My skin journey has been for a lack of better words...a journey.
Throughout my teen years, I never had acne on my face. I did struggle with a bit of back acne when I was 16-17 however, I live in a pretty cold climate so it was easily covered up for about 75% of the year. Once I hit 18, I went on tricyclen-lo (BC) to keep it under control and it cleared up immediately.
About a year later, I decided to get off BC but luckily there was no flare-ups with the acne. My doctor prescribed Retin-A to get rid of the scarring which worked great. I was able to wear the sundresses and tanktops (for the 2 weeks of summer we get) that I never got to wear when I was younger.
Fast forward to about 24, I noticed that I started getting more and more pimples around my time of month. They were these large huge cysts all over my cheeks that were painful and throbbed for days and days.
Slowly, these pimples then started popping up everyday, in addition to these small black head like bumps all over my chin and forehead. I visited my dermatologist and she prescribed tactuo, a really strong benzoyl peroxide cream. This worked for drying out the large cysts, but I still had the bumps all a long my chin. The tactuo worked for a week or two, even though I felt my skin was literally peeling off. After the second week, my skin went NUTS. Overnight I had about 10 new cysts, and the rest of my skin was raw and red. Needless to say, I didn't go to school for about 3 days until I could get it under control. Turns out, I somehow managed to develop an allergy to Benzoyl Peroxide. So that wasn't going to be a suitable treatment. Back to the dermatologist.
She did a bunch of labs, ultrasounds, even x-rays. To check all my hormones, thyroid, liver, kidney, ovaries etc.
Everything came back okay and the dermatologist was having difficulties determining the reason for my random on-set adult acne. She put me on tazorac cream for the time-being to keep my flare-ups down. I also went on a pretty extreme diet, no wheat products, no gluten, no dairy, no sugar, no caffeine. I literally just ate fruits and vegetables and chicken/steak for every meal. The tazorac was also making my face peel like none other. I went to a wedding, and I remember going to the bathroom and looking in the mirror and my entire cheeks and chin had white flakey skin hanging off. It was disgusting. My skin wasn't getting any better and it was just this red flakey mess. The diet was clearly not helping either. I stayed on this regime for 12 weeks, since it takes a while for the tazorac to start working. While it stopped most of my large cysts, I was still getting blackheads that felt like they were burrowed under my skin (See Photo). The tazorac was sort of helping but not entirely. So we changed it up a bit, I started taking apple cider vinegar mixed with water daily to see if that would help at all. I also started taking vitamin A and vitamin D daily (10,000 IUD's of each). Another 12 weeks of this + tazorac + the diet, and absolutely no change. My confidence was so down, I rarely went to class or out on the weekends with my friends. I hated how every morning was such a struggle because the state of my skin would ultimately determine how my day was going to go, or if I was even going to get out of bed. When I did go out, I had to pile on foundation, concealer, powder etc. and have to consistently check my face to make sure I wasn't peeling or my makeup had melted off. It became exhausting. I even had a few girlfriends from childhood say to me: "Poor you, you always had such amazing skin in highschool, we were all so jealous. I guess you got hit by the acne train late"
Much against my wishes after the new year, I decided to go on a low-dose regime of Epuris (Canadian version of accutane). I was given 10 mg/day and was told to keep using the tazorac as a spot treatment. In addition to the Epuris, I am taking:
-A Iron Supplement
-Vitamin B12
-Vitamin D (10,000 IUDs)
-Probiotics
Week 1:
The first week of the Epuris was alright, I did find that my lips were a bit more dry than usual. I live in Alberta, Canada in quite a dry city, so I am used to Carmex everyday. I also found that I had no appetite anymore. I felt full after small meals and would actually feel sick if I ate more. I was extremely lethargic, I usually bounce out of bed. However after the first few days I just felt absolutely exhausted even though I had slept 8+ hours. However, the worst side effect, was the bloating. I am so unbelievably bloated all the time. To a point where I would look as if I am 6 months pregnant. It's terrible, none of my jeans seem to fit. I felt like a huge cow, even with leggings on, it still looked like I was pregnant. I went to see my derm after the first week, and she recommended an Iron supplement, Vitamin B12 and Probitiocs to offset some of these side effects. I didn't notice any peeling or dryness of my skin. However, I've been using tazorac regularly for about 8 months now, which dries out the skin. So I think my skin may have just been used to it.
Week 2:
The probiotics and the iron seemed to help with some of the symptoms. However, I do find myself tired still. I definitely have to drink coffee every morning just to wake me up. I also have been suffering from headaches. I found drinking a lot of water has helped to keep the under control. But I do find myself reaching for advil a lot more than I am used too. I am still very bloated, the probiotics have helped. I am not constipated, and I am going to the bathroom quite regularly. However, I am still very bloated. Which is starting to get extremely frustrating, seeing as I have a closet full of clothes that I barely fit into now. My lips are somewhat dry, but nothing to be concerned about. My skin however has cleared up, it's insane how fast this stuff seems to work. My blackheads have mostly come to the surface, and are easily extracted just by using my fingernails to scrape them. I also have this glow to my skin, that I haven't had in a year. It's also finally baby soft (where there are no bumps). I can get by with a tinted moisturizer and concealer, something that I haven't been able to do in over a year. I have found that my skin is drier than usual. When I get out of the shower it is so tight that the first thing I have to do is load up on lotion. It isn't peeling, however it is definitely "tight". It doesn't seem like I have purged at all, however I think this is due to the tazorac. There has been no change to my scarring yet. I still have very dark purple scarring all over my cheeks. Hopefully this will fade over time. Besides the excessive bloating, all the side effects are bearable.
Week 3:
I think I may be purging. It is nothing excessive, but I do have a bunch of new blackheads that seem to appear each night. They do however come to the surface and are easily extracted 1-2 days later. The one other side effect is redness. My skin is very very red now. Which has gotten hard to cover. I have olive skin, so the red really seems to be showing through. I am still so bloated all the time, I almost think it is getting worse. It's getting really frustrating to deal with. I feel like I've gained 200 pounds in the span of 3 weeks. I'm going to try taking my probiotics on an empty stomach and see if that helps at all. I am experiencing pretty dry eyes too now, I wear contact lenses and have never really had to use eye drops. But I find myself relying on them a lot more to keep the burning feeling away. It's insane to think that such a low dose has so many side effects! I can't imagine what a 70 mg/day dose would do to me!
Product Used:
1. Cetaphil Moisturizer - HOLY GRAIL - This stuff will save your skin. If you find you have flaky bits on your face, don't use an exfoliating brush. Put a little bit of this on a cotton pad and rub it over the parts that are dry. It will get rid of the "flake" and also provide extra moisture. This is a MUST HAVE.
2. La Roche Posay Effaclar Face Wash - For Sensitive Acne Skin, not scented and works really well. I find that the cetaphil cleanser doesn't really cleanse my skin and I need something that will help get my makeup off.
3. Clarisonic with Acne Brush - I know that it's suggested that you don't use a clarisonic. I think my skin was used to the tazorac already so I've found the clarisonic doesn't irritate my skin at all. It also helps get out all the makeup from my pores.
4. Apple Cider Vinegar Toner - I mix 1 part vinegar with 2 parts filtered water, it cleanses the skin without overly drying it out
5. Clinique All About Eyes Rich - My undereyes have been drying out a bit more since using Epuris. This stuff works really well at keeping them moisturized all day
6. Clinique City Block SPF 40 Sunscreen - The Cetaphil moisturizer doesn't have an SPF, so this is vital! I find the clinique is oil free, it doesn't make you break out and is also gives you added moisture. I have the SPF 40 however it only comes in a "cream" color which leaves a bit of a cast on my skin if I don't fully blend it in. For darker skin people I would suggest the SPF 25 as it comes in a "clear" color.
7. Carmex Lip Balm - Pretty self explanatory, you can't find Aquaphor where I live. But I find this does the trick. I usually try to stick with the kind that comes in the tube. Im not a huge fan of using "dirty" fingers in the pan version.
8. Laura Mercier Tinted Moisturizer (Oil Free) - This stuff is nice and "greasy" but in a good way. They say its the oil free version for oily skin, however I find it works best with dry skin. It won't stick to the dry patches and it gives you the extra moisture you need. It has medium coverage, so you still need some concealer. Keep in mind it has SPF in it already. So you don't need to put any sunscreen on. You should never layer your SPF's!
9. Smashbox Oil Free Concealer - This stuff is also nice and greasy and won't crease and settle into dry patches. It work's great at covering my scaring. I do need to layer it a bit for the dark purple scars, however it still looks completely natural.
10. Smashbox 15 Hour Wear - Oil Free Foundation - This is amazing stuff, it makes your skin look so natural and it won't set into your dry patches. It has buildable coverage and works well over cetaphil and the city block.
So thats my journey so far, I haven't seen much online about people on low dosages. So I thought I would share. I'll keep posting and hopefully get some photos up as well.
Hi aiadia
I am also a 25 year old woman on a low dose of 20 mg/day. Oh, and I also live in a cold climate (Scandinavia).
Just wanted to let you know that I can really relate to your situation. Not just because of similar age/dose/location, but the frustration with your skin taking over your life and controlling how your day is going to be. Hang in there!
I am currently on month 3 of my second course of Accutane and so far so good 
Hi aiadia
I am also a 25 year old woman on a low dose of 20 mg/day. Oh, and I also live in a cold climate (Scandinavia).
Just wanted to let you know that I can really relate to your situation. Not just because of similar age/dose/location, but the frustration with your skin taking over your life and controlling how your day is going to be. Hang in there!
I am currently on month 3 of my second course of Accutane and so far so good
Hi GreatDane,
Thanks for your kind words I'm so happy that there are people that can relate.
I am also super sorry that you have to deal with it at the same time!
Really happy to hear that the accutane is going well, it gives me hope that in a few months I can hopefully have acne free skin!
Week 3.5 - Week 4: This week has been the hardest for sure. I purged pretty badly for about 2 days, huge red cysts with yellow heads all over my cheeks and jawline. I was silly and popped them...bad idea. They turned into huge red scabs after that and are still healing.
The side effects are getting worse, my skin is a lot more irritated and dry. It isn't flaking or anything, but it is very very tight. My eyes are also burning like crazy, I need to carry around eye drops everywhere and I've found it difficult to wear my contacts. People keep asking me if I am okay, since they are so red and watery. Looks as if I've been up crying all night. The skin on my body is also extremely dry I have to moisturize every night or else I will start flaking. I've been trying to drink 4-6 L of water throughout the day, this seems to be helping a bit. My lips aren't too bad, they are dry. But nothing that can't be managed with some lip chap. I have lip chap and eyedrops in almost my purse, jacket pocket, night stand, bathroom, jean pocket. Pretty much...everywhere.
I still can't get over how much the side effects have escalated in just a few days. The bloating hasn't gone away, it's almost worse. I actually had to go out and buy "fat pants" a pair of jeans that is a size larger than my usual to accommodate for my huge pregnant like belly!
I've also completely lost my appetite. I will eat a small meal in the morning (2 hard boiled eggs and a banana) and I feel full for almost 8 hours. Which for me, is very bizarre. I find that Im only eating 2 very small meals a day, which I know isn't very healthy but I feel sick to my stomach if I try to eat more.
The one "positive" side effect is that its dried out my scalp. I have quite oily hair, I could go maybe a maximum of 3 days without washing it. But I was constantly using dry shampoo to make it look presentable. Now I can easily go 4-5 days (doing some pretty sweaty workouts too) without washing it. This is probably the only positive that I can think of.
I can definitely tell that my skin is clearing up, even the scaring is turning from a dark brown/purple to red. I had a lot of "holes" (enlarged pores) and black heads that were so deep down into my pores that no extraction tool could get out. Most of them have disappeared and are disappearing. It's such a nice feeling to finally see some sort of improvement in my skin after such a short time. Especially since I had essentially lost all hope.
However, the side effects are really killing me here. I have my blood work next week, and appointment to get my refill. I hope the blood tests come back alright. My derm said depending on how fast I react, I may only have to be on a 4 month round. It seems like it's improved quite a bit, so hopefully I clear up and get off this stuff asap!
Lastly, another product that I've found that's been helping is Clinique Advance Moisture Surge Relief. It's a pink gel formula and a little goes a long way. It's great for wearing as a moisturizer under my makeup. It takes away that tight feeling, without making me super shiny. I almost prefer it to Cetaphil now as my daily moisturizer. Still trying to figure out some makeup trips or products to hide the redness!
Month 2 - Week 1: Did my lab work, and everything came back normal, and I'm on my second month of 10 mg/day. Depending on how this month goes I am going to bump up to 20 mg/day next month.
The side effects have decreased quite a bit, I've discovered the secret:
DRINK LOTS OF WATER
and I mean lots, I find that I am drinking about 6-8 L a DAY. Which in insane, I make about 100 bathroom trips but it is so worth it. It has helped immensely with the headaches, dry skin, eye dryness, etc.
It's made my lips a lot more manageable, they are still dry and are constantly split on the sides but it's bearable.
I had really bad joint pain last week, it was difficult to run which was a challenge for me. I am currently training for my third half marathon and like to run at least 30 km a week. I could barely get through a 5 km run without crying in pain because it felt like my hip joints and lower back were on fire. I started taking a really strong (1600 mcg) fish oil pill daily, the difference it's made in just a week is insane. My joints still hurt, I wake up most days with serious leg pain especially in my hips and knees. But it's made it so that I can train at least 15-20 km a week. It was so bad before that the day after my attempt at running, that it hurt to walk. I may post pone the half marathon, but it's nice to still be able to get out and run as that's my "me" time every day. Hopefully after a month of taking fish oil, I'll be back to normal.
It seems like my skin hasn't made much of an improvement in the last week or so. I think I still may be purging as I wake up every day with a new cyst. I am still using tazorac as my topical treatment, so I am sure that it must be a purge of some sort.
The scarring on my face is still absolutely terrible, I think it's really discouraging me in seeing that actual positive effects of the accutane/epuris. I know it is hard to compare, as my before picture are me with about 3 layers of foundation and concealer. I went through a phase where no makeup-free photos were allowed to be taken of me.
However, I still hate how I am still dealing with these brown marks everywhere. My derm said we will deal with them in 4-6 months when my course is done, but it's still so discouraging. I hate having to wear so much makeup! Luckily instead of having to wear 2-3 layers now, I can get away with 1 layer and some concealer. But still so frustrating when I used to never wear any!
I seem to have the bloating issue somewhat under control now. I still bloat, but ever so slightly. I can fit into my old clothes now!
I take a probiotic (2 pills) every morning on an empty stomach, I am also taking Betaine HCL with Pepsin after each meal. Essentially what the Betaine does is increase the stomach acid in my stomach to help me break down my meals. I was dairy free for about 6 months, but I started slowly reintroducing it back into my diet once I started on accutane/epuris. My derm suggested that it would be a good way to get vitamin D and replace some of the good bacteria in my stomach. Unfortunately, it seems like that small amount of dairy (usually yogurt) was what was destroying my stomach. I don't bloat, but the moment I eat yogurt or drink milk my stomach expands 150% and I turn into a gassy mess. So, I've decided to just completely stay away from dairy and rely on the probiotic to help regulate my gut health. I am still wheat/grain free, low sugar/natural sugars only, no pre-packaged foods and low caffeine. I pretty much just eat fresh fruits and veggies along with eggs, chicken breast or red meat as my protein. I also only eat grass fed organic red meat. It's a really strict diet, but it's become habit now from before starting on accutane. I find that it does make a difference, but it also can be related to stress as well. I find that I only eat junk food (chocolate, high sodium, greasy food) when I am stressed. I've been trying to keep my stress under control and I've stayed away from those foods entirely.
I am happy that my skin is manageable now, I still need to wear a lot of makeup before I am comfortable leaving the house. But it has made a huge improvement from where it was before.
While this is a "miracle" product, seeing as it's already really helped me in a month. I am also concerned with the side effects. In order to offset the side effects I am taking:
-Vitamin D - 10,000 IUDs (I have a Vitamin D deficiency and live somewhere where there is very little sunshine during the winter. This is definitely more than a normal person would need to be taking)
-Betaine HCL - 2 pills after each large meal containing protein
-1 Fish Oil & Salmon Oil Super Strength Pill
-1 Iron pill w/ Vitamin B12 - I think its 400 mg
-Probiotic - 2 in the morning on an empty stomach
It just scares me that I am literally spending over $80 a month on vitamins, and pumping my body full of other things to offset the side effects of one antibiotic. I am also getting scared of the possible long term side effects on my body.
It's so unfortunate that you have to sacrifice so much in order to get normal skin and your confidence back.
I am just crossing my fingers that I can beat this as soon as possible.
I can not wait for the day that I can go back to leaving my house without makeup on!
Month 2 - Week 3
SO DRY DRY DRY DRY DRY DRY
I don't know what happened to my skin overnight, but its SO DRY.
I used to have to blot many times a day. Now I can barely get through 6 hours without having my whole cheek flake off.
Have no idea what the heck happened, but the dryness is torture. I have a mini spray can of the Avene Thermal Water. Without this I wouldn't be able to smile.
Im not sure if it's a climate thing, but man...is it ever terrible. I have stopped using tazorac as a topical and it slightly helped, but still a flakey mess.
Cold Sores
Not entirely sure what the deal with this is. But I have had 5 cold sores in the last 3 weeks. I used to get 1 or 2...a year. I have been super careful with making sure I don't apply lip product directly on the cold sore, or use the same face cloths etc etc. But yet, I'm getting them non-stop. I had 3 on my top lip at one time.
I am a site for sore eyes right now with my peeling skin, and cold sore lips
Tiredness
I am exhausted....all the time. It didn't really get bad until this week. But I find it extremely hard to get out of bed in the mornings, and to even get through at 10 hour day is torture. I've upped my iron from 300 mg to 400 mg so hopefully that helps....but I am sure its the accutane.
2 more months to go...I CAN NOT WAIT.
There isn't much change in my skin, but I'll get photos up tomorrow
Month 3 Week 2.5
I haven't posted in a while. Mostly because I have been beyond frustrated with my skin.
I think my skin is actually worse off than it was when I initially started Epuris (accutane).
I am COVERED in scarring, and I still wake up daily with more huge inflamed pimples. I find it hard to believe that the initial breakout lasts over a month. I've tried to stay positive, but I am back to my previous ways where I don't want to leave the house since my skin is so red, peeling and just covered in huge spots.
At this point, I'm pretty giving up on taking Epuris.
I have an appointment with my derm on Friday, I am thinking I am going to call it quits on this one and just embrace my "pizza face".
Luckily I have the option of loading up on the makeup! Just extremely frustrating that I'm one of the odd few that doesn't seem to respond to treatment.
Hey
I understand what you mean by being demoralized having more pimples now, but there is a huge chance that if you quit now you'll wonder how it may have been if you continued taking it pass the 6 month mark. You're more than half way done. What you got to lose by finishing the course? At the end of the destination there are 2 options:
1) You'll have wonderful skin
2) Your face will be the same but you'll have tried it till the end so you know what accutane does or doesn't do to you
Hi,
I've been reading your posts and I find it so informative. I went on accutane when I was 15, I was also living in Alberta at the time so I totally understand the dry struggle... I'm starting Epuris now again at 23, unfortunately. I know you're feeling discouraged but trust me it'll get better, trust the prossess. I have some tips that I hope you find helpful 
1. Get yourself a humidifier, even if it's just in yoyr bedroom while you're sleeping. Helps soooo much with dryness of all kinds.
2. Green concealer or primer for the redness. I'm olive skined as well and I know the struggle. It will help cancel the redness a bit and keep it covered longer. You will have to use foundation over it though or a skin coloured concealer because it gives a dull-ish colour to olive skin.
3. Take iron on an empty stomach if you don't already. Eggs and caffine inhibit the absorption of iron, so maybe that will help with your energry a bit.
4. If you're having a day where you're extra bloated, try reducing carbs for a day or two. If nothing else, your body will get rid of the water it's holding. Just don't do that on a training day obviously.
I'm not sure if you're still on it or how your journey is going, but I hope it's all well. Good luck to you and everyone else reading this.
On February 5, 2015 at 4:17 PM, aidadia said:Week 3.5 - Week 4: This week has been the hardest for sure. I purged pretty badly for about 2 days, huge red cysts with yellow heads all over my cheeks and jawline. I was silly and popped them...bad idea. They turned into huge red scabs after that and are still healing.
The side effects are getting worse, my skin is a lot more irritated and dry. It isn't flaking or anything, but it is very very tight. My eyes are also burning like crazy, I need to carry around eye drops everywhere and I've found it difficult to wear my contacts. People keep asking me if I am okay, since they are so red and watery. Looks as if I've been up crying all night. The skin on my body is also extremely dry I have to moisturize every night or else I will start flaking. I've been trying to drink 4-6 L of water throughout the day, this seems to be helping a bit. My lips aren't too bad, they are dry. But nothing that can't be managed with some lip chap. I have lip chap and eyedrops in almost my purse, jacket pocket, night stand, bathroom, jean pocket. Pretty much...everywhere.
I still can't get over how much the side effects have escalated in just a few days. The bloating hasn't gone away, it's almost worse. I actually had to go out and buy "fat pants" a pair of jeans that is a size larger than my usual to accommodate for my huge pregnant like belly!
I've also completely lost my appetite. I will eat a small meal in the morning (2 hard boiled eggs and a banana) and I feel full for almost 8 hours. Which for me, is very bizarre. I find that Im only eating 2 very small meals a day, which I know isn't very healthy but I feel sick to my stomach if I try to eat more.
The one "positive" side effect is that its dried out my scalp. I have quite oily hair, I could go maybe a maximum of 3 days without washing it. But I was constantly using dry shampoo to make it look presentable. Now I can easily go 4-5 days (doing some pretty sweaty workouts too) without washing it. This is probably the only positive that I can think of.
I can definitely tell that my skin is clearing up, even the scaring is turning from a dark brown/purple to red. I had a lot of "holes" (enlarged pores) and black heads that were so deep down into my pores that no extraction tool could get out. Most of them have disappeared and are disappearing. It's such a nice feeling to finally see some sort of improvement in my skin after such a short time. Especially since I had essentially lost all hope.
However, the side effects are really killing me here. I have my blood work next week, and appointment to get my refill. I hope the blood tests come back alright. My derm said depending on how fast I react, I may only have to be on a 4 month round. It seems like it's improved quite a bit, so hopefully I clear up and get off this stuff asap!
Lastly, another product that I've found that's been helping is Clinique Advance Moisture Surge Relief. It's a pink gel formula and a little goes a long way. It's great for wearing as a moisturizer under my makeup. It takes away that tight feeling, without making me super shiny. I almost prefer it to Cetaphil now as my daily moisturizer. Still trying to figure out some makeup trips or products to hide the redness!
So what happen?????? Im so frustrated right now with epurid
On 9/26/2016 at 9:51 PM, Phurp said:So what happens???? I'm so frustrated with epuris
Hey!
I ended up going away for the Summer back in 2015 and wasn't diligent about updating my progress.
So my acne cleared up in Month 4, I finally had smooth skin and just had some discoloration scars left. I continued for another month and a half. After 6.5 months of starting (so mid June -2015) my dermatologist said that she thought I was good to go and I could start coming off the medication. My skin was amazing, it was late summer and I was able to just wear sunscreen and some concealer. It was so nice being able to wake up in the morning and not worry about loading on foundation.
My clear skin lasted until about December 2015, and then my acne came back. It didn't come back as bad as it was originally, however this time it was more cystic large red bumps. I was so heartbroken. I didn't want to go back on the Epuris right away, so I tried topicals (Tazorac and Tactuo) and it didn't work. My acne started spreading to my back and chest, so a month ago I decided to go back on the Epuris.
I am on 20 mg a day now, and on week 5 and I am purging like crazy. However, the weird thing is that I have ZERO side effects this time around. What are the side effects you are having right now and how far into your treatment are you?
My best advice is to stick it out, no matter how annoyed you are. It definitely get's worse before it gets better.
Hey gals, I'm surprised at the short length of treatment! I was told I would need 150mg per kilo of body weight which for me =9,000mg total so on a low dose of 20mg this is going to take forever. The manufacterer's website says 120-150mg/kilo total. I did two courses of accutane with no effect but at 34 I am so frustrated that I am trying Epuris. The thing I read on the manufacturer's website that no doctoe ever told me is that it is fat soluble... so if you don't eat it with a fatty food, your absorption sucks. I hope this is why Accutane failed for me..even though Iam resentful that I spent the money and dealt with the side effects twice with no results. So here I am looking to see whether Epuris (supposedly more bioavailable) will have a better effect. -Sask, Canada