I began having severe cystic acne on the lower-half of my face in my early twenties. I went on 40mg accutane for 6 months (145 lbs, 5'10). I cleared up after the 1st month, had chapped lips, but they were manageable. No other symptoms, and I was zit free (except 1 or 2 every month or so) for about 7 years.
I stopped taking birth control after my husband took care of things on his end, and my face went into a RAGE. The acne was so large and painful, and it was humiliating to go to work everyday as a corp professional with a face that looked like a meth addict. (Sorry addicts, there's help out there.) I tried to do several OTC treatments on my own for a few years to no avail. My dermatologist would not put me on accutane, only minocycline, which did absolutely nothing. I ended up going to someone else and have started taking 80mg isotretinion a day.
I am 1.5 months in now. This time around my symptoms are MUCH worse (understandable bc it's double dose now). The chapped lips were so severe I looked like a clown from a horror movie and I have slight constipation. I have terrible rash-like scaly acne and redness on the lower-half of my face, a nightmare to try to cover up with makeup every morning for work so it doesn't look like a zombie tried to eat my face. My nostrils and eyes are also very dry and irritated.
What I've found helpful:
*Use Cortisone 10 Ointment (not cream) for severe chapped lips (said it takes about 3 days). In 1 day, I had DRASTIC improvement in peeling and the awful pain of opening my mouth. I also put the Tube-O-Miracles on my face at night and it helped with the redness/scaliness, and swabbed the insides of my nose with a Qtip - just don't use for a prolonged amount of time or it thins the skin too much. I also ordered Dr. Dan's Cortibalm for maintenance, and will let you know how it works when it arrives.
*For constipation - you all will love this - I eat a couple mini Almond Joy bars a day. The coconut is a natural laxative and relieves the symptoms completely. No joke. I also drink tons of water throughout the day, because you should (even though I hate water).
*Garnier BB Cream helps to cover the acne/scars and serves as a moisturizer but still has nice cover-up.
*And a side note - if you have flaky scalp as well, use a half-ounce of lemon juice on your scalp after shampooing, and let sit for several minutes while you shave or something and it will be cured. Maintain once a week or so.
Thankfully, I don't have any noticeable mood swings or depression. I am just hoping my skin clears up soon, I will certainly post if it does/doesn't at the half-way point. Zits suck.
I now have a rash on the backs of my hands...
These side-effects are so much worse than the first time I was on Accutane. But bc the acne came back we worry the dose was too low before. Did anyone out there have it come back after round 2? That is my worst fear that all of this is in vain.
I've finished my 2nd month of round 2, 80mg. I am so disappointed that my acne is still horrendous. When I did round 1, after the first month I had NO new acne. But currently I am still getting around 3 new cystic zits a day, it is absolutely awful. My skin is so dry, and the makeup barely covers how bumpy and damaged my face is. (no, no topicals work - Ive used EVERYTHING, I promise)
I am using Dr Dans cortibalm on my lips and it is definitely the only chapstick that somewhat works. Though my lips are still extremely chapped and peel constantly. At least the rash on the back of my hands went away after about a week.
I am just very disappointed that my acne hasnt cleared up yet, I have a huge social event I have to present to over 500 people and they are all going to be staring at my absurd skin. This is a nightmare.
i'm sorry you have to do that presentation in front of so many people with your face broken out. That's the absolute worst feeling. But hey, if there are 500 people that means they'll probably be far away from you, right? So maybe they won't even be able to see anything. Maybe a smaller presentation in some ways would be worse b/c everyone would be so close 
You will start clearing up. Some people don't clear up until their 4th or 5th month.... not that that will make you feel better, but you're not alone in still having zits at the beginning of month 2.
Thanks for the empathy Stephen 23, it helps to know other people are struggling as well. When did you see a clear up?
I was hoping over the weekend maybe my skin would begin to heal some, but instead I was slammed with another extreme breakout. I am thinking about just sleeping with a mask of neosporin on my face tonight to try to heal my face as much as possible before the big event this week. Im not sure of anything else to use since nothing seems to work. Maybe cortizone 10?
Yikes - I'm so sorry to hear about the really awfully time breakout. Maybe try putting some hydrocortisone cream to calm down the redness. Whenever I have a bad breakout, if I put anything remotely medicinal on it, it gets wayyyy angrier so maybe try "natural remedy" stuff like charcoal masks or splash some cooled green tea on there before you go to bed. Maybe jojoba or castor oil (low comedogenicity and are suppose to help with irritated skin) or tea tree oil (mixed in with your lotion) or alcohol free witch hazel? If nothing else...green concealer, lots of moisture, and heavy foundation T.T
I was worried about getting even worse breakouts if I stop taking my birth control pills so I was hoping to change to an IUD before starting Accutane (or before the first pregnancy test anyway but I don't have time =/). I asked the derm about the chances of getting break outs after 1st round of Accutane + stopping birth control pills and she just looked at me like I was crazy and wouldn't even vaguely answer it...
On 5/2/2016 at 9:37 AM, llduo said:Thanks for the empathy Stephen 23, it helps to know other people are struggling as well. When did you see a clear up?
I was hoping over the weekend maybe my skin would begin to heal some, but instead I was slammed with another extreme breakout. I am thinking about just sleeping with a mask of neosporin on my face tonight to try to heal my face as much as possible before the big event this week. Im not sure of anything else to use since nothing seems to work. Maybe cortizone 10?
Could you maybe get cortisone shots for some of the bigger ones? That always helps my zits go down super fast.
I saw a clear up at the beginning/middle of month three. I'm almost done with month 3 and I've been getting a few whiteheads here and there, but nothing major.
2 1/2 mo in, breakouts are *slightly* less, I am getting 1-2 new cystic zits a day, or old ones just don't go away and stay very hard and painful under skin. I have been using Cortisone on my face at night, and while it doesn't stop the breakouts, it does heal them a little faster.
The painful rawness/bleeding on the inside of my nose has finally gone away though. Chapped lips are about the same, still using Dr Dan's Cortibalm and I have to apply it constantly, but it's the best thing out there.
I'm hoping by end of mo 3 I will be able to post that the breakouts have stopped. I am also going to ask my derm about prescribingHydroquinone to help fade all the dark spots I have now, I've read it works very well, we will see.
My eyes had been burning since the beginning of treatment, but this week I woke up with what seemed like Pink eye. I used some drops and that made the redness and goop go away in about an hour. But all week my eyes burned like crazy. SInce the goop went away I'm not sur eif it was pink eye or not, I've never had it before, or if it's simply from being dry for so long.
I am continuing to put cortisone on my face at night, it's helping the zits fade faster. Breakouts have lessened finally, but they still happen, I'd say 3-4 new zits a week now.
Between having what looks like meth skin, a clown mouth, a hand rash, and now pink eye, my coworkers must think I have some drug problem or a disease.
So I tried using Hydroquinone bc i read such great reviews about it evening out skin tone from severe acne. It burnt when I put it on at night, but i figured it was bc, well, it is a bleach. I tested apatchon my hand, and it was fine. Guessing my face skin is different and extremely sensitive from the accutane, and i ended up waking to a severe allergic reaction. It looked like i had the worst sunburn ever, red, bloody skin peeling off. And yes, i had to go to work like that as I had extremely important client meetings. it was humiliating and my professional reputation is hindered when you dont have that polished, tidy look.
the skin was so burnt and sensitive, it was impossible to cover with makeup. So fyi, dont use Hydroquinone while on accutane. I am going to take a risk and try it again in a few months when im done w treatment and test a small area closer to my hairline to see if it works. I would really love to get rid of all the dark spots on my face so i can stop using layers of foundation one day.
Update for starting month 3:
I only get about 1-2 new zits a WEEK vs a DAY like last month, YAY!!!
I still use Dr Dans Cortibalm chapstick - the stuff leaves an uncomfortable layer of wax on the lips, but it's the only thing remotely useful. My lips still shed layers of skin about 2x a day like a snake, and they bleed/feel burnt all the time. This is the worst side-effect, sucking up 3 more months of this is the challenge.
I also still put on Cortizone 10 ointment on my face at night - I have to be careful how I lay my head so the stuff doesn't wear off, but seriously, my zits heal in HALF the time, I wish I'd been using this stuff years ago. Also helps keep the scarring at bay.
Still searching for my dream moisturizer that works under makeup and doesnt cost too much. I found Keri Advanced Fast-absorbing lotion - its discontinued so I had to buy it off ebay and it was more than I wanted to spend, not sure what i'll do when its gone. Why are all the good ones discontinued??
But overall I am RELIEVED the cystic acne has finally lessened, last month was ROUGH. I can't wait to not be embarrassed to go to work with clear skin. Tick-tock. Good luck everyone else out there suffering with this.
Hmmm. I went one night without using Cortizone 10 on my face (there may or may not have been drinking involved), anyway when I woke up, the same old painful cystic zits were there along my jaw and lower cheek. Arg! So now I am wondering if the decrease in acne this last month was from the accutane or if it's just the cortizone ointment.
My pink eye also came back yesterday. Again, I don't know if it's really pink eye or just aggravation from acute dryness, but if I use drops it goes away. They burn incredibly bad all the time. Now I have to use the drops continuously, which doesnt bode well with eye makeup.
While my last log said I was getting fewer zits - I did want to mention that my old zits never seem to go away, they stay hard and painful under the surface and never truly disappear. I can run my fingers over my jawline and its nothing but lumps. My skin is so dry it is wrinkled and scaly yet still has deep zits under it. I have yet to find a moisturizer that will help.
I can't believe I am only half way through, time is dragging and I am so frustrated with these side effects. I wish I could take a six-month hiatus and just disappear until this was all over. But I am so scared that this accutane treatment is not going to work, I'm just not seeing the progress I thought I would by this time, nor did I think the side effects would even be this close to bad. Sorry Im whining, but if I dont vent I will lose it.
No improvement - I am getting 1-2 new zits a day. If I don't use cortisone on my face at night it will be full of scaly bumps. I really feel I am going through these awful side-effects for nothing. It is so embarrassing to come to work like this. I should have better improvement by now. I want to throw something.