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lexilex

still oily/breaking out!

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hey y'all. some of you know me, some don't...for those who don't look at my log. the link is below.

i am really frustrated with the accutane thing. these are my current list of side effects:

-really dry insides of my nose. bloody boogers (ugh, sorry).

-sore knees, lower back, heels

-voracious appetite

-dry, red lips

--AND--

--i am stil breaking out (less than before, but..) with whiteheads and cyst-ettes.

--still feel small cysts under my skin, that haven't pushed up yet

--my skin is still shiny, not horrible oily, but i still get a sheen and have to apply powder to counteradct it.

--still getting blackheads

what is the deal? has anyone else NOT seen improvement by the 13th week? especially on this high dose? i just made an apt with my dermo for wed. i wonder if he will increase the dosage or give me topicals or something? anyone have any ideas?

thanks!

lexi

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Lexi,

I've been exchanging messages with a newbie on these boards, Dermpro, in Acne research. I'd love to hear his take on your case. I'll link to this thread and hope he/she sees and responds.

C.

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Well, 12 weeks is basically 3 month. Its possible that it is just taking longer than expected. Sometimes people will continue to break out the entire time and clear soon after completion. You did say that you are breaking out less now, so there is some improvement. My suggestion is to just wait it out. Your derm may keep you

on an extra month or so while your acne subsides......very possible.

Just be patient....I know, I know. It is hard to be patient with this problem. Just remember that just about everyone responds favorably to accutane. You may end up needing a second round to clear up completely. I read something like 70% clear up after first treatment, 80% after second treatment and something like over 90% if a third is required. In all cases, improvement to some degree is always seen after completion.

In the end, I am sure your derm will do what is necessary to get you clear. I know its frustrating, but you are 13 weeks further along than you were before all this and that is a positive thing.

Keep your chin up.

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thanks for the replies:

cloudy: i'd be curious what the newbie says. it is interesting to be a case study instead of writing them...what i am used to.

deadliftda: thanks for the encouragement. my derm already told me that i will be on it for at least 6 months, probably 7. i really, really (REALLY) don't want to go on a second round.

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Hey Lexi,

I can relate... I actually didn't see truly "clear" skin until I started my sixth month of Accutane. Actually, my third month was my worst in terms of side-effects - I had a really flushed, hot face all the time, super sensitivity, and joint/muscle aches too. Luckily all of those subsided as I continued on my course. But honestly, I still got a couple of cysts and whiteheads (especially before my period) all the way up til when I finished. Now that I'm off, my skin is looking the best it's looked so far. So hang in there! I know it's frustrating, I had sooooo many moments of total frustration, but I vowed never to give up hope. So don't YOU give up hope either!!

Mae

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Hi Lexi,

Your side effects, while unfortunate, are not uncommon. Your dosage is right at the top of the normal range, so if you really can't tolerate the side effects, you should ask your derm if a lowering is appropriate. Lowering the dose is OK, as long as you get the overall total recommended dosing inside of you before you quit. There are some people who just can't tolerate Accutane, no matter what you do for them. I hope you are not one of those persons.

I read part of your log, and a few things stuck out. One - don't go after facial lesions! Let your derm do it, as he/she/they have a tool that can remove b&wheads if they aren't too firmly entrenched. Going after these things yourself will just increase the likelihood of scarring.

Second - you list a lot of side effects, but are not saying much about what you are doing to combat them. What type of pain reliever are you using?

Third - don't expect the Accutane to make a great change in the whitehead dept. Accutane shuts down oil glands and thereby takes away a major ingredient of whiteheads, but it doesn't take away the ones you already have. I hope that your acne is not just made up of comedones. Accutane is not indicated for that type of acne, and will not help that type of situation to any great degree.

I would estimate that 90% of my Accutane pt.s see the big push in improvement somewhere in their second month of therapy. About 5% see it within a few weeks, and the other 5% see it about their fourth or fifth month. As the other good posts above state, keep going if you can. You are only halfway through your course, so you still have a long way to go. I doubt that you need an increase in dosage, especially since you've had such a hard time with side effects. You just need more time to see the improvement that I'm sure will come. Also, patients tend to become more tolerant of their side effects as time goes by. If in the coming months your derm decides that you aren't coming along as well as he/she would like and decides to up the dosage, most likely you will be able to tolerate this.

Lastly, make sure that your derm continues to treat your acne once you are cleared and off of Accutane. I find that most of the persons who need a second course were the ones who did nothing to treat their acne once they cleared. At some point (where that point is is highly debatable) you should be on a topical retinoid for the long-term maintenance of your acne. Remember, there is no cure for acne.

As deadliftda so eloquently put it -- be patient, and keep your chin up....

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So sorry to hear lexilex. But I am sure things will look up for you soon.

I was super dry too, but lately I seem to be a little more oily. Not major oily or anything. But now I think it's going again. I dunno how that stuff works exactly, but I am sure it will for both of us. All of us actually. hehe

I am on my 3rd day of my fourth month. OMG the first 3 months went by so fast!!!! I am starting to clear pretty good, but everytime I say that, I break out again. Shit, I might be singing a different tune tomorrow. lol, I hope I continue to clear, and that you do as well.

Good Luck, keep us updated.

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Mae,

Did you say that the reddness (flush) in your face went away even before you were done your course?

I am so red right now, I dread another 2-3 months of this!!! But I'll deal if I have to, clear skin is worth it.

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thanks, everyone:

mae: thanks for the advice. i'm happy that your skin is so clear now...

dermpro: my acne is mostly cysts, actually, i have been getting more whiteheads since i've been on accutane. or maybe they are cysts with a head--donno. about my side effects, i haven't been taking much of pain killers. i have been using accupuncture to relieve some of the back and knee pain, and i have been getting consistent relief. when i came home from work tonight, i counted 5 new cysts. that just doesn't seem right. thanks for all the info...

patience: yeah--it is weird how your skin can totally change it's characteristics over 24 hours, huh? keep it up--it sounds like it is really working for you...

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Only 13 weeks in, I would be patient. I have been off Accutane for about 6 weeks now and have been really pleased with the results. I was on 120mg for 5 months and even in the last month still had a couple of blemishes. However, after getting off the tane, my skin has improved tremendously. I'm still not near as oily as pretane, and if I get a pimple now, it's some tiny tiny little whitehead that you can pop and an hour later you can't tell it was ever there.

I personally think the medicine does crazy stuff to your skin while on it. If you have seen improvement, that means it's working. You situation sounds similar to mine so hang in there.

Don't worry, a week after you quit, your nose and lips will be back to normal smile.gif

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Lastly, make sure that your derm continues to treat your acne once you are cleared and off of Accutane. I find that most of the persons who need a second course were the ones who did nothing to treat their acne once they cleared. At some point (where that point is is highly debatable) you should be on a topical retinoid for the long-term maintenance of your acne. Remember, there is no cure for acne.

Dermpro - I am mad at my derm for just letting my daughter go on her merry way with no counsel. He just said, "hope it doesn't come back". He gave her a prescription for a hydroquinone product for the red marks (after I asked about it). Now she's 3 months post and breaking out again. She's seeing a new derm next Monday. She didn't like the other guy anyway. I agree that it is important to continue follow-up care. If your derm doesn't suggest it, talk to him about it.

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thanks everyone for the advice and well wishes. i am particularly mad today since i have 3 (count em--THREE) new cysts today.

blast!

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About mid-way into month 3 is when I stopped getting any cysts, so hang in there.

I have about 3 weeks left (of a 5 month course) and am so pleased with the results. We took family photos last weekend and I cropped one to put here for you to see. I know it's not up close, so you can't micro-examine my face. BUT - you can look at me and never know that I suffered from moderate to severe cystic acne for over 3 years or that I ever experienced the hell known as the "initial breakout."

Good luck!

post-18909-1116125982_thumb.jpg

post-18909-1116125982_thumb.jpg

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Hey Lexi! It took me till just about month four when my face was clear. I am in month four now and luvin it. No acne and things are good! Some people it takes longer then others, but it will come!

Try some Omega 3 for the aches and pains, it helped me so much and helps for hair loss too. Keep your nose moist, try saline gel, works wonders for me.

Good Luck Sweetie!

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thanks, cass: i think i will try that saline stuff. it seems better than sticking aquaphor up my nose.

go saints: holy shit! you are beautiful and your skin looks impecable. i love seeing success stories.

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i know how you feel, in about my third month, i had all the same symptoms as you except replace the gross, dry, nose with the corners of my mouth ( i couldnt even open my mouth for about a month. it was awful (to endure and to look at)

i didn't even see results til after i stopped (6 months) and, sadly, they only lasted for a month. but, best of luck to you, i hear accutane works on most people. sigh.

if i want to (which i dont really 'cause of the awful side effects) i can't even start a second treatment 'til the fall 'cause i work outside.

good luck though! smile.gif

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