My Accutane (Isotretinoin) Experience

Let's just get right to the point. I want clear skin. I mean who doesn't. So I decided in February 2020 that I wanted to get on Accutane.


Background

A little bit of background on my skin. I've never had too bad of acne after 5/6th grade. It was never perfect but it was never a huge concern of mine. Fast forward 2 years ago, starting my first year of college, my skin decided to go crazy on me. I decided to start tracking my skin through pictures and I had terrible acne around my chin start in March 2018. Then a year later in March 2019, my chest started to fully break out in what seemed out of nowhere and this completely worsened in January of this year (2020). I was OVER IT. I take my skincare seriously but just nothing ever worked. I've been put on on so many prescription drugs, antibiotics, and tropicals, I've basically tried anything you could. I even decided to use more natural methods like cutting out dairy entirely and using natural ingredients like tea tree oil. Nothing worked. So in February, I decided to find a new dermatologist as I had given up on my old one about 6 months ago. I then made a whole list of things I have tried (which was just depressing to see at the end) just in case the dermatologist wanted to prescribe me more. I mean who knows what kind of resilience to antibiotics I have built up over time.


First Appointment & iPledge

On March 16, 2020, I had my first appointment at the dermatologist and her last sentence to me basically sums it up: "You've exhausted an impressive list of things". So she told me Accutane was the last thing I should try, and to my relief, I didn't have to "beg" her myself to be on it. I should tell you that I am absolutely terrible with needles. I swear, I have PTSD from a situation with a doctor when I had the swine flu and now I can't stand shots and blood tests. To my luck, my dermatologist did things a little differently.


During that appointment, I peed in a cup to ensure that as a female, I was not pregnant as Accutane can cause serious birth defects if you are pregnant a month before, during, or up to a month after (I was in the clear). Most others I hear get their blood tested for this step. I then received the booklet of information from iPledge which is a program you must enroll in where you promise you won't get pregnant during your time on Accutane and use two types of birth control methods. For all the females concerned, Accutane has no risk for you or any future children as long as you do not get pregnant before a month after your last pill is taken. The next day, I got a call saying that I was indeed not pregnant and that they would enroll me in iPledge and I could sign in afterward to complete registration. I then waited 30 days to get back in for April 16, 2020.


Second Appointment & Getting Accutane

On April 16th, I had my second appointment. This appointment was very quick. I once again peed in a cup to verify I wasn't pregnant and then the doctor just told me some of the effects Accutane could cause and what some of her recommendations. After this, I was set to pick up my prescription. Before anytime you pick up your monthly dose of Accutane, you must answer some questions on the iPledge website to make sure you know what you're doing. These questions are very easy such as are you allowed to become pregnant on Accutane and what kind of contraceptive you use. Once you answer them, you have a week to pick up your prescription.


I had some issues picking up my prescription. For one, Accutane is very expensive and I was not prepared as to how much. Obviously, this depends on your insurance, but with my insurance, if I had picked it up like originally planned at CVS, I would have paid $275. Not at all what I had in mind. I then learned that if you pick it up at different pharmacies, prices vary. My mom and I never knew this but this is valid for any prescription. We then transferred the medication to a Safeway/Vons Pharmacy and it was $175 with a discount we found on GoodRX. I highly recommend going on the site and entering your prescription and dosage (mine is 2 pills of 40mg) along with your store and you can find some pretty good discounts. A friend of mine also on Accutane found a local pharmacy that had cheaper prices and with her insurance, she paid between $5-30 depending on the brand of Accutane she got. So be prepared for the price but if you find a local pharmacy and your insurance helps you out, this can be a great thing for you. I, therefore, got on Accutane 3 days later.


Month 1 on Accutane

Before I officially got on Accutane, I chose to do some preventative measures in hopes to help reduce the amount of dryness. I have a separate post on what I did prior to getting on Accutane along with going in-depth on my side effects and my routines and changes during this first month. Overall though, I started getting dry in only a few areas during the first week and I tried to moisturize whenever possible. I am prone to sunburns too, and whether or not you are, you NEED to wear sunscreen every day. Even if I stayed inside all day, (which I started this Accutane journey during a quarantine so it was easier to stay inside a lot) I still have a window right at my side. The reason I mention I sunburn easily and am used to it is that I basically treated my skin as if I was spending a week at the lakehouse my family usually goes to every year. Moisturize like crazy every night to replenish my skin, wear sunscreen every day, and a higher SPF and a hat if I go directly in the sun, and moisturize my skin in the morning as well. At the end of month 1, I started having a small "purge" but nothing major. The last symptom was occasionally having signs of a bloody nose when I'd apply oil in it with a Q-tip, however, it never turned to actual bloody noses, I'd manage them before they became a "big" deal and I'd never notice if it wasn't for moisturizing my nostrils.


Month 2 on Accutane

I started month 2 with a blood test to ensure I was staying healthy and there were no major issues since being on Accutane. I also did my required monthly pregnancy test and iPledge questions. Now as far as my skin, my purge continued but it wasn't anything major like how my acne was before I got on Accutane. It was mostly just acne on my T-zone. With that said, all my side effects almost completely went away on Month 2. My arms and scalp were no longer itchy, my face had not had a dry spot since the start of Month 1, and the rest of my face was getting clear. I had some redness on my arms and face towards thee and of the month, By the end of Month 2, I was getting compliments about how clear my skin looked. The main issue in month 2 was getting the medication. They had sent the prescription to the wrong pharmacy which causes a major delay in my getting the medication which resulted in my not getting the medication for about 4 days. I would strongly recommend checking in with your dermatologist and the pharmacy as early as possible to make sure the prescription is ready and at the right location.


Month 3 on Accutane

I started off the month with the usual pregnancy test plus iPledge questions and getting the prescription was a breeze. My face was still getting rid despite rarely being in the sun and applying sunscreen, however, I am quite fair and Accutane thins out your skin so even walking a few blocks to work could be the culprit. My face was never dry visually however by the end of the night I would feel my skin getting a little tight around my mouth. That was usually when I would decide to wash my face for the night and apply moisturizer. I have kept up the same skin routine from the start so I will dedicate an entire blog post to my skincare routine while on Accutane here. The major symptom this month was my upper arms being dry and having dry spots to the touch, however, they were not itchy and barely visual (unless I pointed them out). The tops of my hands get irritated here and there as well and very try so I attempt to remember to wear hand lotion as much as I can. The last thing is that my arms are scratch up so easily, likely due to my thinning skin during this time. I can itch myself a little too much and I end up being scratched so I am pretty careful about that.


Month 4 on Accutane

During this check-in my dermatologist let me know she thought that I would more likely be on Accutane for just 5 months, meaning I had just 2 months to go at this point. My face had remained cleared and my back was only a minor issue but it cleared it all out too. The day before the appointment I started to get a rash on my chest which at first worried me as it looked mildly like when I would get an outburst of acne in that area, but it went away entirely after about 3 days which therefore was confirmed to very likely just be my body's response to Accutane or the dryness linked to it. I think month 4 was the month I saw the most dryness. My upper arms were pretty dry the entire month, sometimes visible as it got a little red on those dry patches but other times no one would even notice. My arms would also get itchier and I noticed it got particularly itchy if I had a bit too much sun or I had a tight long sleeve around them. The best thing I found was to use the anti-itch cream I had been using and in the shower, I would use the shampoo on my arms as well as it was formulated for major itchy and dry scalp. My hands stopped being so dry during this month which was positive. My nose still never actually had a bloody nose but there were a lot of times I got lazy with my coconut oil in my nose to moisturize it that I would notice a bit of blood on my Q-Tip but I seemed to always resolve the issue before it really became anything. Other than this, no dryness on my face but once again, I was very good about staying on top of my skincare routine.


Month 5 & 6 on Accutane

As usual at the start of both of the appointments, I would take the pregnancy test, and once cleared, they would give me my prescription. Both my last months were so much easier. The only thing in terms of symptoms was my upper arms becoming very dry and you could definitely see the dry patches on them if I didn't properly lotion or if I didn't reapply through the day, but my body was never itchy due to dryness. My nose was still dry and I would notice it particularly in the mornings but I would add the same oil and it would be fine. My skin remained cleared too, no other breakouts/rashes on my chest, it was honestly the easiest of the months.


On my last appointment, they also let me know that my skin was responding super well to the medication and that it would in fact be my last month. I took the rest of my pills as normal and I didn't have to go back to the dermatologist after the last of my dosages.


3-Months Post-Accutane

I am now 3 months post-Accutane and I am so happy with my skin. I rarely have any breakouts and when I do, they are super small and usually around my mouth which I think is due to the masks I wear during these Covid-19 times. My arms have remained quite dry but it isn't noticeable. I try to remember after I shower to lotion them up but I will be honest and say I often forget. Other than that, I've noticed my nose is very slight stuffy most mornings. I talked to my friend who was on it as well and who finished a few months before me and she mentioned it was the same for her. I think it's the body still trying to compensate for being dry for so long, but it usually goes away on its own and it's only caused me to actually blow my nose a few days. The one thing I do love is my clear skin and I still don't need to wash my hair too fast. Prior to Accutane, I could get away without washing my hair for 4-5 days as it was trained, I am back to that and glad.


Overall Thoughts

Honestly, Accutane was a great experience for me. I'm not sure if it was the preventative measures I took, perhaps doing it over the summer so it's hotter and in theory sweatier, or if my body agreed with it more, but I would definitely do it over if I had to. I definitely skipped a few pills here and there but it didn't have much of an effect on me, the worse I got was the itchiness on my arms and scalp mostly in the beginning and then the dryness on my upper arms caught up to me by the end. I've heard that for some people Accutane can wear off almost and later in life you may need to do it again, and don't get me wrong, it would suck if I had to do it again, but I'd also do it over in a heartbeat if it means clear skin again in a time where I could break out constantly again.

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