After 6ish years of trying everything and anything to stop my cystic acne, I decided to resort to a very low dose accutane treatment in an attempt to keep my acne at bay while minimizing the common side effects of accutane.
I am going to start off with 10mg per week and see how that works for a while and adjust from there. Fortunately I have a dermatologist who is willing to let me try the low dose regimen...I've read some dermatologist won't allow it.
I hate having to resort to this drug, but at 29 I really can't continue to deal with acne.
EDIT (to be a question): Has anyone else tried a low dose regimen? What was your experience?
Is anyone is interesting in hearing about how it's working/etc? If so let me know and I'll update this post periodically.
Week 1 (8/5/12 to 8/11/12)
I took 10mg on Sunday and Wednesday. Nothing particularly noticeable. My skin may have been slightly drier than usual, but I normally have dry skin and often have chapped lips to begin with, so it's hard to tell if it's from the accutane or just my usual self. A few new cysts came up during the week, but also nothing more than my usual breakout rate. I do notice faster healing/more drying out but at this point it's too early to chalk that up to the accutane.
Week 2 (8/12/12 to 8/18/12)
I took 10mg on Sunday and Wednesday again. I haven't gotten a new cyst since I started taking the accutane, which is huge because I normally don't go a week without getting a new one as a previous one heals. I do get what feels like a pimple coming up, but it never surfaces and the next day it's gone. My skin is less inflamed/red throughout the day and particularly after I shower. Still no side effects I can complain about, except that my molars are randomly sore (the same feeling you get when you have your braces tightened) which is very weird. No dry skin or dry lips, at least no more than normal.
Week 3 (8/19/12 to 8/25/12)
10mg Sun/Wed again. Still no new cysts and old marks are healing. My skin texture is much smoother than it has been. Skin and hair are a little dryer than usual, and I actually don't need to wash my hair everyday and it doesn't get oily. I was in the sun all weekend and although I felt like I was burning, I didn't end up getting burned at all (was not wearing sun screen). Still no impact on my bowels or mood. I've also been eating more foods that I grew to suspect caused acne, with absolutely no negative impact on my skin.
Week 4 (8/26/12 to 9/01/12)
10mg Sun/Wed again. Skin continues to heal and I am still not experiencing any noticeable side effects aside from dry hair. My lips do get a little dry so I always carry around chapstick, but my lips are ALWAYS dry so I can deal with that and it's nothing like I've read about where people's lips crack. Once all of my old red marks heal I may scale down to 10mg a week instead of 20mg to see how I do.
Week 5 (9/02/12 to 9/08/12)
10mg Sunday but skipped Wednesday. On Sunday I developed a cyst above my right eyebrow but it never came to a head and was completely gone by Friday without me doing anything to it. Not sure if it's a coincidence but I strayed pretty heavily from Paleo all weekend (gf/df corn bread, gf/df banana bread, gf/df cookies, baked beans, processed ketchup) and my digestion sucked and I got that new cyst. My hair is starting to get really dry but I've found that washing every other day and using shampoo meant for dry/damaged hair helps. Skipping Wednesday actually helped a lot with making my hair less dry. Still sticking with it so will continue the updates, but aside from that new cyst all is clear and healing.
Week 6 (9/09/12 to 9/15/12)
10mg Sunday/Wed. Not a good week and ended up with one cyst on my forehead, a smaller cyst on my temple, and three minor pimples (the kind that go away in 2 days and leave no mark). There are a few variables at play here; stress and Vegas. I had an extremely stressful work week and then I was in Vegas from Thurs to Sun. I had a hard time finding guaranteed gluten free meals (I'm Celiac, so this is important) so it's very probably I got glutened often. I was also drinking all day and low on sleep (i.e. 4 hours a night for 3 nights) so it was very likely my skin wouldn't be happy. Will see how quickly my skin bounces back.
Week 7 (9/16/12 to 9/22/12)
I got back from Vegas and my skin started to get worse, likely because of the heavy drinking and crappy food, but who knows. So I decided to try taking 10mg of accutane every day this week. I took 10mg on Tues/Wed/Thurs/Fri and my digestion was a WRECK. Every time I ate I felt a little nauseous, I had incredibly loose stool, and generally felt run down. It's possible my digestion was wrecked from Vegas, but I have to think the accutane didn't help. I stopped taking it Sat/Sun and my digestion improved. The good part is my skin stopped breaking out and I'm back to a point where I have no new pimples, and the several cysts are healing. I'll go back to 10mg on Sun/Wed again after my digestion is fully back to normal. One other thing I'm starting to notice is that my hair is thinning out. I never used to my any attention to my hair, but it's definitely thinner in the front and I can see more of my scalp than I ever could. My girlfriend also pointed out a lot of hair shedding on the pillow/sheets.