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Note the sunburned nose. Wear your sunblock religiously while on Accutane!

Right cheek, 10/10/06

Left cheek, 10/10/06

Forehead, 10/10/06

I have just finished my 16th week of my Accutane treatment. My skin is still clear, and it’s still sensitive; not much changes from week to week at this point in the game. I think I’ve fully transitioned from being excited about the improvement in my complexion every week to being excited that I’m nearing the end of my treatment.

This week I noticed a teeny tiny itty bitty little bump under the skin on the right side of my jawline – I have succeeded in not picking at it, but I do touch it a few times a day to see if it’s still there. Why is it there? Why do I have this little pimple-esque bump thing on my face when I have been dutifully taking my Accutane for four months? I try not to worry about such things, but obviously, I do. As much as I try to relax and stay confident that my skin will remain smooth and clear when I am done with Accutane, I do harbor a little bit of fear that my acne will flare up again; but really, who in my situation wouldn’t be at least a little bit worried? In other (miraculous) news, the cyst near my right ear is just about gone. In fact, I can only feel that there is something in that spot when I apply a decent amount of pressure with my finger; if I just lightly run my finger over that area I can’t even feel the cyst at all. I bet it’ll be gone in two weeks.

As for side effects, I still have the same ones: super sensitive really dry skin, insanely dry lips, and muscle soreness. A few weeks after the muscle soreness started, I thought it had reached the height of its intensity, and that it would just stay at that level until I was done with my treatment. Alas, I think my muscles are generally stiffer now than they were a month ago, though other variables (activity level, stress) are in play so I can’t be certain it’s due to the Accutane. The muscle soreness is the side effect I am most excited about being rid of when I finish treatment as it is by far the most bothersome. Though I am looking forward to kicking my obsession with lip balm!

Over the past three weeks or so I’ve been getting intermittent headaches, and I toyed with the thought that they might be Accutane-induced. Headaches are always one of the side effects I’m asked about at my monthly dermatology checkups, and my impression is that headaches are one of the side effects that are taken more seriously. I’ve come to the conclusion that my headaches had nothing to do with Accutane, but were instead caused by too much working and not enough sleeping and relaxing. I really do believe that stress is the worst thing for the body/mind/spirit; it affects everything so negatively.

Despite my lips peeling off my face and my continuously sore muscles, lately I have just been feeling so grateful for Accutane. Anyone who’s struggled with acne, especially severe acne, knows exactly what I mean when I say that being rid of acne has completely changed my outlook on life. The resolution of such a huge problem, and subsequent dissolution of the emotional and psychological burdens that come along with it, has given me the inspiration and energy to focus on making a multitude of positive changes in my life. I hope that my experience encourages and reassures those of you who are currently suffering with acne – regardless of how you choose to treat your acne, please get treatment because there is a light at the end of the tunnel, and boy, is that light bright!

Wow, week 15 already! It’s amazing how quickly time passes – when I first began my Accutane treatment, Fall, and the end of my treatment, seemed so far away. Hard to believe I only have about 5.5 weeks left until I hit magic week number 20! I’ve been wondering if I’ll actually end up taking Accutane for longer than 20 weeks, though, because of iPledge, and the way Accutane is packaged. I’m excited to finish my treatment, but I have to take it for an extra week or two I won’t be bothered at all.

This past week saw a few interesting developments – that is, if you consider pimples interesting. Surprisingly, I had a few tiny pimples on my face, the first I’ve had in a really long time. They were very small and came and went within a day or two each, but I was still a bit unnerved, especially being so far along in my treatment. Of course it was extremely difficult to not mess with them – after all this time of not touching my face due to both a lack of anything to mess with, and amazingly sensitive skin – I was still tempted to touch the pimples! Willpower won out, thank goodness, and they disappeared without leaving a trace.

I have been wondering what could have caused these little blemishes, especially three all at once in random locations (cheek, chin, forehead). I haven’t been eating as well as usual lately, but I’ve also eaten much worse at other times during my treatment. And I don’t think girly hormones are to blame, based on the timing. Who knows? Let’s hope that’s the last of ‘em. Let’s also hope that if I happen to sprout any invisible (yes, these could only be felt, not seen) pimples when I’m off Accutane I have the good sense to keep my hands away from my face, and my cortisol levels low by not freaking out or worrying about them (we all know worrying will only make even more pimples!)!

In other news, I got sunburned yesterday morning. Ran out to the local farmer’s market around 10 am, thinking it would be a quick trip. Of course I’d forgotten my sunscreen layer – I’m often out so early in the morning to go the farmer’s market or the gym that I only use moisturizer, so I think it just didn’t occur to me that I was running later than usual yesterday. And wouldn’t you know, 10 am is peak sunshine time, which means my cheeks and nose were a nice bright pink for the rest of the day (today only my nose is still pink, which looks even weirder!). I will post pictures later on this week so you can see, laugh, and learn from my mistake. I will now put on my sunscreen even when I go to the gym at 6 am and it is still dark!

Today I finished my first 10-pack of Accutane pills; only 13 more 10-packs to go! I accidentally liberated the pack of pills from it’s cardboard packaging the other day, which ended up being a blessing in disguise as it makes the pills significantly easier to remove from the blister pack. I have a lot to report on today, so let’s get to it.

FACE

My acne is clearing up, if ever so unnoticeably. I know it’s clearing up because I have fewer painful nodules, but I still have a nice crop of inflamed papules, a whole mess of little whiteheads, and a seemingly infinite number of clogged pores. Though I have fewer giant pimples, to the casual observer I think I might actually look worse than I did about a week ago due to the fact that the dryness of my skin makes camouflaging my acne and acne scars with makeup nearly impossible.

Let’s talk about makeup for a minute. I’m not really a makeup kind of person and only started wearing it about four years ago when my skin started acting up. For me, makeup means concealer and powder, and I am eagerly anticipating having my skin clear enough to not feel like I need to use makeup to make my face look even remotely normal. My concealer can’t blend in with skin that’s entirely devoid of moisture and is about ready to flake off my face; when I apply concealer to the areas that are flaky it just emphasizes the flakiness. Even the areas of my face that aren’t flaking are hard to deal with in terms of makeup since my skin is so dry that the concealer just looks chalky and weird. I realized today that I may have to ditch my makeup before my skin is relatively clear or normal looking simply because the naked pimples might actually look better than pimples attempting to hide under a veil of chalky, flaky makeupiness. Better, is, of course, a relative term here.

By the way, my lips are insanely dry. I’ve found that brushing them ever so gently with my electric Oral-B toothbrush is somewhat helpful for exfoliating the dry skin, but the effects of that only last a couple of hours. At that point, even with frequent lip balm applications, they’re all stiff and cracky feeling. This morning I felt my lips getting a little dry, but I decided to see how long I could go without feeling like I had to put lip balm on. Bad idea. I realized that I need to be more vigilant about lip balm applications; once the lips start getting dry there is no turning back–it’s like a slippery slope and at the bottom of the slope is nothing but pain and misery. Because of my negligence, a decent sized flake ended up peeling off my bottom lip today and left a bit of a raw spot (ouch!) so I’m going to fight the good fight in earnest tomorrow. My strategy will be to exfoliate with the electric toothbrush in the morning, apply lip balm immediately, and then work diligently to maintain the integrity of the protective lip balm coating. Hopefully, that’ll do it. I really prefer my lips without open wounds!

BODY

For as long as I can remember, I’d get the occasional painful pimple on my upper back, but my chest remained smooth and clear. However, over the past couple of months my chest has become populated by a colony of clogged pores accompanied by some tiny pimples; when I’d run my hand over my sternum I could feel all the little clogged pores like very rough sandpaper. Since beginning Accutane, my upper back has broken out more; I have several painful inflamed pimples now. My chest is clearing up, though. The clogged pores are disappearing and my skin is feeling smoother each day but I’m still getting some of the tiny pimples here and there. I expected the Accutane to cause an initial flare in the severity of my acne, so I’m not too worried about the flare up on my back–I’m glad that all the crap that’s in my skin is working its way out! I haven’t noticed too much of a difference in the skin on the rest of my body yet aside from my hands being a little drier than usual.

SCALP/HAIR

This is where most of the excitement has been over the past few days. I have got some serious dandruff. Serious. The other night I purchased a bottle of dandruff shampoo, which I tried for the first time this morning. I remained itch and flake free until about 11:30 AM. The itching is pretty mild but the the flaking…oh, the flaking. The flaking is insane. Even if I don’t scratch my head, simply running my hands through my hair causes huge flakes of skin to detach themselves from my scalp and nest in my hair. I’m a brunette, so the flakes are quite noticeable. When in the privacy of the restroom, I do what I can to shake them out (this involves flipping my head upside down and, well, shaking it), but they regenerate constantly so it’s impossible to stay on top of the problem. Though my scalp is really dry, my hair does not seem to be too affected yet. I’m a little paranoid about getting super dry hair since my hair is long, so I’ll be taking some precautions to try to keep it moisturized now that I have zero scalp oil to speak of. Pre-Accutane I washed my hair every other day; by the time I’d get to 48 hours post-shampoo I was oily and icky. I’m still on the 48-hour interval for hair-washing, but my hair was much less oily this morning than it would normally be two days after its last shampoo. I imagine I’ll end up stretching the hair-washing interval out to three, or (gasp!) maybe even four days.

SIDE EFFECTS

So far, none except for the dryness-related issues I’ve already mentioned. I have a gut feeling that it will stay this way, too

Today was my eighth day on Accutane. The dryness has really set in–my face is flaking all over and I used about as much lip balm today as I would over a 5-day period under normal circumstances. I noticed that my eyes got a little dry after a few hours working at the computer today; I may get some eye drops to help with this, especially since I do wear a contact lens (yes, only one!). I am still molting (two coats of moisturizer before my makeup this morning, and I was still pulling of little flakes of skin everytime I went to the bathroom today), but my acne is improving subtly. I still have it, and am still getting new pimples, but they just seem a bit less angry.

The big event today was that I got threaded. Threading is a method of hair removal that involves having a string twisted up and rubbed over your skin, effectively ripping the hairs out at the root. I usually get my upper lip and my chin threaded every few weeks (yes, I’m furry–my grandmother is Italian so I can’t help it!), but haven’t been in about six weeks because my skin has been particularly ornery lately. I had so many huge painful whiteheads for a while there that I just couldn’t imagine anything touching my face. Threading can be a bit irritating and painful under the best of circumstances–with a horrible acne breakout it’s unthinkable.

But since my skin has calmed down a bit over the past week, and I was starting to resemble an Hispanic male (I’m usually just a white girl) I decided to give the threading a try. And it hurt like a mother$(*%@^! You may or may not know that in addition to making your skin as dry as the Sahara, Accutane makes your skin really, really sensitive. Getting threaded today was definitely more painful than usual, and even now, several hours later, the skin on my upper lip is stinging a bit. I didn’t seem to turn any redder than usual, and the redness that I did get subsided in the usual amount of time. All in all, I’m happy to have shed my Hispanic male persona, if only temporarily…

I received my prescription for Accutane on June 19, 2006, and despite the best efforts of the iPledge program, was actually able to get my prescription filled that day. More on iPledge (my new favorite thing to complain about) later. I want to sum up my first week before I forget all the juicy details:

DAY 1: The Excitement
I figured iPledge would prevent me from starting Accutane for several days at least, so I’m pretty psyched to begin the same day I received my prescription. I’m on 40mg once/day (I weigh about 105 lbs.), and was instructed to take it with food, preferably at the same time everyday. I had my first pill with some meatloaf around 9:30 PM.

DAY 2: Still Excited
I am just so excited to be on Accutane, because I know it means that clear skin is in my not-too-distant future. I decided that having my Accutane with lunch will be the easiest, so I sneak it down while eating at my desk.

DAY 3: Dryness Begins
The edges of my lips, where the meet my face, are a bit dry. Acne is, as expected, the same as it was two days ago.

DAY 4: Ahhhh, It’s Working
My lips are definitely dry, which I recall from my previous Accutane experience means it’s starting to do it’s thing. My acne looks about the same, but I’ve noticed that my cheeks are a bit flushed, which is a side effect of Accutane. I can live with extra-rosy cheeks if that’s the only part of my face that’s red!

DAY 5: Itchy Head
Around noon, my head became insanely itchy. I work in an open office–no walls–and because I couldn’t scratch my head without attracting unwanted attention, I took refuge in the bathroom…where I discovered that my scalp is flaking like mad. I don’t remember this from last time, but I think I was oblivious to pretty much all the side effects then because my acne was so bad.

DAY 6: I’m Molting
I found some dandruff shampoo in my in-laws cupboard, which has alleviated the insanely itchy head somewhat. But now I’m molting. My skin is peeling off in flakes, especially in the more troubled areas of my face. I guess they need the exfoliation the most, but it really draws attention to the breakouts!

DAY 7: No, Really, I’m Molting
I am in full-on reptile mode. I don’t even know how I can go to work tomorrow without fearing that a piece of my face will fall off while I’m in a meeting or talking to a coworker. I can’t believe I’m dealing with this at my age!