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elmo555

Long Term Low Dose Accutane Treatment

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Hi the reason I'm sharing this is because there is close to no info on the web regarding low dose, long term Accutane treatments. i figured i would share my story and info and offer some insights.

Background info (you can skip reading this if you want)
So basicly started having mild/moderate acne since  2009/2010 (i was 18 then) mild/moderate acne. First year of Uni (2010) i ate like crap, kfc and mcdonalds every meal for literally a whole year. Im not even kidding every meal for a year i ate fast food/ greasy chinese takeout etc with in-between snacks being soft drinks potato chips and chocolate etc. I didn't touch fruit or veg and barely any water this whole time. For all those ppl who think what you eat dont have anything to do with your skin... you are so wrong., well at least in my case my sophomore year of unhealthy eating really f***ed up my skin. I started getting acne during this time (i had good skin prior btw), the acne was mild then starting getting worse which was when i starting googling why ppl get acne and how to stop it. I have tried everything which didnt really work (doxycycline, retin a, durac, tazorac, natural remedies, tea tree, niacin, vitamins  etc etc, blue light, peels, laser, sabaceous gland ablation etc) i started eating SUPER healthy which helped but still would get one or two pimples at a time, I just could not rid acne completely. (juice/ water fasting, psyllium husk, cleanses, detoxs, eliminate simple carbs, low gi diets, wholefoods, no dairy or fried, vitamins, sustained glucose release etc) 

Accutane treatment regimen
I have been on 1x20 mg Accutane twice a week or once a week (depending if i get pimples or not) for close to 3 years now.

Pre treatment- 3-4 acne zits maximum at a given time on face. Very persistent no matter what i did i could not get the pimple count to 0.
Post treatment- clear skin (btw treatment hasnt stopped i still continue to take low dose accutane)

So basicly I have been on Accutane since i think around 2015 or 2016 so thats like 2-3 years. I was put on a low dose by my derm overseas. (I went back to Taiwan to visit relatives and figured might as well check out a derm) You see in the states and Australia accutane is made out to be this scary, last resort drug which derms only give you after you've blown 000's of dollars on s*** which doesnt even work. But in Taiwan its like buying an OTC. I walk into the derm and i told him all the stuff ive tried before which all didnt work and he said why dont you try accutane on a low dose treatment which has minimal side effects. My acne was not bad, around 3 active zits maximum at a time, which was still annoying as the post hyper-pigmentation would last for months. He said because the dose im taking is soo minimal it would be safe and have no real side effects except for some dryness. I agreed and took a blood test which turned out fine and bought like a years supply :D . he also said i could adjust my accutane intaked based on how my skin was going, so if there was no pimples i could take a lower dose etcetc.

So since then my skin has been clear !!!! but some times i would drop the dose too low to like 20mg a week then a pimple or two would pop up so id up the dose again to 20mg every 3 days etc. (it seems this low dose long term accutane thing is quite popular in Taiwan) (Btw just a quick note incase yall dont know, the derms in Taiwan are all very qualified and have just as much training as derms in the states)

Known side effects: (i have had no other complications other than these)
- slight decrease in erection hardness (erection hardness affected, however this was all up to how much accutane i took, i found that after i took a 20mg pill then the next day or two i could feel that it would have an slight affect on erection hardness) if i dropped dosage to like 1 20mg pill a week it had almost zero affect and normal functioning occurred.

- dry lips (of course)...

if you have any questions feel free to ask me (if you even have any specific questions regarding this type of accutane treatment lemme know and i could even ask my derm next time i see him)

 

Edited by elmo555

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Elmo, thanks for posting this. Like you said there is a dearth of information on this. I'm currently on my 3rd course (40mg/day, but im 70kg). My derm is really scared af about accutane, even though there is this movement of low-dose accutane. He is completely against it, and gets all fidgety when I bring it up! I talked to another derm in the US about this and she is completely open to doing this, but it still sounds like you need to justify the utilization to the derm, and then you deal with insurance and ipledge. I'm really surprised how slow, non-progressive academic dermatology is in the US, and it is really frustrating. Lots of $$$, consequences of non-effective treatements and I am pretty fed up.

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20 hours ago, HospitalBum said:

Elmo, thanks for posting this. Like you said there is a dearth of information on this. I'm currently on my 3rd course (40mg/day, but im 70kg). My derm is really scared af about accutane, even though there is this movement of low-dose accutane. He is completely against it, and gets all fidgety when I bring it up! I talked to another derm in the US about this and she is completely open to doing this, but it still sounds like you need to justify the utilization to the derm, and then you deal with insurance and ipledge. I'm really surprised how slow, non-progressive academic dermatology is in the US, and it is really frustrating. Lots of $$$, consequences of non-effective treatements and I am pretty fed up.


yeah the derms in us and aus are more reluctant and cautious to giving out accutane, but i guess the normal full course accutane treatment is quite intense i would presume, i never asked about low dose treatments in the states or aus. But in Taiwan, where im living now i just walk into any derm and say im on low dose accutance treatment and im outta accutane, need another 3 boxes of 20mg and they just go ok here you go. 
btw (1x20mg pill (roche brand) is $2.8USD) so its like 5 bucks a week for me if i take 2 pills. (this is full out of pocket expense no insurance) (I'm 50kgs)

I remember when after the first derm i saw offered me low dose accutane, i said "isnt that stuff dangerous?" he was like nah dont worry you'll be on super low dose it will be harmless, you'll just get dry lips. and so i started my accutane journey which i dont plan on stopping anytime soon. It's like having accutane pills gives me this sense of safety and calm, knowing i can keep my acne under control. Also, i take swisse liver support vitamins every since i started taking accutane, so i know im not screwing up my liver i guess.

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On 3/1/2018 at 3:59 PM, elmo555 said:

yeah the derms in us and aus are more reluctant and cautious to giving out accutane, but i guess the normal full course accutane treatment is quite intense i would presume, i never asked about low dose treatments in the states or aus. But in Taiwan, where im living now i just walk into any derm and say im on low dose accutance treatment and im outta accutane, need another 3 boxes of 20mg and they just go ok here you go. 
btw (1x20mg pill (roche brand) is $2.8USD) so its like 5 bucks a week for me if i take 2 pills. (this is full out of pocket expense no insurance) (I'm 50kgs)

I remember when after the first derm i saw offered me low dose accutane, i said "isnt that stuff dangerous?" he was like nah dont worry you'll be on super low dose it will be harmless, you'll just get dry lips. and so i started my accutane journey which i dont plan on stopping anytime soon. It's like having accutane pills gives me this sense of safety and calm, knowing i can keep my acne under control. Also, i take swisse liver support vitamins every since i started taking accutane, so i know im not screwing up my liver i guess.
Hi Elmo,

I'm thinking on doing a low dose course of accutane, but I am a big dude..about 230lbs. I have taken 2 different types of antibiotics (doxycycline 1 year) and now (minocycline 8 months) and none of those ever gave me any type of noticeable side effects whether on empty stomach or with a meal.

my current treatment prescribed from my derm (minocycline and tretinoin 0.1% microsphere) has improved my face from the major break out i experienced after stopping the doxy/epiduo regimen, but after 8 months of it, Im still getting new pimples daily. I think im going to wait a year before i try anything else, since epiduo/doxycycline took that long to have me consistently 95% clear.

The lack of sex drive (erectile dysfunction) that you experience is a huge red flag for me because I dont know what I would do if i experience that for the rest of my life. I have read a couple posts from folks on this board that say they have to deal with not having a sex drive for the rest of their lives. I wish there were more medical studies/individual stories about the successes/failures of low dose accutane. I am about to be 31 years old right now...have 2 kids and am currently single and i literally think about my acne damn near every single minute of my life ever since i got clear and broke out after my first treatment.

do you know others who have been on low dose accutane or any type of links to individuals who have posted their stories online?

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@Ludadubz
let me go over the sex drive side effect in more detail from my experience as i think this is if not one of the most important factors for guys still on the fence for accutane. Ive been on it for 3 years and i can confidently say that it has not had a big enough impact on my sex drive for me to stop or even consider stop taking it. i would think i have med-high sex drive, the only part accutane affected me was only  sometimes after i took a 20mg pill, the following day like i could feel my erection was just very slightly less hard (albeit it worked fine), but then sometimes it would take till the next day or even next couple hours then its back to normal. Bear in mind this only happened sometimes... i'm inclined to think that your body develops a tolerance to the sex drive effect. Most timesi would take 20mg pills twice a week but have no effect on my sex drive whatsoever. I think accutanes affect is minimal, i think the other factors(ie her clothing, the girl herself, the setting etcetc) which determine how aroused you are will way overpower that of accutane.
I'll keep taking accutane because to me i don't really care if only sometimes my erections may be only 80% hard for like half a day , if it meant having clear skin, thats a good trade if you ask me. :D

there was a girl who posted a few posts before mine on this forum who was also like 3 yrs low dose and if i remember correct she said she had like no side effects. I have a flight attendant friend who would take accutane low dose coz she said the jetlag and lack of sleep and stress would take a a toll on her skin so she used accutane to control breakouts. i remember she didnt mention any bad side effects except not being able to get pregnant while on it.

btw next time i visit my derm to refill accutane ill ask him if he know any male patients on low dose have erectile dysfunction 
  Edited by elmo555

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10 hours ago, elmo555 said:
@Ludadubz
let me go over the sex drive side effect in more detail from my experience as i think this is if not one of the most important factors for guys still on the fence for accutane. Ive been on it for 3 years and i can confidently say that it has not had a big enough impact on my sex drive for me to stop or even consider stop taking it. i would think i have med-high sex drive, the only part accutane affected me was only  sometimes after i took a 20mg pill, the following day like i could feel my erection was just very slightly less hard (albeit it worked fine), but then sometimes it would take till the next day or even next couple hours then its back to normal. Bear in mind this only happened sometimes... i'm inclined to think that your body develops a tolerance to the sex drive effect. Most timesi would take 20mg pills twice a week but have no effect on my sex drive whatsoever. I think accutanes affect is minimal, i think the other factors(ie her clothing, the girl herself, the setting etcetc) which determine how aroused you are will way overpower that of accutane.
I'll keep taking accutane because to me i don't really care if only sometimes my erections may be only 80% hard for like half a day , if it meant having clear skin, thats a good trade if you ask me. :D

there was a girl who posted a few posts before mine on this forum who was also like 3 yrs low dose and if i remember correct she said she had like no side effects. I have a flight attendant friend who would take accutane low dose coz she said the jetlag and lack of sleep and stress would take a a toll on her skin so she used accutane to control breakouts. i remember she didnt mention any bad side effects except not being able to get pregnant while on it.

btw next time i visit my derm to refill accutane ill ask him if he know any male patients on low dose have erectile dysfunction 
 
@elmo555
i am a big dude (about 230 pounds and my height is 5'11) and so far none of the antibiotics i have taken have given me any side effects, so Im hopeful that if I do go on accutane, that I will not experience any either.

The majority of the negative posts of accutane seem to have been for all people who have done the full dosage of it...not a low dose and so far all but, I believe, 1 post of low dose were positive. 

Seems like all the products and stuff on this site have negative reviews...i dont seem to find something that generally works for EVERYONE. I want accutane to be a last step, but I am 30 years old already and I dont feel like going through multiple years of trial and error with different prescriptions...

@elmo555

did you experience an initial breakout when you started the low dose?

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@Ludadubz

i did not have an initial breakout, probably around a month or two in i stopped getting any more acne. i was scared of going on accutane as well and put it off for ages, i lived with acne for like 3 years, 3 years no self esteem, no confidence, then after visiting the derm overseas he really changed the way i thought about accutane, it was no longer some scary life threatening drug to me anymore. so yeah i was like screw it, if heaps of ppl are doin this then might as well man up. i probably get like a pimple every few months now, thats only if i slip up with my diet and start eating too much junk or if im not sleeping right and stressed out.

my advice to you is - if you can get clear skin you are happy with without accutane then sure do that, if you cant however, then maybe you should just try accutane, it's currently the most potent and effective treatment against acne on the market.

(ive seen pictures of ppl who really do have bad acne, full face cystic acne etc, acne which the derms deem qualify for the use of accutane, my acne was at worst 3-4 active pimples (just whiteheads only) and i took accutane anyway.) Edited by elmo555

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@elmo555 How you been man? I currently am on a low dose (20mgs a day) and have been for going on 3 months now. I have been breaking out ever since I started and my neck looks like WW3 started on it, but so far it looks to be calming down (fingers crossed)....how is your treatment going?

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@Ludadubz yeah im doin fine still takin my accutane , so yeah a few months back i got those big deep nodular acne one after the other, so id get one and when it healed id get another on the other cheek, i got like 4 in a row.  this was because i was fully stressed out by my job and boss and i was getting little to no sleep mon to fri. so for me, even on low dose accu if i stress and get bad sleep it still triggers acne. so while i had those nasty cysts i upped my accutane dose like 2-3 times the normal amount to control it.  the actual pimple isnt my concern coz it goes away fast but its the hyperpigmentation marks they leave behind which friggin take MONTHS or even years to fade. 

hows it working for you? did you get any side effects?

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11 hours ago, elmo555 said:
@Ludadubz yeah im doin fine still takin my accutane , so yeah a few months back i got those big deep nodular acne one after the other, so id get one and when it healed id get another on the other cheek, i got like 4 in a row.  this was because i was fully stressed out by my job and boss and i was getting little to no sleep mon to fri. so for me, even on low dose accu if i stress and get bad sleep it still triggers acne. so while i had those nasty cysts i upped my accutane dose like 2-3 times the normal amount to control it.  the actual pimple isnt my concern coz it goes away fast but its the hyperpigmentation marks they leave behind which friggin take MONTHS or even years to fade. 

hows it working for you? did you get any side effects?
Oh damn man, sorry to hear you can still break out. Glad they heal fast for you though....hyperpigmentation does suck and I know the feeling.

I am still waiting for results to show, but it seems like my breakout is finally (hopefully) subsiding. My neck has about 7 cystic pimples all over my neck area and it sucks big time. They are the type that stay for weeks up to a couple of months before they got away, but hopefully this was my initial breakout and hopefully its over and now I can heal (knock on wood)

The only side effects I am experiencing is dry lips and my face does not get oily at all. I usually am full of oil on my face after just a couple hours after i get out the shower, but ever since I been on accutane - I dont experience that anymore. I still get a new spot on my face every couple of days but they are not the big type of spots and usually turn into white heads. When i started my treatment 3 months ago, I was about 220 pounds, but when i went to my derm last week, I now weight 197 pounds. I changed my diet to a vegan type of diet and it has made me lose over 80 pounds in less than a year and now alot of my clothes dont fit unless I wear a belt lol...too bad the weight loss isnt helping with mg acne though smh.

im hoping that with the weight loss and me not wanting to go higher than 20mgs a day, since im weighing less the dosage will have more effect. I cant even bare to think to up my dosage to 40mgs a day, but I will if i dont see results by at least the 5 month mark.

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How is it that you can convince a derm to do a low cpurse treatment long term? I did go on accutane 4 years ago worked great while on it, i could drink a gallon of milk a day and not get a zit....now if i eat anything with dairy sugar or wheat i get oily amd break out on my forehead, im almost 34....most derms ive been to will only consider accutane for severe cases...i hate restricting my diet, i love food, plus i need to gain weight....being oily and having mild acne has really destroyed me socially, I left my career as a teacher, and recently passed up a mgmt position because Its hard for me to feel comfortable in the spotlight when my skin looks like this...i dont feel like I can be myself...accutane def worked for me, just curious how to get someone to sign off giving me a low dose long term, any advice?

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4 hours ago, Jim13 said:

How is it that you can convince a derm to do a low cpurse treatment long term? I did go on accutane 4 years ago worked great while on it, i could drink a gallon of milk a day and not get a zit....now if i eat anything with dairy sugar or wheat i get oily amd break out on my forehead, im almost 34....most derms ive been to will only consider accutane for severe cases...i hate restricting my diet, i love food, plus i need to gain weight....being oily and having mild acne has really destroyed me socially, I left my career as a teacher, and recently passed up a mgmt position because Its hard for me to feel comfortable in the spotlight when my skin looks like this...i dont feel like I can be myself...accutane def worked for me, just curious how to get someone to sign off giving me a low dose long term, any advice?

Call around to different derms around your area. My doc is willing to give me a low dose long term treatment if my acne comes back after I finish my course. You should ask if that is possible before doing an appointment with the derm. Ask the front desk person who picks up when you call the establishment to see if it is possible, if it is not, then call the next derms office until you find someone who will.

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@elmo555 how you doin bro? After 3 months of doing 20mgs a day and no results, my derm upped me to 60mgs yesterday when I saw her.

How has it been goin for you?

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Hi guys,

I am writing this to help and to get helped by people who are suffering from acne (and scars) like me..

I have taken a full regular dose Accutane course about 2 years ago. I was cleared and stayed acne free for about 6 months but it left me a lot of severe acne scars.. After 6 months, it started breaking out again, nothing really serious though. Acne was pretty much moderate and under control but the major problem was severe acne scars left after the course of Accutane.

I was planning to do some scar revision treatments and have scheduled TCA CROSS + Subcision. At this time I had few active acnes on my face, so my Dr prescribed me low dose Accutane to make my acne under control before the treatment (my Dr said it is okay to do TCA Cross and Subcision while on low dose Accutane). I am currently on 10mg/day, 8th day, but Initial Break out started I believe.. 

Just wondering if anyone here experienced Initial Break out from low dose Accutane, when it started/ended, how severe it was.. and anybody here did some scar revision treatment while on (or after) low dose Accutane? 

Currently, I have few whiteheads, several small bumps on both side of my face.. 3 stubborn red acnes that stayed at least 2 weeks on my face which seems to be never come up to the head surface.

Those new acnes basically become white heads > dry up > fall  off one day eventually > become brown spot. I have gotten at least 15 brown spots for past 2-3months..

I decided to postpone  my scheduled treatment because it is certain that it is not a good idea to do any type of scar revision treatment with active acne on my face. I am going to take low dose Accutane for maybe few more weeks/months until my active acnes are fully under control and then going to start treating my acne scars. (I am planning to take low dose Accutane for at least one year btw).

So far for 8 days, 
- Initial Break out is happening
- No side effects are shown
- Acnes are getting dried up a little bit faster
- Few more little bumps appeared

I will keep it updated.. I am planning to upload pictures soon too (before/after TCA Cross + subcision) treatment.
 

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Hi Gimozzi, 
I don't know all that much about TCA treatments, but I know about another treatment that may be helpful. A close friend of mine had severe acne and she went on two rounds of Accutane like you are doing. Once her acne completely cleared, she still had a lot of scarring left behind, so she got some kind of laser treatment/peel done about 2 or 3 times and now her skin is completely smooth with 0 scarring and has been for years!! Once you complete the round of Accutane maybe this could be an option for you? I am not sure exactly what the name of the treatment was but I'm sure if you mention a laser treatment for acne scars to your dermatologist he/she should know what it is. I'm on Accutane right now as well and plan to get one of these done afterward too. I hope this is helpful! Good luck!!

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On 10/27/2018 at 8:26 PM, NataliaTalks said:

Hi Gimozzi, 
I don't know all that much about TCA treatments, but I know about another treatment that may be helpful. A close friend of mine had severe acne and she went on two rounds of Accutane like you are doing. Once her acne completely cleared, she still had a lot of scarring left behind, so she got some kind of laser treatment/peel done about 2 or 3 times and now her skin is completely smooth with 0 scarring and has been for years!! Once you complete the round of Accutane maybe this could be an option for you? I am not sure exactly what the name of the treatment was but I'm sure if you mention a laser treatment for acne scars to your dermatologist he/she should know what it is. I'm on Accutane right now as well and plan to get one of these done afterward too. I hope this is helpful! Good luck!!

Thank you for your suggestion! May I ask what kind of laser treatment your friend did? However, for my type of scars, which is severely pitted deep ice pick and boxcar scars, TCA Cross and subcision seem to be the best option. 

I am currently on day 75 on taking 10mg/day, and I am sadly still experiencing initial break out.. I am not breaking out crazy but I keep on getting 2-4 stubborn cystic acne on my face no matter what I do. They literally stay on my face forever and take so long to get dried up, leaving me red pigmentation marks at the end.  

I can tell that accutane is slowly working though.. hopefully within 1-2 months my acne is under control so that i can start treating my acne scars. I am planning on doing 3 sessions of Subcision + TCA  Cross and 4 sessions of Intracel RF Micro-needling. 

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Hello guys i hope you all stay clear!, my name is Diego and this is my sumary sorry for my bad english im peruvian. Im 24 years old and i develop rosacea papulo pustular, i tried everything creams, lifestylechanges (it helps but not improve as i want) sometimes i breaking out like crazy 7- 8 papules and pustuls over my chin only in my chin wtf? Anyways i did 1 full course of accutane  my skin was great i didnt flare up at all i was in heaven, i think i was found mentally piece but in the next 3 months my flare up came back again. Horrible breakout i decided to put end of this joke and go for low dose accutane. Im on month 2 with 20mg x 3 times week, currently im having the initial break not severe but painful, my derm told me that i can use antibiotics to avoid hiperpigmentation and scars while the initial breakout dissepear, i pretend to be on accutane for life maybe 10mg 3 times week forever because rosacea has no cure and this shit relapse always so one medical treatment ia needed to keep it under control, well thats all guys i will uptdate some of my progress if anyone still here. Best luck to you guys

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I've been thinking about going on a low dose Accutane course for a long time. I've already done a course of Accutane. However, my extremely oily skin returned and some of the blemishes.

I know a derm in Las Vegas named Rueckl who favours low dose Accutane. Unfortunately, I don't live in Vegas. So that's not an option. I am trying to find a dermatologist in Chicago who does that.

A lot of doctors in Asia use this route to combat oily skin; however, in the U.S., Accutane is monitored carefully.  

Oily skin is such a paaaain in the ass.

 

 

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