Hello! So, this is my accutane log. Seeing others logs and activity on this forum has really helped me in the past so I wanted to give back myself. I have dealt with mild acne for the past three or for years (as one might expect in adolescence) but in the past six months it has become far more severe and cystic and painful. I have tried all sorts of OTC medication, diet/lifestyle changes, supplements, doxycycline, perscription BP/Clindamycin/Retin-A/Sulfacetamide Sodium Sulfur, and so on. So, I finally went for accutane.
I just got my first doses five days ago, so I will start my log now. I am on 20mg/day (the derm who saw me wanted to put me on 40 but the doctor overseeing her wasn't comfortable with it because she has apparently seen a teenage boy before have some severe reaction to accutane- something that is obviously a risk and pretty anecdotal but I won't complain as they want what's best for me).
It was pretty emotionally taxing for me last year, as I can tend to be very self-conscious and anxious and I certainly didn't have the best year, for a lot of reasons (my acne included), but things have been getting better for me. I've been changing my thought patterns, taking more care of myself, finding happiness where I can, and trying to put my acne in perspective (I could really have things so so much worse. Of all the medical conditions I could have, mildly painful and very temporary acne is a pretty good deal). So, things look uphill, for my skin and my life. I've been doing my best at least, and will continue to do so, with faith that things will get better eventually.
Day 5
No positive effects yet, of course, but the side effects haven't been too bad. I've been moisturizing and using a sensitive cleanser (acure brand, from whole foods). My lips have gotten somewhat chapped and I've felt abnormally tired, but that might just be from returning to school. Slightly worried about the initial breakout (or as I like to refer to it, my final breakout-- reframing thoughts can be very helpful, though hard), but I'm really happy to be on isotretonin.
Good luck! You have really no acne aside from on your jaw so I know that it'll clean up really fast! Keep us updated 
and dont worry about being on 20mg. I was on 20 for the first three months and then 40 for the rest. I had absolutely no side effects aside from being dry 🙂
Thank you! I'm definitely hoping it clears quickly.
Day 10
Still not much to update on. My lips have been getting pretty dry but chapstick has been helping, and my skin actually hasn't been very bad but I have been moisturizing (though only once a day). I have big cysts on either side of my face, and I have thought about trying to get an appointment in this week to try cortisone for them, but I'm still not totally sure if I should. I think these pictures are a little better because my redness is less accentuated by the lighting, but my cysts are very visible. I'm hoping that the redness/scaring that they leave behind isn't too severe.
Even with this all, I've been feeling pretty good, and haven't let it drag me down too much.
I actually didn't have to get a blood test before I started it, but i know some people do. The follow up appointments are needed to fill your next 30 days, so they will probably be in time to get a blood test done and results back, but I'm not totally sure on the details either!
Day 35
I haven't updated this in a while. I've stayed on 20 mg this month as per my derm's suggestion. About a week ago I started seeming to break out more, which I have equated to somewhat of an initial breakout in a drawn-out way because of my low dosage. My really painful cysts went down with cortisol, but the red marks are still there. I'm afraid I'm scarring, but I'm trying not to worry about it.
Here's to progress.
Don't worry about the scaring, you're so young, your skin will bounce back. There are plenty of things you can do about the scaring later on you even it out if it still bugs you. I have really bad acne scaring and I thought when I was 16 that I would get it fixed. The older I get the more I like it, it adds character, plus it's more masculine, you couldn't pay me to get rid of my acne scars.
Day 68
So, it's continued getting better. My lips have been drying really bad, but my skin has been ok. I've still just been on 20, but I'm going to start on 40 in a few days. I've had a few really large painful cysts that have arisen suddenly that I have had to get injected, but otherwise I haven't been getting too many new pimples. I think that's a good sign.
Where my largest cysts were on the side of my mouth, it now feels really hard and slightly bumpy, even two months after they've gone away. One was right on my nasolabial fold, meaning that whenever I smile it still looks really weird because of the scarring.
Overall, I'm really thankful to be making progress.
Day 77
Things keep getting better, but now I have more scarring, especially on the side of my face. Also, since I've started on 40, I've noticed two side effects. The first is that my lips are now starting to bleed and scab over, as you can see in the picture, which is especially painful when I smile. The second is that the hair on the side of my head is very thin, which I think is due to the medication. I only noticed it now that I cut my hair, but I'm hoping that goes away.
Day 105
It kind of seems like I've made minimal progress in the last month. I'm on 40 mg still and I am still getting new pimples and a few cysts here and there. It's better than when I started, of course, but it had yet to go away. I also still have raised bumps where my largest cysts used to be, even after 4 months, and they can be very unsightly in certain lighting. I have very little pain from my acne now though, which is good. I'm hoping things keep going as they have been.
Day 144
It blows me away that I've made it this far, yet here I am. Day 144. I'm on 60 MG a day now. My skin has surprisingly not been near as dry, but my lips are still very chapped. In today's pictures you can see a really terrible cut I have on one of them now (it showed up on it's own, they were so chapped). I've just been putting a lot of lip ointment on, but every time I smile it breaks the scabbing (and hurts like hell). Any suggestions?
I'm hoping things keep getting better and my scarring starts going away. Right now there is still a lot of atrophy/hypertrophic scarring around where my largest cysts were, which is pretty noticeable in certain lighting, as well as the hyper-pigmentation from them. The red mark by my mouth in the third picture hasn't been a pimple in months, it's all the scar from the cyst. Any suggestions for scarring I can do this summer so my skin is as nice as possible when I go to school in the fall?
Side Note: A comment on learning to worry about skin?
I also wanted to mention something I've been thinking about recently. For those who have had a really bad acne case, I'm wondering if you start to form mental habits, such as worrying about your skin and feeling self conscious about it, even when it's not as bad as it would seem. To me, my acne has seemed really severe, it's easily the aspect of my appearance I think the most about, and one of the first things that comes to my mind when I meet someone is how it looks. Recently, I've been seeing a girl, and every time we get together I can't help but worry about my skin, being sure in my mind that she often thinks about it also. But recently, I mentioned I was on accutane, and she genuinely told me my skin wasn't that bad, of course she could see it wasn't perfect but she had never thought much about it before, she said. And I could tell she was being genuine.
This made me think, after having severe acne, maybe I developed a sort of dysmorphia regarding how I see my face, as I learned to struggle with it when it was at its most severe point. Six months ago, I would have given anything to have the skin that I have now, even if it is still in the process of getting better. I would have called the acne that I have now mild at best, nothing to worry too much about.
Of course it's still good to be objective about your skin, and work to make it as healthy and good-looking as possible for the sake of your own confidence, but maybe we give it much more time and thought than is necessary, especially for those of us who have had it worse in the past, because we've learned to worry about it, even when the worrying isn't very productive.
Day 180
Man, it's hard to believe I started accutane over six months ago. It sounds like I have 1-2 months left in my course, not out of necessity but because I started slow so I have yet to reach my ideal cumulative dose. I'm on 60 mg still. Lips are a pain but I really am hardly getting any noticeable dry skin. My skin does burn pretty easily, so I need to wear sunscreen more! I'm really glad I got on this drug.
1 Year
So it's been a year? That's kind of crazy. Overall, I am really glad I went on accutane. My side effects only seemed to last while I was on it, and to anyone else who is worried about the "permanent" side effects, I urge them to consider the studies and evidence over anecdotal accounts of post-accutane side effects, such as the super long permanent side effects post (I don't mean to invalidate anyone's experiences, but just share my personal recommendation)
My skin is pretty much clear now. Scars, but that's fine. Very occasional pimples-- maybe one day I'll go back on a medication, but for now it is super manageable. I've even been fine after I stopped washing my face twice a day 
To anyone else who is struggling with severe acne now, hold in there. Acne sucks, but so much of it isn't really something you can control, so instead choose to put all your focus and attention on the things you can control-- constantly learning, growing, and improving yourself. That made all the difference for me.
