Worse than ever -- please, reassurance!

[bettina]

I am having quite an extreme breakout; very red, about 10 places all over face.

On accutane 10mg 1 week now, plus one day. I need reassurance, if this isn't supposed to happen, maybe I should seek another medication?

Face dry..like sunburn right before peeling; that hard feeling. Please respond, I am in panic!

Thanks!

[ian]

Hi Bettina,

Hang in there! Accutane takes time, especially in low dosages to start working. It took me several months to get to where I could _really_ notice big differences in my skin. I know how demoralizing and frustrating the break-outs are. Remember, your skin will heal - it just takes a little time.

[bettina]

I was almost wondering if, because it was getting worse and not getting better, I should discontinue (it's only been 10 days).

But it seems that every, or almost every place "coming out" so to speak, has been simmering under the skin for awhile; red places now with p & p's. Perhaps this is the "initial" eveyone talks about?

[Andy]

That's the way Accutane works - first all hell brakes loose, then it begins to improve and keep doing so until you're actully better off than before starting taking them.

I remember when I started taking Accutane, my whole body felt strange and my skin was in it's worst mess ever, it took 1-2 weeks before it recovered and I started seeing it was doing something right.

Just hang in there and give it some more time!

[tryingtogetoverit]

This didn't happen to me, but it was the first thing my dermatologist said could happen. Actually he didn't say could, he said "90% chance that it will." LOL

I love being on the good side of the statistics for once. lol

My first month of Accutane was dry, dry, dry. A month later things were very manageable. I've been on Accutane twice for my acne, I've never taken Accutane with the intention to treat my rosacea. I'll be doing that later on.

Message me anytime if you need support or anything. IN the meantime, this is completely normal and expected. It should pass quickly.
Orion

[bettina]

Thanks! I saw my derm today in tears (me, not her). She said it was normal, and that the hyperkeratosis on my skin would eventually be helped (on my forehead and chin).

SHe also says that it will be a 'very long road', as I am on 10mg per day. Looks like that is par for the course with rosacea.

Oh, I did research and my hyperkeratosis is the enlarged pore type, hardening. Sure sounds like advanced rosacea to me; Stage II, is it?

What fun lives we lead :cry: . I just want it to go away ASAP...and I sure want the discomfort to lessen.

[bettina]

The roughness is going!!

And I am still breaking out in problem areas! So, there is good and bad, but the texture is getting MUCH better. Thought I would post and bump this in case there are others who need hope on the low dose accutane regimen.

I am on Sotret 20mg every other day.

[bettina]

The roughness is going!!

And I am still breaking out in problem areas! So, there is good and bad, but the texture is getting MUCH better. Thought I would post and bump this in case there are others who need hope on the low dose accutane regimen.

I am on Sotret 20mg every other day.

[bill]

has it helped to reduce poor size any.

[bettina]

Hi Bill,

I think it might have affected the way the pores at least APPEAR to be. They do appear smaller, but maybe it's the fact of their seeming cleaner. Except for the patch on my right cheek now.

Funny, there is a patch that keeps blossoming. WOnder what that is all about. Didn't realize there was so much under the skin -- and the cysts leave red marks after they go down.

Is this happening to you too?

[bill]

HI BETTINA, My problem is my nose large poors skin texture In the past month since I started eating better and takeing accutane the the rest of my face looks fine so one week I went and ate all kinds of junk foods ,fast foods and all hell broke out on my face so no more sugars, fast foods, red meets, pizza, for me Maybe you might want to give it a try and see if it helps any. good luck, Bill

[bettina]

Do it all except give up the red meat....I eat healthy, not even sodas. But will eat more fish and chicken. Thanks Bill!!

[bettina]

I am perhaps a bit less inflamed, but still breaking out. I'm interested that many say that it takes several months before a real improvement. I would have thought 2 months would show more.

Am I being overly impatient? Maybe because after YEARS of p & p's... :( .

On a good note, the roughness which I thought was KP seems to be greatly improved.

Still flushing with heat, primarily..Anyone else on 20mg for rosacea and acne???

Thanks
B

[adyus]

Hello bettina.
I just want to point out 2 things:
1. Taking 20 mg every other day is not the same thing as taking 10 mg/day. This is because 20 mg every other day leads to spikes of isotretioin in your body. When it is absorbed you have 20mg....and it takes time to normalize to the value of 10mg. And these spikes are the ones that may lead to increased redness and/or flushing.(look for dr.Nase's info on this...I can't find the post now..this is what I remember from it).
Analogy: I eat 1 chocolate/week. If I ate all of it today...I'd get a flush :P . If I eat a fraction of it every day of the week, I feel ok.(maybe not the best analogy...but you know what I mean).
2. You should be careful with 20mg/day. I for one, would not go above 10mg/day. Of course, if your body is ok with this dosage and you're getting results, there's no problem.
My advice: read more opinions about accutane, especially dr.Nase's posts regarding accutane.

Best wishes,

Adrian Constantin

[bettina]

I was just thinking about this, and there you were! Yes, I had thought of that too, the 'spike' effect. Just lately, the flushing and itching seems SEEMS (almost hate to jinx it) to be better.

The derm has just upped this to 20mg per day. Since now I have no side effects to speak of, I wonder which way to go; unfortunately 10mg generic is no longer available in this geographic area.

I'm now wondering if I should just keep on, then every other day, or up to 20mg per day. The thing about PER day is that the level in the body would be constant.

Do you think I could try every day then cut back to every other if it didn't work out? Also, I am REALLY uncomfortable trying to 'divide capsules' or mess with the vehicle in any way with the sotret.

Opinions, Adrian? anyone??
Thanks

[adyus]

Hello again. The best advice I can give is: listen to your skin. If your skin is comfortable with this dosage and you get results, then I see no problem.
Only concern with this dosage would be permanent thinning of the epidermis. I beleive that Dr.Nase suggested that higher dosages result in permanent thinning, while very low doses only lead to reversible thinning( the epidermis will thicken after you finish the course of isotretinoin). I don't know if 20mg/day will lead to perm.thinning. I've searched for some info earlier, but I've been unable to find anything. You should ask your doctor about this.(the epidermis is our protective barrier against external insults; my opinion is that is wouldn't be wise to thin it permanently)
You also said you were unable to find 10mg pills in your area. Have you considered buying it online?

Best wishes,

Adrian

[adyus]

Hey again. This is a link of a post by dr.Nase that might interest you:
http://www.esfbchannel.com/cgi-bin/yabb/YaBB.pl?board=Rosacea&action=display&num=1123187452&start=15

Regards,

Adrian

[Strive]

What did you decide to do, Bettina? And how it it working out?

[Bradley]

I beleive that Dr.Nase suggested that higher dosages result in permanent thinning, while very low doses only lead to reversible thinning( the epidermis will thicken after you finish the course of isotretinoin).

Adyus, is this 100% correct that your skin is thinned even at low doses? I ask because Dr. Nase posted: "[Accutane] does not thin the epidermis or dermis at this dose and permanently closes sebaceous glands by a significant percentage,"
see this thread: http://forum.rosaceagroup.org/viewtopic.php?t=1405

I understand that you say it is reversible but am slightly worried that this process still happens and I'm sure Dr. Nase would have mentioned this if it were the case?

If thinning of the skin did occur on low doses then surely our facial redness and tendency to blush would increase dramatically?

Bettina, it would be great if you could post an update on how you are doing with the Accutane. I hope things are improving! With regards to the 10mg dosage, as Adyus has already said, they are definitely available online and you don't need a prescription.

[bettina]

Hi guys and I am sorry for not responding sooner, have been busy at a new job (which I interviewed for in full acne-plus-rosacea mode).

The derm put me up to 20mg per DAY. I thought there might be an initial breakout, like what happened in June and July when I first went on my 10mg per day, but not to jinx it, it seems to be calming down and I have NO side effects except a bit of dry skin around mouth. My skin feels better, and even the flushing is calming down.

So with my combination acne and rosacea, this is not a high dose for me.
Good side effects: the follicular plugging primarily on forehead is disappearing, the seb derm is all but history, my nails are growing (or is that an effect of the MD Forte replenishing cream I use at night?).

I am using Aknemycin for the pesky right cheek, and this is not causing undue dryness...derm recommended that as it doesn't dry accutane skin.

I'm surprised that 20mg is fine with me....is it because the Sotret is generic? Has less isotretinoin than brand??? What do you all think??

Thanks Dr. Nase for telling me to hang in...
B.

[bettina]

Somewhere, and I wish I could remember, is where Dr. Nase said that accutane clears DECADES of detritus out, by emptying the pores from inside...DECADES...anyone remember where that was?

And it's still working. A bit simmering, quieter this week, it is, I think progressing. And I'm so thankful.

AND thankful to Dr. Nase...thanks for telling me to hang in, as I am beginning to see results, just like you said, in month #3.

Almost am afraid to type it for fear of jinxing it. Can I trust this? Plust, 20mg on Sotret causing NO side effects for me.

Just thought I would update...

B.

[smudge]

Ive been on low dose 10mg daily for a little less than 2 months and ive had an extremely bad week. my skin was doing better but this past monday my nose became inflamed, blood red and covered in lesions... also had minor lesions in 6 other places on face & extreme puffiness under eyes. I was so distraught i was suicidal. I feel so hopeless because its its impossible to find a doctor that can really give me knowledgable advice. Should i up it to 20mg daily? Ive also been taking claritin D. Zyrtec makes me way too tired.

So 3 months is the wait til results? God i hope so.. there isnt too much more "wait" time left in me. My life has been on hold for too damn long with this crappy disease. Im sick of the embarrassment and the pain.

wish me luck, liz

[bettina]

All I can say is....with 20mg Sotret I am now beginning to see changes and improvement. The red marks where the cysts were are still there, though. I hope time and 20mg will help these.

What did you decide, Liz??

[smudge]

I decided to go up to 20mgs daily. i hope it works.

liz

[bettina]

Liz, keep me posted.

I think this might be good and 20mg per day is still a small dose. I dont flush anymore on this...also, I only take it ONCE a day. Wonder what Dr. Nase feels on that...

may just post the question!