Could really low dose accutane trigger a flare?

[valby]

Hi Guys,

My face had been doing quite well for the past few weeks with no major flushing episodes. But since last Thursday I noticed my face was getting more flush prone and today I have had a flush which has pretty much lasted all day. I am disappointed because the burning sensation I had before v-beam is also back.

So I am thinking this may have been triggered by a dose of 20mg of Accutane I took on the Wed before the flushing started up (I have been taking 20mg every 5 days approx for around 3 weeks, and took for 3 days in a row at the start). Thursday my face became aggravated with some papules and then started flushing/burning. My lips have also been really burning-which is what makes me think it may be the accutane? I know it is crazy to think the tane would work that fast but it has definitely pushed a lot black heads to the surface and started to smooth out the skin on my forehead--so i know it has been working.

Gah I can't stand it. I have to go into the office tomorrow and go to meetings etc. Previously the accutane had really calmed my face down. I just wish I knew for sure. If I knew it wasn't the accutane I would take another dose to calm things down again.

Other thing to consider is that I feel I am fighting off some kind of head cold because I have had a slightly stuffy nose and sore throat, following a horrible taste in my throat last week around the same time I took the Accutane. Last October when I had my first real experience with rosacea flushing I had the same symptoms.

Do you think I should try another dose of Accutane? The strange thing is that my forehead and chin are also involved and they haven't been since last October. Even if they aren't red as such I can feel them burning. Its the burning I hate the most and the pressure which gives me a headache!

[SolomonCox]

Hi Guys,

My face had been doing quite well for the past few weeks with no major flushing episodes. But since last Thursday I noticed my face was getting more flush prone and today I have had a flush which has pretty much lasted all day. I am disappointed because the burning sensation I had before v-beam is also back.

So I am thinking this may have been triggered by a dose of 20mg of Accutane I took on the Wed before the flushing started up (I have been taking 20mg every 5 days approx for around 3 weeks, and took for 3 days in a row at the start). Thursday my face became aggravated with some papules and then started flushing/burning. My lips have also been really burning-which is what makes me think it may be the accutane? I know it is crazy to think the tane would work that fast but it has definitely pushed a lot black heads to the surface and started to smooth out the skin on my forehead--so i know it has been working.

Gah I can't stand it. I have to go into the office tomorrow and go to meetings etc. Previously the accutane had really calmed my face down. I just wish I knew for sure. If I knew it wasn't the accutane I would take another dose to calm things down again.

Other thing to consider is that I feel I am fighting off some kind of head cold because I have had a slightly stuffy nose and sore throat, following a horrible taste in my throat last week around the same time I took the Accutane. Last October when I had my first real experience with rosacea flushing I had the same symptoms.

Do you think I should try another dose of Accutane? The strange thing is that my forehead and chin are also involved and they haven't been since last October. Even if they aren't red as such I can feel them burning. Its the burning I hate the most and the pressure which gives me a headache!

I think 20mg is too much for most people personally (unless you have the weight to justify it)

[phlika29]

I was put back onto accutane at 20 mg per day or every other day and it was just too strong. Could you see if they can drop you down to 10 mg (or even 5mg) every other day?

[valby]

I wish we could get 5mg in Oz but apparently not. I may ask my derm though at least for the 10mg. I am wary of him now because he wanted me on 20mg per day for a year!!!

I thought that taking the 20mg once per week would be ok though?? I weigh approx 55kg.But it seems like that "big hit" of accutane at once is not good for me. I am ultra sensitive to drugs so maybe that makes a difference.

I am tossing up whether to quite the accutane (haven't taken since last Wed) for now and do some IPL.....

[SolomonCox]

I wish we could get 5mg in Oz but apparently not. I may ask my derm though at least for the 10mg. I am wary of him now because he wanted me on 20mg per day for a year!!!

I thought that taking the 20mg once per week would be ok though?? I weigh approx 55kg.But it seems like that "big hit" of accutane at once is not good for me. I am ultra sensitive to drugs so maybe that makes a difference.

I am tossing up whether to quite the accutane (haven't taken since last Wed) for now and do some IPL.....

What symptoms are you working on? Your choices described in your post, IPL and accutane, have different levels of efficacy for different symptoms.

Also, being on accutane everday for a year is not uncommon for those with rosacea. You, not your doctor or anyone on here, can only make the decision regarding the implications to your health.

Hope the best for you.

[valby]

Well the Accutane worked for the inflammation and the papules, which is great. However I wasn't actually tolerating it very well (GI upset). I still think 20mg per day for a year is overkill for me at 55kg.

So I was hoping that IPL would improve the redness/capillaries and perhaps inflammation. Wasn't holding much hope for the P&P's which seem to be difficult to treat with anything topical.

When I am asking about it being "ok" I mean in terms of rosacean skin not the other health risks, which I am well aware of.

Does anyone have any experience of long term use at say 20mg per week (taking it like that i.e. one 20mg tab per week)?

phlika--I rang the derm's office and when I get to speak to him will ask him about 10mg or even if we can get 5mg (which personally I think would be the best).

[Yvette]

Hi Valby,

How long have you been on Accutane? The first month or so as your body/skin adjust you will feel certain sensations that indicate the medicine is working. You may feel your bones ache and twitch the first week or so (very mild and a few times only), your face getting oily and then slight stinging as your skin is starting to dry, and mild sporadic redness or flushing that is temporary and doesn't last. An increase in papules and acne is very common the first month or more - Accutane is closing down the oil glands and pushing out what is beneath the skin. Generally, the milder your acne or pustules, the initial breakout will be over in a month/two - more moderate it could be a few months or more for Accutane to clear you up. I also had some GI upset the first month/two (constipation) but this resolved too after I drank more water as Accutane is very dehydrating. All of this occurred for me the first month or so. I was on 10mg a day month one and two and then 20mg a day months 3-8. I weigh 50-55kg as well. My skin is combination and a little sensitive, but I could handle 20mg a day without much side effects. Everyone is different though.

Again, if you are in your first month or so, some of this is normal. However, if you are having persistent flushing or redness that lasts or feel concerned - please talk to your Derm. Also, keep in mind any skincare you were using prior to Accutane is likely to harsh (drying) to use now. You need soothing hydrating and soothing cleansers and moisterisers - or your face will become redder for sure. I bought all new skincare to use.

Good luck.

Yvette

[valby]

Hi Guys,
So after not taking any accutane since last Tuesday I took another pill last night. I felt the burning sensation again. My skin looks ok today but I did apply some hydrocortizone last night. It seems as though the 2omg in one hit is too much. I will ring derm tomorrow and ask for the 10mg pills. It is a real pity we can't get 5mg here because I actually think that would be more appropriate. Hmmm

[Yvette]

Hi Valby,

Sounds like a good idea to get the 10mg. I agree having the 5mg dose available would be great. There is definitely a difference bumping up from the doses...

Keep in touch.

Yvette

[valby]

Hi All. I have heard back from the compounding chemist and he can make the 20mg pills into 5mg yes: I am happy about this as I really think it will be a lot better for me.

[Yvette]

This is great news Valby! Cool.

Yvette