Accutane Journey

32yo female - Hx of PCOS and Hashimoto’s Thyroiditis
I’ve recently started Accutane and there have been so many reviews that have been vague. I’m hoping to provide a rather in depth review over the course of the treatment with photos along the way.
On 06-01-18 I went to a dermatologist (at the insistence of my GP) after years of failed treatments (tx in the future). I’ve had cystic acne for the last 12 years from PCOS, tried countless OTC tx’s and in the end doxycycline and spironolactone concurrently, for over a year. More than anything, my self confidence took the biggest hit, 32 and still battling acne?!
We talked about Accutane and the risks associated with it, I am exempt pregnancy tests because of full hysterectomy in 2014.
—For those who are women and are not exempt, you will take a pregnancy test, that needs to be positive twice, before being allowed to start—
The day of the appointment, after general counseling on the medication, I had to get baseline labs drawn. You will need these as well, CMP, CBC and a Lipid Panel (this is fasting so don’t eat or drink anything besides water). I also had to sign waivers that I understood pregnancy is a huge no-no and had to register with iPledge. I left and waited to hear back from the labs and that they called the medicine in to my chosen pharmacy!

So the photos are the leftovers of the initial breakout. It was painful, plentiful and punctual (hello alliteration)! I was starting to think I wasn’t going to get it, it had been three weeks of the treatment and my skin was drying up nicely. Then at day 22 my cheeks (both sides) and my chin were awful. I had blackheads come out and play as well. For about four days I had so many blackheads (make note they weren’t actual blackheads but just clogged pores), that they were pushing themselves out of the crease of my nose.
Queue the difference. Where my initial breakout was full of cystic acne, it didn’t hang out for several weeks, more like those four days and it dried up, much to my surprise! The “blackheads” I used an extraction tool on and GENTLY cleaned out as they came, I never forced any that weren’t easily coming out.
At my 4 week appointment I had to fast again, nobody thanked the office for having me go without coffee for my labs. They included a CMP, lipid panel and hepatic function. I was told to start moisturizing my face and not use Neosporin because it’s not acne friendly. I was appalled at the idea of putting any type of lotion on my face because I have been oily for my entire adult life! But I nodded my acceptance and moved on. I was also told there is a chapstick called Dr. Dan’s that’s made with 1% hydrocortisone to specifically help dry lips whilst on accutane. They are upping my accutane to 40mg twice a day to keep with the 1mg per kg and I went on my way! Labs looked great!
The first month had no major side effects, really only eye dryness and dry lips. No myalgia (muscle pains) and no depression. I added a ton of water to my diet, drinking 80-100oz a day, I didn’t think it could hurt since accutane affects your liver. I’ve been low carb/high protein for years, so I’m on a low sugar diet. I’m now only washing my hair 2x a week, it’s that dry...
What I use:
Cetaphil gentle cleansing bar soap-with warm water and a soft washcloth at night
Clearasil overnight spot patch-as needed with cystic acne
Okay regenerist night recovery cream-at night
Vaseline lip balm-as needed
Ordered the Dr. Dans chapstick
Refresh tears- also as needed
Aveeno positively radiant daily moisturizer with SPF 15- every morning after wiping my face with a water only washrag
Hope this helps!