Hi all,
I would like to share my story for how I have reached this stage in my acne journey.
So I started getting acne around the age of 16, as most teenagers do. I went through the usual bout of trying all the products out there like clearasil, simple etc. to try and help, but seemingly nothing would. I don't remember much about how I felt about my acne at this time, but I think I thought it was relatively normal, particularly going around school seeing people going through the same as me. So I went to my doctor who prescribed me all the usual antibiotics: lymecycline, doxycycline and erythromycin. All of these had some effect for a brief period, but little more than that.
I was also prescribed various prescription topical treatments from my doctor, benzoyl peroxide (at a wide array of strengths), salicylic acid etc. Again, any improvements were temporary. I would spend hours and hours of life (and still do) researching just about every single acne treatment on the internet, constantly confused as to why I could get nothing to work. I tried diet changes (no carbs, no sugar, no dairy, no nuts, loads of antioxidants, green tea and loads of supplements covering just about every single vitamin that exists).
I then moved doctors as I went to university and went through all the regular treatments there, until one day, when I had just turned 20, after complaining to a GP about my longstanding acne issues, I was referred to a dermatologist for this unheard of drug 'accutane'. At the time, I had no idea of the significance of this or the side effects etc. that came with the drug. I upped my research of acne and found a lot of the horror stories I was reading online to be truly terrifying. I did not want to trade off good skin for potentially long-term debilitating side effects. During the three month referral period that I was waiting in order to see a dermatologist on the NHS, I luckily stumbled across the site. I was absolutely determined to avoid going on accutane at all costs and I started on the acne.org regimen. Slowly but surely, my skin started to clear up. Finally, a solution! I was absolutely religious in its strict rules, no picking, waiting for as long as it took for the copious amounts of benzoyl peroxide to dry on my skin. It became a complete obsession. I was losing a good hour in my life (morning and evening combined) to apply this stuff, but it was working, so I was happy. When I finally had my dermatologist appointment for accutane, my skin had improved and the derm was more than happy for me to avoid accutane. Result.
During that summer, when I was travelling, I cut down on my usage of the regimen to just once a day rather than twice due to time constraints, and it continued to keep me clear (I think the heat helped). However, I found that upon returning to the UK and going back to the regular twice a day application, the benzoyl peroxide was no longer working and all hell broke lose. My acne was probably as bad as it has ever been at this point. The BP had also prevented any of my old pigmentation from healing, and seemingly I still have that very same pigmentation to this day. The solution I thought I had found, was not really a solution at all.
I then went through a period of being minimalist. Maybe I was just doing too much to my skin? I took capsules known to cleanse the blood such as burdock root and followed a strict water only regimen, where I would do absolutely nothing to my skin. I was exceptionally patient with this as I had heard it can take up to 6 months for the skin to recover after all the BP use. I broke out in huge numbers of whiteheads initially but I saw dramatic improvements to my skin tone. Over time my spots I did have were becoming less inflamed and angry. However, I still had 10+ active acne on my face, which I was not happy with. I was unable to make this regimen take the extra step needed to get clear.
Back to the drawing board. I then researched local dermatologists in my area to find someone who I could speak to about my longstanding acne issues. I then went through a 2-3 month period of extensive LED light treatments and a sacilyic acid cleanser and serum to moisturise. This procedure reportedly worked in 70-80% of cases seen there). I was optimistic. I was finally seeing someone who understood what I was going through and had seen this sort of thing hundreds of times before. However, following a worsening in my acne over this period (which the derm seemed surprised at), I was told that I needed accutane, and that if I continued as I was, I was going to continue doing long-term irreversible damage to my skin.
I went home that day and balled my eyes out. My whole acne journey had done a complete full circle. I have now had 7 years of my life plighted with moderate acne. I now feel like, although I hate to admit it, I need to be on accutane. I cannot continue like this, constantly thinking about my skin every single day of my life. I understand that the vast majority of people (perhaps not on here given the nature of the board), just get the classic dry skin lips nose bleeds etc. But there are also people out there who truly believe they have experienced long-term effects from accutane. That scares me. But I have reached a point in my life now where this truly is the last resort.
I was told that the waiting list for accutane on the NHS would be 5 months so I have gone private, and have been seen within 2 weeks. I have some coverage from my private healthcare through work, which covers me for the consultations, but I will have to pay for the drug and the blood tests. I have had my initial consultation with the derm, who agreed to put me on accutane on a course of 30mg for the first month, followed by 3 and a half months on 60mg. I wasnt overly impressed with my derm to be honest, I had a lot of questions to ask, but he didnt seem particularly prepared to answer them in any detail. The cost for my course (just the drugs) will be 463 and I will need a blood test before I start (next week), one after two months and then one at the end. I am not entirely sure how much the blood tests will cost but I believe they will be roughly 150 per test.
I believe that, one day, when I have clear skin, I will be a better person from having gone through the emotional rollercoaster of acne. Right now, I am struggling to see that far ahead and more concerned about passing the upcoming blood test and the infamous initial breakout. I will be documenting my experience, from start to finish on here, as I think it will helpful for me to express my thoughts. But most importantly, hopefully I can help a few of you along the way who are going through a similar thing.
I will update following my blood test next week (quietly confident about passing this, as I passed one when I was younger and due to take accutane). I am due to start taking the pills on 6th December.
Apologies for the massive post!
Just finishing my first month of accutane. I know how emotionally damaging acne is, I'm currently in the worst emotional state of my life over it. You will pass the blood test and the IB is worth clear skin after! Im currently in my IB phase but I know it'll be worth it! Just keep a healthy diet, drink lots of water and good luck when you start. xx 
8 hours ago, Valerie22 said:Just finishing my first month of accutane. I know how emotionally damaging acne is, I'm currently in the worst emotional state of my life over it. You will pass the blood test and the IB is worth clear skin after! Im currently in my IB phase but I know it'll be worth it! Just keep a healthy diet, drink lots of water and good luck when you start. xx
Hi Valerie, thanks for your support and advice, I appreciate it.
Do you mind me asking how bad your IB has been, when it started and whether you are getting acne in places you wouldn't normally? It sounds like, from what I have read, that you are going through the worst stage at the moment so stick at it! It will all be worth it in the end. I believe I saw on one of the other threads that you are taking 10mg per day (correct me if I'm wrong), why is that exactly? Will that eventually get you to the recommended 120mg/kg?
8 hours ago, vtr said:Hi Valerie, thanks for your support and advice, I appreciate it.Do you mind me asking how bad your IB has been, when it started and whether you are getting acne in places you wouldn't normally? It sounds like, from what I have read, that you are going through the worst stage at the moment so stick at it! It will all be worth it in the end. I believe I saw on one of the other threads that you are taking 10mg per day (correct me if I'm wrong), why is that exactly? Will that eventually get you to the recommended 120mg/kg?
Pretty bad 
I don't usually get cysts but I keep getting them on my chin its horrible. Yes I am taking 10mg for a year and I have no idea but I've read that apparently theres more success with lower dosage over a long period of time or the same success with less side effects. I rather just speed up the process and start on high dosage. It doesn't even feel like I'm on accutane my lips aren't even that dry and either is my face. I hope ill get good results I'm feeling down and don't want to wake up on Christmas with 5 new pimples lol
4 hours ago, Valerie22 said:Pretty bad
That sounds horrible. It seems like, from what I have read, that cumulative dose is the most important so as long as you reach the 120mg/kg, you give yourself the best chance of ridding yourself from acne. If I were you I would stress this to your dermatologist. I would also try and chat to your derm to say you want to speed up your course a bit, I'm sure they will be understanding.
I'm equally dreading christmas and new year where I expect my skin will be worse than its been in a long time! Keep your head up and remember that with every pill you take, you are one step closer to clear skin.
1 hour ago, vtr said:That sounds horrible. It seems like, from what I have read, that cumulative dose is the most important so as long as you reach the 120mg/kg, you give yourself the best chance of ridding yourself from acne. If I were you I would stress this to your dermatologist. I would also try and chat to your derm to say you want to speed up your course a bit, I'm sure they will be understanding.I'm equally dreading christmas and new year where I expect my skin will be worse than its been in a long time! Keep your head up and remember that with every pill you take, you are one step closer to clear skin.
Yes I just don't want to miss out on this time of year because my face we all know how bad acne looks on winter days lol and thanks for the encouragement I'm so happy this site exists and we can all help each other xx. I have a dermatologist appointment Tuesday so hopefully I can ask to raise the dosage
On 26/11/2017 at 11:19 PM, Valerie22 said:Yes I just don't want to miss out on this time of year because my face
How did your appointment with your derm go? Just waiting on my blood test results so I can start.
10 hours ago, vtr said:On 2017-11-26 at 6:19 PM, Valerie22 said:Yes I just don't want to miss out on this time of year because my faceHow did your appointment with your derm go? Just waiting on my blood test results so I can start.
great! found out I was extremely low in iron, got a supplement and my hair isn't breaking off anymore and I have so much more energy. Im at 30 mg right now my face still looks bad and my lips are starting to get really dry
Update: so Ive now passed my blood tests and have been given 30mg of roaccutane (20mg pill and 10mg pill). Which I will take all at once (apparently this is advisable) and with my evening meal tomorrow. Having a few beers tonight so thought that wouldnt be the best way to start!
It also turned out that the blood tests privately in the UK cost 400! Which I was surprised at. I have paid it this time but I am trying to find out whether they will allow me to do this via my GP, as that will save me 800 going forward (one blood test after two months and one at the end of the 4.5 months).
In terms of the products I will be using:
Cetaphil Gentle skin cleanser, 2x a day (seems to be the consensus on here despite the concerning fact it has SLS in it).
Morning: Simple hydrating moisturiser during the day (more lightweight than the below).
Evening: Cetaphil moisturising cream (didnt like the fact that the lotion had cetearth 20 and cetearyl alcohol in it but may just be me being paranoid.
Aquaphor for any particularly dry patches of skin
Eucerin intensive lip relief
Thats it! Will see how I get on with those for now. Tomorrow will be day 1. Anxious and excited!
Day 3: No real changes yet as very early days but a few things to comment on. Skin seems to have improved slightly in that my existing spots have reduced quicker than they would normally. I've had a few whiteheads come and go but nothing too troublesome.
No side effects as of yet except I seem to be getting some stomach pain when taking the accutane. I already take lansprozole (a PPI) for a hiatus hernia just before (usually an hour before but sometimes less if i forget) and I have now added in the roaccutane, taking it with food mid-meal. I am thinking it maybe because of this, so I am going to experiment with taking the accutane just after my meal and/or taking the lansprozole earlier to space them out a bit more. Will see how I get on.
Lips a bit dry but nothing major, I am moisturising them and my skin liberally to help combat the dryness when it comes.
Day 5: so skin starting to get a bit flaky and feeling pretty tired a lot of the time (this seems to come in waves). No longer getting any stomach pain, I seem to have resolved that by taking my PPI earlier, taking the accutane after rather than during my evening meal and drinking lots of water when taking them (400ml). Seem to be having acid reflux issues worse than I would normally however, but not necessarily an issue if this is just short term.
In terms of my skin, a good number of new acne have appeared over the last couple of days. Existing acne I had before I started accutane seems to have improved quicker than it would otherwise but a couple of new cysts have appeared on my chin and smaller ones elsewhere. Wouldn't describe this as an initial breakout as such as I tend to get a good number of new breakouts regardless. Skin is particularly itchy today, lip dryness is bearable with vaseline during the day and eucerin intensive lip relief at night.
Day 9: so still not really any sort of 'initial breakout' as such. I stopped breaking out on my chest, back and shoulders a couple of years back when I stopped using shower gel altogether but have had around 5-10 since starting accutane but these seem to be subsiding now. In terms of my face, I have had quite a few whiteheads and my skin seems very fragile. I'm not someone who picks at my skin like a lot of people seem to do on her, I will only rarely (maybe like once every 2 weeks) pop a whitehead if I am going out, by doing the 'safe' method that I believe I learned on here, sterilising the needle then squeezing with some tissue without excessive force. However, even though I am not picking at my skin, even shaving (with a two blade razor) seems to irritate my acne a lot easier and I tend to see some blood which isn't pleasant and I am hoping doesn't lead to scarring as there is not much I can do about this. I have a couple of red patches on my skin currently from this.
I was looking at the patient information leaflet and 'an initial worsening of acne which subsides in 7-10 days' was listed as a very rare side effect (1 in 10,000) so it appears that if I don't get that many more breakouts than normal, then I am in the majority so to speak. Obviously still too early to say for sure whether my acne will get worse in the days to come but touch wood it won't.
So in terms of side effects, on Wednesday I felt really nauseous during the day, just the impending need to be sick and a headache. I took some paracetamol which helped and it subsided by the evening, so not the end of the world, perhaps it is just by body adjusting to the drug. Also had my first gym session whilst on accutane, I didn't seem to be able to lift as much as usual but didn't really experience any more aches and pains etc than I would normally.
On Thursday night I went out and drunk far too much. I'd read that if you feel okay when drinking then just carry on and I took this far too literally. I'm not a regular drinker, but when I do drink (go out maybe once a month) I drink a lot. I think I had around 15-20 units which is excessive. Something I am not proud of and I have told myself that other than Thursday night and new years eve, I will not drink any other alcohol. Hoping it hasn't put my body under too much strain given I am only on 30mg and I only had a week's worth of the drug in my system. In terms of hangover, stomach felt fine but my head was absolutely pounding, more than it would usually.
Believe I get more tired than I used to during the day as well. I am starting to understand what everyone says about dry lips, they seem to be getting drier and drier by the day and I have to have vaseline with me at all times.
Day 11: I moved onto my second pallet of pills today! Lips are really dry at the moment, so I have purchased aquaphor (I thought this was initially what I had bought with eucerin intensive lip relief but now believe they are different) and also dr.dans cortibalm so hopefully one of those will help.
Tend to find that my skin is getting flakier, my skin tone seems improved but getting lots of small breakouts, mainly whiteheads, in areas I wouldn't usually get much acne such as on my forehead, neck and nose. Tiredness seems an ongoing problem, I'm hoping I'm not this tired throughout the duration of the course!
Day 16: so I make today the 16th day of my accutane journey.
So far, I have little to report really, I'm still getting breakouts every day, as I did pre-accutane, the whiteheads have been and gone, my skin tone has improved slightlyand I have no horrendous side effects.
I am drinking lots of water to keep hydrated, am back in the gym again (decided that I need to do this to keep myself sane) and will try to eat as healthily as possible over the christmas period with little to no alcohol.
Worst side effect is the dry lips, it turns out eucerin intensive lip relief in the UK has exactly the same ingredients as aquaphor so they are the same. They are very good at moisturising my lips but I have painful cracks on the end of my lips. I went to a couple of pharmacies about this and they were of very little help. I have ordered Dr Dan's cortibalm online with hydrocortisone but I doubt it will arrive this side of Christmas. Once it arrives, I will see if it can help the cracks. At the moment, it is pretty painful to eat and talk! If I don't have any luck with that, I will either go to my GP or back to my dermatologist I think. I could deal with my lips at this level for the duration but I have a long way to go and with my dosage doubling in a couple of weeks, I am keen to get this sorted asap.
Day 22: still not really much change to my skin, continuing to break out as normal, I have particularly painful one on the inside of my nose. Not noting more whiteheads than normal, that seems pretty similar.
Side effects wise:
-Think I may have a bit of back pain, nothing too serious and may just be my mind playing tricks on me
-Cracked lips on the edges still by far the most annoying part so far, I'm using blistex lip relief on this, which is helping a bit, but I still feel it's getting worse by the day. Still waiting on dr dan's cortibalm to arrive. Eucerin intensive lip relief doesn't help with the cracks either.
-No nose bleeds yet
-Skin does get a bit flakey but isn't overly dry
-No notable changes to my mood
-Have found wearing contact lenses twice a week or so to be fine, I use hycosan eye drops which help
-Continuing to avoid alcohol and still going to the gym
-Have developed a rash on my hand between my thumb and index finger, nothing major, e45 helps keep it at bay
I am remaining patient. I have 8 more days on 30mg so will see how that goes then will get bumped up to 60mg so things may change then. Here's to clear skin in 2018.
Some hydrocortisone / steroid cream for the cracked corners of your mouth will do the trick after a few days. Derm said that was fine to do until it improved. The dry lips never really go. Everything helps but it's a constant battle needing very regular re-application. Blistex helps. So does Carmex. Good luck!
13 hours ago, Juwalker said:Some hydrocortisone / steroid cream for the cracked corners of your mouth will do the trick after a few days. Derm said that was fine to do until it improved. The dry lips never really go. Everything helps but it's a constant battle needing very regular re-application. Blistex helps. So does Carmex. Good luck!
Hi Juwalker, thank you for your reply.
I appreciate you are not a doctor but would this be fine in theory:
http://www.boots.com/hc45-hydrocortisone-cream-10032884
Even though its intended for bites, itches etc.?
Day 26:
Not having a great time of it of late. I have developed a cold which combined with the accutane, is making me feel pretty awful. I have a persistent runny nose, headache and feeling of fatigue. Hoping it clears up before I move onto 60mg or I will probably feel even worse.
In terms of my skin, I've got a giant cyst above my lip, certainly one of the biggest I have had in a while which isn't good. Probably have around 10-15 active acne, and other than that particularly horrible cyst, my skin is pretty much the same as it was pre-accutane.
I have started using hydrocortisone cream on the cracks in the corners of my mouth and still slathering on eucerin intensive relief. Too early to say whether the hydrocortisone is helping yet or not.
26 days down, 109 days to go!
Day 30: so my last day on 30mg today. Finding this whole experience quite interesting to be honest, and pretty terrifying at the same time. I have developed what appears to be accutane induced eczema on both my hands, which is spreading down my arm. I've never had any sort of dry skin condition before.
I'm using E45 on it to hopefully die it down but no luck as of yet.
In terms of dry lips, the hydrocortisone has really helped for the cracks after just 3 days. Giving myself a bit of break from it now as worried I will probably be ingesting some of it, which undoubtedly can't be good for you (but then again neither is accutane lol).
Got a question for anyone who is lurking on here, I'm currently taking 30mg, 1 20mg 1 10mg pill shortly after my dinner which almost always contains at least 20g of fat so there should be maximum absorption. I already find this quite difficult on my stomach and will now be taking 3 20mg pills for a while. How should I take them? I was thinking about doing 1 20mg pill with my breakfast (only 5g of fat) and then 2 with dinner but I was concerned that I would lower accutane's effectiveness and thus increase my chances of relapse. All advice greatly appreciated.
I'm taking a few multivitamins as well on a rotation system, iron, magnesium, vitamin b complex etc. primarily to help with the tiredness. Nothing with vitamin A in.
Just to add, my cold has now cleared up, I went through an absurd number of tissues during those few days lol. Im finding still though that the inside of my nose is dry and crusted at night and in the morning is blocked. When I clear it there is some blood. Im going to put some Vaseline up there tonight and see how that goes.
In terms of my acne, still lots of new breakouts, particularly concentrated on one side of my cheek which is odd.
I was advised to take the dose (60mg) altogether with your main meal for optimum performance. I asked about 20mg of fat idea ( because I had read that advice somewhere) but the doc said that it is just advised as above and to keep eating healthily. Did have fat in main meal though which was probably around 20 mg including pudding ( chocolate). Had a probiotic drink too each day which I also read somewhere was advisable . Had last dose yesterday. All finished now. Skin totally clear on face. Back almost there. Doc said will remain in system and keep improving for up to 6 weeks. Good luck!
Didn't take any vitamins at all during the accutane course. Previous to course took a multivitamin and omega 3 and will go back to that in about 6 weeks.
Glad to hear that hydrocortisone helped. Did that also. Stopped and started as needed. No prob with that.
Unlucky about the cold. Hope it keeps improving.