I have a dermatologist appointment next Thursday and for the past week have been going CRAZY trying to decide whether or not to take roaccutane. I was told by a different dermatologist several months ago that as I'd tried lots of topicals, peels etc that roaccutane is my last option, and he also expressed concern about some scarring on my cheeks. However, after much thought I decided not to take his advice, and instead chose the acne org regimen. It's been 3 months. While it's cleared most of my comedones, I am still getting cysts and red bumps that linger and refuse to heal peoperly. My cheeks are covered in pih/pie/scarring and I'd say it's high moderate. I have MUCH more scarring than what I started with and it seems every pimple is leaving a dent or hole. My skin is deteriorating fast and I fear if I don't take action soon I'm going to be very, very badly scarred. I was going to see a naturopath but honestly I fear that it's just too much trial and error at the rate I'm scarring.
I'm terrified accutane will be too much for my already fragile skin, or worse, that I'll be left with long term side effects.
PLEASE, what do I do? I've been out of my mind going back and forth, and I'm so scared to take the gamble and be one of the unlucky ones.
the first derm wanted to start me on 10mg a day with oral erythromycin - is starting at a very low dose better?
Right cheek
Left cheek
left cheek, with makeup (very very dry)
1 hour ago, rapharapha said:Sounds like a good combo 10mg accutane and oral(?) ery. The alternative i can think of is some kind of tetracycline antibiotic.
btw I totally feel with you!
Yep the previous derm suggested the oral erythromycin to help with the IB. I'll see what this new derm thinks. Are you currently on roaccutane?
I was on accutane low dose a number of times. Helped perfectlyt. And minocycline 2 times helped perfectly. Currently was on accutane 3 months, moderate dose, helped perfectly in 3 weeks. But then something got fkd up. I think I overdried my skin and accutane made it extremly sensitive (pain and scar prone), i put vaseline that made me break out and gave a lot of scars. So low dose accutane is probably good way to go. Now i dropped accutane and will try minocycline. Do you use moisturizer, if so which one?
16 hours ago, rapharapha said:I was on accutane low dose a number of times. Helped perfectlyt. And minocycline 2 times helped perfectly. Currently was on accutane 3 months, moderate dose, helped perfectly in 3 weeks. But then something got fkd up. I think I overdried my skin and accutane made it extremly sensitive (pain and scar prone), i put vaseline that made me break out and gave a lot of scars. So low dose accutane is probably good way to go. Now i dropped accutane and will try minocycline. Do you use moisturizer, if so which one?
So you think it got too dehydrated? What were you moisterising with? I actually tried Vaseline too but wasn't sure if it was breaking me out. I'm worried my face is over dried from the BP and that accutane will scar me worse, should I lay off the regimen a week before starting accutane? I'm currently using 'Simple light hydrating moisteriser' but it's definitely too light. However whenever I try something heavier I'm always scared it's breaking me out. I'm thinking of ordering CeraVe or eucerin cream for accutane, though.
Sorry for long time no reply. I really don't know what to moisturize with or to wash my face with.I wash with boiled and cooled on room temperature water, and use Minocycline antibiotic (for 20 days) and I'm currently satisfied (not perfect but much better). I used too high dose Accutane (for me, but it was around or a bit lower then 0.5mg/kg/day), didn't moisturize and dried my skin with some wash. It somehow caused opposite reaction and/or infection (after 2-3months), I aggravated by putting vaseline and nivea cream (don't know which one caused more damage). I think I should've started and stayed on 5-10mg of accutane for 3-4 months, with gentle face wash or water, no moisturizer, and would have perfect skin now. I had moderate acne.
Be gentle. Don't use any topicals at all from now on. Wash with cetaphil wash and moisturise with cetaphil moisturiser. Use Vaseline and blisteze on lips. Try and relax re breakouts on roaccutane. Less is more. Derm will advise. Good luck!!!
Just realised this was 30 July you posted. How's it going?
1 hour ago, Juwalker said:Be gentle. Don't use any topicals at all from now on. Wash with cetaphil wash and moisturise with cetaphil moisturiser. Use Vaseline and blisteze on lips. Try and relax re breakouts on roaccutane. Less is more. Derm will advise. Good luck!!!
Just realised this was 30 July you posted. How's it going?
Good advices. What do you think about low dose accutane (5-10mg) and Cerave hydrating cleanser without moisturizer? (also wander how is it going for you)
Hi Rapharapha. No experience and knowledge re low doses. Suppose less side effects is ultimate aim and reducing scarring which makes sense if you are scarring and have had the drug before maybe. Could it be to do with your bloods too. Not sure if all derms have the same approach. Know someone else who's been started on 20mg although she is older and heavier than my daughter. Not sure if the cumulative dose approach is being followed now either. Our derm said they treat until acne has gone now which I felt may make you more susceptible to relapse. I think they are trialling different approaches rather than knowing what they are doing exactly, unfortunately!!
We were advised no topicals two weeks before roaccutane and none during the course either and to keep using moisturiser and Vaseline as required. Her skin is not at all dry despite day 40 and 30mg for 28 days and then 40mg 28 days. Dry lips though that are cracking a bit. Don't know re cerave. Cetaphil is good.
Cerave has a lot of good ingredients for skin I heard. I have both of them, and they smell and feel similar, although am afraid to put any of them on my face :D. I wash with water only (boiled and cooled to be lukewarm) and feels good. Am no on Accutane for a month already and Cerave and Cetaphil washes could moisturize a bit that is good when on Accutane.
Yes 40mg is a lot for her, it was a lot for me and I was 80kg. I would start with 10mg, and then after a month or 2 increase to 20mg, that would be top. And would then stay on 10mg long term, like 12months. This would give good cumulative dose, and probably no risk of sideffects. I'm not a dermatologist though. (even better go with Minocycline a month before accutane) Some dermatologist use low dose approach. But recommended is 0.5-1mg/kg that is so high in my opinion (this is probably for extremly severe acne, that is accutane developed for initially).
My problem is that I always used 10mg for 4 months, cleared my acne within a month or 2 and then I dropped. So, awfully low cumulative dose, and I had to go on accutane again after 3 months, and then in circle, and just more and more scars each year.
On 7/31/2017 at 0:18 AM, T1901 said:Simple light hydrating moisteriser
What brand is this and exact name?
Researches say cumulative dose (the total taken dose at the end of therapy!) is the only important thing on the success of clearance of acne, and long term clearance of acne.Thisshould be around 80-120 mg/kg at the end of therapy I think. Again, recommended daily dose is 0.5-1mg/kg for severe acne, and the above researches are for this range I think. <-These are the facts.
Regarding scarring I think I should clarify.
Scarring during treatment. I would recommend lower dose (10-20mg) and maintain long term low dose. This will minimize dryness (and sidefects) and thus scarring during treatment. <- this is just my speculation, I cannot back with research, and is nonstandard treatment.
Regarding long term acne cure and thus long term scarring from acne it is important to get to cumulative dose. Don't know if long term cure is possible with these low doses (lower then 0.4mg/kg), as I haven't read researches. My opinion is probably yes.
Again, I'm not dermatologist, and accutane helped me tremendously, but at the end (after like 5-6 low dose short courses) I think it ruined my skin because of topical overdrying and reaction that followed in combination with moderate daily dose accutane (I speculate).
On 23/08/2017 at 6:58 PM, rapharapha said:Sorry for long time no reply. I really don't know what to moisturize with or to wash my face with. I wash with boiled and cooled on room temperature water, and use Minocycline antibiotic (for 20 days) and I'm currently satisfied (not perfect but much better). I used too high dose Accutane (for me, but it was around or a bit lower then 0.5mg/kg/day), didn't moisturize and dried my skin with some wash. It somehow caused opposite reaction and/or infection (after 2-3 months), I aggravated by putting vaseline and nivea cream (don't know which one caused more damage). I think I should've started and stayed on 5-10mg of accutane for 3-4 months, with gentle face wash or water, no moisturizer, and would have perfect skin now. I had moderate acne.
That's okay, have you noticed improvement with overall skin health/tolerance? so nivea and vaseline made it worse? I actually thought they'd help, how strange. I have heard a lot of good things about Cerave and theres this brand Aveeno that seems to have good reviews for moisteriser and face wash - their products are for dry and sensitive skin. My skin is over dried from the Acne org regimen so I need a better moisteriser.
On 23/08/2017 at 7:19 PM, Juwalker said:Be gentle. Don't use any topicals at all from now on. Wash with cetaphil wash and moisturise with cetaphil moisturiser. Use Vaseline and blisteze on lips. Try and relax re breakouts on roaccutane. Less is more. Derm will advise. Good luck!!!
Just realised this was 30 July you posted. How's it going?
Thank you for your response! 
I actually decided not to take accutane. I know it can work miracles for so many people, but for me personally I decided I wasn't willing to take the gamble. Also, I wasn't entirely comfortable with my derm - he wanted me to do 20mg for 2 weeks, then 40, and didn't explain when to stop using the bp. I've actually started Epiduo a week ago which has worked in the past, because my main issue now is PIH and scarring so I thought accutane was too drastic for me. My face is very dried out and irritated which must play a part in why it's not healing well so I need to find a good way to hydrate without breaking out.
UPDATE: Decided not to take Accutane. Currently a week and a half into Epiduo after having around 70% success with the acne.org regimen. Anyone know if I'll still get a big IB from Epiduo since the BP from the regimen cleared most of my clogged pores? I used Epiduo a couple of years ago but can't remember if I had an IB. Currently only have a few actives as opposed to the 40 + pimples I dealt with a few months ago. Main issues are awful PIH/PIE, scarring, a few cysts and dry slow healing skin. Will be seeing a naturopath to deal with my hormonal issues (I have PCOS) and have been consistent with a dairy free, refined sugar/carb free, low GI pescetarian diet so fingers crossed.
I would definitely suggest Minocycline antibiotic, and after one month low dose accutane (5-10 mg long term as maintainance). On minocycline you could be less harsh with topicals (so you allow your skin to regenerate), then stop them first day of accutane. 10mg/day accutane is very low and effective. PS. I still think accutane is great in low dose although it destroyed my skin (on 30 40mg) because of some strange reaction/infection/skin dehidration don't know what exactly. Harsh topicals also destroyed my skin (it was azelaic acid I think) couple of years ago, so now I prefer oral antibiotics. Ask your derm about minocycline and then low dose accutane as maintainance (say you are not comfortable with high dose accutane).
well, my derm says that in her experience, people taking very low doses like 10-20mg/day have a higher chance of relapse even after taking the required cumulative dosage and in the later months the side effects keep piling up so being on it for a longer time is definitely not enjoyable, lol. I was prescribed 30mg/day and was given oral azithromycin to help with initial breakouts.
On 8/26/2017 at 8:28 PM, eternalrocket said:well, my derm says that in her experience, people taking very low doses like 10-20mg/day have a higher chance of relapse even after taking the required cumulative dosage and in the later months the side effects keep piling up so being on it for a longer time is definitely not enjoyable, lol. I was prescribed 30mg/day and was given oral azithromycin to help with initial breakouts.
Good info about her experience. And sounds like very good treatment plan for you. One derm said to me azithromycin (fun fact: discovered in my country :D) is not effective for acne (but I think probably is moderately effective).
I've been on accutane 10mg-20mg 4 months like 6 times, no sidefects whatsoever except dry lips, complete remission every time, but relapse after 3 months. Definitely too low cumulative dose. I thought I would eventually overgrow acne, but almost 28 I lost hope.
On 8/28/2017 at 6:31 PM, rapharapha said:Good info about her experience. And sounds like very good treatment plan for you. One derm said to me azithromycin (fun fact: discovered in my country :D) is not effective for acne (but I think probably is moderately effective).
I've been on accutane 10mg-20mg 4 months like 6 times, no sidefects whatsoever except dry lips, complete remmision every time, but relapse after 3 months. Definitely too low cumulative dose. I thought I would eventually overgrow acne, but almost 28 I lost hope.
I've heard that azithromycin is quite effective against acne, but anyway, I'm sorry to hear that your acne Is still there at that age, I guess maybe just try to keep it under control and get on with other things in life, or maybe do a full course of isotretinoin to prevent relapse, not the best advice but that's all I can say really. good luck!