1. Pruritus (itchy dry skin) occurs in 23% of Accutane patients. Just be glad it's not (yet...) "pruritis ani" (er, don't even look it up). It sounds like you're doing well lexilex. With a dose that high I should hope so! Take it easy on your body and treat yourself as well as you can, because the Accutane at your upper limit dosage (aggressive impatient New York school of acne dermatology right?) will really be doing its thing. I trust everything's generally going well for you too. High-five! (I'm super cool too). Take care.
  2. Dry, cracked skin

    Forums Prescription acne medications 6 replies

    That's entirely up to your dermatologist. Share your concern over the obvious side-effect you're experiencing and ask what they think. It has only been a month, however, and even side-effects which may be alarming at first can quickly and completely disappear shortly thereafter. This is why you really must consult your derm about this.
  3. Dry, cracked skin

    Forums Prescription acne medications 6 replies

    What's your weight and dosage?
  4. You have to take probiotics when you take antibiotics. I thought everyone knew this.
  5. Internal hormonal and oil gland receptor variables aside, someone basically has acne because of excess sebum production (oily skin), which potentially blocks pores, AND/OR hyperkeratinization, which means excess and uneven shedding of skin cells within the pore. This explains why people can have oily skin and no acne, while other people can have dry skin and lots of acne. If your keratinization is normalized, then no matter how oily or dry your skin, you will NOT have acne. This is why normalizing keratinization is probably the most effective thing you can do to treat acne; it is ALSO, unfortunately, probably the hardest. Accutane not only almost completely minimizes sebum production but ALSO actually alters the skin's keratinization process so that skin cells shed off the inner walls of pores do not clump up and block pores-- it effectively normalizes keratinization. If you have acne on skin that is dry, this means that your problem is keratinization. Normal skin sheds the dead dermal cells off of the intrafollicular (pore) walls at a rate of approximaely every 28 days; in acne sufferers (for whom hyperkeratinization is almost always to some degree a factor), the rate tends to be closer to around every 3 days. This means that if you don't regularly exfoliate you're going to have blocked pores = acne. You should exfoliate daily, ideally with salicylic acid or glycolic acid. You would really benefit from the baking soda and ACV component of the cleansing regimen in my program linked below. Whatever you do, always moisturize after cleansing in order to help the dryness.
  6. Vitamin E

    Forums Scar treatments 6 replies

    I completely faded my red marks by doing the following: 10g / day MSM powder diluted in a glass of water, drink all down at once, every day 10 x 1000mg / day vitamin C with meals, spread over meals, every day egg - lemon mask every day (whole egg with 1 teaspoon fresh squeezed lemon juice) 20 minutes, then shower it off and go to bed; use any good non-comedogenic moisturizer after showering, preferably one with aloe vera and all-natural/preservative-free ingredients. (the best moisturizer you can buy for fading red marks is in my opinion "Allergenics: Non Steroidal Cream" as linked in my program linked below, but you will also fade them if you just do the above) a lot of people also add in baking soda and apple cider vinegar to simultaneously deal with active acne, but in your case if you just want to fade red marks then so long as you do all things above, you can afford to leave them out. if you just do the above you're gonna pretty much totally fade your marks within 1 month (within 6-8 weeks guaranteed). in fact you'll already see pretty amazing results within 1 week!!! to get all the details about how to do this stuff (like what MSM is and where to find it), etc., just click on the natural acne program link below.
  7. Your cleansing regime

    Forums Diet & holistic health 6 replies

    Good luck!
  8. Your cleansing regime

    Forums Diet & holistic health 6 replies

    Who cares how it works? IT WORKS! If something doesn't seem right just tweak it until it does. Everyone's skin is different. So listen to your skin. steaming opens pores to loosen sebum impactions, works especially well for blackheads and in general doubles the effectiveness of whatever you do to your skin immediately after steaming baking soda granules gently exfoliate, lighten and balance skin tone while dissolving dirt and grease acv dissolves sebum in pores and gets excess and unevenly shed skin cells out of pores, enhances acid mantle of skin, lightens marks egg white - lemon mask: egg white albumin tightens pores, lightens marks, lemon dissolves and clears out dead skin and sebum in blocked pores nivea baby milk soothes and fights inflammation, gives your skin a well deserved break (literally, babies it) with a product designed for the most sensitive skin in the world (babies') without blocking your pores (even though it feels oily, just wash it off, it is actually really moisutirizing your skin and will help normalize sebaceous secretion) in theory aspirin mask is performing same function as a salicylic acid cleanser but the latter comes deceptively packaged in commercial products with overdrying ingredients, counterproductive for acne; direct application of aspirin has proven time and again a highly effective overnight on-the-spot cure (3-4 nights usually for all but the most stubborn acne lesions), an alternative is rubbing a fresh cut garlic clove on the spot. (you can also dice up the garlic and swallow it down with just a little water-- incredibly powerful antibacterial limiting your P. acnes bacterial populations from the inside out, like an antibiotic without the prescription
  9. Ice Cube

    Forums The Acne.org Regimen 6 replies

    ps the garlic method works very well on any and all pimples for that matter
  10. Ice Cube

    Forums The Acne.org Regimen 6 replies

    LOL I thought this was gonna be about Ice Cube rapping about cystic acne. If you ask me the only thing worse than cystic acne is sitting through that new xXx movie. Damn that shit is shit. yeah it does seem to help initially doesn't it? also very effective for stopping a cold sore in its tracks in those first few moments at first tingle, hold ice cube firm on 'tingling' spot for 30-45 minutes minimum (going through several cubes if necessary) and 9 times out of 10 the cold sore won't form, period. but it has to be 'at first tingle' as if afterwards it's probably too late. you could also try rubbing a garlic clove on the cyst and 'strapping' the clove under a band-aid over the cyst overnight. i've done this myself before when i used to get the occasional cystic body acne and in so doing i was able to cut my cyst-healing time by at least half. it really works very well because garlic is an incredibly powerful antibacterial agent, to say nothing of many healthy properties when ingested. you just get a garlic clove, cut it open so you've got the fresh raw inside of the garlic clove exposed, and rub it back and forth on the cyst firmly for a minute. then make sure the fresh raw inside of the garlic clove is facing the skin and strap it firmly in place over the cyst using a band-aid (plaster for those in the UK). doing this every night and leaving it on overnight will bring it an average cyst to a head within 1 week for most, sometimes 2 weeks for more stubborn ones. WHATEVER YOU DO, DO NOT POP THE CYST. This is seriously major-league STUPID, take it from someone who's learned the hard way. Just don't do it. You think you're sorted but you've really just fucked yourself, it's not going to be pretty and you've seriously set back your healing of the cyst to say nothing of quite likely causing an even deeper longer-lasting infection followed by a very likely scar.
  11. In the United Kingdom and here where I live in the Republic of Ireland, only dermatolgoists can prescribe Roaccutane (Accutane). One doctor I went to a year ago in Dublin actually brought up my acne even though I was there for something else, and he suggested an antibiotic. I'd been through all that crap before, and when I started discussing Accutane with him, the reason for why only dermatologists can prescribe it became very clear: this guy couldn't tell a whitehead from a blackhead; in fact, he actually thought that Accutane worked by killing bacteria. When I heard this I knew that getting this guy to take care of your skin would be like hiring Michael Jackson to babysit your kids. Not a bright idea. What's especially annoying is that, at least yhere in Ireland, you can't even SEE a dermatologist without FIRST getting a referral from a doctor. So I just told this clueless doc to write me a referral. You really should go to a specialist for specific issues, i.e. you go to a cardiologist for your heart, a chiropractor for your spine, an endocrinologist for your hormones, a urologist or gynecologist for your bits n pieces, and you go to a dermatologist for your skin. Even if you've done your own homework and know that it's Accutane you want to take it, it is very important that you have supervision from a qualified practitioner and specialist during the course, as well as the right dosage over the right period set for your own individual case by someone with extensive experience in administering Accutane, i.e. a dermatologist, rather than a pediatrician. if it;s just a matter of getting accutane, fine, go with w your pediatrician if s/he can prescribe it. however, not all doctors are created equal and i for one believe that you should go to a specialist (ie derm) who can most competently) set the appropriate course ofttreamtent and supervise properly throughout.
  12. doggy hit the nail on the head: i'll copy this right here from a previous post i made: it's important to bear in mind that people with dry skin can have acne because they can have hyperkeratinization (excess skin cell shedding within pore) even though their sebum production is comparatively low; the pores will still be blocked by the excess shedding of keratinized epithelial cells, at a rate of something like every 3 days in the case of most acne sufferers rather than roughly every 28 in most with normally keratinising non-acneic skin. conversely, people with oily skin can be acne-free because despite high sebum production their keratinization is normalized so skin cells within the pore do not desquamate (shed off) so quickly and unevenly as to clump and stick together, thereby potentially blocking pores. * * * so to answer your question, yes oiliness can cause acne if your pilosebaceous units tend toward hyperkeratinization but it won't if they don't. if your keratinization is normalized then no matter how much sebum you produce you won't get acne. this is why kel knows people who are oily-faced but acne-free, and why, on the other hand, amy lee has dry skin on buttocks but still gets acne there. kel's friends keratinise properly but amy lee's butt skin, alas, does not. what you should do if you want to start taking steps to minimize oiliness is don't use soap, just wash at most twice daily, with a mild non-drying cleanser if you want, and above all always moisturize non-comedogenic after showering. exfoliating gently from once a day to twice a week always help ensure that these too-rapidly shed skin cells don't block the pores but are brushed out. maybe check out some other stuff i do in my own acne program linked below to see if it helps.
  13. Can I eat chicken?

    Forums Diet & holistic health 6 replies

    Chicken is AWESOME so long as it ain't from kentucky and it ain't fried.
  14. Cream of Tartar Acne Cure

    Forums Diet & holistic health 6 replies

    A VERY smart and reliable former acne sufferer friend of mine told me this today as a personal trick of hers from her acne days, and she claims it was absolutely brilliant for her mild to moderate acne. You take 1 tablespoon of cream of tartar in a glass of juice or a cup of tea once a day, and it pretty much clears you right up, especially if you've got mild to moderate acne. It's a powder that's used in cooking as a raising agent, especially to stabilize egg whites when whipping up a lemon meringue pie or something yummy like that. It mixes right into a drink, and supposedly 1 tblspoon a day is extremely effective for acne. When ingested straight up, it's supposed to be powerfully cleansing for the colon, liver and gallbladder. I bought a little tin of cream of tartar at Tesco's today and I'm going to give it a try. I've got a fresh mug of green tea in front of me and I'm adding the powder right now. I'm drinking it down now shortly before retiring for the night. Let's see how it goes!
  15. .

    Forums Prescription acne medications 6 replies

    yo i have the exact same trousers but thankfully i've never pissed them. sorry to hear about that and definitely tell your derm and/or GP/MD. what you can do on your own: take saw palmetto herbal capsules, 2 caps 3 times daily, which among other benefits improves bladder swelling, and also drink cranberry EXTRACT rather than juice as it really cleans out your kidneys and urinary tract whereas the juice is risky even though you're on Accutane as it really spikes your blood sugar risking inflammation and/or breakout.
  16. Steaming is great for opening your pores thereby reducing comedogenesis but make sure you moisturize afterward as it can dry out your skin otherwise, which can lead to breakouts. I include a brief twice-daily steaming ritual in my own cleansing regimen within my program as linked below. Don't know much about the tanning as I never get enough sun here to have to worry about it. It's controversial though isn't it? If we all listened to dermatologists about the effects of the sun on our skin none of us would ever leave the house.
  17. shocking photo

    Forums Scar treatments 6 replies

    Now THAT's what I call a fake ID!
  18. Cream of Tartar Acne Cure

    Forums Diet & holistic health 6 replies

    blackbirdbeatle thanks for the tip i googled it and found the pioneer thread before trying, seemed promising poorprettyface you're right about the detox, it's often recommended in a solution along with epsom salts and a fresh lemon squeeze-- do you smoke, are you quitting? i quit last year, just cold turkey, and i've been fine. my sister still smokes, like all slim, trendy 20somethings in London, sadly (literally, they ALL smoke, pisses me off), but I'll pass on this tip to her when she quits, which should be soon I hope
  19. "Sorry didn't know... I though Zenmed helped with Scar Treatment." Why are you plugging a product when you don't even know what it's used for? If you don't know what it is and isn't used for, you clearly haven't used it. If you haven't used it, why are you telling others to use it?
  20. Thank you Julieta. I hope that my accutane course works out for me. I get the prescription from my derm on Monday and I wonder what the dosage will be. Yours seems quite high relative to your low weight! I weigh 75 kg, but I am expecting to be put on 40mg; that's the vibe I got from my derm. I would prefer a dosage of 60mg because the consensus among derms is that for prolonged to permanent remission of acne an accutane course should have a total cumulative dose of 125mg/kg, and seeing as I am on a 5 month course this would mean I should have a daily dose of 60-70mg to reach the cumulative ideal. With your daily dosage of 60mg per day, you will reach the cumulative ideal after just 100 days! Wow, it looks like you are well on your way to really curing your acne Julieta! On the upsdide, the higher the daily dosage, the greater the remission of acne after accutane; on the downside, the higher the daily dosage, the likelier and more severe the side-effects! I agree with you that the greatest motivation comes from remembering that it will all be worth it in the end. Like Machiavelli says, the ends justify the means! Sure he was talking about how to be a great dictator and not a great accutane patient, but the principle is the same. The "yellow stuff" in the "big inflamed bumps" is a sign that you probably have a particularly severe Proprionum acnes (acne bacteria) infection inside these lesions, but this should settle down in the next week or two as the accutane takes over. The fact that they are cluttered close together is the result of a pore blockage so large and deep that the neighboring pore walls get compressed to the point that even a little sebum/oil is that much likelier to block them, resulting in the apparent "multiplying" effect that is very common among moderate- to severe- and especially cystic- acne sufferers. If they don't seem to be settling down in the next few days I think your mom might have the right idea. It would probably then be a good idea to give your derm a call and see if she can prescribe just a week or two of antibiotic (erythromycin is safe with accutane and tetracycline isn't, but your derm knows all this) to deal with the infected and inflamed yellow bumps and so minimize what hopefully is THE big initial breakout we all worry about and want to be done with ASAP. As horrible as it can feel at times-- and maybe I'm being a little premature saying this before starting my own course-- but in a way, assuming you keep on top of your health and don't suffer too bad side-effects, it IS kind of like an adventure, isn't it? A great big adventure day by day, knowing that we're that much closer to great skin. And then there's the adventure inside our body as the Accutane makes its way through our system, hopefully doing more to the acne than to our liver or brain! It's like the movie Fantastic Voyage..... but sadly without Raquel Welch. You're still within the third week so it may continue to get worse, but I'm sure before the end of April you'll be well on your way to better skin. Out of curiosity Julieta, how did my accutane equation work for you-- what was your Leeds grade between 1 and 12 when you started and what's your age? It's none of my business but I'm very curious. Granted it doesn't necessarily mean anything, and of course I hope you clear quickly and completely no matter what! Cheers, Antony
  21. Dermatologist recommendation? in OC

    Forums Scar treatments 6 replies

    One of the leading acne-specialist dermatologists in the world actually works up in Newport Beach. His name is Dr. James E. Fulton Jr., and he founded the Acne Research Institute in Newport which then changed its name to Vivant, Inc. Here is his contact info. Vivant, Inc. (formerly Acne Research Institute) 1236 Somerset Lane Newport Beach, CA 92660 Contact: James E. Fulton Jr., MD - Founder Phone: 714-722-1805 FAX: 714-722-6826 Perhaps this is the reason all those teenagers on The OC have improbably perfect skin? But after reading all the harsh, abrasive and indeed invasive things you are or are considering doing to your skin, I would suggest that you do the following, which I recommend to friends with adult (25+) acne and which is especially effective in such cases. But first, please answer this important question: have had your acne since your teenage years or did it just start in your early 20s? This actually is an important clue as to the best approach. Here is what you do and don't laugh because this works. For 3 consecutive days, eat nothing but organic golden delicious apples, eating as many as you require to feel full and drinking 3-4 liters purified (bottled or filtered) water daily. You really must not eat anything else: this is a cleansing fast, and you will see not only your skin lighten and begin to clear but your eyes clear and the iris become bright and very defined, a sign that your liver is strengthening and can now more effectively deactivate and eliminate used and excess hormones that will otherwise remain in your blood to overstimulate your oil gland hormone receptors thereby causing further acne. At the end of every day, this fast ideally involves a self-administered enema but many people find that a little embarrassing even in the privacy of their own home as it does involve sticking a tube an inch into your ass and flushing your bowels with a solution to really flush out all the toxins your body is trying to eliminate during the fast. So you can avoid the enemas but it won't be as effective. To do the enema, you get an enema kit from any pharmacy (say it's for your ailing grandfather) and fill the enema bottle with 2 liters water and 3 tablespoons Espom Salts (likewise available at any pharmacy). Put your face over a bowl or sink of boiling hot water (from kettle or microwave) and cover head with a towel, relax and steam your face like this for 10 minutes. Then crack open an egg and whisk it in a bowl, apply egg mix to face with cotton ball and leave to dry for 20 minutes. Then shower 5-10 minutes lukewarm water with gentle cleanser no harsh drying alcohol astringents or anything like that. Best is an all-natural cleanser with tea tree oil as its active ingredient. Most common mistake is to really scrub and rub in a cleanser. Don't. Gently softly rub in circles around face and rinse off. Air-dry face and then lightly apply oil-free/non-comedogenic all-natural moisturizer with aloe vera and go to bed. In the morning steam face as before and then shower as before and then apply same moisturizer and go out. After the 3-day apple fast you will be dying for a huge bar of fudge or something really decadent, but resist the urge and instead stuff yourself with vegetables and fruits all day, bringing in some fish, brown rice, maybe chicken and turkey over the next few days and then phasing back in whatever you want. Immediately after the 3-day apple fast, begin taking the following herbal supplement: DermaCleanse Capsules from ZenMed. Available at http://zendmed.com. Do not buy anything else on this website as it comes with a uselss cleanser and moisturizer but all you want are the CAPSULES. These powerfully detoxifying capsules are extremely effective at clearing up skin and have been extremely good for my skin and my friends to whom I have recommended them, however the must be used in a certain way, and it's not the way the maker of the product tells you to use it. They come in bottles of 90 and are well worth the reasonable price. From the first day after your 3-day apple fast, take 6 capsules a day (2 at each meal) and do this for the next 3 weeks, continuing with your twice daily mini steam facial and nightly egg mask. Then do not take the capsules for the next 2 weeks. Then take them again as before for the next 3 weeks, then go off them for 2 weeks and so on. It is extremely important that you cycle them like this as otherwise your body "gets used" to them. The maker says to just keep taking and taking them, but if you do this you will clear up in the first few weeks but then break out again. They tell you to keep taking them because obviously that makes you use more product which is more profit for them. You must cycle it, with 3 weeks on, 2 off, 3 on, and so on, and you WILL clear up and stay clear. This program after your 3-day apple fast combined with your daily face-steaming and your nightly egg mask WILL clear you up almost completely and indefinitely. It is very important that after doing the egg mask every night for 1 month that you do NOT continue it, and at most only do maintenance egg masks 2-4 times a month thereafter, continuing it any more beyond this will have the opposite effect and make your skin WORSE. You say that you are currently on minocycline. In my observation this is the most effective acne antibiotic: it begins clearing you up within 2-3 weeks, can be taken the longest and has the most prolonged effect. You should take a daily probiotic while you are on your antibiotic as it kills not only the acne bacteria but also the good bacteria you need in your intestinal tract to properly digest your food. This is why people generally get sick often and feel queasy a lot of the time after any prolonged course of antibiotics. Go into your health store and get something called Acidophilus, and take one capsule with every meal. As you are 29 and will want to deal with your scarring, it is important before you consider abrasive methods like those you mentioned-- microdermabrasion and/or peels and/or laser resurfacing (ablative lasers, those that precisely peel off the top-most or corneal layer of the epidermis), that you deal with your active mild to moderate acne. You cannot truly deal effectively with scarring unless you first tackel your active acne. This is why at 29 with persistent mild to moderate acne you may want to consider a course of Accutane, but most likely a dermatologist will insist you at least first undergo 1 or 2 antibiotics treatments, which may clear you up temporarily before you break out even worse once the acne bacteria mutates into super-resistant strains (which is actually always what happens after a course of antibiotics-- whenever someone with acne goes on antibiotics and then never has acne again afterwards, what has happened is that while they were on antibiotics the internal cause of their acne, the oversensitive oil gland hormone receptors and fluctuating levels of male sex hormones, has naturally self-resolved. The antibiotic itself has not cured the person; the root cause of the acne itself has dissipated while the antibiotic was helping to manage the symptoms.) If you continue on minocycline the you will almost certainly begin clearing up in the next few weeks and may continue to clear for months, but unless your acne naturally self-resolves while on minocycline you are only waiting for another breakout within weeks to months following your termination of the minocycline. The fact that you still have mild to moderate acne at 29 suggests to me that either your oil glands have especially sensitive hormone receptors and so are overstimulated by normal amount of androgens (male sex hormones in the blood), and this is genetically determined but is also actually the major factor in almost all cases of acne, or you have unusually high androgen levels, which an endocrinologist (a doctor specializing in hormones) can diagnose. It may also be the result of an undiagnosed food intolerance/allergy-- you would be surprised how common this is in acne sufferers, especially to iodine (milk, excess red meat, shellfish). It may also be the result of toxic congestion, which a week or 2 on a non-inflammatory diet would almost certainly clear up: little to no sugar, only raw, unheated vegetables, fruits, brazil nuts, walnuts, salmon, trout, tuna, cod, mackerel, brown rice, raw egg yolks (no whites), and lots of fruits especially apples, berries of all kinds, and kiwis. Only water and lots of it to drink, nothing else. Your acne would almost certainly clear up after at least two weeks on the non-inflammatory diet, and even if it didn't this would at least confirm unanimously for you that your acne was without question the result of either or both of the first two possible causes I mentioned: oversensitive oil gland receptors and/or excess androgen levels. If this is the case at 29 then I doubt it will be much improved in the next few years, so any antibiotics courses will still only be minimizing the inevitable. I would seriously consider Accutane in your position, as at 29 your moderate acne is persistent and if not self-resolved by then almost certainly will not self-resolve any later, regardless of what antibiotics you take or what topical treatments you do. Even IPL/ALA/Clearlight/Bluelight/N-Lite/Smoothbeam laser therapies in cases where they are effective are practically always only temporarily so. N-Lite (you can google it) may be a suitable option for you as it simultaneously deals with active acne and acne scarring; killing the bacteria while lightening and fading scars while also sealing off sebaceous glands to some extent. The other alternative is a birth control pill with built-in anti-androgenic effects, such as Ortho Tricycline or Diane-35. Antibiotics are effective for late teens to early 20somethings to go on for 1-2 years and then go off and find thay they are clear because their androgen levels have subsided in late adolescence while the symptoms of their inner cause of acne were suppressed by the antibiotics. I asked you before exactly WHEN you started getting acne, as this is a big clue-- if your acne at 29 is a problem that you have had since your teen years, it will likely respond very well to N-Lite and may even yet self-resolve while on antibiotics (but this may take years). If you had little to no acne and then suddenly started breaking out within the last 10 years (adult onset acne), then you should consider Accutane. Either way, I warmly encourage you to take a month now to try my own personal program at the top. I can almost guarantee it will do as good a job as your minocycline, but as you have begun minocycline you should continue using it as per your dermatologists' instructions, and perhaps your new dermatologist will have better advice. The Mino will start clearing you within the month, but my program at the top can be done at any time and will certainly do wonders for your skin regardless of whatever else you are doing for it at the time. Best of luck! - Anto
  22. Alex, I will be beginning my first and hopefully only course of Accutane next week, and like the A-type neurotic I am, have spent hundreds of hours over the past month researching it inside out and upside down before deciding on it, even going so far as to date a dermatologist in order to get the "inside scoop". In the process I honestly believe that I have learned possibly as much about the drug, at least theoretically, as many dermatologists. Off the top of my head and I can tell you following about your situation: Unlike tetracycline (and to a lesser degree Minocycline and Doxycycline), there is no contraindication of erythromycin while on Accutane. This is why it is usually the antibiotic a dermatologist will prescribe if they agree with the patient that they should definitely consider Accutane but will first try an antibiotic for a month or so to see if it helps. Almost always, the erythromycin only makes the acne worse within the first month (it has one of the higher rates of bacteria-resistance in the acne antibiotic group), and the patient then returns to the derm who can prescribe the Accutane knowing that they are on somewhat firmer legal ground, as they can now more or less claim that they are administering Accutane as a "last resort" (an important technicality in this litigious day and age of derms and pharmaceutical companies like Roche quivering at the slightest possibility of a negligence/malpractice suit, hence the miles of red tape to walk past before taking Accutane). Usually a derm will start a new patient on tetracycline or minocycline and then move on to the others before considering Accutane; however, if the acne is severe enough to merit an immediate course of Accutane (tests pending) or if previous antibiotics courses have proven fruitless, it will usually be erythromycin and then possibly Accutane. As there is no harmful interaction between the two, you can take the erythromycin worry-free and have only the side-effects of Accutane to concern yourself with. However, as with any antibiotic, the erythromycin will kill off not only the (bad) P. Acnes bacteria that causes acne in oil-blocked pores, but ALSO the (good) L. Acidophilus and 20 other strains of intestinal bacteria that are essentialy for properly metabolising the food you eat. This is why many people feel inexplicably sick or generally queasy after prolonged (more than 1-2 weeks) courses of antibiotics. So to eliminiate this "silent" side-effect you will benefit from a probiotic supplement taken every time you take the erythromycin, available from any health store. This in no way whatsoever limits or interferes with the effectiveness of the antibiotic: your erythromycin is killing all the bacteria in your body, even the good bacteria in your intestines which you NEED to properly digest food; the probiotic is keeping the good bacteria in your intestines alive and well and doing nothing else. Think of it as fighting a war with a country to convert it to democracy while not killing its citizens so that they'll be a country left after the war. As you expect an initial breakout on Accutane, having a non-contraindicated antibiotic in your system at the time should help minimize the breakout by limiting the overgrowth of P. Acnes bacteria in oily/blocked pores. Ordinarily erythromycin itself tends to result in an initial breakout as the P. Acnes try to fight the antibiotic before dying off, but when combined with Accutane for the first month or so it should help prevent the initial breakout from becoming anything beyond any previous breakout, as well as faciliting a quicker recovery from the breakout. The reason for the initial breakout when starting Accutane is that your body is a masterpiece of self-regulation (homeostasis), and when you introduce a drug that begins to atrophy the oil glands and desensitize them to stimulation by your androgens (male sex hormones)-- which is what Accutane does by numbing the hormone receptors of the oil glands so they are not so overstimulated by your androgens, testosterone in particular, thereby shrinking the oil glands and drastically reducing oil production and thus eliminating blocked pores-- you body responds by trying to seek balance. So it fights back twice hard, producing even more oil in an attempt lubricate what it registers as over-drying skin, but to no avail as the Accutane persists to cumulatively limit the oil glands size and thus capacity for oil production. So you often initially get even oilier, and if not an initial breakout is still almost inevitable if you have active acne before Accutane (which of course Accutane presupposes), because a whitehead/blackhead/cyst takes anywhere from 1 to 6 weeks to develop within the skin before making its presence known at the surface. Therefore pimples which began forming up to over a month before Accutane is started will only just be breaking out within the first month or so on Accutane, which accelerates this process by shrinking the oil glands and thus "squeezing out" its contents. It can be ghastly, but be happy because it's getting all the excess sebum (oil) out of your oil glands for good, or at least for a long time. In most cases, if something goes wrong on Accutane (i.e. side-effects or bad breakout), it happens in the first month. You should still pay close attention to your health throughout and may even break out again, but it's usually just the one big initial breakout, which will be minimized by your erythromycin as well as any topicals your dermatologist prescribes (moisturizer, gentle cleanse, etc.). Seeing as your name is Alex I don't know if you're a guy/girl. Barring those who have moderate to severe acne, guys tend not to breakout after the first 4-6 weeks as often as girls, whose acne-causing androgens (male sex hormones) tend to be less stable and predictable owing to the hormonal flux of their monthly cycle (hence the "PMS" acne from 1 week before to the period). Girls can minimize this by supplementing with Chastetree Berry and guys will help regulate androgen levels with Saw Palmetto, both availalbe in an effective capsule form from any health store. These are both perfectly safe to take alongside Accutane and either one taken alongside your short course of erythromycin while help minimize your initial breakout as well as minimizing or altogether elminating subsequent breakouts during and after Accutane. I am beginning Accutane myself next week for persistent moderate acne, at 21 and having exhausted all other avenues. So I look forward to hearing from you how things proceed and I hope that you have nothing but success.