And if this is the initial breakout, I hope it lasts only a week or two, and after that it will start clearing up. But the breakouts could be from stress, or eating bad. I don't know..

I try to moisturize my skin well (I use Bioderma Atoderma Nutritive right now), because my fear is that I would get new scars from Accutane, and I really don't want that. I read a few say Accutane helps scars, but others say it actually gives new scars. I hope it will help me a little. My dermatologist said that it won't cause new scars, but that's all:(.

I took pictures in the morning, but my scars and redness are less noticeable in the morning. So maybe I should take pictures in the evening, for a more realistic image of my skin. My face is actually worse than it seems in the pictures, more red:(.
You can see the breakout on my chin and cheeks:(.

(Pictures in my gallery)

Week 2

So my initial breakout is happening. It's pretty ugly, maybe not the worst acne I've ever experienced, but still it's bad. It has started around day 10, and is still happening.
If someone would like to illustrate all types of acne on one face... well mine would be a very good example. All of the blackheads on my nose are bigger, and feel like they are coming out. I have whiteheads mostly on my chin, like 10 of them, and I have some whiteheads on my forehead, close to the hairline, where I never had acne before. I have 3 cysts on every cheek, and they are painful, and the biggest cyst is close to my nose, where I normally don't get acne.

As for side effects:

I'm not super dry, actually I think my face is like normal now, not too oily and not too dry. My body is not dry at all. Some of the pimples (whiteheads on my chin) are starting to dry though, so maybe dryness is coming (and the end of my ugly initial breakout too:)).
Although I don't feel dry, putting on makeup is pretty hard, first of all because of the crazy amount of pimples, and second of all I'm so scared of dryness that I moisturize like crazy, and maybe too much... so my makeup is slipping, and feels gross. And my skin is peeling a little bit, and you can see the small flakes better when I have makeup on. Maybe I'm using the wrong moisturizer, I wish I had the confidence to go out without makeup:(.
I'm waiting for my order to come, Missha Perfect Cover BB cream, which is pretty moisturizing and has SPF42 in it, so I think it would be a pretty good foundation while I'm on Accutane, and it covers nicely.
My lips are dry, but not bleeding, just normal 'chapped lips dry' when I don't use chap stick every couple of hours. I had very minor nosebleeds like 3 times last week. I wear contacts and I can definitely feel my eyes are getting dry quicker. Luckily I don't have any other side-effects yet: no joint pain, no tiredness, no depression or mood swings, no headaches.

I'm still wondering if the dose is too low for me, because people talk about crazy dryness, and I don't have that, and my dose is 30 mg/day although I weight like 68 kg (150 pounds) so this is not even half of my weight in kilograms. I know it sounds stupid but I'm scared of the Accutane not working enough because of this. I'm glad I don't have crazy dryness yet, don't get me wrong, but that's at least a sign that it does something.

And I'm not sure about my dermatologist either, because she said that she doesn't believe in cumulative doses, she usually stops the treatment when the acne is gone. And she doesn't believe in monthly blood works either, and she didn't ask anything... Not even how much I weight, did somebody had depression in the family, do I take any other pills, what I use for birth control, nothing. I know the iPledge in the US is a pain in the ass for some people, and you definitely have to wait longer for the first prescription, but at least they have to monitor your health properly while you're on the drug. Over here it's taken too lightly I think. I might switch to a new dermatologist soon, because I don't trust this one. All of the information I have about the drug is from my own research, she didn't tell me anything. And I want the full cumulative dose because I don't want to risk my acne coming back. I know even if you take the cumulative dose you have a chance to get acne again, but I would feel saver if I'm taking the full dose.

(pictures in my gallery)

Week 3

Still taking 30mg/day

Another week has passed, and it feels like time went by a bit quicker this week. My initial breakout is still there, but maybe a bit better. It's strange, some days I feel like it's improving, but other days I want to cry, and see no improvement at all. This day is a "better" day, so I'm optimistic.
My blackheads are still bigger, and I have blackheads where I've never seen them before (like the top of my nose). But they are not as bumpy when I touch them. And I was sooo stupid, because I picked at some, and now my nose is bright red and raw:( Not touching my face again while I'm on this drug.
As for cyst and whiteheads, luckily the deep cyst on my cheeks went away, and currently I don't have a cyst!.But it left a red scar, and I couldn't tell if it's indented yet:(. I dind't touch that at all, but it did hurt when i washed my face, and when I slept on that side. I'm hoping that it won't scar:(. The whiteheads are still coming and going, they appear so fast, but go away pretty quick too. They are mainly on my chin and the bottom of the cheeks, but I have a pimple where I haven't had a zit, NOTHING in my 26 years . My temple. It's not that bad, but it's strange that Accutane causes this.

Side Effects:

• Dryness - it's not that bad yet, I can live with it, no cracking or anything crazy
• Dandruff - never had it in my life, but It's not noticeable after I washed my hair
• Eczema - I have it on my left hand, had it before Accutane but It's getting worse
• Bloody nose - not bleeding, but have blood in it
• Headaches - I had one headache in my 21 days on the drug, so might not be from Accutane
• Body pains, joint pain - Yesterday my body felt stiff, nothing too bad though
• Crazy dreams - since I'm taking the drug I dream a lot, and a lot of crazy stuff
• Tiredness, depression - I felt a bit tired, but again, not sure if it's from the drug. And I was ill too. As for depression and mood swings, well, I don't think the pill is causing it, but the acne does. When I went Christmas shopping one day, I went to try on some clothes too. And I can't describe how much I hate dressing room lighting. When I left home I was a bit more happy about my face as usual, but when I saw my face in the dressing room, I felt like a monster. Not just the acne, but the scars were sooo noticeable in that light:(. Sometimes I am really depressed about my scarring, this stuff I have to live with, and sometimes I feel like I can't. I had nice skin until I turned 23. I know that this is only a superficial thing, and there are much worse things in life than acne and acne scars. And I know it is shallow to always think about your apperance but I can't help it, I do, since I have this problem. The first thing I do in the morning, is checking my face, and that's the last thing I do... And I constantly worry about my skin, what do other people think of it, and I spent most of my free time reading forums, searching for acne stuff. It Is my life now, sadly.
  Sometimes I think that this stuff happened to me for a reason, like it's teaching me that your life isn't about your looks, and you have to accept yourself. But it's so hard, and I feel like I'm alone in this, who has acne at 26? Normally nobody. At least nobody I know

Sorry for being so negative, but I think everybody can relate to this in these forums. And people who doesn't have acne can't understand what it does to our LIFE not just skin.

So I'm definitely not in the clearing phase yet, and I don't even know if I've left the initial breakout behind, or it's gonna be much worse after this week, because as I've read most of the people get their IB in the third or fourth week..
But I made an "experiment", because I felt like my skin is not that dry at all, at least not as dry as other people describe their dryness. I did moisturize very well before, so I was curious If I am dry at all, if I don't do that. I didn't moisturize my face or my lips for a couple of nights. And In the morning, my face wasn't dry, at least not "Accutane dry"...And my lips were a bit bad but one layer of chap stick did the trick. So I'm still thinking about the dose is too low, or the drug's not working well for me. But at the same time, I'm scared of upping my dose, because that might lead to another (and potencially worse) IB. I'll see my derm at 5th of January, so we'll see.

I'm taking some supplements while I'm on the drug, because these might help with the side effects

What I'm taking:

• Vitamin E - good for hydration and healing
• Vitamic C - good for healing and immune system
• Omega 3-6-9 Oil - helps absorb vitamins like A, D, E, K

Other than this, I'm trying to drink a lot of water.

So this is my skin at week 3

Hi Naomiskin

Just wanted to let you know that I can SO relate to your feelings about acne - it really can take over a person's life. I feel exactly like you. My skin is literally the first thing I think about when I wake up and the last before i fall asleep. It is exhausting. And I HATE dressing room lighting as well!

I am on my second course of accutane and doing a low dose (20mg/day) this time around because I had every single side effect in the book during my last course (40mg/day), and pretty severely too. Oh, and I am 25 years old and weigh around 50 kg.

Think it's a bit worrying that your dermatologist doesn't check your liver function or pregnancy tests at all? I live in Denmark, and here we don't have Ipledge either, but have to come in for monthly blood tests. Maybe you should at least consider doing a home pregnancy test once in a while just to be on the safe side?

Hi GreatDane!

Thanks for reading my log and good luck on your journey, I hope this time you will be clear for good, and don't have to worry about acne any more:)

I think what my derm does (or doesn't) is worrying too, but I'm not concerned about getting pregnant. I'm on birth control pills, and I don't have a boyfriend and I'm not planning to date till I finish this:). But I'll find a better doctor (I have to go to this one for the next check up tho), because the lack of monthly blood tests is a bit scary for me.

As for updates my skin is doing a bit better, I really hope that this is the end of the IB *fingers crossed*, well I have one new cyst and a few whiteheads, but compared to 15 whiteheads only one side of my chin (yes, I counted:D) it's better. It's getting a bit drier, so I guess that's a good sign?

Glad you are doing well

Also think you are doing the right thing by looking for a new derm - at least to get a second opinion.

I am crossing my fingers that this time accutane will work for good, but right now my skin's progress seems to have stagnated - I was pretty dry for something like a month, but now my skin is "normal" in terms of oiliness (I still get a few pimples) - maybe it has adapted to the dose..? So I'm considering raising my dose to 30 mg/day as well, but will give it a few more days before I decide.

Hoping this will be the end of your IB too - think the dryness is a good sign

GreatDane - When where you on Accutane before, and how long did it work for you? I heard that the cumulative dose is important if you want remission. Did you reach it the first time you were on Accutane? And I also read that higher dosage is a better option if you can handle it, so I'll ask for 40mg/day, and see how I can handle it. Maybe you should try the 30 mg on every other day first?

Hi GreatDane!

 

Thanks for reading my log and good luck on your journey, I hope this time you will be clear for good, and don't have to worry about acne any more:)

 

I think what my derm does (or doesn't) is worrying too, but I'm not concerned about getting pregnant. I'm on birth control pills, and I don't have a boyfriend and I'm not planning to date till I finish this:). But I'll find a better doctor (I have to go to this one for the next check up tho), because the lack of monthly blood tests is a bit scary for me.

 

As for updates my skin is doing a bit better, I really hope that this is the end of the IB *fingers crossed*, well I have one new cyst and a few whiteheads, but compared to 15 whiteheads only one side of my chin (yes, I counted:D) it's better. It's getting a bit drier, so I guess that's a good sign?

My first month, I had 40mg & had the blood test before I took my first pill. For month 2, I had my blood test before I came in & was upped to 50mg for month 2 and 3. I did not have a blood test for month 3--my derm allowed me to take both months. I'm on month 4 now, and still on 50mg. Again, I only had a blood test before my appointment. I have 50mg for month 5 as well, and do not require a blood test for month 5. Trust in your derm : ) If your body is reacting fine to the accutane, I think that is why they delay the monthly blood tests. If your liver enzymes were elevated or anything, you would probably have monthly blood tests, or if your dose was a lot higher. That is just my 2 cents!

I was on Accutane a year ago for about 5 months - think it was 20 mg/day for the first month or 2 and then 40 mg/day for the remaining 3 or 4 months, so don't know what my exact cumulative dose was..

I was clear for something like 4-5 months after finishing the first course and then things slowly started to worsen again. There are so many opinions and studies on the importance of cumulative dose - some say it matters, some that it doesn't. Some swear to low dose, some to high. Its a jungle. For me, the low dose is good right now, because of less side effects (last time on 40 mg was horrible!), but I'm getting really impatient, which is why I'm considering increasing my dose.

 

Hi GreatDane!

 

Thanks for reading my log and good luck on your journey, I hope this time you will be clear for good, and don't have to worry about acne any more:)

 

I think what my derm does (or doesn't) is worrying too, but I'm not concerned about getting pregnant. I'm on birth control pills, and I don't have a boyfriend and I'm not planning to date till I finish this:). But I'll find a better doctor (I have to go to this one for the next check up tho), because the lack of monthly blood tests is a bit scary for me.

 

As for updates my skin is doing a bit better, I really hope that this is the end of the IB *fingers crossed*, well I have one new cyst and a few whiteheads, but compared to 15 whiteheads only one side of my chin (yes, I counted:D) it's better. It's getting a bit drier, so I guess that's a good sign?

My first month, I had 40mg & had the blood test before I took my first pill. For month 2, I had my blood test before I came in & was upped to 50mg for month 2 and 3. I did not have a blood test for month 3--my derm allowed me to take both months. I'm on month 4 now, and still on 50mg. Again, I only had a blood test before my appointment. I have 50mg for month 5 as well, and do not require a blood test for month 5. Trust in your derm : ) If your body is reacting fine to the accutane, I think that is why they delay the monthly blood tests. If your liver enzymes were elevated or anything, you would probably have monthly blood tests, or if your dose was a lot higher. That is just my 2 cents!

But how do you know (or how do they know) if your liver enzymes are elevated if they don't do the test? I'm still a bit worried about this.

I was on Accutane a year ago for about 5 months - think it was 20 mg/day for the first month or 2 and then 40 mg/day for the remaining 3 or 4 months, so don't know what my exact cumulative dose was..

I was clear for something like 4-5 months after finishing the first course and then things slowly started to worsen again. There are so many opinions and studies on the importance of cumulative dose - some say it matters, some that it doesn't. Some swear to low dose, some to high. Its a jungle. For me, the low dose is good right now, because of less side effects (last time on 40 mg was horrible!), but I'm getting really impatient, which is why I'm considering increasing my dose.

And did your acne came back as severe as it was before you took Accutane the first time?

I know they say a lot of things about Accutane, and some things are just confusing and seem contradictory (like taking the drug with a high fat meal helps absorption, but you should avoid high fat meals because of the triglycerides and stuff...), and who knows what they will find out next time. And everybody is reacting differently, I know:(. But I am getting impatient too, I know it's been only one month for me (well not even a full month) but It's frustrating, and even if it works, you can worry about the acne coming back, like it's a never ending story full of stress:(.

I feel the same way, thinking about a higher dose, but I'm too afraid it will cause a flare up. So maybe I'm good with 30 mg.

A little update for today - Day 25