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hello , here's my short story , tomorrow im starting accutane 20mg twice per day, my doctor told me to use Erylik gel (Erythromycin 4% - Tretinoin 0.025%)
so my question is , isnt that going to dry my skin too? wouldn't it be too much ?

thx in advance

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Nick, I'm sorry to tell you this, but you are about to experience the most unimaginable skin dryness that a person can experience. So dry that your skin will lose all integrity and become extremely fragile. I can't explain why your doctor is giving your an oral retinoid as well, maybe he's trying to expedite the process??? But the AB will help to calm your current lesions, plus try to mediate the severity of any outbreaks in the first month whilst your skin 'purges'.

Don't worry about it drying your skin too much. As isotretinoin works directly in the sebum glands, your sebum production will decline to almost 0, literally! Therefore you actually can't systemically dry your skin any more than that, you'll just get there sooner.

It's going to be a rough road over the next 6 months or so, but keep your chin up. Talk with your family about any problems and try not to let it get you down. The drug doesn't cause suicidal tendencies (like some profess), a common response to the adverse effects is depression, subsequently suicidal ideation for some, however that it completely individual specific. 

Sorbolene was my best fried during my 3 courses, however, knowing what I know now I would probably try using an organic facial oil. When your dryness really starts to get hardcore, opt for jojoba oil. Is is a substance most like our natural sebum, but don't worry, it won't cause you acne. Jojoba is very good at getting moisture in the skin and keeping it there, much better than others, including sorbolene. Maybe use a good moisturiser of choice, water or oil based, until it gets hardcore, then switch to the jojoba. Anything water based just won't cut it. You don't normally need a lot for your skin (literally 1-3 drops for the whole face), but in your case, I have no idea how much to use. Find your sweet spot by seeing how much your skin drinks it. Gently rub it in until no more will. At night definitely leave a decent amount on the surface of your skin. I know you'll get it on your pillow, but it's a good compromise considering the alternative. If you don't like the smell/flavour to use it on your lips (what will get dry first), then opt for using peppermint oil, again sparingly! Whilst you still have acne, using tea tree oil on your lesions would be good. Firstly for the antibacterial/anti-inflammatory properties, but also because it's an oil and your skin will need the nourishment. In the morning, wash your face with a good cleanser (I'll get to that) and apply the jojoba, again rub in as much as you can and leave the rest on the surface whilst you're still at home. Before you leave grab a piece of toilet paper and dab off any excess that hasn't absorbed so you don't look like a pizza. If you have to reapply during the day, do the same thing. Apply some, wait as long as you can for it to absorb (go to the toilet or something) and then dab off the excess. Remember to always thoroughly wash your hands before touching your face. Sebum is the bodies natural barrier to skin entry bacteria. Without it your acid balance is thrown off and you have no (natural) defence. I say use toilet paper because that is generally the softest thing we have that's disposable. Tissues are fine but paper towel is getting a bit rough. You will understand what I mean in 3 months, your skin is SO sensitive and fragile.

Also, try to find a good, organic oil based face wash. Anything else will leave you so upset/disappointed once you dry your face. And let me tell you, I tried so many things, but the more I searched them more I lost motivation. However, because of all the stigma behind using oil-based cleansers on acne prone skin, I never did. As a result I went through so much more discomfort that I needed to. I had my courses between 18 and 21 so you could say I was pretty green/naive about skin care. I'm now 29, have degrees in biomedical science, nursing and paramedicine (along with a little engineering from my earlier days)... I like to think I understand what's going on a bit better now. I just wish I new back then what I do now (about skin).

It really won't make much difference (long-term) if you don't use Erylik gel, so use what you want on your face (you're the one who has to put up with it!). Personally, I would use it until I started noticing significant dryness/whenever my acne started to clear (whichever comes first), then switch to tea tree (if you still have active acne) or jojoba if you don't. BUT, regardless, get an organic oil based wash NOW! I can't stress that enough.

Where are you located? I might be able to recommend something.

Avoid mineral oils, synthetic lanolin, cocoa butter, vegetable oils, parabens, etc.

Use rosehip, tea tree, peppermint, chia seed, argan, jojoba, shea butter, camellia, etc.

Although calamine is usually a great thing, very soothing, don't use it. Zinc will dry your skin out further. It may be ok in certain formulations with other ingredients however, generally speaking, try to avoid it whist on isotretinoin. 

Any other questions, please ask. My days on Roaccutane were some of the worst I've been through. I remember peeling skin off my lips in sheets, like snake skin. It was horrible.

Good luck and stay positive. There's always a light at the end of the tunnel.

Edited by Nathan_NP
auto-correct/grammatical errors
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i really appreciate how u are trying to pull me  from the mistakes u made, the things u didnt know and i obviously dont know now, i live in lebanon, its near israel in case u dont know this country , many doesnt.
my doctor gave me these:
roaccutane 20mg (twice a day)
aquagena soap  (morning and night)
hyseac 3-REGUL (morning)
Erylic gel (night)
EFFACLAR Hydrating cleansing cream (on need)
sunscreen and any lip moisturizer  

are these okay? from what i understood i can use this moisturizer for now but when it gets extreme i need to switch to jojoba oil? anything else to add?

and also what should i be eating before taking accutane?
today was my first day and i ate lots of almonds and cashew before taking it.

what about blackheads ? should they go away? my doctor said so but i ve read a lot that blackheads dont disappear after months of accutane 

thx in advance

Edited by Nick Isra
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Hi Nick, sorry but I don't have time to look up those particular products, but if they are from your dermo they they should be fine for the time being.

You don't need to switch to jojoba specifically. But a water based moisturiser just wont be able to keep up once the dryness gets hardcore, even with slathering it on your face every so often. 

Like I said, you can use any combination of rosehip oil, tea tree oil, peppermint oil , chia seed oil, argan oil, jojoba oil, shea butter, camellia oil, etc. There are a lot more good ones. BUT, not all good oils can be left on the skin. Whilst they're not comedogenic as such, they are just too think to allow the skin to 'breathe' naturally and eject waste (olive oil, castor oil, maybe coconut and avocado). Great for the skin, just don't leave them on in thick amounts. You probably wouldn't like the sensation anyway.

At all costs avoid mineral oils, synthetic lanolin, cocoa butter, vegetable oils, parabens, etc. Any oils not listed here, just google and see what info you can find.

You can get a normal diet before taking your dose. Just try to eat relatively healthy. You don't need to go overboard on almonds and cashews, but if you like almonds, go for it. The biggest thing is just about eating a balanced diet. Lots of fruit and vege, good meats (in order of preference: Oily fish, fish/chicken, lean pork, lamb/beef), lean is better but moderate fat intake is fine, especially if grass fed. Whole grains are up to you, try to limit heavily processed grains, well heavily process anything really. Aim for a diet rich in both animal derived and plant derived omega 3's. Dairy is up to you. Personally I wouldn't go overboard but yogurt and hard cheese are usually fine. Don't go overboard on milk, cream, ice cream etc, but you don't need to cut it out. Probably the biggest thing is avoiding processed fructose. This sugar can only be metabolised by your liver, which will already be compromised by the accurate, so it will be very easy to over stress it. Yes it would take quite a bit of high fructose intake to really overload it but you're going for optimum health right?

Regarding your blackheads, yes, they will clear. Your sebum production will decline dramatically by week 3-4, at which point you won't really form any new plugs, however it does take time for your body to clear what's already there. Moisturiser will help it along, but don't be tempted to squeeze beyond the end of week two (once the dryness starts to set in). Your skin will become very fragile, meaning that you will tear it very easily. You don't want to damage your skin any further than it already may be. Be gentle, don't force anything, keep moisture up to it and was with your good quality, organic oil based cleanser.

Good luck!

(Sorry but I won't be answering any more questions beyond today. I received just enough backlash from a post last night to make me rethink my position on this site. Some people just don't want to hear how it is. I'll leave it to everyone else and there respective medical treating teams)

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