I created a "blog" but thought I'd move all of my entries to here instead.
Before accutane
I'm 23 and have had acne of varying degrees of severity since I was 16. In those 7-8 years I've tried pretty much everything (oral/topical antibiotics, benzoyl peroxide, salicylic acid, exercise, every diet, lifestyle changes, etc.) except isotretinoin/accutane. I was stubborn and the side effects / stories I read kept putting me off...
Unfortunately, at times my acne was severe enough to cause keloid scars on my chest. Other times it was just about manageable with regular antibiotics (doxycycline/erythromycin). That being said, even during those time periods my skin was never good by normal standards - I'd just learned to live with sub-par skin with the hope I'd grow out of it (no signs of that happening any time soon). That changed this year when my skin started getting even worse, and so I decided to take the leap and try to get on accutane.
I started the accutane course on July 12th. This blog will document my weekly experiences with it: how my skin's doing, my mood, other side effects, etc. I plan to post pictures in the future, but I'd prefer to wait until I start getting results (fingers crossed).
Week 1 (Accutane)
I had an initial breakout within the first 3 days. Hard/inflamed bumps along my cheek bone/side neck, which I haven't had that badly since I was 16. I don't really get active/severe on my back but I got 3 random hard lumps. I also got whiteheads around my chin.
My face and lips started feeling dry after about 3 days. After 5 days much drier. The crack/bit where the nose meets the face felt sore/burnt when I wiped it, as did my skin near my upper eyelids when I rubbed them slightly. With moisturiser the dryness isn't too bad though. Putting Vaseline on my lips morning and night sufficient so far.
End of week 1 my lips and skin near chin around mouth started flaking. I started applying Vaseline to my lips every 6 hours now.
Got a few more breakouts on forehead, side forehead and cheeks. Still quite red and inflamed. Lips begin to look dry after a couple hours of applying Vaseline.
I feel like my mood has changed. I can't say for sure if it's the accutane, but I've started feeling down, less motivated. The initial breakout is really bad, so it could just be that. I prefer not to look in the bathroom mirror and I'm really not looking forward to going to work where hundreds of people each shift see my skin close-up. I also feel slightly more tired than usual.
When I used benzoyl peroxide in 2013, it dried my skin out similar to now and also caused an initial bumpy/lumpy breakout similar to this, which improved after that. So hopefully similar will happen now, except the results will be permanent/long-lasting.
I haven't had any joint ache yet, which is good because I'm into running/fitness and want to get back into that.
There's still 2 days left of week 2, but I doubt much will change between now and then. If it does I'll add it to this post. I'm feeling positive about the future, it's just I know the first 1-2 months (or more) are going to be hell. I hope this is the worst of it, but I'm prepared for worse.
Update: More initial breakout on my forehead. Really bad.
3 hours ago, Jollyhohnson said:I'm really surprised how quickly the IB has hit you. Are you on quite a high dosage?
Oops. When writing the log my first thought was to include that info, but somehow ended up forgetting!
I weigh roughly 75kg and have been put on a daily dosage of 40mg. I think my derm said it'll be increased if my body handles the current dosage well. My next appointment is on 17th August. I'd like to eventually get up to around 80mg as I read somewhere that people on lower dosages have a higher relapse rate. I really want long term remission.
Week 3 (Accutane)
It's only the middle of week 3, but I'll update this post if something changes.
Physically, my skin has never looked this bad. But I feel like I might be on the cusp of improving from here on out.
Before taking accutane my skin was the type to look normal for the first part of the day, but then start looking shiny/oily later on, especially by evening. The first 2 weeks I felt like my skin's oil levels were confused - my skin felt dry but still looked shiny/oily in the evening - basically the worst combo. Could be why I broke out badly?
But the last few days I've pretty much completely stopped producing oil. Now my face is just as dry in the evening as it is in the morning. I feel like things have stabilised. No more surprises (I hope). I haven't had any lump breakouts since, and my chin has gone dry/flaky - all the whiteheads have disappeared. My forehead & side neck/cheekbone lumps have drained/dried/scabbed up and feel like they'll flake off over the next few weeks. They look physically worse than last week, but last week they were inflamed / oily / rock hard and gave the impression they weren't going anywhere anytime soon.
I've also started getting infrequent mild joint ache (shin/knee/elbow). Nothing too bad though.
Mentally, going to work with my skin in its current state is sucking big time.I've told a few colleagues about what I'm going through and they've been supportive, so I feel more at ease. I still see hundreds of strangers each shift and can tell they're looking at my skin though.Whether true or not, I feel like I'm getting judged for it.
My mood is back to normal though. I no longer feel slightly down. I think that may have been caused by lack of sleep, not the accutane. I got a full night's sleep and have felt good since then.
Fingers crossed no more breakouts.
I know just how you feel when it comes to going to work with a face full of acne - it's feels like a real act of bravery just showing up and getting stuff done. Mentally it's just draining.
I'm really nervous about the joint ache side effect. I'm a pretty active person and sport is really important to me.
80mg sounds a little high. I've heard too that higher doses tend to prevent relapse, but at 75kg I would have thought 70mg would be your absolute maximum.
4 hours ago, Jollyhohnson said:I know just how you feel when it comes to going to work with a face full of acne - it's feels like a real act of bravery just showing up and getting stuff done. Mentally it's just draining.
I'm really nervous about the joint ache side effect. I'm a pretty active person and sport is really important to me.
80mg sounds a little high. I've heard too that higher doses tend to prevent relapse, but at 75kg I would have thought 70mg would be your absolute maximum.
It is! Embarrassingly I find it hard to make eye contact with people...
As for exercise, my joints are ok today. Up until a couple months ago I was running 5x per week, but I kind of stopped since then under the assumption I wouldn't be able to exercise on Accutane, so i gave up thinking it'd have be all for nothing anyway. NowI'm a bit wary of getting back into it
In terms of dosage I only put 80mg because I thought they only did 20mg or multiples of it in pills. So I probably wouldn't be able to get 75mg a day. That said, I also read somewhere that a dosage of 0.5 to 2 times bodyweight is kg is common. I haven't read many people go to double bodyweight (could be for some other condition?), though i do recall a few lighter people on higher than bodyweight doses.
Tomorrow will be the end of week 4. The time has flown by.
Mentally I still feel fine. Physically, my skin has barely broken out since that awful initial breakout in the first 2 weeks (pictures coming). I've had the odd small spot but no lumps. The lumps have mostly scabbed/peeled/flaked off, but I still have active parts on my side neck line (a problem area for me), and I still have a lot of redness all over.
By no means am I anywhere near clear yet, but now that my actual acne is starting to go (I've not been this "clear" for quite a long time, so this is huge for me), I can now see how much redness I have leftover. I hope, if my skin doesn't breakout anymore, then the redness will have the chance to fade over the next few months.
In terms of dryness, my skin stopped producing any noticeable oil after 2 weeks, but my skin hasn't actually been that dry. I think the initial flaking/peeling in the first 2 weeks made it seem worse than it actually was. Now that that's over, my lips feel dry after a few hours of not moisturising, but they don't look dry or cracked/split, and it's not like it's an emergency to find the Vaseline. And my face looks/feels normal (I moisturise it once a day and feel ok). I guess that shows how oily my skin used to be, if it has taken/required 40mg daily Accutane just to bring it down to normal levels, whereas people with normal skin at the start would get intense dryness. Then again, maybe I'll get that if/once they increase my dosage.
Overall I'm feeling really positive. I no longer have any doubts that my skin will get fully clear with Accutane in a few months time, but what i do have concerns with is relapsing. For instance, I hope having naturally oilier skin doesn't become a problem in terms of relapsing once I finish my course. I've read conflicting information on this. One source said that oil levels return in most people but acne doesn't (the oil changes and becomes less susceptible to blocking pores, or something), and other sources saying oil levels permanently reduced (by 40%?) / pores shrunk. I read that people with seborrhea are more prone to relapses. I don't have seborrhea but I'm naturally in the oilier side of things.
I'll ask my dermatologist these things next time. My next appointment is next Thursday (17th August). I'm roughly 75kg and on 40mg/day. I think they said they'll increase this if my body is tolerating it well. I'd prefer this as well, as lots of studies link dosage to relapse rates. Some don't link them, but I'd rather not take that risk. I definitely don't want to put up with acne ever again! 8 years sucks badly enough thankyou!
Brainfog moment: I can't remember if they want me to have the blood test a week before the next appointment. Last time I did everything on the same day and got the prescription ordered early as well, so perhaps not.
I'll upload some pictures in the next post once I figure out how.
On 08/08/2017 at 10:16 PM, Juwalker said:Wow!!! Amazing progress!!! Thanks for sharing!! Keep smiling and good luck!!
Thanks!
Half way through week 5 today. I'm actually still getting breakouts, but I think they're going away faster than they come. Also yesterday evening my face looked slightly shiny, which implies I'm still producing oils. Appointment on Thursday where I hope I can get up to 60 or 80mg, assuming the blood test doesn't report that I'm dying (I feel good though)... Ha.
Glad you're starting to see some progress! I have a question for you if that's alright: how did you deal with your initial breakout? I'm currently getting some painful and inflamed cysts and I'm just not sure what to do with them. Not that I ever knew what to do with them before Accutane either ... sigh
3 hours ago, Jollyhohnson said:Glad you're starting to see some progress! I have a question for you if that's alright: how did you deal with your initial breakout? I'm currently getting some painful and inflamed cysts and I'm just not sure what to do with them. Not that I ever knew what to do with them before Accutane either ... sigh
Unfortunately I didn't. It was the most awful thing ever! If my confidence was low before, then it was basically zero during those first 2 weeks. Not what you wanted to hear i'm sure, but I'm sure yours won't get as bad as mine!
In terms of washing/moisturising I tried to be a minimalistic as possible because I felt like every time the lumps got wet it only made them worse and take longer to go. Luckily they eventually started flaking/drying out!
Thought I'd raise your spirits a bit and show my progress pics, I was on 40mg for the first month and 80mg for 4 months and it's changed my life.
Both shoulders were completely
covered and so too was my back and chest. Just left with small scars which are fading on a monthly basis.
5 minutes ago, Jc123 said:Thought I'd raise your spirits a bit and show my progress pics, I was on 40mg for the first month and 80mg for 4 months and it's changed my life.
Both shoulders were completely
covered and so too was my back and chest. Just left with small scars which are fading on a monthly basis.
Thanks for the raised spirits. That's a massive difference! You'd never even be able to guess from the after pictures that you had acne in the past.
How long have you been off accutane now? And have you had any breakouts since then?
I suppose it really does depend on the person because I've heard of people on 80mg and having no significant sides but for me personally my lips got extremely dry and the skin on my hands would peel and flake off at times lol.
But apart from that I had no major side effects.
Some tips to manage the dry skin:
luke warm showers instead of hot
showers
rub lips gently with a small hot towel to remove the dryness and then apply chap stick
Cetaphil moisturiser in my opinion is the best for your face
Week 5 done.
Dermatologist appointment today! I had my blood test before the appointment. Hopefully nothing bad on the results. In terms of the actual appointment: I've been moved up from 40mg to 75mg (at ~75kg bodyweight). I won't start it until I get my prescription but she said I can take 60mg between and now then. I might take 60mg until the end of the month and wait to get the next prescription before taking 80mg, because I don't like going into town (and it;s nearest pharmacy they can send it to).
She reassured me that the initial breakout was normal and that redness is exacerbated massively whilst on accutane (all red marks / scars show up a lot more). I think my skin has less spots/acne than it has had in a long time, but because of all of the redness and marks it feels/looks worse to me.
I also asked her why/how accutane works and she couldn't explain it. We talked about the conflicting studies (some showing permanent oil reductions, some saying it comes back as before but acne stays away). Oh well. She also told me that there's a ~30% relapse rate, so hopefully I'm not that 30%!
Next appointment is October 6th, 7-8 weeks from now. Said I don't need to have a blood test again until after then. Feeling positive. Can't wait for October!
Glad to hear you got the increased dose you wanted. Let us know how it goes.
A 30% relapse rate is pretty high but I guess it depends what's defined as a relapse. Although I really hope Roaccutane clears me for good I could live with a few SMALL hormonal breakouts now and again, but I imagine someone who's after perfection might count that as a relapse. For me it would still be a massive improvement. It was really nice that the dermatologist made the time to have that chat with you though.
Yay for feeling positive!!
On 22/08/2017 at 11:08 AM, Jollyhohnson said:Glad to hear you got the increased dose you wanted. Let us know how it goes.
A 30% relapse rate is pretty high but I guess it depends what's defined as a relapse. Although I really hope Roaccutane clears me for good I could live with a few SMALL hormonal breakouts now and again, but I imagine someone who's after perfection might count that as a relapse. For me it would still be a massive improvement. It was really nice that the dermatologist made the time to have that chat with you though.
Yay for feeling positive!!
Thanks, I will do. I also forgot to mention that my derm said keloid scars are treated with cortisone injections (I knew that) for free under the NHS (did not know that). I feel like I read a few years ago that keloid scars are considered a cosmetic thing, meaning I'd need to go private and it'd cost £100-200 for a few injections, which I'd need to do for months with no guaranteed of improvement. They said I can get these injections after I finish accutane!
Yeah, i read that most people who relapse get it much less severe than they used to get it. I could live with small breakouts too!
End of week 6 today:
I've only been on 60mg for 3 days, but I can notice a difference from 40mg already. My lips are the same (Vaseline every 3-6 hours), but my face got drier (forehead flaking slightly which is new, and my mouth area and chin are flaking again - ew), and my side neck area (which I still have a lumpy breakout problem with) got much drier. I feel like this'll help a lot in the coming weeks. Overall the dryness isn't too bad. I recall benzoyl peroxide in 2013 made me just as dry as this (except lips).
Last week I got a couple of new lumps on my side neck. They're calming/drying now. I also got a couple of small spots. Overall I'm getting way less breakouts than before.
My redness/scars are still bad, and look even worse in exposed outdoor lighting. I really hope this improves with time.
13th Aug:
21st Aug:
Side view redness compared in indoor vs outdoors:
End of week 7 yesterday. Yesterday I started 75mg @ 75kg bodyweight, the 1mg/kg higher end dosage.
Dose journey so far:
July 12th I started 40mg (~0.5mg/kg)
August 20th I started 60mg (~0.8mg/kg)
August 31st I started 75mg (yesterday, ~1mg/kg)
October 7th is my next appointment
Overall my skin is looking less red and better as a whole. A coworker I haven't seen much since during/after my initial breakout said "it's cleared me right up". I still have a ways to go though. And since increasing to 60-75mg, I've had a few breakouts again. I think these will settle again in a couple of weeks. Skin isn't especially dry, but today I forgot to mousturise my lips on my break and they were really dry by the time I got home.
Bad news is I have noticed a keloid scar the size of a spot on my right neck line, and a smaller one on my left neck line, as well as one on my upper right back (shoulder blade). I felt them the other night and they're definitely keloids. I'm going to have to get cortisone injections for them and hope they flatten/hide them. It's got me down quite a bit to be honest.
Sympathies. You probably wouldn't have noticed them if your skin wasn't clearing tho. If it keeps on improving there will be less overall scarring in the long run. As you say you can tackle them when the treatment is over. Think you need to wait 6-12 months after tho cos skin is very delicate after the treatment. Keep positive! All the best.
8 weeks done. Physically not much has changed, but internally I feel like I'm less breakout-prone now, like my skin has become more stabilised. I have 1 active spot on my left cheek. Right neck/cheek line you'll see a keloid, left you'll see 2 small ones. The rest is redness/scars (especially on my neck/cheek).
