I read a ton of Accutane logs when I was trying to decide whether or not to take Accutane, and I found them really helpful, so I thought I would add mine to the mix.
Background and my decision to take accutane
I started getting acne when I was 14 years old. Its moderate acne frequent white heads (small and large), and the occasional cyst on my chin. I have tried nearly every topical, both prescription and over the counter (including the Acne.org Regimen), birth control, spironolactone, 6 types of antibiotics, and every acne diet imaginable. I saw some clearance from antibiotics and benzoyl peroxide, but I always had noticeable acne. My dermatologist offered me Accutane many times over the years, and I had always refused out of fear.
A year ago, I got engaged and desperately wanted to have clear skin for my wedding. I did everything I could short of Accutane I was already on spironolactone, birth control, and doing the acne.org regimen. I went on the highest allowed dose of minocycline (which had been the most effective of the 6 antibiotics I tried in the past), and went on an insanely restrictive diet (no sugar, no gluten, no diary, no eggs, no pork, no seed, bean or vegetable oils, absurd amounts of vegetables). My hard work paid off I didnt have clear skin on my wedding day, but its the closest I have come since the age of 14.
But I hated my life. I spent an absurd amount of time on my skin. I faced constant anxiety about staying on my face regimen and diet going out to dinner with other people was a nightmare. I felt constantly deprived and stressed. I finally decided enough was enough, and I agreed to go on Accutane at the age of 26. I started the day I returned from my honeymoon, so my skin was very close to clear upon starting.
The plan
I weigh 56kg, so my dermatologist said I would do 60mg/day for 5 months. He told me it was not safe to combine Accutane with minocycline or spironolactone, so I was to quit them cold turkey. I have also decided to drop my restrictive diet, because its making me completely crazy. My derm strongly recommended I quit the benzoyl peroxide as well because its too drying, but since it is not medically unsafe, I have stubbornly decided to continue using BP until the Accutane dryness kicks in I am TERRIFIED of an initial breakout.
*PRO TIP for people with HSAs and HRAs do your research before your derm writes a prescription!! my dermatologist originally said I would do 30mg twice a day. I did some research with my prescription drug insurance company (CVS caremark) and found that the generic Zenatene would be the cheapest for me. Also, thirty 30mg pills would cost me $435, where as thirty 40mg would cost me $104 and thirty 20mg would cost me $93. So I asked my derm for a 40mg and a 20mg a day instead of two 30mgs which saved me over $600 (for one month!).
Week 1
So far, so good. I had what may be the start (and hopefully, end?) of an IB? Several small white heads emerged. Here are the possible side effects I experienced:
Dry skin started around day 4. Probably wouldnt have started this early if I hadnt persisted with the BP.
Dry lips started around day 6. That may have started earlier if I didnt start applying aquaphor preemptively on day 1.
2 dull headaches that went away with increased consumption of water.
Ive also noticed Ive been slightly grumpy, but I imagine that has more to do with increased stress at work.
Alright, thanks for listening! J Ill keep you posted.
Good luck! I'd imagine you'll have to come off BP pretty soon... the dryness is pretty horrific even without it 
So have you reintroduced dairy and sugar to your diet completely, or are you introducing them slowly? I still haven't reintroduced those two since I started accutane (aside from like a bite of a baclava and some honey-lemon water during a cold) cause I'm mortified it'll cause me to break out.
I'm dreading going onto an HSA next year (forced by my employer), but thanks for the tip on that! Just in case I have to do a second round.... (god forbid)
5 hours ago, Stephen23 said:Good luck! I'd imagine you'll have to come off BP pretty soon... the dryness is pretty horrific even without it
So have you reintroduced dairy and sugar to your diet completely, or are you introducing them slowly? I still haven't reintroduced those two since I started accutane (aside from like a bite of a baclava and some honey-lemon water during a cold) cause I'm mortified it'll cause me to break out.
I'm dreading going onto an HSA next year (forced by my employer), but thanks for the tip on that! Just in case I have to do a second round.... (god forbid)
Yeah, I've already had to start reducing the dosage on the BP. I guess I'll try to wean myself off completely over the course of the next week or so.
I reintroduced all the bad food pretty quickly, actually. I was on my honeymoon surrounded by good food and I just kind of gave up on the diet. Out of habit, I still eat very healthy compared to the average person, highly favoring veggies and resisting sugar. I still haven't brought myself to eat a piece of pizza yet... But I seem to have several significant cheats each day now.
Day 9
Had bad stomach pains and threw up two times. Could this be related to accutane? A few google searches could not find a much of a link between accutane and vomiting...
I called my dermatologist - he advised I pause the accutane until my stomach returns to normal, then start taking the accutane at half dose. If that's okay, I'll go back up to the full dose. If the stomach pain and vomiting continues, he says we'll have to stop... so... fingers crossed all goes well.
5 hours ago, Kay789 said:Day 9Had bad stomach pains and threw up two times. Could this be related to accutane? A few google searches could not find a much of a link between accutane and vomiting...
I called my dermatologist - he advised I pause the accutane until my stomach returns to normal, then start taking the accutane at half dose. If that's okay, I'll go back up to the full dose. If the stomach pain and vomiting continues, he says we'll have to stop... so... fingers crossed all goes well.
Sorry to hear about your sickness. Better safe than sorry though in terms of pausing the treatment, hopefully you recover well. Nice to see another new accutane log! Good luck!
My stomach barely slowed me down - I took 40mg a day for 3 days, and went back up to 60mg.
Week 2
Skin is still mostly clear. I don't think that's because the accutane started working - I just think the BP and minocycline still are. (I've tried to come off antibiotics enough times to know my skin doesnt usually get worse until a month or so after quitting). I'm still using BP, but I'm down to about 2/3 dose because of dryness. Hoping to ween off BP soon because I'm tired of applying it and of bleaching my hair.
Side effects:
Dry lips - very pronounced now. It's not a problem, I just have to apply aquaphor regularly. I learned the hard way to always have it on my person - I just bought a bunch and put them in all my purses, my backpack, my glove compartment, my desk at work... My husband kindly offered to carry one on his person (I'm much more forgetful than him)
Slightly dry skin - but nothing that cant be controlled with Cetaphil moisturizing lotion.
TMI ALERT - read at your own discretion! The inner lips around my vagina are super itchy. I imagine because of dryness? It's driving me nuts. I hope my derm can suggest something for it because I do not wanna pay $100 for a gyno visit on top of all the accutane costs.
Overall, so far so good! Excited to be two weeks in!
Week 3
Still persisting with the BP - though I'm down to half the dosage, and I had to skip the evening application twice this week because I was too dry.
I had another mild breakout, but my skin is still looking relatively okay. (Again, I attribute this totally to the BP i'm still using and the massive dose of minocycline I took in the 6 months leading up to accutane)
Side effects:
Dryness! Dry lips have become much more severe - I apply aquaphor constantly. Skin is dryer, too. And now my eyes are dry as well. I don't like putting in eye drops, so I have opted to wear glasses instead of contacts most of the time. It's helping my dry eyes a lot, but frankly, it's not helping my self esteem! Acne and glasses? Not my favorite look.
Day 25
The last couple of days I have been breaking out like crazy. Lots of big, red pimples with no head that don't seem like they're going to go away. I don't know if it's the worst breakout I've ever had, but it's definitely the worst breakout I have had in a looong time because in the last 6 years, I've been highly medicated for it. I look terrible. I am so upset. I keep bursting into tears knowing I have to go to a friend's wedding tomorrow and see all these people I haven't seen since college. This is not how I want them to see me.
I resisted accutane for years - I only agreed to take it because I felt like I couldn't live with my skin for one more minute.
My derm assures me I will be clear by the end of my course, but that's 4 months away. I know, I've had acne for 13 years, what's four months more? But it feels completely unbearable. Sigh... Really hoping this initial breakout doesn't last too long.
Hey you'll get through this! The first two months sucked so bad for me I didn't think I'd get through it but now I'm about to start month 4 and my face is completely clear trust me there's light at the end of the tunnel. Ask your derm for prednisone if things don't calm down it works really well for breakouts I stayed on it for about a month and it kept things at bay. Good luck!
Thanks for everyone's support last week!
Week 5
I am slowly recovering from my massive breakout from week 3-4. One by one, the pimples have been coming to heads and I have been carefully popping them. I know you're not supposed to pop on accutane, but I can't help myself. Huge white heads look terrible, and the pimples go down so much quicker once they've been popped! I'm hoping there are no consequences.
I have had a few new pimples since then, but they have been small and are recovering quickly.
I am starting to seriously worry that accutane isn't working on me. Why? Because my skin's not dry. I mean, the skin on my face is slightly drier than it was before. I had to take my daily benzoyl peroxide dose down to 2/3 of what I was using before, and I use a little more moisturizer than I was before, but I am not dry by any means. The back of my hands are a little rough, but aside from that, I haven't experienced dryness anywhere else on my body. (Except for my lips, which are very dry and require hourly aquaphor) And yes, before you ask, I take my pills every day with a big meal that has plenty of fat. Can accutane work without making you dry?
Hey there! Welcome to the accutane club I am on Day 113. I am also 26 years old. Are you on Birth Control by chance? I was also on BC and spironolactone for 3 years -- I was mostly clear, but still got spots every few weeks (not cystic) but when I went off BC and spiro back in October last year my skin went a-wall. So, back on BC and now on accutane. I worry about getting off BC again post accutane....sigh.
5 weeks is still early to see lots of dryness. Everyone is diff. It took me about 2 full months to really start noticing (I am 3-1/2 months in)
Started at 20mg twice a day (first month), 30mg twice a day (second and third month), 40mg twice a day (4th month started June 6th)
I really suggest not using the BP anymore even though it feels reassuring. Your skin will literally change overnight one of these days, and the BP will burn it and cause damage. The accutane will work, but you also have to trust in it! When your skin does change you wont be able to pop your zits without leaving a huge red mark b/c accutane slows the healing process of cuts, wounds, and popped zits. I learned my lesson, as have many others.
CNA7 - Thanks for your wisdom and advice!!
I have been on bc for about 4 years. It helps a little, but not a lot. I'd love to stop taking it but I'm scared of stopping after accutane, too. I tried spironolactone for a year and never noticed much difference.
You mentioned that my skin will change overnight - was that your experience?
Day 65 - How time flies!
I haven't updated in a while because not much has changed.
Facial skin still hasn't gotten particularly dry, so I am still using benoyl peroxide at 1/2-2/3 dose.
Skin looks great - Since week 5, I have had very few new bumps, and the new ones I have gotten have been small.
Side Effects:
Dry lips - fortunately, I can keep them okay by applying aquaphor every hour during the day, and slathering vaseline on them at night (and reapplying any time I wake up to go to the bathroom at night. on the rare nights I make it through the night without waking, they're peeling a lot by morning).
Dry skin - Mild. I use more moisturizer on my face than usual. My arms are occasionally itchy. My armpits get very irritated when I shave. The backs of my hands feel scaly.
Veins (particularly in arms and hands) are more visible - Two people commented on it. I hadn't heard of this as an accutane side effect previously, but noticed it was happening and looked into it. Other people have reported it, as well.
But yeah, so far, so good! Still surprised how fast things are going.
Week 12
My skin was almost completely clear for an entire month, so I finally did it - I stopped using benzoyl peroxide.
Within 2 days, I had some bumps, one of which was large and painful. This of course confirmed my suspicions that accutane might be helping a little (benzoyl peroxide was never enough to keep me clear before), but doesn't seem to be doing THAT much for me. My skin is still very acne prone, and aside from chapped lips, I have virtually no side effects.
I explained this all to my dermatologist - he was also a little concerned and considered upping my dosage from 60mg to 80mg (I weigh 58kg). Ultimately, he decided we should stay on the current course. He said at the end of month 5, we will evaluate whether I need to extend my treatment.
In more exciting news - I hit my health insurance deductible, so accutane costs are cheaper now!
I apologize for doing a terrible job updating this. After a few weeks, I realized it was easier to get through the treatment if I didn't think about it, so that's what I did. (To clarify - it wasn't the side effects that were stressful - it was the fear that treatment wouldn't work. Accutane was really my last shot) I have been done for two months now, so I thought I'd give some final thoughts.
Side Effects: Overall, my side effects were mild and totally livable. My lips were incredibly dry, but as long as I applied aquaphor every waking hour and slathered on the vaseline at night, I was fine. The skin on my hands and face was very dry, but again, this could be combatted by proper moisturizer. I experienced some mild lower back pain while I was on this medication. I was not bothered much by any of this, and if enduring those side effects forever would ensure eternally clear skin? Yeah, I'd sign that deal.
Results:My results were common, from what I hear. Around the 3-4 week mark, my acne flared. After 6 weeks, I started to see improvement, but still got regular acne. Then miraculously, I became clear a week into my 5th and final month. After I ended treatment, I stayed very clear. Since then, I have only had a few pimples and they have been so teeny tiny, I barely noticed them.
After effects: My lips are still dry (not nearly as dry as they were during treatment), and I still carry aquaphor in my purse. Aside from that, the only result has been clear skin.
Reflection: I know accutane is a really intense option and many people have had long lasting side effects because of it, but it was a really positive experience for me. I don't know if the results will last forever... I try to enjoy the moment and not stress about my acne coming back, but I still find myself worrying. Despite that, the last three months have been some of the happiest of my life. I don't spend an hour a day on skin care. I change my pillow cases every other day instead of every day. I don't have a panic attack everytime I have a piece of candy or pizza. I can hang out with friends or go to work without worrying about what my face looks like. I go to the store without concealer on. It's kind of amazing.
Advice: If you're here because you're debating about accutane, this is my personal opinion: Accutane should be used as a last resort. However, if you have tried everything else, if you are unlikely to outgrow acne, if you are in good health, if you have faith in your doctor, and if acne is seriously impacting your quality of life - I think accutane is worth trying.
Thanks for listening. Thanks for your support. Let me know if you have any questions.