25M Acne Review - Difficult but Worth It in the End

My Dad's side of the family has a history of acne issues, even into our 20's. I've always been self-conscious of my skin. I look young and I've dealt with acne from my high school days all the way into my mid-20's. I had some success with Epiduo, but it wasn't completely clearing my skin and I was getting tired of the maintenance routine, bleaching everything my face touched and having to completely avoid the sun. These might sound like petty excuses, but it had been years and I was ready for something that just worked once and for all. I decided to experiment and go off Epiduo and my skin started to break out. Around this time, I went on a big trip with my college friends. I look back at the photos of my skin with embarrassment. It was right before I started treatment. At that point, I was on my own, I could pay for it myself and I decided to start Accutane (Isotretinoin).

Month 1 - 60 Mg: The first 3 days on the medication my skin became more oily but I didn’t see any major changes. By day 4, my lips started to become dryer and after a week, my lips were chapped and there was noticeable redness and dryness on my face. Two weeks in, my acne had become noticeably worse and pretty much all my face was dry. The next two weeks after that were similar – dry face, bad acne, and some depression as I had no self confidence to go out and socialize.

I want to elaborate briefly on how it affected my social life. I am an outgoing person but the first 3 months on Accutane killed my confidence and I would rarely show my face in public. The worst example is when one of my favorite bands came into town and I could not bring myself to go because I was too embarrassed about my skin. My acne was worse than it had ever been before, on or off any other medication. As my dermatologist said, and as many people on acne forums said, it would get worse before it got better.

Month 2 – 120 Mg: My dermatologist doubled my dose. I finally had enough confidence to start working out again, but the acne severity was still pretty sever and I still was embarrassed about my face.

I should talk about what I used to moisturize. I tried to use only all-natural soaps and shampoos so there weren’t any artificial ingredients drying out my skin. I used lip balm constantly (not the bar kind, the kind you can apply with your finger). I used sunscreen whenever I was outside, and I moisturized my entire face twice a day. I also used eye drops, because my eyes were becoming dry and this would cause some strange side effects later down the road.

Month 3 – 120 Mg until the end: I started to see some improvement. I still had breakouts on my cheeks and forehead but the acne around my mouth and chin was gone. At this point I thought the medication was affecting my libido. In retrospect, I think I was just a bit depressed from being socially isolated.

Month 4 – This is the time when my skin really started to improve. My lips were still chapped, my eyes were still dry and my complexion was pale but I was making good progress.

One of the things you are advised to avoid while on Accutane is alcohol. I did not completely follow this advice. I wasn’t drinking often, but there were a few cases where I celebrated and had some drinks. I was aware of the toll I was putting on my liver and I could feel my body aching the next day after drinking.

Month 5 – My skin looked good. The chapped lips, dry eyes and pale skin were still there but the acne was pretty much gone. This is also when I noticed the scarring. The bad breakouts I had experienced in the first couple of months on Accutane left scarring on my cheeks. Not terrible, but noticeable. I still have this scarring today, although I think it’s improving.

Month 6 – Before starting Accutane, I thought I would be on it for 6 months maximum. At this point in the treatment, I realized I needed to keep going until my skin was completely clear. Some people do a second round of Accutane but I was not enthusiastic about that idea.

Month 8 – This was my last month on Accutane. My skin looked good but it wasn’t perfect. Ultimately, I decided to end my treatment because I was happy with the progress and content with the occasional small pimple.

The dryness on my face got better. My lips and eyes got slightly better and I I moved to a sulfur soap and Soolantra for my rosacea.

Lasting side effects and review: My lips have never returned to what they were before taking Accutane. I use lip balm every day and have slightly redder lips than I did before. My eyes also never got back to what they were before, but a few drops of eye drops every few hours seems to do the trick. I mentioned before the strange side effects in my eyes- I got pinkeye three time while on Accutane. I never had it before and have never experienced it since. My eyes were simply so dry that they were not flushing out bacteria. I also have newly discovered irritable bowel syndrome. My dermatologist says its not the Accutane but I didn’t have before. I can manage it with diet but its hard not to associate the stomach problems with the treatment.

To summarize, the lasting side effects are the scars on my face (which I hope are improving every day), my slightly dryer lips, my dryer eyes and my sensitive stomach.

Was it worth it? Absolutely. My skin looks great. It’s not 100% clear, but when I do get a pimple, it’s either small or only lasts for a day or two. I don’t have to keep up the same meticulous maintenance routine every day and I’m confident and happy. I would recommend Accutane if you’re willing to go through some short-term sacrifice and are aware of the possible short term and long-term side effects. It works differently for everybody but I am happy with my experience.