Started low dose accutane \ isotretinoin for rosacea

[Yvette]

Wow - that's great flying-er! Sounds like you're starting to see a glimpse of what Accutane can do. Here's to more to come!

Yvette

[Snegovik]

Originally Posted by flying_er

Week 6 Update:

Wow, it's hard to believe I've just completed my 6th week on accutane. I don't want to jinx myself but things are going pretty well. During the last week I've only had a few new bumps show up and they were quickly stopped in their tracks and never got to be full sized. Before accutane I knew when an area was going to breakout. I could feel it under the skin and then see the trouble forming. Now it seems like a breakout starts to form and then just goes away. I'm not complaining, it's just new behavior for my skin.

Snegovik, how is your treatment going?

It sound like you are doing well. I am glad to hear it.

I had to slow down a bit, because I got very dry eyes and increased flushing on my ears suddenly. It seem that my skin could not take 10 mg a day. As soon as I took a couple of days off, it helped.
My scalp is clear and the folliculitis are gone. Redness in my face is less, but my worst area is around my mouth/nose, and I think I will need to stay on accutane for a long time to beat that back. My derm says he will remove what accutane will not take, with laser.
But if I am going to stay on 40 mg/week, this will take time. Hopefully these side effects will be less as I get used to accutane.
I could easily live with dry eyes and flushing for a while, but after reading here that some report that when accutane trigger these symptoms, they can be permanent after the treatment, I decided to take it easy.

[flying_er]

Snegovik,
I'm sorry to hear about your ear flushing. I've always had a bit of a problem with ear flushing and it may be a bit worse now that I'm on accutane. I'm going to keep a close watch on that issue. So are you now taking a 10mg pill every other day?

Yvette,
I know you had some flushing problems while on accutane. Did your ears flush?

[Snegovik]

Originally Posted by flying_er

Snegovik,
I'm sorry to hear about your ear flushing. I've always had a bit of a problem with ear flushing and it may be a bit worse now that I'm on accutane. I'm going to keep a close watch on that issue. So are you now taking a 10mg pill every other day?

Yvette,
I know you had some flushing problems while on accutane. Did your ears flush?

I only get 20 mg pill here in Norway, and I take 1 every third day. So about 6,5 mg a day. That seem to work well.
When my ears flushed it was not usual redness, but long lasting burning and very red. At the same time the eyes got bloodshot and sore. It might just be a flare because of stress, but it was so sudden and long lasting that I think it was the accutane. When I cut back on the dosage things got better after 2 days.

But I would like to take 10 or even 20mg a day for a while, because I think my difficult spots in the face needs it. I will just take things slow and try to increase and cut back until I find out how far I can take it.

[Brighteyes]

Snegovik, how are your occular symptoms responding to the low dose accutane?

[Yvette]

Hi flying-er,

My ears don't flush much, mainly my face. My face did flush a little more here/there on Accutane. I'd see sporadic flushing when I first started Tane, when my dose was upped from 10mg a day to 20mg a day, and then here/there when Winter or colder weather started. I want to stress the flushing was mild and sporadic, not several times and not intense. I talked to my Derm. about it and she said it was common to have a little flushing. She said if I wanted to I could slightly "alter" my dose depending on how my skin was doing. Occassionally, I did that, instead of 20mg a day, I might of took 10mg a day or skipped a day or so entirely. Mild alterations or "fine tuning" dosage may be necessary to keep your skin in check.

Talk to your Derm. about any specifics. Take care.

Yvette

[Snegovik]

Brighteyes,

My ocular problems and the ear flushing gradually got better when I lowered the dose last week. I am now back to 10 mg/day. It takes time, but I see improvement every week. My experience is that there are small flares here and there, as Yvette says.

I saw your thread about laser and accutane. My derm recommended accutane first. Personally I do not have a big fear of accutane as long as I can go on a low dose, and control it myself. Like when I had a ocular flare and flushing, I just took a break for a few days.

But I would be very sceptical if the derm told me to take 20 or 40mg and keep going no matter what happens.

There are side effects from long term tetracycline also. Not to mention hydrocortisone as some use for seb derm. It flared my rosacea big time, and maybe caused some permanent damage according to my derm. But many people can live with seb derm and have a pretty much normal looking skin because of the hydrocortisone. My boss for example, used it for 15 years, now he is soon 50 and his sebum production is so low that he is okey without using any meds. I find it hard to shout out big warnings to all people, just because I had a negative experience, when I know so many people all over the world have great benefit from it.

If I were you, I would try to be realistic and not listen to the worst pessimists, but at the same time have respect for the meds. In most cases you can see what worsen your condition and stop in time.

[flying_er]

Thanks for the input Yvette. I'm going to see my Derm next week, I'll talk to him about the mild flushing I'm seeing.

Week 7 update:
Okay, 7 weeks on this low dose, 20mg every other day routine. I have to say that I'm pretty happy with this routine so far. I'll try to quantify what I'm seeing.

- P&P activity is roughly 50% reduced at this point.
- Hot rashy/itchy skin issue is 75% reduced.
- My skin is smoother and softer feeling.
- I have had some ear flushing, need to watch that.
- Minor aches and pains, I feel more tired.
- Minor dry lips/nose/eyes, all easily managed with drops/cream/ointment.
- Getting some flaky skin on my forehead. It's moist and smooth feeling, but still flaky.
- I got an Initial Breakout that started on day 10 and lasted 2 weeks, it wasn't all that bad.
- I've still got a lot of red marks that need to heal but I think that's going to take time.

These results are far better than what I ever achieved on the typical Doxy/Mino/Metro/Finacea etc etc routines. And honestly, I felt worse during my last Doxy cycle, it really messed up my stomach and gave me headaches. My stomach is fine on low dose accutane and no headaches.

And just to throw another factor into the mix, I cleaned up my diet a lot over the last couple months. I'm on a low gluten diet, eating tons of veggies and fruit, lots of water, way less sugar\coffee\coke\dairy\chocolate and no alcohol.

[Yvette]

Hi flying-er,

You're very welcome.

Your progress is great and on track. It's great to see some results - lessening of acne/papules and skin clearing! Softer skin. Great news and more to come.

When you see your Derm., you may want to ask if you could have 10mg pills instead of the 20mg. This makes a big difference. Then you can 10mg a day and the effect won't be as harsh as 20mg every other day. I started 10mg a day months one/two and then moved to 20mg a day in month three - boy could I feel the change. Mainly, body wise, more aches and pains, but I did have slight flushing going up in dose or when weather was cold and I was out in the elements. Occassionally, I backed down on dose and it helped. Having 10mg pills makes dosing a little more flexible. My Derm. was happy to do this, when I was at 20mg, she prescribed 10mg in the morning and 10mg at night. She said it may be better on the stomach splitting up the doses.

For your slight flakiness, ask your Derm. for suggestions. I had a little of this too, and my Derm. said I could take a very mild scrub (like Ponds or something not abrasive or with any acids in it) and mix a small amount with a gentle cleanser. Then apply the mix gently to the face to cleanse and remove buildup. I did this once/twice a week at night if I was flakey. It didn't aggravate my skin. I applied moisteriser afterward.

I agree eating less gluten/refined sugars/alcohol etc. creates a less acidic environment in our stomachs which results in less inflammation overall. I find this beneficial too.

Check back with ya soon. Take care.

Yvette

[flying_er]

Just curious, has anyone here gone to the dentist while on accutane? I've got an appointment for a cleaning in a couple weeks and was wondering if my gums might be more sensitive due to the tane.

I've also read some articles that state higher rates of tooth decay while on accutane. Has anyone experienced that?