42 Yr Old Professional, Mom on 2nd Round of Accutane

Just finished a month of 20mg/day and I will be starting 40mg today. Very typical side effects- dry lips, dry eyes, slight back ache. My skin looks amazing and I'm starting to not think about it!! I had some very stressful meetings at work this week, and having clear skin elevated my confidence a thousand times over. I'm grateful for this med. I was a little disappointed with my insurance coverage, but can't say I'm surprised. My bill for labs was $233 and the script cost $80;it's going toward the deductible. On the good side my triglycerides were only 45 and the APN said that's the lowest she's seen in someone over 30! I'm really concentrating on making sure my skin is moisturized and the cetaphil cream seems to be working the best.

Been 10 days on Accutane - I've been started on 20mg/day and next month the dose will be increased. The two bad cysts have calmed down, but one new one formed a few days ago, so it's painful. I notice my lips being a bit chapped and cheeks/chin are flushed and feel warm. I feel more irritated this weekend(usually I'm calm and pretty easy going), but we are closing on a new house in a couple weeks, so I'm chalking my angry mood up to that stressor!

I had extremely clear skin until going off to college and then the cystic acne started- anywhere from 1-10 around my chin area at any given time. My self esteem plummeted, didn't want to go to class, avoided people and functions, grades suffered. It was a complete 180 degree downward turn since high school and I couldn't handle it.
Antibiotics, birth control pills, creams and lotions worked fairly well throughout my twenties, but I never gained back the confidence I once had b/c every time a big event came up I had a major breakout. Finally at age 30 I was offered accutane and it cleared my acne. Luckily I did not even have any scars. I had my life back!!!! My career flourished, met the man of my dreams and got married, and had a baby!! However, after 7 yrs (age 37), the acne came back. I didn't want to go back on accutane b/c we wanted a second child and so I suffered through acne until I finally got pregnant at age 39. During the second half of my pregnancy my skin was awesome - glowing and virtually zero acne. It started coming back when baby was about 10 mo old (I was tapering breast feeding). In last 1.5 yrs I've been on antibiotics and for last year on spirinolactone. Once added the spiro, my skin cleared up nicely (except for scarring) however had to keep increasing the dose and was maxed out at 200/day. In Sept of 2015 I started needing injections in the large cysts on my face, and so the accutane discussion started again. From Sept to Dec I have had 2 injections and several large cysts and Derm recommended accutane. With all of the IPledge checks,I just started my first dose a couple days ago.