Erika's Accutane Journal

August 29, 2003 (mid-end of week 4)

I am sitting on an airplane on my way to NY for the Labor Day weekend and I just took my first 40mg dose of Accutane. I'm wondering if I'm going to have ill effects mid flight. Yesterday, I went in for my monthly Dr. appointment/bloodwork and the Dr. upped my dose to 60mg/day (40mg in the am and 20mg in the pm). This is high considering I only weigh 115.

I have been on 40mg for nearly a month now. Let me backup a little. I'm 33 and I have done 2 courses of Accutane in the past. The last time I was on the medication was about 5 years ago. I took 60mg/day for 20 weeks and the results (from what I remember) were quite good. It's hard to recall a time when my face was actually clear (or what I consider clear anyway). I remember that my skin remained good for about a year after the Accutane. But alas, it came back, and with a raging vengeance! I have tried EVERYTHING from microdermabrasion, to Proactiv, to Retina-A, to Tetracycline, Minocyclin, Tazorac, Dermologica, BenaClin, Finevin, Cleocin, Alpha-hydroxys, NeoStrata, monthly facials, changing make-up brands, changing soaps, product after product. It gets expensive let me tell you.

I was dead set on not taking the Accutane for a 3rd time. I know how terrible the side effects are and what a bad wrap it's gotten in the past few years since the political big-wigs young son committed suicide while on it. I went to dermo #1 to get an opinion on my acne and while standing about 6 feet away from me he recommended Accutane. I was furious. I had made a point of removing all my makeup and gone out of my way for this appointment and he didn't even examine my skin. Maybe it was so bad that he didn't need to. Anyway, I did not go on the Accutane because I felt a second opinion was in order. I made an appointment for a 2nd dermo who was not on my insurance plan; I had to pay out of pocket. I had heard about her from a woman that I saw while at one of my facial appointments. She had great skin so I asked her if she could recommend her Dr. and she did. I did a little research and found that the recommended Beverly Hills dermatologist had quite the internet buzz and quite a good reputation. I called to schedule an appointment and the first available was well over a month away. So I waited in acne hell. By the time the appointment finally rolled around, I was at my wits end. I nearly broke down in her office. She went over my acne history and examined my face CLOSELY then the dreaded words came "Accutane". I felt like I was back to square one. This was a Dr. that I could not afford to get the treatment from but I surely did not want to go back to the insensitive dermo #1 where my insurance would be honored What to do? I called my general Dr. to see what they suggested. Luckily, she informed me that there was one person on staff in their office that could prescribe the Accutane and I should make an appointment with her because my insurance would cover it. So it goes. A third Dr. and a 3rd recommendation, this time, after blood tests and 2 pregnancy tests, I got the prescription for Accutane.

I wish I would have started documenting my trials and tribulations with Accutane from the start but it did not occur to me until about week 3. Anyway, from what I remember there's not too much to say about week 1. 40mg/day, 20mg in the morning and 20mg in the evening with food.

The cysts begin. My face was a mess when I started (again, I wish I would have taken photos from the start) and has remained bad so far but week 2 marked the beginning of the undergrounds. Ouch. It began with one large nodule on the right side of my face near the top of my cheek bone. The dryness also started. My face had skin flaking off yet none of the zits I had from the start were going down. It was miserable. Luckily, I was on vacation with my family who offered support and listened to me moan about it. It's also a nice distraction to be in a foreign country seeing the sights ( : Thanks Dad! By the end of the 2nd week, on the way back to the US I had a HUGE cyst on my chin just under my lip on the right side which I'd picked at and it was scabbing over. 2 new cysts on the upper left cheekbone were just forming. Joy.

See photos, which were taken at the end of the week. The zit under my lip healed and so did the cyst on the right cheekbone but it was like they were multiplying. My left-lower cheek and chin have never been this bad in my entire life. They itched and stung at the same time. Cysts on both sides of my neck, the one on my right was about the size of a quarter ok, maybe a nickel. I want to hide. The dryness has gotten worse and I noticed what I call the plugs coming out. Meaning that all the pores on my nose expelled themselves. That was kinda cool. I have no oil on my face, no shine whatsoever. I'm thirsty all the time and there is a definite need for chapstick to be within arms reach.

I'm home from NY and sitting here with a clay mask on my face. I think flying makes my face itch. I don't feel like I'm seeing ANY progress. If anything, I feel like my face is just the same or worse than when I started. I'll take photos tomorrow. Still on the 60mg/day that the Dr. upped me to but not noticing any real difference yet. It's only been 4 days at that dose though. I dont know if I can take 4 more months of this. If I'm not showing any progress in 4 more weeks it may be time to rethink this whole Accutane thing.

I just took week 4 pictures and compared them with the week 3 pics. I am definitely worse this week than last. Take a look for yourself. This is quite depressing. I really didn't think my skin could get any worse and it just keeps proving me wrong. Maybe this is due to the higher dose that I've been on now for 5 days. Who knows? I'm sure that I will have some pretty major scarring after all is said and done. I can't imagine when or if that "done" thing will ever even happen. I'm going to try my best to hide for the next few weeks. Ugh!

I got the results of my blood work today and my Calcium levels are high. The Dr. said not to worry and that she would do a hormone level check on our next visit just in case. DONT WORRY!?! I just read on the internet that elevated calcium is linked to cancer. One stat that I read said 10-20% of breast cancer patients have elevated calcium. So my skin clears and then I get cancer. Great. Ok, I'm being dramatic. I think maybe the calcium is high because of the Accutane. I'm sure all is fine in zitopia.

Still on the 60mg/day. I just got done examining the photos and unfortunately there is not a much change. I must say that there is a marked minor change in the chin area. I feel that my whole face (where I'm broken out anyway) is much less irritated, red, and inflamed. I'm not itching quite as much but still some itching by the end of the day. As far as side effects go, pretty much the same: Dry, flaky, chapped lips, peeling dry palms, cough, achy. One of the strangest side effects that I have noticed more & more recently is a soreness, almost like shin splints behind the heels of my feet and running up my legs. It's like I worked out and the muscles are sore there. But I didn't work out.

I got a bikini wax last Friday. The Dr. said it should be ok to do but to have them test an area. It was more painful than it used to be (before the Accutane) but I survived. I'd much rather suffer the pain of waxing than do that horrible dreaded shaving thing that made me itch like there's no tomorrow and break out in an ugly rash. I've got enough red marks thanks! Till next week.

What a depressing skin day. Yesterday I thought it sure would be nice if some of these honkers on the left side of my face would pop so that they would heal and get out. Well, today I woke with 3 ready-to-go ugly white pus filled things. Of course I went to town on them and now they look much worse than before. Currently, they are all scabbing over and are super red.

I can't believe that I'm still getting new formations! I have a cyst starting right in the middle of my chin underneath that hurts like all get out... my 2nd chin. One is enough thanks! The photos of this week look worse than last! When will this end? I have never had acne that has lasted this long. I almost feel like the Accutane is not working and that it must be an infection or something else. I'm going to talk to the Dr. about it on my next visit but thats not for 2 more weeks. In the meantime I'm going to hide out. I canceled plans that I had tonight because I really dont want to be seen like this, even with my makeup on. I go to the gym in the mornings and I don't wear makeup, its awful. I can't look anybody in the eye and I think that people are staring at me thinking how gross I my face looks. I have no desire to date anybody because of the acne. I wouldn't want anybody seeing me in the morning light. I might send them screaming away.

As for side effects: Mostly the same. Having dry hair, dry skin, dry lips, dry vagina, dry throat, dry eyes, itchiness, muscle aches, headaches, etc. would all be worth it to me if my skin would clear up. But right now I can say honestly that it is not. I had a bit of a scare yesterday with the weird ache that I keep getting behind my heels on my feet. When I went to stand up, I almost fell because it hurt so bad. I sat down and stretched a bit then slowly walked around and it seemed to be all right. This is worrisome to me however. I will talk to the Dr. about it on my next visit.

Week 6, for me, is not what I have heard others report. Many people say that between weeks 6 and 8 is when they have noticed a dramatic change. I surely can not say the same. Guess I'll keep my fingers crossed for week 8.

I just got done comparing the week 7 pictures with weeks 5 & 6. I'm sorry to report that there is not a huge difference. The chin/jaw line is the only area that seems to be healing by the pics. I say this "by the pics" because I can definitely feel that there is healing going on now. The quarter size growth that was on my neck is completely gone and the persistently bad left side is finally looking less red and seems as though it may be in the healing process as well. Unfortunately, the right side of my face seems to have gotten worse. If it's not one thing its another. Also, my chin has really been breaking out with cysts/nodules this past week. One good thing is that the cystic acne that used to last weeks, even months, is now coming and going in just a few days and with healing time its more like a week. This is still way better than a month.or 2!

My zits are always peeling! It looks like I've been using retin-A but I havent! I'm always wanting to pick at the skin that is constantly coming off my face. I can't help it! I'm sure this isnt good for me but then again neither is coffee or red wine. I find myself pulling scabs off on a daily basis. Most are almost falling off but there are some that bleed when they peel off. I know this can't be good.

I finally have some semblance of a a sex drive (fheew!I thought there was something seriously wrong with me). I have still been in hideout mode but I've gotten to the point where I just dont give a damn and I've gotta get out and live life, zits or no zits. I'm still achy but I've been working out regardless. I feel like the benefits of working out (to lessen depression and obviously help the heart and the looks) outweight the joint/muscle pain that I now get because of the Accutane. I've heard about a vitamin that helps with the pain called MSN (I think) and Im going to ask my Dr. about it when I go in next week for my bloodwork. I've also been reading about B5 which I am going to ask about. I'm not sure if its a good idea to take these while on the Accutane or not. I don't want ANYTHING to interfere this far in the game! I would only quit now if I were having some pretty major ailments or serious depression. I'm just too far in, I've got to see this thing through.

All I can say is THANK GOD for makeup! I sure feel sorry for the guys that are going through this and don't have the makeup to cover it up. As you can see from the photos, no miracles have occurred over the past week. There is most definitely a difference in these photos when compared to the early photos but still not clear, not really even close. I have adopted a new attitude though. Its called fuck it. I don't know if it is because I've been dealing with this for SO long now (well over 4 months) or if Im a tiny bit clearer now and Im more confident. Either way, I think my new attitude is good. I even wore my hair back to work one day this week just because I felt like it. I guess I'm just getting tired of hiding because of my zit face. I figure people should like me for me and not because my skin is perfect. I think this is a much healthier approach but it won't last forever Im sure. I have to think that there is a possibility that the Accutane won't work for me. Then I'm going to have to live with it.

My 2 month Dr. appointment was yesterday morning. What a mess! The Dr. visit actually went fine, it was dealing with the pharmacy and getting the prescription filled that was maddening. My Dr. didnt know much about the Vitamin B5 or the MSN but said that vitamins shouldn't effect the Accutane at all and should be fine to take. I'm going to do a little more research on the B5 before I do anything with that. She also said that she usually sees more improvement after 2 months than what I am showing. We decided to up my dose to 80mg/day which will be the most I've ever taken. I'm starting this week with 60mg one day and 80mg the next and if that goes fine I'll increase in a week or 2. Since I'm doing the every-other-day thing I needed to have 20mg pills. Also, the way that my insurance works I would have to pay for 2 prescriptions if the Dr. had prescribed 20mg tablets and 40mg tablets to last me through the month. This would be the most logical thing to do but insurance issues won't permit it. My regular Save-On pharmacy didn't have enough of the 20mg pills to even get me through the week. They wouldnt get another shipment in till the end of the week if I were lucky. I asked them to call around to find somewhere that had the pills in stock and they could not find anyonewith the full amount. One place had enough for about 2 weeks. I decided to stop by a pharmacy that I used to go to (Rite Aid) and check. They had them. Yeah! But here's the ridiculous part: The sticker that is now required to be put on the Accutane prescription by the Dr. who prescribed it was filled out wrong. My Dr. checked the male box instead of female and the pharmacist said this would be a problem and that they probably couldn't fill it. So much red tape for this drug it's unbelievable! They ended up calling my Dr. and getting her to fax over a new prescription with the correct box checked. Between the Dr. visit and the pharmacies I spent 2 and a half-hours dealing with this crap. I'm so glad its only once a month!

Not much to report on side effects. Sex drive was back strong last week, which is good. It scared me when it went away for so long! What?!? I'm a 33 year old woman!
Dry skin, hair is getting worse, dry lips, joint ache, and some lethargy. Nothing out of the ordinary. I get my blood results at the end of the week. I'm interested to find out what that calcium level is this time. We'll see.

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