44 Yr Old Female, Lifelong Skin Struggles - Scottsdale, AZ

Hello! I want to say Thank You to all of the users here who have shared their stories! You have encouraged, inspired and guided me, so I am sharing my experience to give back to others who are also struggling with their skin and are considering accutane. I have had acne and skin problems since I was 12. I am caucasian, I have no children, am single and have never used accurate before. I have considered it so many times, but the horror stories scared me too much to try it. I've aged, and my skin has gotten worse, while all along, I was hoping age would bring an end to what I'd labelled a teenager's affliction. A few months ago, I decided that I had gone through my last mental breakdown over my skin breaking out, and was finally going to exercise my last option. I promised myself that I would use accutane to end the neverending breakouts.
I have:
-Whiteheads, always
-Blackheads, always
-Undergrounders, Painful, lasting 2-4 wks, they never come to a head and can't be released, injections just lengthen the time they hang around
-Cystic acne
-Large pores that do not clear themselves
-Infected pores that open up and take @ 4 days to drain and close
-Bumpy skin, varying sizes cover my entire face, and sometimes my chest and back
-Oily skin all year long
-Chest and back breakouts, on occasion
-Acne inversa, flares 2-4x/year

I have tried every and any thing to clear my skin. Dietary changes help my overall health but have little effect on my angry skin, so I eat most closely to Paleo and almost exclusively organic. I have tried, and still use some of these "cures":
BP, Differin, Benzaclin, Salycilic Acid, Retin A, Proactive, charcoal products, organic products, pharmaceutical grade expensive products, cheap drugstore products, clay masks, LED lights, microdermabrasion, facials, extractions, injections, dry ice, steaming my face, dermatologists, cosmetologists, estheticians, BC pills, antibiotics, washing with oil, washing without oil, changing pillowcases nightly, sleeping on my back, not touching my face, washing make up brushes daily, supplements, lowering stress, no sun exposure etc., etc., etc....

Often times, my acne is physically painful, but not always. My pores are large because they're propped open from the sebum and oil stuck inside. They refuse to clear themselves and it leaves my face freckled with purple-red scars that last several months, even up to 1 year. I have acne every day. I don't have even 1 day with clear skin. It gets worse with my hormone fluctuations including stress from cortisol, or if I eat a lot of sugar, but especially if I skip on my skincare routine.

I use Perricone MD, exfoliate with a buff puff type scrubber and wash morning and night. I use IT Cosmetics and only wear makeup if I have to. I clean my brushes.

Every other day, I use a metal loop extractor to "scrape" my face. If I do not manually clean my pores every 48 hours, my skin erupts with a variety of "infections". Full facial extraction takes about 45 minutes in a 10x mirror. My chin is always loaded and requires 5-6 passes to clean. My cheeks and forehead produce impressive amounts of sebum from pores that show no sign of impaction, therefore I cannot miss any area. My skin makes varying degrees of both hard and soft sebum, which slithers out of my pores like snakes under the pressure of the thin, steel loop. They're followed up by erupting blobs of oil. Most of my pores, bumps and zits willingly clear when prodded, though some simply will not give up their contents, which often leads to scarring because they remain in place while I press them for weeks, or even months. If I merely stretch my skin with my fingers, dozens of pores will produce.
It's disgusting, and I am tired of it.

If I sat idly by, had a grease laden junk food diet or poor hygiene habits, I could see a reason for my situation. I'm finally certain that I have done my due diligence, and after 30 years of living with an ugly complexion and low self confidence, I am going to clear my skin with a dangerous pharmaceutical. I am sorry for those with permanent digestive, muscle and other problems caused by taking the drug and am concerned for my health, yet I am hopeful when I think about the others who walked away with clear skin and no other lasting effect. I tend to fall in the "average group" when it comes to how bodies react to prescription drugs, but I am discerning when it comes to ingesting pharmaceuticals, I prefer the natural way.

I can't think of any other solution to my worsening skin, and I suspect I will be asking myself why I waited so long to try accutane.

Wish me luck!
(I am waiting on the pharmacy to fill my prescription and will update as soon as I have something to report!)

I take 30mg twice daily. I take it with coconut oil and/or avocado and/or nuts.
What's going well:
I seem to be tolerating my dose very well. By the 3rd day, my greasy skin was noticeably drier and I couldn't be more thrilled if it stopped at that alone! By day 4, my skin was noticeably smoother and my lips started to dry. I am all over the tube of Aquaphor, and for the first time in my life, something actually sticks to my lips for more than 10 minutes! It's the drying effect that I love and I can feel my skin tightening. I asked for Hydroquinone which appears to make a difference in the discoloration.
On a side note, the Norplant birth control in my arm has taken away my period, better yet, the unreasonably painful cramps that came with it are now mild and only last 48 hours. That is a big win!!

The not so bad stuff:
My face peeled within 2 days. I had headaches the first 3 days, but they seem to have gone away. I have some white+black heads and underground cysts, and my pores are still producing sebum, just... not as much as before Claravis. Last night, a of 2"x3" patch of skin on my chest peeled off a little too easily. The skin on my body itches, sometimes my face will itch. My face feels tight and dry around the nostril and upper lip area.

My Rhuematologist just put me on Methotrexate. 6 pills once a week. I worry about my liver but we are monitoring it monthly. Anyone else out there with RA in the same boat? Has anyone used Milk Thistle to help the liver stay healthy? I don't know what I am going to do without my random glasses of wine (red is the best valium) since alcohol is processed through the liver, they don't want me to have it anymore. Sad face.

I started late October, it is late January. I'll call this month 4.
I am still on 30mg Claravis 2x daily. I have zero symptoms, beyond dry lips. Once in awhile, I have flaking skin on my face. Some days are worse than others but that is directly due to how much water I drink. I cannot tell that I am even taking a drug.
I do see improvement, but I am worried to come off of my dose in a couple of months. I am in no way cleared up, but it is exponentially better. My nose, chin and forehead look great with very few whiteheads here and there.
Any blackheads have pretty well disappeared.
I still struggle with undergrounders and cysts on my cheeks. My right side has several plugged pores/lumps that won't produce. They drive me crazy. My cheeks are very porous and on a weekly basis, I am able to extract some of the pores that are still filling.
I asked my derm to extract some of these underground lumps and she said no way because of scarring. One of them that I have had for about 7 months finally came close to the surface. I was able to get a needle into the pore and over 2 days I extracted a ridiculous amount of sebum, I can't believe how much is actually in the ones who are months old and reluctant come up. Needless to say, I bled and was scarring...as expected.
On a whim, I put on a silicone scar sheet and within a few days, the scarring was completely gone. So anyone struggling with acne scars, go get scar sheets and cut them into small sections. I can wear the clear ones all day and night. You can find them in the drugstore, but I like the clear type and I personally have only found them online-
https://www.amazon.com/ScarAway-Professional-Silicone-TreatmentSheets/dp/B001AJ4L1E/ref=pd_lpo_121_bs_t_2?_encoding=UTF8&psc=1&refRID=N1Z7FRWNCAEZA2WB1Z7V
I am not advising you to go against your doctors orders or to extractions while taking accuatnce. I took a risk. The scar sheets worked and I use them on other long term acne scars. They actually work, but perform exceptionally well on the open zits. Just keep it on 24/7 until it closes then back and forth with air and scar sheet until there is no scar. For me this takes less than a week. How has no one told me about scar sheets for acne scars!?!?!?
I am off methotrexate, if anyone else out there is trying to take both drugs. They switched me to Enbrel for my liver's sake. I have had a bit of alcohol over the holiday, but am taking a ton of milk thistle. My labs look great with the exception of raised cholesterol levels, which my derm says is normal.
The hydroxyquinone helps tremendously with scarring.
In short, there is improvement but I still have clogged pores and cysts. Just not as many.