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Low dose Iso for mild to moderate acne (10mg/20mg)

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(@small-llama)

Posted : 11/21/2017 9:10 am

Hi all, 

In October 2017, after >15 years of antibiotics, contraceptive pills, topical treatment and a few dietary approaches I stormed into my doctors office and refused to leave before I was prescribed roaccutane.  A colleague of mine had just said my shoulder would look like a "moon crater" which gave me the last push. I was breaking out every month around the start of my period, the scar tissue on my face and back worsened considerably over the years and there was no other cure in sight. However, my doctor was reluctant because my acne was moderate on the back and mild to moderate in the face (I had it under control with duacne gel in the face), but he eventually agreed to give a low-dosage course a go. It was really not an easy decision and I read a lot of material beforehand (I had been considering it for several years). A very good literate review can be found here  https://www.ncbi.nlm.nih.gov/pubmed/23013115  . 

To be honest, I am still worried about the drug because there is too much smoke for there not to be a fire.. My biggest concern are the effects on the brain, i.e. emotional disorders, depression, suicidal ideation because my boyfriend has struggled with mental issues for years and I have a vague idea how terrible this can be. The hair loss and constipation experienced by some are also not a great prospect. 

Anyways, I went on 10mg per day (I weigh about 65kg) and almost immediately the iso kicked in. After 4 weeks, my face looks 80% clear and my back has improved considerably. I know - already after 10mg only! In line with the small dose, the side effects are very bearable. Of course, everything is DRY. In the beginning, I also felt a slight stingy headache in the back of my head and from time to time it's like something "weighs" on my brain. My boyfriend claims my mood changed slightly for the worse and I take soflax prophylactically but other than that only the damn dry lips. Eucerin Aquaphor (a tip I got from this forum) has worked great in that regard.  My scalp is dry as well, so I only need to wash my hair 1x per week, which is quite cool :)  I have to admit I still drink alcohol socially and I feel like I get tipsy more quickly now on iso. 

Understandably, I still have small new pimples developing around the mouth and on the chin, but so far I am really HAPPY with how this is going. Of course, the big question is how long should I continue and which cumulative dose is recommended to avoid relapse? I am now going into my second month and the doctor increased to 20mg/per day. 120mg/kg cumulative seems to be standard for low dose, however, according to the paper I linked above, there seems to be evidence that's it's the length of the course (i.e. amount of months) and less the cumulative dosage that seems to be the determining factor for remission. We don't really know yet. 

All in all, there is mounting evidence that a low-dose iso course is very effective for the treatment of mild to moderate acne. Has anybody here done a 10-20mg course and was "cured"? How long did you take it and did you relapse? 

Thanks and good luck to all!

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MemberMember
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(@willingpastor)

Posted : 12/20/2017 3:59 pm

Finally someone else who is on the same dosage as me! My skin issues sound near-identical to yours - Ive always suffered with mild/moderate acne which was somewhat controlled with antibiotics and topicals but I always felt that they were just masking the internal issues which were causing my acne - I.e overactive oil glands.

last year I had to come off the contraceptive pill temporarily and it caused a MAJOR flare up in my acne which never really resolved itself so Ifinally decided that I had had enough and decided to visit a private derm here in the UK.

I weigh 54kg and she decided to prescribe me 10mg as a staring dose but seemed confident that within the first month I would see improvement.

Did your derm give you a rough idea of how long you would be taking iso for? I forgot to ask at my first appointment *doh* so Ill have to wait until next month. Not sure if she plans on keeping it to the usual 5/6 months or maybe doing a longer course seeing as Im on a smaller dose? Well see I guess. Time is dragging though!

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