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Hi guys, so yesterday was my first day of taking Accutane or Roaccutane as we call it in Europe. My dermatologist prescribed me only 10mg of Accutane daily, so i decided to do weekly logs, not only because I noticed that not many people get such a low dose as 10mg daily, but also for me to note the progress. I will be taking Accutane for 6 to 8 months with possible increase of the dosage to 20mg daily after the first month. My dermatologist said 20mg is maximum that she'll ever give me.

Just a quick history of my acne: My acne started as I turned 15 and I am 20 now. I have never had severe acne, but mild to moderate (depends on the part of the year). Each summer my skin was clear, I had BABY SKIN EVERY SUMMER, but as Fall/Winter came I would get baaad breakouts. I've changed 3 Dermatologist and tried everything - from topical treatments to antibiotics. Doxycyclin cleared my skin completely, but as I stopped using it acne came back. Minocyclin did something only when taking 100mg daily (50mg daily did NOTHING). Azithromycin which I have been taking until yesterday did nothing at all. 

After 4 years I started getting acne on my chin area which I have NEVER had before. I have always had them on the inner part of my cheeks (which I do not anymore!). So after going to a gynocologist last year he told me I have mild PCOS! And wanted me to take bcp which I refused until a month ago. I am now taking Belara and have started seeing small results after 3 weeks. Unfortunately my acne is not only hormonal, which is why I will be taking Accutane. My derm explained to me that each year after summer (because I spend the whole summer at the seaside and a lot of time under the sun) comes to thickening of my skin which is why I always start breaking out each Fall. So she thinks the only solution is Accutane and I believe her because she is the ONLY dermatologist that accutally made an effort to take a look at my skin and took time to explain everything to me! 

So this is my story, I hope someone will read it and will maybe find out something useful! :-) Each week I will post the changes I see (and the dreaded IB)! 

Edited by Kathi

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Day 4: I know it hasn't been a week yet, but is it possible that my IB started? Considering that I've taken only 30mg up until this point (still haven't taken today's pill). 
I've got quite a few new breakouts and they all hurt. I feel horrible. Face is still a little bit oily. 
No side effects at all.
 

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Week 1: After the breakout on the 4th day, the next day my skin started getting calmer. My redness has already reduced and my skin looks nicer. I thought I was making it up because it's been only a week, but my parents noticed it also. I really hope it continues getting only better. 

My skin also started peeling off, but I don't have any severe dryness. 

Side effects: on the 5th day I had a headache and felt nauseous. 
Yesterday I had a feeling in my stomach as if someone was kicking me with fists.

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Week 2: initial breakout is definitely here. It isn't bad, but there are small breakouts on my lower left side of the cheeck. My right side is pretty much clear from breakouts, aswell as the forehead. The redness is still reducing. 

Skin and lips aren't that dry. Nothing a little moisturizer can't help. 

No other side effects this week. 

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I don`t understand the thing with initial breakout. How you know it is because of Accutane? If you weren`t on Accutane, you won`t have that breakout?
As i`ve read Accutane starts to work (or better said, starts to see results) after about 40-45 days of taking it. This means in the first 40 days you will still get the breakouts you usually got. Maybe a bit more breakouts since the glands storms off the oil they have.

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I think people will step into the IB phase from a first few day taking Accutane, right from the time they notice its side effects. Some people in this forum said that their skins become better from the 3rd or 4th week, usually for 2 weeks. But everyone is different. Let's wait & see her progress.

@Kathi: drink more water, refrain yourself from wearing makeup. Water can flush out the toxic in your body, and counter the side effect of accutane (my assumption only).

 

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@DogBB7 Everybody reacts differently, it's completely individual. I'm pretty sure it is initial breakout, because after the breakout on the 4th I had almost none new breakouts and my skin started calming down. (P.S. Before I started Accutane and was on Azithromycin I would break out every single day.) And now all of the sudden in the 2nd week I started breaking out again. And I'm definitely seeing that Accutane is working because as I've stated before, my redness has reduced A LOT!
I've seen people on Accutane who were clear after less than 2 months, but then again I've seen people who after 5 months were still breaking out pretty bad. 

@shmilyM thank you, I do actually, and i noticed that I get thirsty real quick! So I don't know if it's because of Accutane? 
I try to wear as little makeup as possible. My derm actually gave me an excellent BB cream that actually helps my skin. And i stopped using any washgels. I only wash my face with warm water and put on 2 hydrating creams my derm gave me (one in the morning and one in the evening)

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I've seen people on Accutane who were clear after less than 2 months, but then again I've seen people who after 5 months were still breaking out pretty bad. 

That's definitely depends on the severity of acne of that people. If glands were bigger and produces lot of oil, it's clear that it will take much more time rather than a person which have few cysts and pimples and starts Accutane.

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You will experience dryness of the skin or mouth, a common side effect of Accutane.
Source: https://www.drugs.com/sfx/accutane-side-effects.html
I am no expert but I have found a drinking routine that works best for me. You might want to have a look at this. Drink water (ounce) half your body weight (pound). Assuming you are 100 pounds, you need 50 ounces water. The more the better (may be). 500  - 700 ML within 15 mins after waking up, 200 - 300 in the morning or near lunch, 500-700 in the afternoon, no more than 400 ML 2-3 hours before going to bed. If you want to drink more, drink in the morning or afternoon, not evening. Trust me, you don't want to wake up all night and answer the call of nature. 

Keep moving forward. 

DogBB7, yeah right, no one experiences the same, ultimately we all want to be clear of Acne. So let try & wait what will come. 


 

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Week 3: Still breaking out quite. Skin is getting reaaaally dry. I have a lot of flakiness and my skin is peeling off. I really hope it'll start getting better soon. However, even when I do get break outs they go away fast and don't leave any red marks.

Side effects this week: 2 I had a headache Edited by Kathi

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Week 4: At the beginning of the week I broke out pretty bad and it really did hurt. It was so inflamed.. Around friday my skin finally started calming down and is getting better. I reaaaally hope IB is over! 

My skin is really dry, lips a little bit less. Of course my hair doesn't get oily at all anymore. 
No side effects this week.

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Hope everything well.
What really concerns me is will IB actually disappear (expected outcome) or it will leave more scars, marks, redness on face (even worse than before Accutane treatment). 
Less oily hair seems to be a good sign. But beside Accutane, is there any changes in your diet/routine (which can be the cause of less oil)?

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@shmilyM Luckily I don't have a skin that scars :) the only thing I get are red marks, but as I already said, now while on Accutane, breakouts don't leave any red marks (or even when they do, they're really light and go away in a couple of days) I'm also having my derm appointment next Friday and she'll probably increase my dose to 20mg so I expect to break out again :( 
As I've heard, everybody on Accutane stops having oily hair because your oil glands shut down. There is no change in my diet, but my hair started getting less oily a few weeks before starting Accutane because I was/still am taking BCP because of my mild pcos. But at that time I could go max. 3 days without washing my hair. Now I can go even longer, but I don't because I just feel that after 4-5 days my hair is not clean anymore. It isn't oily nor does it look dirty, but I just don't feel like it's fresh washed :D 

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STOP IMMEDIATLY TAKING ACCUTANE...

Before it has done too much damage to you.

I suspect you're suffering from vitamin D deficiency, and I invite you to fully read this thread :

http://www.acne.org/messageboard/topic/325195-vitamin-d-has-cured-me-of-oily-skin-and-acne/

What brings me to this is that you say you have baby skin every summer... which times right when your body got enough vitamin D to work with.

Many many people got success with Vitamin D3 (the best form to take as supplements). I have not tried this yet because I'm waiting for my blood test results to confirm that I'm actually D deficient. However I've started taking B5 since a couple of weeks and my 5 years painful and resistant acne really really improved, as well as my skin and my mood. It's clearly amazing and I'm not using any topical treatment since 2 years. B5 has more effective on my skin than any antibiotic. I'm planning to start supplementing on Vitamin D in the next days to fully achieve proper skin, without accutane!

I can't argue enough about Accutane danger and terrific horror story about this poison and I have promised myself to never take this. I've seen what it does to close friends and I thank your doc for not getting you a big amount yet.
Talk to your doc about this!
Consider getting a blood test and supplement yourself in vitamin d3 before taking any much accutane.

Don't forget to tell us how this evolve. Good luck from France ;)

 

 

Edited by ObviouslyRandom

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@ObviouslyRandom Thank you, but no I am not suffering from Vitamin D deficieny. I have already seen that post and that was my theory also. I talked to a couple of my doctors about this, including my parents who work in the health system. They laughed and said that if i had vitamin D deficiency I would have A LOT bigger problems than just acne. But both my doctor and my parents let me get my Vitamin D levels tested to prove me wrong because I was so convinced that was the case. My results came in and the level of my vitamin D is more than perfect. My derm already explained everything to me, aswell as why I get acne after summer. My derm is never going to give me a bigger dose than 20mg because she said my acne isn't that critical that I need a huge dose. I didn't want to take Accutane before, but since I have a really great derm and my parents in the health system, they explained everything to me and I believe they know what they are doing <3 

P.S. Please don't believe everything you read on the Internet and don't follow it. Always consult with your doctor because after all they are the person who studied medicine and know what's best for you. Also taking vitamins is not so harmless as you might think (ESPECIALLY when it comes to Vitamin D), so please never do it without consulting a doctor. Edited by Kathi

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My bad then Kathi, didn't know you had this tested before. 
Sorry it wasn't the culprit, would have been easier to handle.

But you know by the way accutane works, taking a small dose would require you to do a very long treatment to completely achieve durable effect. It's a weight related amount, so you'll have to endure side effect for a much longer time than other people who increase their dose progressively.

What did your derm say about having clear skin during the summer and acne otherwise ?

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@ObviouslyRandom No problem! :) I wish it were that easy..

Yes, she has explained everything to me. I'll be taking Accutane for 6 to 8 months depending on my results. I'm taking it really well so far, I barely get any side effects :) I hope it stays that way.. As long as the side effects don't influence my daily life, aren't too strong and don't have a huge effect on my blood results I'm okay with it and have no problem with taking Accutane for as long as I have to.

She explained to me that sun does me more damage than good. I understood it this way: Since I spend a lot of time under the sun and in the sea, the sun and the sea clean my pores, but at the same time my skin gets thicker and thicker with a lot of bacteria under it. While the sun and the sea helps clean the skin, as soon as the Fall comes around and it isn't so sunny and warm anymore, all of the bacteria and dirt that is under my 'thickened skin' has to come out. Which is why I get bad breakouts in the Fall/Winter. I guess I'll have to move to Australia or California :D since we in Europe can have quite cold and gloomy Falls and Winters :(  Edited by Kathi

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Week 5: It has been a good week. The IB phase is definitely over. I've had only a couple minor breakouts this week. (Especially on Friday when I've gotten like 3-4 minor breakouts, but they calmed down the next day) The redness has reduced so much and this makes me so happy! I still don't expect to stop breaking out completely in the next 2-3 Weeks because I can see some stuff under my skin that still needs to come out.

Skin is really dry and it is sometimes hard to control it (especially when putting makeup on). Lips aswell. 

No side effects this week. 

Also on 9th of December is my first derm appointment since starting Accutane. I'm already excited to hear what she'll say and if she'll increase my dose to 20mg (I expect to have the 2nd IB then :( ). I'm also getting my bloodwork done on Wednesday.  Edited by Kathi

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Update: As of today, I will be taking 20mg daily. My next derm appointment will be at the end of February. 
My derm is satisified with the progress, but wants to make it faster. She also suggested me, if I start getting headache on daily basis I should just switch back to 10mg daily.

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So what is the point of switching to 20mg daily if 10mg has already done a good job?  

What is the meaning of the term "making it faster"? Does "faster" mean "shorter Accutane journey"? If yes, OK, I agree, just do it. 

Getting headache is a likely outcome once you start increase the dose. So I suggest to live with it peacefully, Increase gradually, say you take 20mg on Monday, 10mg on Tuesday, back to 20mg on Wednesday, lower to 10mg on  Thurday ... If nothing (unexpected) happens then you can continue 20 mg on Monday, 20 mg on Tuesday ... etc. The basic concept is constantly exposing yourself to stressors (20 mg Accutane) and get rest (lower the dose back to 10mg) properly so your body can get used to it. 

Just my humble thinking. 

 

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That was the plan, first month 10 mg daily, after that 20mg. The main reason for that was the fact that I study in another country and I come home to my country cca. once a month. So she gave me 10mg to see how I'm going to react to it (so no strong side effects happen while I'm away from home) and after that she wanted to decide if I'll be okay taking 20mg. So now that I'll be home for Christmas holidays, if anything happens I can come straight to her.

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Hey!!! I hope you are well!! I'm sorry if I have missed something, but I have just read some of your early posts and I am replying to hopefully help a little about them ( if you have not already solved them ). You mentioned that you had dry and flakey skin, and hoped that it would go away soon. It will not go away until after you finish, your oil glands will be shrinking. I suggest a friendly, fragrance free, thick, moisturiser. Make sure to use moisturiser when your skin is still a little wet, or the moisturiser will just sit on the top of your skin. 

Also, make sure you take your tablets with your biggest meal. A nice lip balm is great to always have in your pocket. I would also take a moisturiser with you if you go out as winter weather can make you feel so dry. 

I respect everyones opinions, but I agree with you, don't listen to all of the bad reviews on the internet and stop because of them. A lot of people do not follow instructions whilst on Accutane ( I know some do and still dislike Accutane ), I mean some people actually do things they are specifically told not to, and then complain how Accutane is horrible. I have heard to many people complain about many procedures they have, and they forget to mention that they did not follow their dermatologists instructions. Your dose is low and many people opt to do this as it reduces side effects. Taking care when in the Sun ( although it is winter, still using a sunscreen when going out is a good thing to do ), moisturising, using lip balm, going easy on exercise, eating right, sleeping well, drinking lots of water will help you get through and you will have a huge smile at the end! 

Also, I have had like one or two headaches ( which may or not have been from Accutane ) so far, and I would not quit taking 20mg/day just yet. Try it for a week or two, and if you prefer just taking 10mg/day, then drop back down. It doesn't matter how long it takes for you to finish, as long as the cumulative dose is enough. If you can handle 20mg/day though it means you are done twice as fast, and 20mg/day is a low dose and shouldn't cause many more side effects ( if any ) compared to 10mg/day. 

Bad/noticeable side effects usually occur in higher doses. The reason why your dermatologist probably doesn't want you going over 20mg/day is because many people go onto higher doses and can't take the side effects, and end up quitting before they take a high enough cumulative dose. They then have to do another course at a lower dose. Perhaps your dermatologist has seen this from experience and wants to keep you low so that you don't experience bad side effects. Anyway don't be discouraged by a low dose. It is the cumulative dose that matters. You can take a speed boat and finish in 4 months or a rowing boat and finish in 8. Which ever suits you best is what you should take. 

I'm not 100% sure on this, but I thought the ladies had to visit the dermatologist more regularly for blood tests. Birth control also helps with acne as it will help control your hormones. 

Good luck and feel free to message me if you need any help ( I will try my best ). I will read your blog with interest! 

Edited by Irk

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@Irk Thank you!! Yes, I completely agree with you! People should really orient on the things that DOCTOR says, and not on the things someone on the internet said. 

 

Week 6: No big changes this week, it was an ok week. A couple of new breakouts that drove me crazy, but thankfully they go away pretty fast. I seriously hope I'll stop breaking out soon... 

No side effects at all this week. 

Edited by Kathi

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Week 7: The beginning of the week was like the last week.. a couple of breakouts.. but my skin started calming down and since friday I haven't had a single breakout!! :D I loveeee it! 

My eyes sometimes get pretty dry.. and also I'm not sure if this is from Accutane because in my room is constantly really reaaaally warm, but I've been sweating more.. 
No other side effects.

Also I think I should write my skin routine: 

I stopped using any washgels (I honestly think they just destroyed my skin).. I only wash my face with warm water 

Since my derm said I'm not supposed to use any acne products anymore, she gave me:

Uriage CU-ZN+ cream 
Uriage D.S. Emulsion 

Also since my hair got really dry she prescribed me Phytokératine shampoo and conditioner.
 

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Week 8: Getting clearer and clearer. I've had only a couple of minor breakouts this week, they were so minor that I didn't even pay any attention to them. Redness has also reduced a lot. A little bit more time and my left side will be completely clear from redness. 

No side effects. I've had a horrible headache yesterday but I don't think it's from Accutane at all. Edited by Kathi

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