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Low Dose Accutane
Feb 6, 2009
6 Feb 2009
Hi, I have just taken my first low dose of Accutane
Brand:Sotret
Weight:90Kg=200lbs
Sex:Male
Age:48
Dosage:20mg once daily
Supplements:None

Day 1
Chronic oily skin, blotting on the hour. I have mild Rosacea and more severe Acne Vulgaris of the nose and chin. My dermatologist in the USA had no real off label experience with low and microdose accutane. I brought him multiple studies from Israel, Turkey, UK and more.... he was interested. I have a back-up of Eythromyacin, I am hoping not to use it. I have been on Doxycylcline for the last year (this is not allowed with Accutane) since being diagnosed with Rosacea. My derm will only allow for a one month antibiotic security blanket. Eythromyacin does not have contraindications with Accutane, when its gone I have to ride it out. I am Professor at a local college, needless to say it is difficult to have skin problems and have to lecture in front of crowds. I hope I am lucky and can avoid the dreaded intial outbreak so many Accutane users report.

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.
7 Feb 2009
Brand:Sotret
Weight:90Kg=200lbs
Sex:Male
Age:48
Dosage:20mg once daily
Supplements:None
New behavior: No alcohol or caffeine

Day 2:
I took my first Accutane 20mg pill last night at 9:00 with a bowl of oatmeal some apples and a big glass of water. Slept fine, no reported side effects. I will continue to take my dosage at night before bed. My acne is very controlled right now, I have been on daily Doxycycline for months. So, I guess so far so good.

Day 2 continued: Rosaceans I did have a flushing episode today, it was short and faded within minutes. I don't know if I can blame the accutane or not. I no longer have the security blanket of Doxycycline since it is forbidden with Accutane. I have one month of Eythromyacin but I am holding on to it for emergency situations. My Derm says thats all I get. Needless to say I was bummed out to have the flush happen. The Rosacea forums suggest even smaller doses of Accutane for Rosacea. I have both acne and Rosacea so I am torn between low dose recommendations. I also had my upper lip go slightly dry. I used lip balm and wondered if I was imagining this (I mean I have only taken one pill for Gods sake) since it is one of the most common side effects listed for Accutane users.

I just took my second pill, I have chosen to take Accutane just before bed. If there are side effects I was hoping to sleep through some of them......more to come.

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.
8 Feb 2009
Brand:Sotret
Weight:90Kg=200lbs
Sex:Male
Age:48
Dosage:20mg once daily
Supplements:None
New behavior: Lip Balm

Day:3
Well its official I tried caffeine again and I flushed within 3 minutes of drinking it. It appears that I no longer have the protection of Doxycyline and normal Rosacea symptoms have returned. I don't think the Accutane has caused any flushes, just normal triggers. I am for sure not imagining the dry lips. Only two pills and my lips are mildly dry. Its definitely noticeable. However, I have no headaches, no night vision problems and no detectable gastrointestinal problems. So far, I can't even really tell I have taken this drug other than the lips issue. I will take my third pill before bed tonight.

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.
9 Feb 2009
Brand:Sotret
Weight:90Kg=200lbs
Sex:Male
Age:48
Dosage:20mg once daily
New behavior: Zinc, Vitamin E, B and C supplements

Day 4:
Well its the morning of the 4th day. I have taken 3 20mg Sotret Acctuane pills. Slept like a baby, no sign of side effects other than the slightly dry lips. I am waiting for my acne to go crazy since I have stopped all antibiotics. I seem to be in a lull. Good! I don't want to post imaginary results but I gotta say I am waking up with less oil on my face already. Usually I am soaked. It would be hard to believe that this drug in only 3 pills could reduce my oil output already. However, if it can cause dry lips almost instantly then maybe a slight result could be possible already. I have no side effects other than the lips. No headaches, vision, nausea or pain anywhere so far. I have started to eat very healthy, low fat, grains and fruits are the route I am following. I am looking into supplements as well. I am thinking that a healthy diet and attitude might help with this therapy. I know that without antibiotics my acne should explode anytime now. We shall see.....

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.
10 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily
New behavior: No soda pop of any kind

Day 5:
Well I took my 4th pill last night. I know it sounds crazy but I can see changes already. I have even more fear of this drug than I had in the first place. It has to be powerful to have these effects in the short term. I definitely am waking up with less oil on my face. My first day of work was met with 50 percent less blotting with tissues. I had several events where I felt I had flushed (rosaceans pay heed) under some job stress but checking in the bathroom showed just regular looking skin. My Acne has not burst forth in the abscence antibiotics yet. Pores seem slightly smaller already. The mild lip drying is still present. I have no reported side effects with the possible exception of the lip drying and maybe one other. My libido seems to have taken several steps backwards. It should be noted that all of the results I am reporting could be due to just coincendental factors. Inside though, I really think it is this drug. I have read other Accutane logs with similar results. I am trying to be very objective, I pay attention to small details. One other thing that is definitely happening is the anti-imflammatory effect. My skin color is more even and red veined areas are looking less apparent than they have in years. I realize this is only 80 milligrams of Accutane and the diet changes could be part of this...... I don't know. It seems impossible to already be feeling the effects of this drug, but my oil ouput and skin color has shown changes. I know, I have to look in the mirror every day. I will continue to log results, I expect the suspected effects to become more apparent as time goes on. Then I can report with more confidence what I am already suspecting. I remain mildly optimistic wondering about what I am experiencing. I am thinking of asking my Derm to reduce the dosage to 10mg.

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.
10 Feb 2009 Cont-
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily
New behavior: No soda pop of any kind

I will be taking my 5th pill in a few minutes. I am still in shock that this drug shows effects in such a short time. Causes me to fear this drug even more. I will be asking my Derm to reduce the dosage for sure. He may balk, he was dragging his feet over the low dose idea. The sex drive thing put some real fear into me. I will be testing my libido regularly to detect any lapses. I hope my initial fears are in error, maybe self-fullfilling prophecy from all the negative posts on this drug. Well its show time.

:dizzy:
Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.


Ps. Thanks for the vote of confidence BabyNyc
11 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily
New behavior:None today

Day 6:
Well, I will be taking my 6th pill in a few minutes. I gotta tell ya, you probably won't believe me though. My pores which I double checked with my Wife are reduced by over 50 percent. I was blotting 10 times a day with tissues to soak up oil. I now blot 4 to 5 times a day during work. My acne was under control from a year on Doxycycline, so I didn't have much when I started Accutane. However, by now I should be breaking out gang busters with Acne Vulgaris all over my nose. Ususally my nose is throbbing from the swollen sebaceous glands. It is feeling of normal size again. It actually looks smaller. It is like a switch has been thrown and my oil glands are being told to stop. My pores are shrinking at a rapid rate. A 100mg dose (20mg once a day) of this drug has caused these reactions in only 5 days. I say it again, I am very scared of a drug that has this powerful effect in that period of time. To the rosaceans who may be vieiwing this log, I feel extreme hot flushes in the cheek but not my nose, however when I check to see how bad it is, it is insignificant. I look mildly flushed compared to how I used to look. My side effects are extremely mild to none. Slightly dry upper lip is all I have..... I have read many horror stories about this drug, I won't go into the details. So, my fear levels are high. I am happy and at the same time scared to death. I really want to take even lower doses. I have considered getting gelatin caps and a syringe and drawing out 5mg doses to put in the caps. I wished this came in pill form so I could break them into pieces. I am not sure what I am going to do yet. It almost feels as if my body needed this, it makes me wonder how it works. Its like something out of whack has been corrected. Some individuals lives are ruined by this drug. I find that it is the high dosers who report the worst problems. Low dose this drug might just be heaven sent. My job is already one hundred percent better. My wife is throwing a party this weekend and I am actually looking forward to it. Miracle or curse......we shall see.:confused:

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.

Best Wishes
LowTane
14 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily
New behavior:Optimism :D


Day 8 & 9:
Well its the morning of day 9 and I have taken 8 Acctuane pills for a total cumlative dose of 160 milligrams. I still take it at night before bed with a small meal. Well, I am in love with this drug, fear and all. Now, my face is never gonna be scar free without some intervention of some kind. I have had acne to long on my nose. However, Accutane is like a chemical facial. My pores are shrinking and my oil is more like a normal human at this point. I am in shock that this drug could be so rapidly effective. Blotches are already lighter than before and getting better as we go on. I can no longer even tell I am taking this drug. I have no side effects at all, not even dry lips. I have mildly insignificant micro flaking of the skin. So, inspite of the fear I am one happy camper. To Rosaceans, yesterday was flush free, and also, Acne Vulgaris seems to be in hiding. I have had a few minor pimples that have come out of the skin and been washed away. Now it should be noted that I have stopped a lot of other behavior as well. This could be helping the results along. At this point I can't really list a single problem. Now I know this could all go bad overnite so I am not going to get to euphoric and tell someone to run out and get on this drug. But I will say this, I will never take high doses of this drug ever. I made the commitment when I started that if low dose didn't work then tough luck. I have read at least 3 to 4 hundred hours on this subject. To many questions out there still even after almost 30 years of data collected on this drug. But I am hopeful that my derm may consider micro-dose long term if it will help manage my Rosacea and Acne Vulgaris. Low dose is the answer in my opinion. One more thing, the stories about diminished sex drive may be true, but for me so far that is not the case. All seems perfectly normal. Well thats all for now folks, I think I will take my (almost) oil free face out into the world for a few errands. Stay strong all............

Ps. Keep in mind that a lot more people have taken this drug than the horror stories support. If the several million people that have taken it so far all had very poor results I think this drug would be off the market for good. The reported birth defects seem to be the biggest negative factor that gets reported. I also suspect that the really high doses are causing the majority of problems where other side effects are reported. Purely an opinion from my personal research. Take it with a grain of salt, cuz I really don't know enough.

Best Wishes
LowTane :p
18 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily

Day 13:
I gotta say, that Accutane changes the normal process for a zit. I was already for a long drawn out process for my new acne. It started very painful as usual, but.... my zits are drying up quick. Its as if they are drying from the inside out. Pain came and went. The normal expected redness and swelling is very mild in comparison to past acne events. Wow, I am loving this drug. Pores that I expected would need surgery are much, much reduced in size and appearance. Oil is still very well controlled. I have no side effects whatsoever. My attitude is improved 100%. After reading all the horror stories online I was braced for the worst. I might as well be taking a vitamin pill. I am thinking that the Europeans have it right. We are giving much to high of dosages in the United States of this powerful drug. Pill #13 goes down tonight.

Day 13: cont-
I just took pill #13 a few moments ago. I have two zits on the chin and 3 on the nose. They are not that red though. It really is a lot easier to deal with the zits on this drug. I hope this does not last for weeks. It would be nice to get past the intial breakout. To the Rosaceans. No flushing at all, no hot skin...nothing. It seems this drug does control Rosacea. The downside is I have heard it doesn't cure it like it can Acne. When all is said and done the next hurdle may be getting a Derm to commit to long term Microdose Tane. Well, good nite.


Best Wishes
LowTane:D
I started on Monday 2/16. I am 48, male,190 lbs and am on 40mg/day. My systoms are similar to your except I was on tetracycline for 11 years (absurd, I know) and everything else that did not work. My breakouts were usually not bad, mostly on the nose and trunk. My face started to get really read last October and it took me 4 months to get a derm appt. Since nothing else worked, including prescription creams, they said this was the best option.

I decided to quit drinking while I am on it...will make friday nights rather dull, but I like my liver.

The first day I had some mild headaches. The second day I broke out a little, but I`m not sure if it is from the accutane or the fact that I stopped using everything else. Today I was a little more broken out but they went as quickly as they came, which was strange. My eyes get very dry about an hour after I take it (with dinner) and that lasts for an hour or 2. My skin is less oily, for now. I sleep like a rock.

I was told to drink a lot of water and exercise and eat well.

My 19 year old daughter just finished up. She was never that bad but nothing got rid of her mild acne so she tried it and has flawless skin.

Good luck. Keep in touch.



[QUOTE=LowTane;3877069]6 Feb 2009
Hi, I have just taken my first low dose of Accutane
Brand:Sotret
Weight:90Kg=200lbs
Sex:Male
Age:48
Dosage:20mg once daily
Supplements:None

Day 1
Chronic oily skin, blotting on the hour. I have mild Rosacea and more severe Acne Vulgaris of the nose and chin. My dermatologist in the USA had no real off label experience with low and microdose accutane. I brought him multiple studies from Israel, Turkey, UK and more.... he was interested. I have a back-up of Eythromyacin, I am hoping not to use it. I have been on Doxycylcline for the last year (this is not allowed with Accutane) since being diagnosed with Rosacea. My derm will only allow for a one month antibiotic security blanket. Eythromyacin does not have contraindications with Accutane, when its gone I have to ride it out. I am Professor at a local college, needless to say it is difficult to have skin problems and have to lecture in front of crowds. I hope I am lucky and can avoid the dreaded intial outbreak so many Accutane users report.

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do belive this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long term side effects.[/QUOTE]
Thanks Blueyz..........

24 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily
Symptoms: Dry lower lip
Behavior: Cetaphil soap and moisturizer b4 bed



Day 20:
I never did use the emergency Erythromyacin my Derm gave me for the intial outbreak.
No side effects other than lower lip slightly dry.
Sex drive still functional.
Micro-flaking on nose and chin (only the areas where acne presents).
Oil reduced 95%
Rosacea symptoms = Zero!
Acne breaks and drys in 24 to 36 hours.
Pores and scarring have been affected significantly.
Confidence has improved 85 percent.
Fun factor and socialability improved beyond measure.
Pessimism diminished somewhat. (Still I do not take this drug lightly!)

Pill # 20 is on deck in one hour! :wave:

My take and speculative wishful thinking: I honestly am starting to feel that this drug at this low dose is not going to kill me. I have 100's of hours (really I do) of reading blogs and research papers on this subject. I think that the high dosage approach is where the problems can really present themselves. Even though some individuals report no problems in the long term from higher dosages. I don't think I would be comfortable on this controversial drug at the 5mg/Kg of body weight norm here in America. My hopes are at the very worse, a 5mg every other day maintenance dose (or less) in the long term if required. I am aware I could still have problems in the long term. However, this drug is 30 years old. Millions have taken it, wouldn't this be a much bigger story if everyone had long term side effects. The web shows a small group of individuals (in comparison to the number of individuals who have taken this drug) blaming this drug for every bad experience they have had post Accutane. I am not saying they are wrong, I am wondering if they are just a small percentage of a very large group. Just a thought..................

Best Wishes
LowTane

Declarative statement: I am not recommending this drug. I am only reporting results in the most objective manner I can muster. I do believe this drug can be dangerous. I am taking this risk of my own accord. Please read other blogs that discuss the seriousness of possible long and short term side effects.
The studies are very interesting. My gut feeling, however, is that this drug was designed to be taken at a higher dosage. Lowtane, we are about the same age and weight, and our results appear to be very similar with little or no side effects, even considering that from what you have written your condition was considerably worse than mine. The forgoing would seem to indicate that, all things being equal, I could take a safer, lower dose. The open question, however, is whether it makes a difference to our relative long term health that I will stop after 6 months and you will stop after 11 months. I will start the "recovery" period earlier, but may have more to recover from. You will start the "recovery" period later, but will have had the reduced stress on your body for a longer period. I am a lawyer, not a doctor, so I don`t know. As a classic type A personality, I just want this to work and be over and done as soon as possible. As long as I don`t have any really bad side effects, I won`t push for a lower dosage, longer treatment option. We will see how the blood work turns out. My triglygerides were always borderline high, my LDL low, but my HDL also low (5 to 1 ratio instead of classic 3 to 1). I will continue my 4 days per week on the treadmill (about 3.75 hours per week) and 3 to 4 days of weight training (about 1.25 hours per week) and see what happens. I am certain that by not drinking 2 to 3 nights per week my triglycerides will improve. Hopefully, any increase from the Tane will be a push, at worst. In any event, I have already lost a few pounds by not drinking, I am sure.

As for current side effects, after 9 doses of 40mg, I sleep very soundly, much more so than usual, and I remember more dreams than ever. I have some breakouts, but they come and go fast. For the first time in almost 40 years, I don`t worry about them because they will be gone soon and knowing there is an end is empowering. I have chapped lips, and some peeling on the nose, but no more oily skin. My face feels tight sometimes. Pores are markedly reduced. No temper Tanetrums (couldn`t resist) yet.

Optimism is the prevailing emotion.

Regards........
OldLawyer, good to hear from ya.... thanks for chiming in for Drew. Its good to hear results from more than one person. Thanks for sharing the details of your therapy.

26 Feb 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily


Day 22:
Well, I have realized that I will get to a point where my face will not advance any further. Once the Acne is gone and the oil has dryed up the only thing left will be scars. At this point my reporting will only consist of observable physiological ramifications that may present during the completion of this therapy. The next phase of interesting material may consist of posts logged after Accutane therapy is complete. Will there be a remission? Will OldLawyer's more conventional dosage get him a remission? Will my Rosacea symptoms come back while the Acne stays in remission? Will I become impotent? Will other long term side effects present months or years after suspension of Accutane therapy? Like my hair falling out as some individuals report. Or, is my Dermatologist correct with 20 years of Accutane experience when he says "poppycock?".......Will I need and Will I be able to talk my doctor into long term ultra-lowdose acctuane? If he does, will it help me to remain oil and rosacea free? Like say 2mg a day, 1/10th what I am taking now. Will the return of my youthful dashing good looks cause me to trade my wife in for a younger beautiful woman? Will I get Laser Genesis to erase the remaing micro-scarring? Or, will an asteroid hit the planet making all of these questions moot? More importantly, will I break 80 in golf? Well, I am rambling now. These are questions that my abstract musings produce over time. On a serious note, as I walked down the hallway at my Dermatologist office I heard him say over my shoulder "Accutane will change your life". I looked back him and I thought, I'm worried about it ruining my life. So here I sit looking at my new face thinking, regardless of the fear factor here, wow!, this drug has changed my life, it has for now given it back. I haven't been this happy in a long long time.

I will take pill 22 in about 30 minutes.

Keep the Faith
LowTane :rolleyes:
Thanks Nikki for the input. I think my reading agrees with Nikki's two cents. Many inidividuals report remissions of up to 1 to 2 years. Although my Acne is not cystic my oil production is over the top. My intent is to change my life style and see if that helps at all. I have resigned my self to the fact that my situation might not change until I am a very old man and my testosterone and hormonal values change. But hey, who knows what the future holds. I also have high hopes for sustained microdose therapy of Accutane in the long term. Whether my Derm would go for that is another question. Some Doctors are reporting success in maitenance of Acne and Rosacea in the longterm with Accutane. I have read that with ultra-low doses some doctors are not requiring blood tests. So, we shall see what becomes me..... when this is all over in about 9 more months. So far, I am overwhelmingly greatful for the break in oil production and resultant Acne.

Best Wishes
LowTane
Definately some food for thought, LowTane. My doc tends to be a high doser, and if my body tolerates it, I will go with that. She was much more optimistic about long term results. Common sense (which is dangerous) tells me that relapses in teens with standard acne as opposed to the more vascular rosacia type would be more prone to relapses, taking hormonal activity into account. Moreover, a 10 year remission would leave us with 58 year old skin, which should be less suseptible to the markedly increased oil production. Studies on Rosacia give it a life of 8 to 15 years in most cases. Having been in this boat for 13 years, I question that prediction, but I will admit that over the last 2 years, the episodes of really bad breakouts were decreased to a cyclical one week per month (but as we know, that episode affects appearance for the rest of teh month). Here is something else that you may be interested in: Although my skin was never really blemish free, the rosacea type acne did not really start until after I caught a mild case of the chicken pox from my kids at age 35, and the really bad redness did not start until 5 months ago, which prompted my derm appt. My doctor told me that the bad thing about getting a mild case of the pox as an adult is that mild cases can affect the vascular system. Within a month after recovery from the pox, I developed severe seasonal allergies that would only respond to steroids. Also, my blood pressure rose from 110/70 pre-pox to 170/120 post pox. I am on the mildest dose of BP meds available and that gets it down to 110/70 again, but if I go off it, the BP shoots up again. Keep in mind that although my diet ok but is not the best, I have an affinity for Jack Daniels and I have a high stress job, I exercise regularly, I am not overweight and all other vitals are good. My doc maintains that the pox was the trigger for all of this, including my skin. That is why he put me on antibiotics, which only worked well for a year and did nothing for the oil or the swelling of the nose. With accutane, all of the skin issues are now gone after less than 3 weeks. After I am done with my course, I will definately raise the issue of long term low dose, and if my derm won`t do it, I will go on this again if need be. If that doesn`t work, I`ll try the light show previously discussed in this post. The best part is that there are still options.

Until next week.......all the best.
6 Mar 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg once daily

Day 29:
All extremely interesting OL. I started to have gastrointestinal problems from a high stress job coupled with poor diet. Diet sodas had replaced water and alcohol was a weekly event. Rosacea surfaced right on cue with the gastro problems. Many Rosaceans report the same thing, gastro first Rosacea next. Who knows, its all anecdotal....could simply be age. Well on another subject I have had some possible side effects today. A headache that lasted all day and some strangely weird wooziness and head scrambling. I had to cancel a lecture give a takehome test which tickled my collegiate captives to no end. The headache left after a good size meal and 2 asprin. The more I read about this drug the more I fear it. To many times I have read " the exact mechanism for Accutane's success is unknown". This drug has been out for 27 years. It is the number one selling drug for Roche. I have read as many as 5 million have taken this drug. It has been considered for removal from the market by the FDA. Debates have been fielded on the congressional floor over this drug. I think I am wise to be fearful. What scares me is the articles that discuss the permanence of the side effects. I for one cannot wait to get my dose lower. I have considered skip dosing, but I am afraid I may not get a long term remission if I play ping pong with the plasma levels. I don't know who reads this, but these are the things I think about.


I don't know if this helps anyone reading this blog. I can say this, my face is better than it has been in years. It feels great.....I just wonder will there be an ultimate cost. Google up side effects and lawsuits and Accutane before you even think about taking this drug.

Pill 29 on deck, maybe..........

Best Wishes
LowTane
LowTane
While there are many reports of horror stories, I take them for what they are. As an attorney, I learned long ago that if my clients are happy with my services, they tell me; if they are not, they tell everyone. Over the last 5 to 7 years of free internet access and blogs, the stories I read seem to represent a relatively small sample. Most reports show that any side effects go away after the course is complete. At 40mg per day, I have not noticed any increase in frequency of headaches. My temper seems to be a little short at times, but it is no worse than when I am on prednisone, and I learned to control it. My bottom line is that as long as the side effects are not present, I have no worry. If they appear, I will assess it then. Aspirin and cough syrup and other OTC drugs all have side effects. Reading the labels shows some can be serious and long term. As long as I give full disclosure to my doc, I will let it ride.
Good to hear from ya Chooch. Thats cool.. Its nice to hear from other low dosers. But I must ask, what was your outcome after your accutane experience. Success, failure? Will you take it again. Did you have a remission etc... it would be cool to hear your story.

Old Lawyer, good to hear from you. You are right, there are side effects listed for every drug. There are lawsuits for multiple drugs on the market. Also, the sampling of horror stories is small in comparison to the number of patients who have prescribed this drug. I had wanted to go with a very low dose all along to feel this drug out. I know that long term antibiotics are no option either. I am torn between long term extremely low dose maintenance accutane and going for the high dose and hoping for a really long remission. I have skipped two pills so far and my headache and dizziness hasn't resurfaced. Could have just been a fluke and had nothing to do with Accutane. My derm is going to lower my dose next month anyway. So, still contemplating my next drug move. I do appreciate your reply. Good Luck...

9 Mar 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg every 4 days.

Day 32:

Well if you have been following along at all you know I am taking liberties with the dosages of this drug. I have backed off on the 20mg daily to 20mg every 4 days. I have no increase in oil yet from the lower dosage. I have felt better on the lower dose. My facial redness (flushed look really) is more normal skin tone now. I am still dry and have very mild flaking. I am 100 percent clear and my pores have shrunk 85%. I am loving this part of this, all things are better. I do believe some of the extremely high dosages doctors have prescribed some patients have really caused some terrible problems. My reading shows that a lot of people get remission but still come full circle back to acne and oil. Many people do this drug several times with long breaks in between. My goal is to go low and stay low and check out my results compared to hopefully someone on higher dosages. Maybe old lawyer will stay around long enough to be that guinea pig. Well all for now......


Best Wishes
LowTane
Lowtane,while i was taking accutane my face was pretty close to normal..
hardly any oil and no breakouts..but once i stopped taking it the oil and
breakouts started coming back...you see with low dose all you are doing
is suppressing everything, once you stop taking it your face will slowly revert back to its old self.... you won't destroy the oil glands on low dose....to
maintan an oil & acne free face you have to stay on the drug long term. Or
take the normal high dose for 6 months and hope it destroys the oil glands.
but since you have slight rosacea i would not take the high dose because
that would push you into full blown rosacea and you don't want that..or
you can scrape the drug all together and look into photodynamic laser..
my advice to you is to go as low as you can...and if you have no side effects
just keep taking it...i am thinking about trying it again...maybe see what i can
get from 20mg a week...not sure though...its a love, hate relationship i have
with this drug.
good luck.
"Continuous Use Offers Versatility A great benefit of using lower doses of isotretinoin is that it can be used continuously. There are other important advantages, as well. "In terms of pharmacoeconomics, it is cheaper to use lower doses, it is better tolerated by patients, has fewer side effects, fewer laboratory abnormalities, and of course the patients like it when they have continuous elegant treatment," Dr. Plewig said."

Key word in that statement "Continuous"

I agree with you lowtane that there are many people who
relapse after taking high dose...80mg a day for 6 months.
so how unlikely is it to get a long term remission from 20mg
every 4 days, which works out to 5mg daily.
So if it is cumlative that is the important thing.. at 5mg daily
you have to take it for 8 years

80mg a day for 6 months =14400mg
5mg a day for 8 years = 14600mg

Continuous use is what is the important thing with low dose..
its called "maintance therapy".
So if you are willing and able to take it on a continous basis you
will maintain clear skin.

It sucks because we have been cursed with oil glands that are stimulated
by the hormones flowing in our blood...its not that we have more male
hormones then the average guy who has clear skin...its just our oil
glands are constantly stimulated...so if you don't destroy them or
shrink the crap out of them they will continue to pump out oil.
good luck man.
12 Mar 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg every 4 days

Chooch, heres the part I am talking about:

A total of 617 patients completed the study. In group 95% of patients achieved considerable improvement or complete remission of their acne;

Somewhere in that 95% were low dose Accutane users who acheived complete remission.

Where low dose is concerned my thinking is that the lower doses cause less damage to vital systems. I could tolerate a minute amount of strychnine once a week for a long time. However, a full cup would kill me instantly. I know that analogy stinks but its all I could come up with on short notice. Since the actual mechanism that makes Accutane effective is unknown, I believe it warrants extreme caution. I know there are quite a few individuals out there wishing they had never seen or heard of this drug. Many other countries are reporting responsible long term usage on much lower doses. I believe it is prudent and wise to re-think western methods. Many blogs report high dosage acne relapses. If someone starts on low dose, they can always later on try a higher dosage. At least they had time to feel out the drug and see if they can gain complete remission without as high a risk. I only posted two studies, there are more from Germany, UK, Turkey, Israel, Sweden etc... They are all advocating therapies that involve lower dosages, for very good reason I believe. So, for me, I feel much better trying the lower dose regimen before committing to a higher dose regimen. I certainly wouldn't recommend this drug to anyone without caution. I am 100 percent acne free on my entire body, with extremely minimal side effects thus far. I am maintaing that condition so far on 20mg's every 4 days. I bet based on how my body feels, that I could do it on even less. I intend to try and prove that point in the very near future. Dr. Plewigs study suggest some individuals maintain an acne free state with as little as 2.5mg's twice a week. To be fair, it is working for people with mild to moderat acne, I don't see a lot of low dose reports for really bad cystic acne. This drug completely cleard up my nasty oil acne riddled skin in one month. I am blown away. I had to take in 4 different studies which I printed out and show my Derm before he settled down to the idea of low dose. Now he seems to be fully on board with the idea. We could do American acne sufferers a big favor if we would all do the same thing. Educate them thar Doctors as to what the foreigners are up to with this controversial drug called Acctutane. Some Doc's may listen.

Well, enough conjecture for tonight.

Ps. I would rather take this drug for 8 years safely and remain acne free, than taking high dose for 6 months and possibly suffering from side effects for the rest of my life. However there are no real long term studies on low dose Accutane either. It could be just as risky.

Best Wishes
LowTane
19 Mar 2009
Brand:Sotret
Weight:90Kg = 200lbs
Sex:Male
Age:48
Dosage:20mg every 7 days

Well, not much to say here. I am half way through the second month of my Accutane therapy. A total of 660mgs of Accutane have been consumed. As you know the title of this thread is "LowDose" Accutane. What is considered low dose? Anything less than the common standard of .5 to 1 milligram of Accutane for every Kilogram of body weight. You will find that researchers consider the total cummulative dose the key factor in remission rates. So, you would end up taking just as much Accutane as a high doser. It would just take a longer therapy to reach the total cummulative dose. So, whats the difference? Some Doctors believe that higher doses result in better and longer remission rates. There are many reports of successful remission at higher dosages. Recently reports on low dose studies have also shown good remission rates for low dosers. Some doctors in other countries are using low doses bi-weekly to sustain remission in some patients. These doctors have reported that monthly blood tests are not required at these low dosages. So, this is actually where I wish to end up if I don't get a remission. Start low, stay low and try to avoid any longterm side effects at all costs. Now it should be noted I have found no studies on longterm low dose Accutane therapies. Short term studies exist. Therein lies the problem. Long term lowdose could be as much a risk as short term high dose. All of these assertions should be taken with a grain of websalt. Ask lots of questions, get more than one doctor's opinion if possible. Try to ignore threads like this one and form your own opinions based on professional resources only. I paid to get the scientific journal access for Rosacea, Acne and the effects of low dose Accutane. I am convince it is right for me, with my obsessive mindset and all. How is it working so far? Wow! My life has improved immensely. But, inspite of it all. There are a multitude of people suing and winning over Accutane longterm side effects. It is easy to find what seems to be normal average everyday people reporting on different blogs horrific experiences with this drug. I can't ignore that entirely, I just can't. It is anecdotal and non-professional reporting to say the least. I still think there is some merit in paying heed to these stories. It is also fair to say that many high dosers report the return of there acne. Yet, it is also fair to say that many high dosers report long multi-year remissions with no long term side effects. It is also my speculation that successful Accutane users aren't as likely to report. They are to busy having fun. With 12,000,000 users world wide reported it seems that the percentage of bad experiences might be low. So, in the end, I know nothing other than what my own research has produced in the way of a perception of Accutane. I just know this, if engaging in certain behavior can result in a permanent long term outcome, I really want to dot my eyes and cross my tees before leaping into a therapy. My experience with doctors has shown me that it is okay to second guess them. This is where the "get a second opinion" cliche originated from. People second guessing their doctor. Please read up on possible longterm side effects. It is not a fantasy, many of these effects are listed right on the warning label in my very own Accutane prescription box. I am just a regular person trying to deal with a mentally devasting physical condition. Acutally two conditions. I have both Rosacea and Acne, and because of Accutane you would never know it. It has amazed me to no end......

I wish you the best...

LowTane
Shidoshi, I slowed down to 20 mg a week for awhile. I felt better and my skin's progress didn't seem to change at all. I am now back to the 20mg daily. If I have headaches and libido problems I will probably back off again on the dosage. I believe that doing the least amount of harm while building on the total cumulative dose is the way to go. If I don't get a remission after all of this I may try another round. What the dosage will be I have no idea. I am hoping that life style changes coupled with the Accutane therapy will give me a new acne status quo. If I have a relapse I will go back on antibiotics until my rest period is up. I will then try Accutane again. The last possible idea is exteme low dose long term. I have thought about this quite a bit. Some doctors are doing this with some patients. It violates the FDA's rules for administering this drug. I guess they are williig to take this chance with their licenses. I am at a point now where I can't tell I am even taking this drug. The lack of oil and the smallest pores I have had in 12 years are what remind me that his drug is still present in my system.....

Best of Luck All
LowTane
Hello......

I have a Derm Appt. on thursday. I will be checking my cholesterol, triglycerides and liver enzymes. I expect if he remembers I will get my current 20mg dosage lowered. We shall see....... I will continue with this low dosage ideal until I reach some sort of an outcome. I don't think this board will be all that interesting until my therapy is complete. The days following successation of said therapy will be the most interesting. Will I get a remission? Or will it be a full blown oil slick and a regression into social leprosyship? Thats the most important question. I have no idea..... I wish I could post all the studies I have read so that you could read them in one place. I can't, almost everything is copyrighted. So, I can tell you about them, and hopefully you can find them for yourselves. Right now I am enjoying life more than I have for quite some time. This drug as far as I know is a miracle for me. It is the answer for my problems. How will I end up? I am not sure, low dose maintenance for the long term? Will I get the Derm's blessing for intermittant low dose? I don't know. My pores have shrunken in ways I couldn't have imagined. Blotchiness reduced to levels I never dreamt of.........I feel normal. I can touch my nose. I am out of pain. I look like a normal human again. I am in love with Accutane, and yes, still fearful of this drug. Well, that is it for tonight. Can you drink on Accutane, well this post was conceived on 3 glasses of a very good Cabernet Sauvignon.

Nite
LowTane
Hello All :p

I noticed this thread has now passed 8000 views. I was thinking about this today. I don't know how many return to this thread more than once, but my hopes are that viewers will spread the news to their prospective doctors about low dose therapy studies conducted in other countries. I am not a scientist, I am the lab rat. When I look for low dose Accutane information I get results from Italy, Israel, Iran, Turkey, Sweden, Germany etc.. So far I have not found any major studies conducted in the United States. On my last visit to my Derm he lowered the dosage to 10 milligrams a day, to do that he gave me a prescription for 20 milligrams a day 10mg twice a day. He told me to take just one 10mg pill a day. He did this to cover his butt, because he was "off label" tinkering with the dosage of this amazing controversial drug. I was told that he attends conferences annually and low dose Accutane therapies were not on the agenda. Now, granted this is only one doc, but his position seems to echo my research for American drug therapy choices where Accutane is concerned. No real [B][I]long term [/I][/B]studies have been done where low dose Accutane is concerned. The idea is that some docs believe that it is the total cummulative dose per kilogram of body weight that counts. This means you would be on the drug a lot longer than someone on a higher dose. The target number seems to come from earlier studies. It is 120mg per kilogram of body weight. I am 90kg (200lbs) that means that my total cummulative dose would equal 10800 milligrams. At 10mg a day it would take 36 months to reach that goal. Now there really aren't any studies supporting this type of therapy. So what it comes down to is that doctors who opt for this low dose regimen are in violation of the FDA approved therapy. So, the doctors have a little leeway but can't get crazy without being in violation of the approved "on label" therapy. My ignorant, layperson informal opinion is derived from a simple analogy. What good is it if the cure kills the patient. The horrible side effects, bloody noses, depression, suicidal tendancies, triglyceride elevations, cholesterol elevations, bone and joint disorders etc.. are minmized with the lower dose regimen. With this caveat, maybe???????? Because who really knows. Long term low dose studies are not very abundant. I just think it would suck if this miracle drug that changed my life so drastically to the positive in such an amazingly short time was removed from the market. Or worse yet, individuals pass on trying this drug due to all out fear. I have virtually no side effects, and a perfectly clear face now. I am thrilled to death. If you are in America, approach your Derm and ask them about the studies conducted in other countries that criticize high dose accutane therapies. Tell them you know of formal studies that suggest that low dose therapies are just as effective as high dose in some patients. See what they say! My Derm decided to play ball. Now, I don't know if I will get a remission when I stop this drug. I will continue to post even after I stop Accutane to let people know what happened to at least one person on low dose Accutane therapy. At the very least, I am super glad to be off antibiotics. I am glad to get this amazing break from my tortured, swollen, oily, acne ridden face. My job, my sex life, my attitude and my fun factor have all improved a million percent. I am in short, enjoying life again for the first time in years.

Disclaimer: Accutane can be a very dangerous drug for some people. I believe this with all my heart. I don't wish to talk anyone into using this drug. Do your homework, consult multiple doctors. And never, ever self medicate off the internet. To many items need monitoring with monthly blood tests to take a risk self medicating. Read about all the possible side effects this drug can cause. At any dose this drug causes birth defects. Remember, what works for one person may be a catastrophe for another.

Luck

LowTane
In summary:

The purpose of this board was to explore the results of using low dose Accutane (Isotretinoin) over a longer period of time than normal therapies with high doses used in a shorter period of time. After becoming desparate with Sebaceous Hyperplasia (enlarged over active oil glands) and mild Rosacea I began reseaching the web heavily and discovered some studies in foreign countries that showed the efficacy of lower doses of Accutane. Why go with lower dosages? To minimize side effects, long term and short term. The end result desired? To go into long term remission for Acne and Sebaceous Hyperplasia. Here is where the debate begins. Some studies have shown significant remission rates with lower dosages. The United States is furthest behind in this type of therapy. Just talk to your Dermatologist and see..... The rule of thumb in this country is "higher dosages = longer remissions and/or possible cures". Individuals have reported the return of their acne with high and low dosages. Other individuals have reported cures and long term remissions with both high and low dosages. We have all heard time and time again that everybody is different. Even though we are of the same species. Its true, drugs seem to effect people differently. I am opting for the lowest dose possible and still maintain an acne oil and rosacea free face. So far I am running perfect, first on 20mg a day and now 10mg a day. I will try to lower the dosage again upon my next appointment. My American Derm is suprised and mildly shocked at the overwhelming positive effect low dosages are having on me. I am 200 pounds. I have referenced links to different studies on Accutane therapy at pubmed and medscape. Talk to your Derm and show them the studies if they are not already enlightend to low dose Isotretinoin therapies. Best of luck....

PS. No matter how I try to explain the positive effect this drug has had on my life it will be understated. I am ecstatic. I have regained my life for the first time in years. I say this knowing that the longterm problems some individuals talk about where this drug is concerned could still be waiting for me somewhere up around the bend.

LT

Disclaimer: Accutane can be a very dangerous drug for some people. I believe this with all my heart. I don't wish to talk anyone into using this drug. Do your homework, consult multiple doctors. And never, ever self medicate off the internet. To many items need monitoring with monthly blood tests to take a risk self medicating. Read about all the possible side effects this drug can cause. At any dose this drug causes birth defects. Remember, what works for one person may be a catastrophe for another.
Hey Shidoshi.... good ta hear from ya..

Well a short report, 200lb man taking 10mgs of Isotretinoin (Accutane) daily remains one hundred percent acne, rosacea and oil free. I have no side effects at this point and can't even tell I am taking this drug other than the positive effects described. Like I have said before, this thread will become more interesting once I stop taking this drug. I hope visitors have cut and pasted the links provided to read some of the abstracts published by ligitimate research professionals in regard to Isotretinoin. Many types of drug therapies have been tried for Accutane. Hopefully this type of information may provide different individuals with alternate methodologies over the American traditional high dosage approach. Accutane has stopped 3 major negative physiological aspects of my life. All the while in the back of my mind, I still have some worry in regard to the long term outcomes. I have noticed the lower the dose the better I feel mentally and physically. Some dizzy euphoric episodes have dissappeared. 10mgs a day is 1/9th of a traditional high dose of this drug for my body weight. So the question still remains, will lower dose over a longer period of time be as effective for remission as a higher dose over a shorter period of time? That is the question. We shall see...............

LowTane
Hello All

As a "high doser" I wanted to add a different perspective. I had the dosage increased last week from 40mg per day to 40mg every other day and 80mg on the other days, after 2 months of treatment. I have noticed no change and no side effects. The only real difference for me over the last 7 weeks is that I am not very hungry during the day and tend to eat more than before at night. Since I added the pills every other day, I now take one every morning and the second one at night on the required days. Before, I took them at night. I make sure I eat enough fat in the morning for max absorpsion. I acknowledge that everyone responds differntly, but for me this "normal" dose has been just fine. I assume I will be up to 80mg per day after my next visit in 3 weeks, but we shall see. I no longer consume alcohol regularly. I have imbibed twice in 7 weeks, and not to excess. I drink plenty of water. I am in a better mood most of the time, due to my improved appearance. Nonetheless, I really want the next 13 weeks to come and go so I can be done and see what happens. I remain skeptical about long term remission. I will keep you posted and wish all the low dosers the best of luck. I guess my philosophy is that if this drug is really pounding my body and my body wins, I can start the healing. My concern with low dose is that even though the pounding is less, it lasts longer. To me, it would be like getting nicked and cut until you bleed to death. So, if my body is going through the equivalent of a 5 month hangover, when the toxins are gone I will start to heal. On the otherhand, drinking every day for a few years and stopping just short of getting a hangover keeps your body from healing for a long time. Just my thoughts....
Hey thanks OL. I wish you the best on the higer dosage. I have definitely read criteria where successful remissions have occurred at many different dosage levels. I have no idea which is best. I just seem to find that side effects are worse at higher dosages. All things can reach a toxic level in different individuals. Lower dosages just seem safer is all. Many studies confirm now that the total cummulative dose seems to be the important factor, not time...... So, either way, I think this drug can provide some long remissions at low or high dosages. I am skeptical like you of the possibility of a cure or really long remission. That is why extreme low dose intrigues me. What if I have to be on it many times in my life. Its nice to know that extremely low doses are keeping me 100 percent clear. I am hoping that 1mg a day will keep me clear. I don't know that yet. But, if I have to take this drug long term to stay clear, I want the dose to be really low. I am leaning towards the idea that this may be how I end up.

I wish everyone the best, regardless of the chosen Accutane therapy. What an amazing drug, regardless of controversy. I am blown away at the results.


Best

LT
Lowtane,

I also have SH. Can I ask a few questions please:

1) How long have you now been taking Accutane and at what dosage?
2) Any side effects?
3) How long term do you expect to be taking it?
4) Can you drink alcohol whilst taking it?

Thank you
Hi all....

I am back from the Dermatologist and the blood tests are the same as always. Cholesterol and Triglycerides are normal, for me anyway. We are going to take the dosage lower. I will now skip dose the 10mg's a day to 1 capsule every other day. We talked about long term outcomes and total cumulative dosages. I would have to be on Accutane for a long time at this dosage to hit the often mentioned "total cumulative dosage" of 120mg's per kilogram of body weight. At these dosages I can see he is considering a possible maintenance dosage. He mentioned he has a guy that has been on 40mg's once a week for 7 years. Which is equal to about 5.5mg's a day. Which is around 1/15th the normal dosage of 80mg's daily for a short term therapy. So it would take 15 times as long as the normal regimen of about 4 months. So that is about 60 months, or 5 years. What does it all mean? I am not sure. I think that the more I read I find some doctors are starting to see alternative therapies as a possible course of action with Accutane. When you think about it, its possible that some individuals could get maintenance dosage levels long enough for their body to actually change on its own to an acne free state. Who knows? I can tell you this, the low dosage wouldn't even be noticeable if it weren't for the lack of zits, oil and rosacea. I am much happier at this lower dosage than I was on the 20mg's. Even though the 20mg's wasn't that bad. Still, I had some weird feelings and libido problems on 20mg's that I wasn't sure that Accutane had caused. However, on 10mg's those symptoms are gone.

Well thats about all folks, it's life changing. It's controversial and maybe even dangerous. I believe that low dosage this drug may help some people but not others. I believe some people could have problems with this drug at any dosage. I will continue to share what I can as it comes up. Read all of the studies from the links provided in multiple posts. When you goto pubmed and medscape, help me and others out here. Re-post those studies. Make sure you only post health board approved site links. Pubmed and Medscape are government run and I was told okay to link to.....

Best Wishes
LowTane
Good to hear from ya OL!


Summarization:

This thread started with two main characters. Lowtane (myself) and Old Lawyer. Lowtane started on 20mg daily of Accutane while OL went with a more traditional dosage of 40mgs daily. LowTane continued to lower his dose slowly overtime while Old Lawyer had his raised over time. Two different therapies for some of the same type conditions. In effect Sebaceous Hyperplasia (massive oil) and resulting acne. LowTane had the lovely addition of Papular Rosacea. So far both candidates have had a complete remission of all symptoms from their ailments. The thread was fairly exciting at first with the onset of results. Once the Acne, Rosacea and oil disappeared the thread became a little dull with nothing new to report. So, I posted multiple links throughout the thread pointing to studies from two board accepted sites. Pubmed and Medscape. The studies are wide ranging geographically and ideologically. Many countries have been more pioneering in the approach to their usage of this horribly controversial drug. I used these studies to convince my Dermatologist to try a low dosage regimen. He bought in and here I am. With my dosage sinking ever lower the drug remains effective and I have zero side effects. I will however be on this drug longer than Old Lawyer. The one main idea of Isotretinoin therapy revolves around total cummulative dosage. This is the total ingested milligrams per kilogram of body weight. Because of this I will be on the drug longer than Old Lawyer. The total most agreed upon in the medical community seems to be around 120mg per Kilogram of body weight. Convert your body weight to kilograms and multiply it by 120mg and you will get the correct total. What everyone should know at this point is this: I believe this drug has caused some individuals severe health problems. Even after they have stopped taking it. I also believe some people have taken it with no problems at all. Millions have taken this drug. There are not millions of lawsuits. Accutane is extemely effective period. At what cost to each individual is the subject of much debate. I am a chicken, I have opted for low dose simply from fear. Also, if I were you I would not self medicate. You must have the blood tests to keep an eye on this drugs affect upon your cholesterol, triglycerides and liver enzymes. You are risking a heart attack or destroyed liver without knowing the facts only a regular blood test can provide. My life has been changed for the better. At what long term cost if any is unknown at this time. I believe old lawyer and I will make this thread interesting again when we cease our therapies. I don't want to tell a single person to take this possibly insidious drug, yet I want to kiss a chemist every time I meet one. What incredible results! My life has been changed. Just remember, what works for one person can be a devastating failure for another. I would suggest the low dose approach initially just to see if your body can deal. Some doctors online report using the low dose approach before going to higher dosages. I love the low dose approach. Even if I had to stay on this drug for life, I wouldn't mind if the dosage was only 10mgs once a week. I am now doing 10mg every 3 to 4 days. At this dosage I am not even sun sensitive. Rosacea is zero, oil is gone. No zits....yeeehawwwww!

Best wishes
LowTane
Nice to hear from you. My problems started 30 years ago with a very oily nose. As time went by, the oily nose turned into a red oily nose with clogged pores and slight swelling. Over the years, the oil has become worse and spread to the entire face. It's so bad it coats my face and dries. It's like wrapping your face in a plastic wrap. When I wash the dried oil looks like peeling skin. I also have rosacea, so the result is red, oily and irritated skin.

I've been on all the standard treatments including tetracycline for years, Oracea, metrogel, salacylic acid washes, sodium sulfate washes and topical antibiotics. I'm now 54 and pretty depressed about the whole situation. I've also had numerous laser treatments to help with the redness.

When I read your posts, I had a glimmer of hope and so I hope you continue to post. I'm very interested in what will happen once you stop taking the accutane. I hope you obtain permanent remission, but I've heard from others that is not always the case.

It's a shame we just can't take accutane for life, but I don't think long term usage is recommended. I don't think long term usage has really been studied in a large clinical trail. I wish it had been, the drug has been available for 30 years.
LT,

It sounds as if you are controlling the oil and the rosacea with 20mg a week. What will you do if you stop the drug and all your symptoms return? Will you continue to low dose indefinately? What does your doctor think about the long term effects of the drug? Have you discussed this with him? My doctor keeps telling me my oil will go away on it's own. I don't think so since I'm 54 and have more oil on my face than anyone I've ever seen. I literally have little pools of oil above every pore on my nose within 2 hours of washing with a sulfer wash. In 4 hours it looks as if I have splashed water on my nose and forehead. If I let it go and don't wash for 8 hours the oil will actually run in little rivers from the pores. It's freakish! I could be some drug companies science project. I wish you continued success in your efforts. Please keep your doctor informed of everything you're doing.
Yeah, I would say that we are controlling the oil and the Rosacea. I would also say that at this microdose with monthly blood tests that my Doc is comfortable that he is doing no harm. We will probably take a break sometime and when the oil returns go back to what works. He is fully informed as to what I am doing. Some people have been able to controll oil with vitamin A. Accutane is a substance "isotretinoin" that we have in our bodies naturally. I am not concerned about long term usage at these levels. I am getting burned out on the blood tests though. However my Doc is not comfortable with his liability without them... I am trying to talk him into every two months for blood tests. So far no go...... I totally understand the pools of oil coming off your face. My face use to look the same way. Add the acne and the Rosacea into the mix and I looked bad. I am very happy with what Accutane has done for me.

Best Wishes
LT
49 year old male.
Rough estimates of dosages follow:
Started 20mg daily Accutane (Isotretinoin) Feb of 2009
Reduced to 20mg every other day after 2 months
Reduced to 10mg daily for one month
Reduced to 10mg every 3 days for one month
Reduced to 10mg once a week for 2 months
Quit Accutane

I have (had) Rosacea that flared with pustules along with Acne Vulgaris on the nose and chin. Sebaceous Hyperplasia (max oil) afflicted me as well. I researched low dose Accutane and found multiple studies in other countries where outcomes were extemely positive. I found these studies on legitimate sites that report research outcomes. Pubmed and Medscape mainly. I took the studies to my Dermatologist and showed him the results. He tried it with me and I have had great results. Its true that the low dose approach may not work for everyone. Its also true that the high dose approach may not work for everyone. Ingesting a drug until your nose bleeds and your eyes dry out doesn't appeal to me, it never did. I wouldn't commit to high dose therapies. It was never an option.... It should be noted that millions have tried the high dose therapy and have had success. In light of the bad press Accutane has had, a low dose movement would be welcome. When you approach your Derm don't mention blogs. Ask him or her about research papers that you found on Pubmed and Medscape published from Dermatologists in other countries. See if you can get them interested or at least talking about it. You can always go high dose later if low dose doesn't cut it. Accutane changed my life for the better, no doubt. I have had success so far and zero side effects. I didn't even have dry lips. My pores have closed up, my oil had dropped to normal levels. My Rosacea has abated. My dosage was extemely minimal. I pray they don't pull this drug from the market. It has saved my life, my career and restored my self image. I may need it again, its to early to tell. I have been off of it for a couple of months now. I am getting laser treatments for pores and veins in my nose. I will continue to report the post Accutane results until it doesn't matter anymore. Please read this entire blog for more hints and tips to my approach. The fact is, very low dose therapy worked great for me so far, and no side effects. Less risk. Dermatologist will tell you that the exact mechanism that causes Accutane to work is unknown. Understand that Doctors are going off label and risking licenses even though they are giving less of a drug. Seems strange, but its true. The FDA has stringent guidelines for this paticular drug. Know for a fact that this drug can cause severe birth defects at any dose. Know also that some people suffer horribly from the use of this drug even years after ceasing usage. Although this hasn't been conclusively proven some court cases have been won. These patients swear this drug caused their problems. I believe it to be possible. I also have an opinion that high dose is what caused these individuals to have long term problems. However, millions have taken this drug high dose with no problems reported. Drugs affect different people differently. My results may not be your results. Never self medicate with illegal drugs from the internet. You must have blood work when using this drug, you could die. See your doctor and ask for a low dose approach. See what happens.


I wish you the best.
Hello all... I have been off low dose Accutane for about 2 1/2 months now. I have had a couple of zits on my chin and nose. They were small and cleared pretty quickly. I was alarmed. But I am still staying clear at this point. I have had noticeable oil at the end of a long day. After washing it didn't come back or pool up like it used to before Accutane therapy. My Rosacea has been in check. I talked to my dermatologist about this and he said there is no precedent for Accutane and Rosacea. Well, there really is, multiple studies exist that were completed by vaild researchers. Consult Pubmed and Medscape for recorded studies. I wish Doctors in the US would consider low dose alternatives more frequently. It has been a short time for me since I have ceased Accutane. So the other shoe may drop shortly. The best I can do is to continue to describe what occurs in the coming months. I will do this..... I believe that low dose may be the answer for some people. Everyone is different. I have heard many reports from individuals who have been on Accutane serveral times, while others only once. I have read reports where acne has come back and others where it never returned. Still, Accutane is the only thing that has ever helped me. Its fair to say, that down the road I may have health issues from my experience with this drug. However, many people have reported that they have not had long term problems, even from high dosing. To all of you who land on this page, please remember to tell anyone of concern about low dose possibilities. Direct them to vaild reseach studies found on Pubmed and Medscape. These items may help them with their dermatologist. Maybe some day low dose therapies will be commonplace with this controversial drug. Rememeber don't self medicate with illegal drugs obtained on the internet. Accutane really does require bloodwork monitoring to be safe.

LT:wave:
Hi there,
I'd like to thank you for your updates, Lowtane and Old Lawyer. They have been most informative. I wanted to show you what you have inspired in me and my story. I have included dates from when I started recording this.
Weight:75Kg
Sex:Male
Age:35
Case: Moderate acne since 14 controlled by daily vigorous exercise and over-the-counter treatments and extremely low fat and suger intake.
By controlled I mean only a bad pimple every couple of weeks instead of every day. This has been continous and my skin, although clear on some days, still had the healing marks of the pimples from a few weeks ago, so I never was clear in that sense. Luckily for me, my skin heals quick quickly and with little scarring. This year I made up my mind that, even if it kills me, I will rid myself of acne. The OTC stuff never really helped keep my pimples at bay.
My First success!
Aug 7 2009: My first success was with the treatment using large B5 dosages, 6 grams a day. The long term affects of this are unknown, but I can tell you that the short term affects are miraculous.
Aug 21 2009: My skin was clear of new pimples and the old ones have alomst healed up. This cleared me up quite quickly and finally gave my skin time to heal (to the point that one girl who had just met me, on finding out I had a brain, said "I thought you were just a pretty boy". I have never been a pretty boy before!)
After a lot more reading about it I found that this is not a permanant cure and it's long term affects are largely unknown. There are some case studies of individual paitients suffering terrible side effects after a few years of this, however they were individual cases and not a study on a group. They could be isolated cases (1 in a million chance of happening) or it could be unrelated, however the odds are unknown and I decided to seek a cure more proven.
15 Sep 2009 : Introduced 20 mg a day of accutane, 6 grams of B5. This decision was mostly inspired by this thread the Lowtane and Old Lawyer have been posting too.
17 Sep 2009: Wasn't ready for the dry lips and face of accutane. I dropped to 10 mg a day, 6 grams of B5.
20 Sep 2009: Feeling better and more prepared (with lip balm) and back to 20 mg a day, 6 grams of B5.
26 Sep 2009: Dropped to 4 grams of B5 a day, keeping at 20 mg accutane. Face is getting a bit red.
28 Sep 2009: Accutane is holding well with the drop in B5. Very dry skin but not too much flaking.
30 Sep 2009: One small whitehead, the first since 2 weeks after I started B5.
6 Oct 2009: Down to 2 grams of B5, 20 mg of accutane.
9 Oct 2009: Down to 1 gram of B5 a day, increased to 40 mg of accutane for the weekends. I believe that I can take extra accutane over the weekends as I am not going out much. I have basically shut my life down and I am living like a bit of a hermit (well, no big parties) until I have my face under control again.

To get to my conclusion, so far a low dose accutane regime seems to have almost taken over the role of B5 in 3 and a half weeks. Both methods target dropping the production of skin oils although in different ways. B5 takes away the fuel (makes fat just under the skin break down), whereas accutane makes the engine smaller (makes the skin oil glands smaller). Accutane, being the only permanent cure seems like the obvious choice.
Can I gather that you found that you acne was controlled by low dose accutane in about a month? Although you are 15 years older I believe that our problems are closer related than I would have to a 15 year old.
I hope to one day be able to update a thread with "Off accutane, face clear".
Now for my post, 4 small surface pimples but no real oil. They have appeared and healed quickly. I am trying not to worry about it. I am going to stay off Accutane regardless. I want to see how long this lasts without the support of low dose treatment. Its the only way this journal will be significant. If I can have long term remission on low dose Accutane then maybe there is hope for other people on this drug. I am still against high dosage, it is my personal preference. I fear this drug greatly. Low dose has been easy, no side effects so far whatsoever. Complete clearing of Rosacea and Acne symptoms resulted. This was achieved on a average dose of 10mg once a week in the last couple of months of treatement.

I wish you all the best..

LT
Well you sure don't post as much when your acne is at bay..... I am off Accutane for around 4 months. My oil has increased slightly with only an occasional pimple. Pores are about the same. All is still well. I am still waiting for the other shoe to drop. To new readers of this blog.... I am a 50 year old male about 200 pounds. I tapered from 20mg daily to around a 10mg once a week accutane dosage over a period of 6 months. It has put my acne vulgaris and my rosacea in remission. I don't get the red flashes and pustules or zits any more. I had tried everything over the last 35 years. I believe in the low dose regimen. I had virtually no side effects at these dosage levels. I have recommended repeatedly on this blog that individuals go to pubmed and medscape and create a portfolio of low dose studies to present to their dermatologist. They may or may not listen. I am no expert of any type, but I have the opinion that dosing at levels that make your nose bleed and your lips crack off your face may affect other body parts in an adverse manner. I just couldn't get myself to agree to those levels of this controversial drug. The argument is will lower dosages give long term results? Well, I am testing that theory on at least one person. Accutane improved my life one million percent. Dried up my oil, closed up my pores, cleared my Acne and killed my Rosacea. The extreme social unease that I have been living with is gone. Remember to strategize when approaching the doctors with the low dose idea. It is not prevalent in the USA, be sure to tell them that PubMed is a service of the US National Library of Medicine that includes over 18 million citations from MEDLINE and other life science journals and that medscape is a physicians resource site. Do not tell them stories from blogs with personal accounts like this one. They consider the information anecdotal and unsubtantiated. I agree with them on this point.

Good Luck

LowTane
Thank you so much for your blog. It was of tremendous help to me. Today I began 40mg/day of Claravis. My doc would not agree to a lower dose, even tho' I requested it many times. 6 mos is my planned duration. I did visit another derm yesterday who is out of my network, who agreed that if my acne comes back after 6 mos, he'd put me on 10mg/day (possibly for a long term). I am 51, 5'6", 120lbs. Thanks to your blog, I'm armed with info, and am asking questions. I pray it works for me with minimal side effects (after 37 yrs of cystic chin acne), as it did for you. Thanks again-





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