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PimplesAndWrinkles

48 Year Old Man On Accutane

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Yes, that's right! It doesn't seem right to have to fight gray hair, wrinkles, and pimples at the same time.

My history: 47, male, moderate to light acne since college. Not bad in my 20's and 30's but I've had more problems with cystic beasts on my nose, face, and chin since I turned 40. It's gotten so annoying after trying many oral and topical prescriptions (as well as B5 and Proactiv) with limited to no success, that my derm told me to try Accutane.

I have VERY oily skin and the thought of drying out sounds so appealing! I feel great when I wash, but usually I'm a grease slick within two hours.

Week #1

During my first week, I've broken out in small to normal size pimples on my jaw and chin worse than anything I've had since my 20's. I have about 12 of them now and they seem to be subsiding (haven't had a new one today - wow!). Fortunately, I can just let my beard grow out until they go away.

Has anyone had such a quick breakout on Accutane? This started on my second day!

Other than that, I haven't had any other effects. My skin is still oily. In fact it seems MORE OILY than before.

When can I expect to start drying out? I'm on 40mg/day now and I am 6'0 and 190 lbs.

Not much more to say now.

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Day #12

I guess enough has happened for a mid-week report.

My initial breakout continues, with a few new pimples every day. Most of them are in the chin area, under the beard I'm growing out. I don't think I'd continue with this course if I couldn't cover it up. There must be 30 of them in the area under my beard, though many have died down and are fading away.

My skin has started to dry out. I feel tight/dry skin, slightly dry lips (they stick together), and my eyes could use some drops (feels like they did when I had contacts). I haven't flaked or peeled yet, but I suppose that will happen when I bump up to a larger dose.

I have two pretty nasty cysts on my right cheek and a few smaller pimples. Pretty ugly! I hope the breakout confines itself to my bearded area. Also, my scalp has broken out quite a bit, which is not unusual, but probably more than normal.

Another thing: I'm sure the pores on my nose have gotten smaller. This is a good thing. I think my nose looks smaller, though nobody else would probably notice (it wasn't THAT big to begin with). I just hope the nose doesn't break out. My LEAST favorite thing is a giant cyst on the nose.

Can anyone comment on using antibiotics while on Accutane? If this breakout persists, I may ask my derm about this (next appointment Thurs Jan 5, 2006).

Good News: no backaches, hair loss, or any other nasty symptoms yet! We'll see how the blood work goes, but my triglycerides were 25 to start, so I hope to be in pretty good shape!

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Well, it's the end of my second week and I saw my derm today. Blood work was real good. Cholesterol went DOWN from 180 to 170 and triglycerides slightly up from 25 to 47. She doubled my dose from 40 mg to 80 mg.

I have no negative side effects other than the initial breakout. No soreness, only mildly dry lips, eyes, and skin. The breakout was the pits - dozens of pimples and a couple of cysts on my chin. I've grown out my beard so it's pretty well covered up. I have a few other pimples on my face that aren't covered, but I'm used to that!

I thought my breakout was pretty severe. If you count the very small whiteheads that come and go quickly, I've probably had over 100 pimples and 4 or 5 cysts in the past two weeks. I asked the derm how she would rate my breakout and she said "mild." Made me feel like a real baby! I reminder her how many there were hiding under my beard and she said "yep, but still mild." She told me that after she saw her first accutane patient who had a major breakout, she cried.

I actually have a feeling that my breakout may be subsiding. I don't have many painful spots left, most are healing. However, I just increased my dose to 80 mg, so who knows what that will do? Better brace myself!

I hope someone benefits from my journal. I know it's frustrating for me not being able to find another "old guy" who has been throught the Accutane experience!

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You'll have another break out after you up the dose to 80 mgs. But don't worry it won't be nearly as bad as the first one. You'll certainly notice that you'll have to moisturize and apply more lip balm on though...

And in the end, it's for the better.

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Week #3

Well, today marks the end of week 3, so here's the latest. I'm only doing weekly updates because many of the logs I read are too long and I don't have time to wade through them. Also, I think you can get overly occupied with this ordeal and it's good to not overdo it. In the past week I've played basketball, tennis (indoors) and gone skiiing three times. Make sure you don't spend too much time staring in the mirror waiting for things to get better!

The past week has been better than the first two. My initial breakout has slowed down, but I'm still breaking out. This may be partly due to the fact that I was bumped up from 40 mg to 80 mg daily. Surprisingly, I haven't noticed any changes from this. My skin is still mildly dry (but it is more like how I think normal skin should be). I've got slightly dry lips (a little peeling) and my eyes get dry when I walk through a department store (really dry air there). No muscle aches. My hands are getting marked up because I scrape and cut so much more easily. However, they heal up in about a week.

On my face, I've currently got 4 or 5 small active pimples, but that's nothing compared to the first two weeks when I was getting a half dozen new ones (and bigger ones) every day. The biggest story of the week was a monster cyst that started to form on Friday night right on the front of my face about a half inch from my nose. I knew it was going to be a bad one because it was deep and spread out over a large area. Unfortunately, I had to wait until Monday morning to get in to the derm for a kenalog injection. Fortunately, this stopped the monster in its tracks and two days later, it has shrunk dramatically. I think we beat the beastly thing, for which I am thankful.

I'm washing twice daily with a Purpose bar, applying some Aquafor on the lips a few times a day. No moisturizing of the skin needed. If things keep getting better on my face, I'll be very happy with the results. I may even shave this beard that is covering up lots of lumps and blemishes in my chin and jawline!

I haven't done any supplementation with Vitamin E (maybe I should), fish oil, or anything else. I'm taking my Accutane at breakfast and dinner with milk or some fatty food.

I hope this helps someone and see you next week!

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I haven't done any supplementation with Vitamin E (maybe I should), fish oil, or anything else.

Consider fish oil supplementation (get the "odorless" kind) to prevent the joint and muscle aches before they start. It seems to help a lot, and for someone active like you it could really crimp your style. Fish oil is good for you anyway. I posted a link in prescription meds to a study i found indicating that Vitamin E had no effect on Accutane symptoms so i wouldn't bother with that, unfortunately i haven't found a similar study regarding the fish oil but it certainly seems to make a big difference to me and other posters.

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I haven't done any supplementation with Vitamin E (maybe I should), fish oil, or anything else.

Consider fish oil supplementation (get the "odorless" kind) to prevent the joint and muscle aches before they start. It seems to help a lot, and for someone active like you it could really crimp your style. Fish oil is good for you anyway. I posted a link in prescription meds to a study i found indicating that Vitamin E had no effect on Accutane symptoms so i wouldn't bother with that, unfortunately i haven't found a similar study regarding the fish oil but it certainly seems to make a big difference to me and other posters.

Thanks for the advice. I've always had one concern about fish oils. It is said that iodine can affect acne adversely, and I don't know what the iodine content is in fish oils. Do you know? Also, there are concerns about purity with mercury, etc.

Thanks very much

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It is said that iodine can affect acne adversely, and I don't know what the iodine content is in fish oils.

Well, i'm sensitive to shrimp, and people say that's because of the iodine content (which really doesn't make sense as other foods have even more iodine and don't cause a predictable breakout), but i haven't noticed any acne from fish oil while on Accutane. The only effect i've noticed is that when i started to get back aches, they went away within a few days of starting fish oil supplementation, and when i was between Accutane packs for a few days and didn't think to take the fish oil anyway, the pain returned with a vengeance and again went away when i took them again. If you are really worried you could just wait and see if you get the pains, i was just trying to help you avoid them altogether.

Also, there are concerns about purity with mercury, etc.

As far as i know, no one has ever actually found mercury in fish oil. From this link http://www.ohiohealth.com/healthreference/...egory=questions

There's growing concern about mercury found in certain types of fish. But there's no evidence that fish oil supplements contain mercury. Studies indicate that mercury is more likely to accumulate in the meat of the fish rather than in the oils. One recent study of 20 brands of fish oil supplements found no mercury contamination.

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Day #15

One milestone today. It's the first day I've looked in the mirror in the morning without finding any new whiteheads ready to pop on my face! That's progress! However, I've had a few come up throughout the day today, but the frequency seems to be slowing down.

Also, I'm not getting the large, deep, nasty stuff any more. Mostly, they are on the surface, come to a head quickly, and heal up pretty fast. I call that progress!

I've read some postings that say red marks take a LONG time to fade on Accutate, but I haven't noticed that yet. If anything, they seem to heal up faster. Not sure why, but I'm not complaining!

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As to the fish oil, my dr specifically said to stay away from these supplements while on Accutane! I don't know why, but it was in the same conversation when he said to stay away from vitamin A supplements and multis. I assumed it was because they contain a lot of vitamin A, I don't know, so ask your dr before you start taking these.

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As to the fish oil, my dr specifically said to stay away from these supplements while on Accutane! I don't know why, but it was in the same conversation when he said to stay away from vitamin A supplements and multis. I assumed it was because they contain a lot of vitamin A, I don't know, so ask your dr before you start taking these.

Cod liver oil contains loads of Vitamin A and yes you shouldn't take that on Accutane. Fish oil doesn't and it's fine.

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It's the middle of week #4 and things are going pretty well. I'm still breaking out and have been consistently since day #2, but the frequency and severity are definitely decreased. Most of the pimples come to a head quickly and are gone in a couple days. They don't leave any kind of mark at all. Good thing, since I've had dozens (hundreds?) of them in the past 25 days.

I'm almost ready to shave my beard, since my chin has calmed down, and there are just a couple small pimples left there. I can feel a few lumps from the old cysts, but they are small, and I can't even see any discoloration any more.

Strange, but when I went from 40mg to 80mg after two weeks, I didn't really notice any change in symptoms. Still about the same amount of dryness, no joint pain at all yet, and the breakouts may have increased a little, but nothing dramatic. I don't moisturize anything but my lips and I haven't had any significant redness or rashes. I need eyedrops once in a while, especially in stores and malls where the air is dry.

I live in northern MN, so I spend a lot of time outside in the cold, and I notice that my face stays red after being outside longer than it used to, but after a few hours it calms down. I'm being extra careful about keeping my face covered when I ski, because the wind, cold, and sun feel like they could really do some damage. Strange, but in the past I'd be out in the bitter cold, with sun and wind and wouldn't think twice about it.

It's hard to believe I have only three days until week #4 is over. The time is flying by quickly. I was VERY oily before Accutane, so I had to put a paper towel to my face every two hours at work. You know those cheap brown paper towels? After holding it against my face to soak up the oil, it would look like the Shroud of Turin! I haven't tried it lately, but I'm really looking forward to having it come off almost perfectly dry! This is the best thing about Accutane so far for me. I don't feel like a grease slick constantly. So this is what most people feel like all day! I actually can feel good about washing my face only twice a day. In the past it felt like it needed a good scrubbing an hour after I had just done one.

I have a derm appointment on Thursday (4 week checkup) and I'm wondering if she is going to bump me up to 120 mg. Does anyone think this is a good or bad idea?

This has gotten long, but I hope it will help somebody some day!

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Great to hear that accutane is being quite kind to you :D

About going up to 120mg, if you can sense that 80mg is working (clearing/drying) then as long as you stay on that for long enough (for the weight/mg ratio thing) then I can't see a reason for pushing your body any more with such a high dose.

Keep fighting,

Tom

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I've been told I'd be on a six month course. I began on 12/22/05. Six months would be 180 days. The first fourteen were at 40 mg, so I could count those as only 7 days, making the total 173 days.

Multiply the number of days times the daily dose:

173 days * 80 mg = 13,840 mg total.

Divide the total by my weight:

13,840 mg / 84 kg = 164.8 mg/kg

I think that's about what it should be, so maybe she'll keep me at this dose for the next five months!

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As to the fish oil, my dr specifically said to stay away from these supplements while on Accutane! I don't know why, but it was in the same conversation when he said to stay away from vitamin A supplements and multis. I assumed it was because they contain a lot of vitamin A, I don't know, so ask your dr before you start taking these.

Listen to your derm, DO NOT TAKE ANY supplements! Your liver is having a hard enough time as it is with out its metabolic enzymes wasting their time on providing you with expensive urine and further fucked up sebum!

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Week #4 - Day 28

It's hard to believe, but this is already my last day of week #4. The time does go by fast. I have good news to report. I haven't had a new pimple in 4 days! When my breakout was occurring (starting day 2 and peaking at day 15), I couldn't go 4 hours without a few new whiteheads. I shaved my beard and found that things had healed up pretty nicely. I've actually been able to shave with a razor the last few days! I still have a few lumps here and there, but the redness has subsided very nicely. I'm not completely clear, but I feel like a normal person.

My skin is dry, but not overly so. I keep saying to myself "so this is how normal people feel all day!" I don't have to wipe the oil off my face every two hours. I have to moisturize my chin area once or twice a day or it flakes and peels. I apply Aquafor on the lips several times a day. The inside of my nose can get dry and sometimes my eyes dry out. However, none of the dryness is severe. I'd call it all pretty mild.

No sore joints. I played two hours of full court basketball on Monday and thought I'd really pay the price, but I was only sore in a way that I would have expected under normal conditions. I've also been able to play tennis and ski like normal without problems. For this I am very glad! I haven't had any other problems like red face, rashes, etc. So far, I'd call myself pretty lucky - though the initial breakout was no fun at all.

I have a derm appointment tomorrow for a four week checkup. I am wondering if she'll up me from 80 mg to 120 mg. If things could just stay the way they are right now for the next five months, I'd be a happy camper!

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Great news! May your journey continue as such! Just goes to show that the horror

stories of accutane are often stories...the depression, the massive changes etc.

:clap::):clap:

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Just a quick note. I had my four week checkup yesterday and the derm was very impressed with my progress. The only negative point is that my triglycerides went up from a baseline of 27 to 104 in four weeks. We need to keep an eye on the bloodwork, but otherwise things are real good!

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Just wanted to say hello, and wish you well!

Thanks Brandy! The emotional support on this forum is worth as much (or more) as the technical information. There are so many nice people here! I hope I can help others as much as I've been helped!

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Well, since today is a noteworthy day (the last day of my first month - Day #31), I thought I'd drop a quick note. It has now been one week since my initial breakout officially subsided and I've had one tiny whitehead on my jaw in the past week. My face still has a few small bumps from cysts, but they are shrinking nicely, and most of the red marks are gone.

I'm delighted with the results after one month. I will stay on 80 mg/day for at least the next month, which is fine with me, because I don't want to upset the apple cart.

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Just wanted to say hello, and wish you well!

Thanks Brandy! The emotional support on this forum is worth as much (or more) as the technical information. There are so many nice people here! I hope I can help others as much as I've been helped!

You're welcome! And I agree, this board is fabulous!

Plus, I figure us....... ahem........mature adults, cough, I'm 36, cough, should stick together. :D

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Im glad the Accutane is working for you. I also live in MN (east central/North Branch-Cambridge).

I was on the Accutane 13 years ago. At the time I was a 19 year old female at 125# and over the course of a year was worked up to the doage for a 175# male.

I didn't have alot of the side effects, just a sore back when making the bed. But I did have hair loss twoards the end. My cystic acne has returned but not nearly as severe and is treated with topical prescriptions. Good Luck and Hang in There.

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Just wanted to say hello, and wish you well!

Thanks Brandy! The emotional support on this forum is worth as much (or more) as the technical information. There are so many nice people here! I hope I can help others as much as I've been helped!

You're welcome! And I agree, this board is fabulous!

Plus, I figure us....... ahem........mature adults, cough, I'm 36, cough, should stick together. :D

Brandy,

It's great to hear from someone close to my age. I don't think I've encountered anyone over 40 on these boards yet. Maybe that should just make me feel young! So, are you on Accutane too?

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