I've had extremely genetically oily skin since I was in middle school. My mom at 60 still gets the occasional chin break out from still being oily. I tried everything. Topicals to antibiotics to tretinoin to adapalene, clyndmycin, Didn't try birth control since I'm a guy... Spent so much money going to dermatologists and buying products...I had horrific breakouts on my forehead in my teens and it just went away. I rarely had cheek break outs. My problem was always my chin and lips. I never had more than two breakouts at a time. Maybe one every 2nd week or month that would come to a head and pop. But these were big cysts at times. As big as a quarter even sometimes. When I was living in Asia I was fed up with being 27 years old and still breaking out.... having to run to the mirror every morning to check. Fearing about going out too late. Fear of intimacy because of that cyst on my chin or that mark that I had to hide with makeup. Canceling plans, work, life, etc etc. Since Accutane was readily availble in 10mg or 20mg for 15 dollars I opted to take it.

The beginning was great. Low dosage meant less side effects. My oily skin was not that oily anymore. I had to blot maybe once. Sometimes I didn't even have to. Before I had to blot every hour.
I started taking 20 mg. I had one or two small noncystic breakouts because I basically stopped BP a few months after I started Accutane. 6 months in... a year in my skin was flawless. Everyone was complimenting me. I was so happy I had my life back. I took less and less of it. 20 mg every other day. Then 10 mg every other day. Then 10 mg twice a week. The less I took, the more my skin became more oily. But still not back to old times. 2 years went by, 3 years went by. My skin was still doing great. I would get a minor break out every 2nd or 3rd month. Mostly during periods when I didn't take it routinely. I was drinking a lot. I had a social life again. I was careful not to take accutane if I had alcohol for a few days after.

Instead of trying to find other solutions (as I am now), I was just busy with life and didn't want to go off it fearing that all of my oil would come back and I would break out again. So I kept taking it whenever I would remember. I went a month without taking it. I had a deep cyst again on my chin. It freaked me out, so I went right back. I never added anything to my routine though. Which was cereve hydrating cleanser and moisturizing lotion mornings and nights. No exfoliation, no bp, no salyicylic acid wash. Again, my skin was relatively clear. But, by the 4th year, things took a turn from the worse.

I always had back and joint pain when taking it. It wasn't a big deal. I thought I was just weak and not active enough. However, by the 4th year, my joints creaked and my back and muscles were so tight every morning. I kept taking it though because again, I was more obsessed about not breaking out and ruining my work and life. The oil started to come back too. No matter if I increased the dosage to 20mg, which I couldn't do because the pain was unbearable. My oil came back to 90% as it was. And with the oil, came the break outs on my chin and lips again. One day I was working in the garden and my left ankle had this sharp pain that made me collapse. I couldn't walk. It was fine 10 minutes later. But it scared me enough for me to go off of it. Even if I was on it, I was still breaking out once a month or so...so accutane no longer worked for me.

When this pandemic is over, I will go to a chiropractor and take x rays of my back and joints. I feel so much better now that I'm off of it for the past few days. But, I fear the long term damage.
I also think accutane made my vision worse, especially at night. I didn't lose any hair or experience any cracking of the lips. I wasn't depressed at all. I thought taking 10mg twice a week or weekly would make the oil go away. But it didn't work for me. I was prepared to take it for the rest of my life if I had to. I took a blood test every 3 months. All levels of my liver were fine. I had high uric acid, but I've always had that even before going on the pill. I do regret not trying to find other solutions during the latter years. When I tried to go off of it, I didn't introduce a new product. I was too busy with work and life. Too scared.

If anyone's in my same situation, I would still recommend accutane at low dosages, but it has to end. I wouldn't be on it for more than two years after trying every other option. Now, with this pandemic, I'm able to stay at home and try new things. I bought an LED light therapy mask that was supposed to kill bacteria but it actually just made my post pimple marks darker. I currently have no active pimples on my face. I'm also starting to take supplements because I never did before... including trying the high dosage pantothenic acid, which seems to be lessening my oil, but it's only been a few days so I can't say for sure. I'm also taking Vitamin D3 with K2, cod liver oil and fish oil. If this doesn't work, then I will add BP back onto my regieme at night, even though it didn't completely clear me when I used it for years prior. I tried cereave's new BP wash, but it gave me a break out on my cheek, which I haven't had one in 8 years. I also tried their salicylic acid lotion and it gave me a break out on my forehead. I haven't had one in over 10 years. I even tried the non alcoholic witch hazel by dickens, but I was still breaking out on my chin. But at this stage, I've tried everything. I'm not sure what I'll do if these vitamins won't work.