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Raprazant,

Hi! I need your professional input here. Tell me about your experiences with accutane and it causing scars (if it did, that is).

I've been taking it for about 8 weeks now and am getting cysts that I never had before. I've heard it's normal to break out at first, but it's been two months already! So far, it's not helping my acne, just drying up the oil. I have shallow scars now from it and I really try not to mess with my face. I started taking accutane to help lessen my oil production and tighten the pores a little. I never had the cystic acne, just the occasional pimple here and there and some blackheads. Am I doing the right thing by taking accutane? Before this, I used differin for two years and it worked fine, then I did a stupid thing and got microdermabrasion done and it totally wrecked my skin. My skin freaked out and now i'm on accutane. Any advice would be great! Thanks!

Judy

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Raprazant,

Hi!  I need your professional input here.  Tell me about your experiences with accutane and it causing scars (if it did, that is).  

I've been taking it for about 8 weeks now and am getting cysts that I never had before.  I've heard it's normal to break out at first, but it's been two months already!  So far, it's not helping my acne, just drying up the oil.  I have shallow scars now from it and I really try not to mess with my face.  I started taking accutane to help lessen my oil production and tighten the pores a little.  I never had the cystic acne, just the occasional pimple here and there and some blackheads.  Am I doing the right thing by taking accutane?  Before this, I used differin for two years and it worked fine, then I did a stupid thing and got microdermabrasion done and it totally wrecked my skin.  My skin freaked out and now i'm on accutane.  Any advice would be great!  Thanks!

Judy

sorry it took me a while to reply, i was out of town for the holiday.

ahhhh, dermabrasion is a no-no while on or after taking a rhetinoid. they will tear your fragile facial skin up, even the synthetics like diff/taz.

unfortunately differin, being a transdermal, will only deliver the rhetinoid locally in much smaller amounts. once you stop taking it the half-life of the small amount that's in your system will disappear quickly. that's the m.o. with accutane: megadose your body with it and the rhetinoid will be in your system for years.

with accutane the cystic breakouts are normal, some get it more severely than others. give it another month and your skin should settle down completely. don't do anything to irritate your facial skin. if you have to wash your face, which i do not recommend, do it with your fingertips and a super-light moisturizer/cleanser like cetaphil. anything else is just an irritant and will provide no benefit.

btw, what's your bodyweight, dosage and course length?

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Hi Raprazant!

Thanks for replying. I weigh about 110 lbs, take 40 mg a day, and am supposed to take it for five months, I think. I just recently started taking it once a day a little over three weeks ago. Before that I was just taking 40 mg. every other day.

Are you saying that it's not good to rub while washing and not to pick at the skin while on accutane? I try not to pick my face, but sometimes I get these oil clogs that stick out of my pores, so I pick at those to get them out. They are so annoying. Did you get these? They leave a tiny hole where the clog was, but seem to close up mostly. Are those going to leave scars? I'm a paranoid freak when it comes to my face scarring. I already have quite a few and don't want anymore!!

Should I just give the accutane more time to work then? I feel like my skin was so much better before accutane, so it really worries me as to what my skin will look like in the end.

:? And also, what moisturizer do you recommend, if any? Cetaphil lotion is too greasy, but I may use it cuz I don't know what else to use. Any suggestions?

Sorry for all the questions, but I've been reading all your posts and you have alot of good info!

Thanks,

Judy

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For me, the acne that scars are the cysts. Those little plugs of oil (comedo i think is the word for that) don't really scar, the pore should tighten up in a few days after you remove it. I know people always say don't pick at acne, but i've found if i don't get those little plugs out i end up with a cyst and a nice scar.

Yes, you need to give Accutane more time to work. The breakouts should lessen in a few more months, and you may not see full improvement until you are actually done with the prescribed course of medication.

A nice moisturizer is Purpose. I really wish i had it when i was on Accutane. It's a nice pure, light, water based moisturizer and doesn't have fragrance that can irritate sensitive skin. If you can't find that, just look for a water based moisturizer that is for sensitive skin.

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Hi Raprazant!

Thanks for replying.  I weigh about 110 lbs, take 40 mg a day, and am supposed to take it for five months, I think.  I just recently started taking it once a day a little over three weeks ago.  Before that I was just taking 40 mg. every other day.  

Are you saying that it's not good to rub while washing and not to pick at the skin while on accutane?  I try not to pick my face, but sometimes I get these oil clogs that stick out of my pores, so I pick at those to get them out.  They are so annoying.  Did you get these?  They leave a tiny hole where the clog was, but seem to close up mostly.  Are those going to leave scars?  I'm a paranoid freak when it comes to my face scarring.  I already have quite a few and don't want anymore!!

Should I just give the accutane more time to work then?   I feel like my skin was so much better before accutane, so it really worries me as to what my skin will look like in the end.

:? And also, what moisturizer do you recommend, if any?  Cetaphil lotion is too greasy, but I may use it cuz I don't know what else to use.  Any suggestions?  

Sorry for all the questions, but I've been reading all your posts and you have alot of good info!

Thanks,  

Judy

are you taking 20mg twice a day or 40mg once a day? i'm 215lbs. and i take 2x20mg a day. if you start to feel the side effects become more acute skip a day. it's not the intensity of the dosage that makes accutane effective it's the duration.

i would say do not rub your face while washing, in fact i've found that any contact with your face causes irritation and will increase the redness. i don't even explicitly wash my face rather i let the water from the shower run over my face and then i pad it dry with a towel. washing with medicated cleansers is highly overated. they don't address any of the causes of acne and will just irritate your fragile skin.

it's alright to remove visible comedones from non-cystic acne but DO NOT attempt to force any non-visible ones to the surface. all that you'll end up doing is tearing layers of skin away and risk scarring. in most cases extracting visible comedones will not leave scars although the mark will appear red for a while. i've always gotten whiteheads and they should be removed very carefully. i usually do it with a diabetic syringe because it can completely extract the plug/whitehead without leaving any marks. i don't recommend this though as people can severely scar their skin if they don't know what they're doing. this is essentially the same method derms use to lance and extract whiteheads.

i use cvs [drugstore brand] extra mild facial moisturizer. i don't use cetaphil at all but other people seem to like it.

if you're at 4 months i would say go the full 6 but it's your decision. obviously your acne is intense and sporadic so it may be the case that no amount of accutane will give you full remission.

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For me, the acne that scars are the cysts.  Those little plugs of oil (comedo i think is the word for that) don't really scar, the pore should tighten up in a few days after you remove it.  I know people always say don't pick at acne, but i've found if i don't get those little plugs out i end up with a cyst and a nice scar.

Yes, you need to give Accutane more time to work.  The breakouts should lessen in a few more months, and you may not see full improvement until you are actually done with the prescribed course of medication.

A nice moisturizer is Purpose.  I really wish i had it when i was on Accutane.  It's a nice pure, light, water based moisturizer and doesn't have fragrance that can irritate sensitive skin.  If you can't find that, just look for a water based moisturizer that is for sensitive skin.

good post and you're right, many times there are whiteheads, that if left alone, will become cystic and most likely scar. abscession below the surface is responsible for this "ice pick" scarring. it's a hard call though to recommend to someone, over a messageboard, that they go after said whiteheads. i've learned to do it efficiently purely through my own experience.

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Thanks Rap & Beentheredonethat,

Good advice from both! The comedones I'm referring to are not under my skin, but rather on top. They are basically clogs of oil that are sticking out of my pores. So, really, I'm not forcing anything out that's too deep in my skin. I just want my pores clear and I'm impatient, I guess.

Rap, I take 40 mg. once a day at night. I got free accutane from roche and 40 mg. is all they sent, so that's what I take. I think they give me a 5 month supply, but I will check to see if they will send another month to make it 6.

Also, is it good to put moisture on every night or just when your skin is really dry? I keep thinking that the less I put on my skin the better it will get...is this stupid? I already wear makeup and wish I didn't have to.

Thanks you guys for all your help!

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Thanks Rap & Beentheredonethat,

Good advice from both!  The comedones I'm referring to are not under my skin, but rather on top.  They are basically clogs of oil that are sticking out of my pores.  So, really, I'm not forcing anything out that's too deep in my skin.  I just want my pores clear and I'm impatient, I guess.

Rap, I take 40 mg. once a day at night.  I got free accutane from roche and 40 mg. is all they sent, so that's what I take.  I think they give me a 5 month supply, but I will check to see if they will send another month to make it 6.

Also, is it good to put moisture on every night or just when your skin is really dry?  I keep thinking that the less I put on my skin the better it will get...is this stupid?  I already wear makeup and wish I didn't have to.

Thanks you guys for all your help!

if the comedones are at the surface and you can extract them without causing any abrasion to the surrounding skin, go for it. it will probably help the pores to close up faster. i used to get the same condition around my nose and i would spend hours pulling them out with pin tweezers. i'm glad i did because it caused the gaping holes that were my pores to shrink up.

that's odd that they gave you only 5 months supply since they recommend a six month course and even more odd that they gave it to you for free. roche would be the last place i would think to look for free meds.

moisturizer doesn't cause acne, apply it whenever you feel like it. basically, i've come to learn that anything topical very rarely causes acne. pores aren't clogged from the top down rather from the bottom up.

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hey rap,

the comedones at top of the skin are those blackheads even if the color isn't really black and there is no redness. and does accutane stop formation of thoses?

also, if you don't mind i am kinda confused of what whiteheads are, do they look like the picture under the post, " what are these"

toward the bottom of the page, or are they different? thanks

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hey rap,

the comedones at top of the skin are those blackheads even if the color isn't really black and there is no redness. and does accutane stop formation of thoses?

also, if you don't mind i am kinda confused of what whiteheads are, do they look like the picture under the post, " what are these"

toward the bottom of the page, or are they different? thanks

whiteheads are clogged CLOSED pores where the comedone has reached the surface.

blackheads are clogged OPEN pores where the comedone has reached the surface. blackheads don't have to be black.

accutane pretty much lessens the formation of both but understand that even people without noticable acne still have blackheads.

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dr. rap,

I was wondering if you could look under the topic post, "what are these and do you get them " by willis, in this forum. there is a clink for a picture, i was wondering if you knew what those were. thanks

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dr. rap,

I was wondering if you could look under the topic post, "what are these and do you get them " by willis, in this forum. there is a clink for a picture, i was wondering if you knew what those were. thanks

heh... dr. rap

they look to me to be non-inflammatory whiteheads as in the pore wall has not broken down. this would explain the lack of redness. I'm just guessing though, hell they could be fever blisters for all i know.

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it's a hard call though to recommend to someone, over a messageboard, that they go after said whiteheads. i've learned to do it efficiently purely through my own experience.

Hehe perhaps i should clarify. What i related was my personal experience. I am not a doctor, and some of what i do (like removing oil plugs on the surface or lancing whiteheads with a sterilized needle) is controversial as to whether it does more harm than good. For me, i know my own skin, i know what helps it and what hurts it, and many doctors are beginning to admit that the "never ever touch your face or pop a zit" line is not neccessarily the best for everyone. I know from experience that if i let a blemish take its own course, i will end up with a cyst the size of a golfball, and a cooresponding ugly scar. If i deal with the blemish when it surfaces, i get a little red spot that goes away in a few days, or a wide pore that closes up in a few days. However it should be noted that your skin is not the same as mine, and your mileage may vary if you try to apply my technique on your own skin.

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