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yuvraj

Low dose accutane after full course.

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Sorry if this is long 

Hi. I am a 20 yo guy from India.I am 6"3 and weight 79kg.  I started getting acne when I was 14, it was really really bad huge blood filled cyst( sorry  ik its gorss) that would hurt really really bad. I tried changing diet but nothing happened. I went to derm and she saw the severity of my acne and prescribed me accutane and it was the best medication ever given to me. It cured my acne in 2 months, I still had marks and scars(which i have until now) but my skin was free of pimples. Then I left accutane after 3 months( i didn't bother to complete the course because my skin looked good) and I got acne back after a year and I was put on accutane again, my skin and lips were extremely dry but it was nothing. My acne cleared once again and I had that good skin once more. I left accutane again after 4 months. Then I got acne again after a year this time  it was less sever but enough to scar me and hurt. I didn't eat accutane or went to a derm because i was so frustrated after having tried everything so I just let acne heal itself, it did but took a long time and ofcourse left scars. I kept getting acne but it was less and less severe every year. I also went to homeopathic and ayurvedic doctors, took bp, ss acid, anti-biotics, you name it. I have tried everything but the only thing that always works for me is acctuane. I was acne free for 1 and a half year and I thought I am finally out of acne "stage" but on august 2016, I got bad acne, 4 cyst on forehead, and 3 cyst on my right and left cheek. It was bad and again I didn't do anything. I was lucky that they didn't scar but gave me hpp. After that I was acne free for 6 months but lately I got acne on forehead and it kinda heart and then I got this medium sized cyst on my cheek which hurts if i touch. It has blood and puss.( ik its gross) fortunately the pimples on my forehad is gone but the  one of the cheek is still there. I don't want to go through acne again and I am tired of it now. It stops me from going out. I even left my gf because i didn't feel like seeing her like this it wasa  5 year relationship and i was so sad and sitll am because of it.  I have given all hopes but the accutane is something that has always worked for me. In India, you can get accutane without prescription. Hell I can get anything without prescription so I want to know that if I do 5 months course of accutane on 10mg/day and then after 5 months, I take accutane 20mg per week. Can it cause any damage? also my skin is oily so i would like to take it to control oil and mild acne because i am scared to get acne and bad oily skin again. In india beauty is measured by how pale you are and when my skin gets oily it makes me look dark however when i am oil free (good skin days)my skin looks good but its only winters.  and will my body be used to 300 mg  a month (since i will be taking 300mg for the first month) and if i lower my dose after 5 months will it stop working since my dose will be lowered? and also do you get used to accutane and does it stops working? does your body build resitence to it? sorry for so many questions. 

Sorry for bad English too.  Edited by yuvraj
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It's best to be under the care of a doctor since the medicine is quite strong and can affect your liver. That's why they do monthly blood draws. It's not worth permanent liver damage. 

Also, 20 mg/week is pretty low. So is 10mg/day, especially for a male. Accutane is prescribed according to your weight, so if you're not taking a high enough dose or if you take a really low dose over a very long period of time, your acne may return after you're done. I'm assuming that's what happened to you. 

Edited by cloudydreamer
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10 hours ago, cloudydreamer said:

It's best to be under the care of a doctor since the medicine is quite strong and can affect your liver. That's why they do monthly blood draws. It's not worth permanent liver damage. 

Also, 20 mg/week is pretty low. So is 10mg/day, especially for a male. Accutane is prescribed according to your weight, so if you're not taking a high enough dose or if you take a really low dose over a very long period of time, your acne may return after you're done. I'm assuming that's what happened to you. 

Thanks for your reply. There are people who have taken very low doses of acctuane, say 5mg/day or 20mg or 30mg a week for 3 or more years. I want to take a low dose accutane because my acne is not at all severe, i just want to get rid of oily skin and occasional cysts that I get and my skin takes soo much time to heal. The pigmentation i got from cysts 7 months ago is still there but not visible. So my question is , if i take 40mg a week or 20 mg a week for a long time, will it help me get rid of oily skin and ocassional cysts? there are also studies done and the success rate of of low dose long term acctuane was very high. I will keep getting my blood tests done and if there will be a problem i will stop taking it. BTW I am a male and weigh 79kg (174 lbs) so idk if 20 or 40mg will be enough to control oily skin for a long term. 

Edited by yuvraj
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I would absolutely not get on accutane again. I know having acne is terrible and it lowers your self esteem so much, but there are many ways to heal yourself. Based upon what you've said you sound incredibly stressed, and understandably. You've probably heard this a million times, but stress really is a culprit for many people. I know acne makes you want to isolate yourself and stay sheltered, but that only adds to the stress. There's an amazing app called Insight Timer and it's a meditation app. Here me out before you shut down the idea. Take at least 5 minutes every day to begin your day with a positive podcast. Also, try to get out more. I know your self esteem is low right now but there's many ways to get out of your rut. Go on walks in nature, read a book, learn another language, or do whatever makes you happy. Maybe even send a text to your ex explaining your circumstances. People are a lot more understanding than we give them credit and honesty is often in our favor. I'm only saying this because I was in your same situation, I gave up all of my friends and I isolated myself all due to my insecurities. I didn't realize I was chronically stressed, and I always shrugged people off when they mentioned stress being an issue. I started doing the things I mentioned above along with writing three positive things at the end of every single day. Now if none of this applies to you there's a lot of other things to examine. What is your current skincare Regimen? What is your current diet, and what diets have you tried in the past (also for how long is key). Lastly, what supplements and medication are you taking right now? I am so against accutane, there's so much dermatologists don't know and neglect to inform their patients of the repercussions. 

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Apply yogurt for 15 min, do every 2 days, to gently bleach skin
take vitamin D3, if you are inside most of the time, it might stop oily skin
use face cleanser at night only


 

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3 hours ago, WestCoast82 said:

I would absolutely not get on accutane again. I know having acne is terrible and it lowers your self esteem so much, but there are many ways to heal yourself. Based upon what you've said you sound incredibly stressed, and understandably. You've probably heard this a million times, but stress really is a culprit for many people. I know acne makes you want to isolate yourself and stay sheltered, but that only adds to the stress. There's an amazing app called Insight Timer and it's a meditation app. Here me out before you shut down the idea. Take at least 5 minutes every day to begin your day with a positive podcast. Also, try to get out more. I know your self esteem is low right now but there's many ways to get out of your rut. Go on walks in nature, read a book, learn another language, or do whatever makes you happy. Maybe even send a text to your ex explaining your circumstances. People are a lot more understanding than we give them credit and honesty is often in our favor. I'm only saying this because I was in your same situation, I gave up all of my friends and I isolated myself all due to my insecurities. I didn't realize I was chronically stressed, and I always shrugged people off when they mentioned stress being an issue. I started doing the things I mentioned above along with writing three positive things at the end of every single day. Now if none of this applies to you there's a lot of other things to examine. What is your current skincare Regimen? What is your current diet, and what diets have you tried in the past (also for how long is key). Lastly, what supplements and medication are you taking right now? I am so against accutane, there's so much dermatologists don't know and neglect to inform their patients of the repercussions. 

 Thanks mate. I explained my ex a long time ago why i couldn't meet her and asked her for sometime until my acne clears up. She got really upset when I didn't meet her on her birthday(i know its my fault but i was hard for me). I do go out but not very often. Right now I have this huge whitehead which is going down but i just dont want to leave my house with it. I go to gym in the morning and it makes me feel better. I am not highly stressed but sometimes i do feel very bad. I have tried literally everything. Diary free diet, cleansers, BP(makes my acne worse) retin-a(i know it makes your face look bad for sometime but i tried it and it made my face look bad so i stopped), I tried salicylic acid facewash(it worked for sometime ), Anti-biotics(every anti-biotics, Monocycline, etc etc you name it) and anit-biotics made my acne soooo much  worse i regret taking them. Clindamycin phosphate gel was given to me witha accutane and it worked wonders. I have tried everything and for how long? I think I am still trying because the anxiety of getting acne back never lets me do anything. I don't eat junk,  its very rare, once a month. 

My current regimen- Wash my face is morning with cetaphil facewash and apply rose water as toner and aloe vera gel (which doesn't make my skin too oily) but no matter what my nose always gets oily and its the worst part of my face, its covered in blackheads and large pores. 

At night, I do the same.

If I go out, I use acne-moist cream which is an oil free moisturizer.

Sorry I forgot to tell you that my acne is hormonal and I am 100% sure about that. I didn't tell you that I was androgen blockers and it made me so clear and oil free in 1 month. But of course androgen blockers can feminize a man and so i went through some bad side effects like sleeping 12 hours a day and being tired even after that, back pain, sweating, loss of sex drive. TO be honest I could have went through these side effects without any problem but the thing that stopped me from taking androgen blockers was breast development, in 1 and a half months, I hadn't developped anyting on my chest, but my nipples used to hurt so I stopped and my oily skin came back. I was on spiro 75mg/day. 
1 hour ago, AhaGuru said:

Apply yogurt for 15 min, do every 2 days, to gently bleach skin
take vitamin D3, if you are inside most of the time, it might stop oily skin
use face cleanser at night only

I haven't tried vitamin d3. I will. Thanks! And I have to use cleanser two times a day because in the morning I go to the gym and I sweat a lot because its really hot in my country so i use cleanser to kill the germs and in the night too I use the cleanser since your face gets dirty throughout the day. 

Edited by yuvraj
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Just now, AhaGuru said:

Try using raw honey as cleanser in the morning
its the best!
 

I once used Honey and oats scrub and it made my acne worse. 
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Well that's how you know who the real people are in your life. If she is willing to stay by your side when you're at your lowest you know she is genuine. Don't shut her down and maybe give her a chance to see all sides of you. I'm not trying to give you relationship advice on here, but I really do feel for you. I know acne makes life unbearable at times, but keep fighting and take back your life. You're doing more than most people would and it's great you've cleaned up your diet and lifestyle. This isn't something I typically reccomend as the first diet method to try, but have you ever tried reducing your fat intake and oils? I've read many people have had success with their breakouts when they completely eliminated all oils including healthy ones like olive oil. Just a suggestion, you might already be doing so. Another question is what happens when you stop taking the hormones? Do you have any severe side effects? Lastly, based on your routine you're not doing anything to combat the acne. I know you said you have in the past and you experienced a lot of irritation with the products you used. I'm not a fan of any of the products you listed and they never worked for me either. I would reccommend a gentle retinoid called Differin (or Adapalene). It takes 3 months to see results, but for many people it's worth it. Something else you said raised some red flags, nothing seems work for you. Have you ever considered you might have pityrosporum folliculitis (also known as malassezia folliculitis)? It's a form of fungal acne and typical acne treatments only make it worse. It shows up in the form of pustules, papules, and comedones (whiteheads). Without a picture I can't say whether or not you fit the description, but research it and tell me what you think. If it seems possible, I'm very knowledagble on the subject and would be happy to give you product reccomendations. I hope some of this helps! 

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Well that's how you know who the real people are in your life. If she is willing to stay by your side when you're at your lowest you know she is genuine. Don't shut her down and maybe give her a chance to see all sides of you. I'm not trying to give you relationship advice on here, but I really do feel for you. I know acne makes life unbearable at times, but keep fighting and take back your life. You're doing more than most people would and it's great you've cleaned up your diet and lifestyle. This isn't something I typically reccomend as the first diet method to try, but have you ever tried reducing your fat intake and oils? I've read many people have had success with their breakouts when they completely eliminated all oils including healthy ones like olive oil. Just a suggestion, you might already be doing so. Another question is what happens when you stop taking the hormones? Do you have any severe side effects? Lastly, based on your routine you're not doing anything to combat the acne. I know you said you have in the past and you experienced a lot of irritation with the products you used. I'm not a fan of any of the products you listed and they never worked for me either. I would reccommend a gentle retinoid called Differin (or Adapalene). It takes 3 months to see results, but for many people it's worth it. Something else you said raised some red flags, nothing seems work for you. Have you ever considered you might have pityrosporum folliculitis (also known as malassezia folliculitis)? It's a form of fungal acne and typical acne treatments only make it worse. It shows up in the form of pustules, papules, and comedones (whiteheads). Without a picture I can't say whether or not you fit the description, but research it and tell me what you think. If it seems possible, I'm very knowledagble on the subject and would be happy to give you product reccomendations. I hope some of this helps! 

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Just now, WestCoast82 said:

Well that's how you know who the real people are in your life. If she is willing to stay by your side when you're at your lowest you know she is genuine. Don't shut her down and maybe give her a chance to see all sides of you. I'm not trying to give you relationship advice on here, but I really do feel for you. I know acne makes life unbearable at times, but keep fighting and take back your life. You're doing more than most people would and it's great you've cleaned up your diet and lifestyle. This isn't something I typically reccomend as the first diet method to try, but have you ever tried reducing your fat intake and oils? I've read many people have had success with their breakouts when they completely eliminated all oils including healthy ones like olive oil. Just a suggestion, you might already be doing so. Another question is what happens when you stop taking the hormones? Do you have any severe side effects? Lastly, based on your routine you're not doing anything to combat the acne. I know you said you have in the past and you experienced a lot of irritation with the products you used. I'm not a fan of any of the products you listed and they never worked for me either. I would reccommend a gentle retinoid called Differin (or Adapalene). It takes 3 months to see results, but for many people it's worth it. Something else you said raised some red flags, nothing seems work for you. Have you ever considered you might have pityrosporum folliculitis (also known as malassezia folliculitis)? It's a form of fungal acne and typical acne treatments only make it worse. It shows up in the form of pustules, papules, and comedones (whiteheads). Without a picture I can't say whether or not you fit the description, but research it and tell me what you think. If it seems possible, I'm very knowledagble on the subject and would be happy to give you product reccomendations. I hope some of this helps! 

My skin cleared after her birthday but it was too late. She already cheated on me and lied to me about her cheating. This continued for a very long time and i was hurt. I can't tell you much i was hurt. but oh well, We are not discussing my relatonship here. lol but yeah acne took that away from me. And talking about oils. I can go on and on about it. firstly, in my country there is oil in everything, in lentilles there is oil, roti(chapati) is made in oil and then ghee is poured on chapati to make it tastier. Ghee( it is white butter? it is made from cow's milk) is actually healthy. You will not find any indian who eliminated oils from their diet . I make my lentilles myself. Without any oil, i don't eat roti . No consumption of ghee or any type of oil. I wake up, go to gym, come back and eat oats with peanut butter and 10 almonds. Then after two hours, I have green tea, and then boiled lentilles(oil free) and then at 4, i have green tea again, and after two hours i eat apple or a mango and then late at night i have my dinner with boiled lentilles(no oil). It did help me but sadly I do get mild acne. I get cysts too but very rare. I don't know what you meant by  "what happens if you stop taking hormones" if you mean spiro, then my skin gets bad again. While I was on spiro, my skin was free of oil, no oil at all and my nose were free of blackheads. I don't have a pic of now and i dont want to take it because it makes me depressed. I can post a pic of my old acne which returned after stopping accutane (this time less severe)but still used to hurt a lot. My acne is kind of what you described. I don't know what ismalassezia folliculitis but it sounds like my  case. Lastly thanks for taking your time to help me. :) And i don't have acne like in this pic right now but it left scars :( 

212.jpg

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Things will get better, just stay positive and stay on track you're doing the right things. The skin takes a long time to heal and consistency is key! I'm not trying to tell you what to do, so listen to your body and disregard anything I say that doesn't apply to you, but there were a few things that stood out to me. One is the amount of nuts your consuming. Peanut butter is actually really bad for acne, most of the time it has sugar or high fructose syrup in it and even if it doesn't have those things peanuts have a very high mold rate and don't digest easily. I would reccomend only consuming  handful of almonds a day. I suggested reducing oil because you mentioned you live in India. I know that's extremely hard to avoid living there, but try your best to not eat out and cook as much as you can. Make sure he fruits you eat have a low glycemic index and don't consume more than two servings a day. Also it's best to consume fruit on an empty stomach since fructose digests very quickly and you don't want it mixing with other foods allowing the sugar to sit in your stomach affecting your insulin levels. Are you vegan? Also, my making an assumption so pardon me if I'm wrong but it sounds like you eat a lot of the same foods everyday. Our body thrives off of variety because it supplies us with the various nutrients we need to aid our health/skin. Have you ever tried supplementing with cod liver oil? It's a vitamin A supplement (accutane is a powerful vitamin A derivative) and our body only converts 1/12th of the vitamin A we consume through diet into retinol (which our skin needs). Vitamin D is also a great supplement for skin. They might be worth a shot. I would also highly reccomend you incorporate a retinol, like Differin (aka Adapalene). Your skin really isn't that bad, I see far worse in clients every day. Stay positive, you'll beat this and come out stronger and healthier!

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Just now, WestCoast82 said:

Things will get better, just stay positive and stay on track you're doing the right things. The skin takes a long time to heal and consistency is key! I'm not trying to tell you what to do, so listen to your body and disregard anything I say that doesn't apply to you, but there were a few things that stood out to me. One is the amount of nuts your consuming. Peanut butter is actually really bad for acne, most of the time it has sugar or high fructose syrup in it and even if it doesn't have those things peanuts have a very high mold rate and don't digest easily. I would reccomend only consuming  handful of almonds a day. I suggested reducing oil because you mentioned you live in India. I know that's extremely hard to avoid living there, but try your best to not eat out and cook as much as you can. Make sure he fruits you eat have a low glycemic index and don't consume more than two servings a day. Also it's best to consume fruit on an empty stomach since fructose digests very quickly and you don't want it mixing with other foods allowing the sugar to sit in your stomach affecting your insulin levels. Are you vegan? Also, my making an assumption so pardon me if I'm wrong but it sounds like you eat a lot of the same foods everyday. Our body thrives off of variety because it supplies us with the various nutrients we need to aid our health/skin. Have you ever tried supplementing with cod liver oil? It's a vitamin A supplement (accutane is a powerful vitamin A derivative) and our body only converts 1/12th of the vitamin A we consume through diet into retinol (which our skin needs). Vitamin D is also a great supplement for skin. They might be worth a shot. I would also highly reccomend you incorporate a retinol, like Differin (aka Adapalene). Your skin really isn't that bad, I see far worse in clients every day. Stay positive, you'll beat this and come out stronger and healthier!

I don't eat meat. :) I tried cod liver oil for a month by seven rivers? idk i didn't notice any improvement so stopped taking it .Vitamin d is something i didn't try. will give it a shot. Well I have been eating two huge spoons of peanut butter since the last two years lol btw when i started peanut butter two years ago to gain weight, i used to have it with milk and it actually made my skin better( i know its weird) but i gained weight just to make my scars look betteR( because scars look better if u gain soem face fat) and i didn't get any acne at all so i doubt that the peanut butter is culprit. All I want now is to be my face less oily and the blackheads on my nose to go away. they have been there since puberty.  :( Edited by yuvraj
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5 hours ago, yuvraj said:
7 hours ago, AhaGuru said:

Try using raw honey as cleanser in the morning
its the best!
 

I once used Honey and oats scrub and it made my acne worse. 
Yes scrubs makes acne worse
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Alright, well it sounds like you're in tune with your body and know what works for you in regards to diet. The last suggestion I have that will help oiliness and blackheads is a BHA. There are several BHA products on the market that target your concerns. Two of the most popular BHA's are Paula's choice BHA and Corsx BHA. I would also reccomend using something a little more hydrating for your night time moisturizer and you can continue to use the aloe Vera as your day time moisturizer. I know it seems like using a moisturizer on oily skin is a bad thing, but when you use a good moisturizer it will stop your skin from overproducing oil to compensate for the lack of moisturer. I HIGHLY reccomend Elta AM moisturizer (the Elta PM is good too) and I've never had a client breakout from using it. It's worth a shot, but your current skincare regimen doesn't have any active ingredients to help repair and replenish the skin. An example of a skincare regimen: cerve hydrating cleanser, Paula's choice BHA, and Elta AM moisturizer. Keep it simple and effective. Do your own research and see if any of this applies to you, but I feel like it could be beneficial! 

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