[QUOTE=birthdance;759415]My acne came back when I was 18, although much more mildly, and I went on a second course...[/QUOTE]
I have heard it comes back for many after the first course of Roaccutane. How long did you eat it each time? Did you have those deep piples under the skin which don't go away for a long time? I have many of them, some pretty big, and I really hope going primal can make them go away..
It's obviosly that everyone reacts individually on different foods. I also think that chemicals is one cause of acne too. Do you use a primal schampo, deodorant? What do you use on your face? I have heard coconut oil can work. Do you have any experience of oils?
I apologize if someone has mentioned this already in this post, but Chris Kresser did a pod-cast on the "gut-skin axis" specifically dealing with acne. Google "Chris Kresser acn"e and you can find it easily. You might find some of it helpful.
Ive been on accutane. Trust me stay on it. The results will be amazing, I only get 1 or 2 pimples a month. I've never had hair loss and I've never heard of anyone who has experienced hair loss. Your lips will be chapped ALL THE TIME and your skin will become dry and thats about it. Your treatment should end by the time school starts again so you'll be back to normal by then.
I had acne since I was 10, and very severely with scars into my late teens. My father had bad acne as well, so I was told it was genetic. I was put on antibiotics on and off for acne treatment for a few years with no effect. Finally when I was 17, my dermatologist suggested Roaccutane, and my mother insisted that I take it (we're a traditional Chinese family.. what parents say goes at that age). My skin cleared up after 12 months or so on it. I'm 30 now, and I only get 1 pimple every so often before my period.
I had serious depression and anxiety issues from my late teens to mid-20s. I didn't make the connection then, but now I think it's the medication. I really would try lifestyle changes first, and accutane as a last resort.
I had abysmal acne in high school and part of college. Ultimately what helped me the most was to wash my face with only water, and stay away from wheat, soy and corn. I still get pimples every now and then, but I no longer look completely disfigured. I think it will get even better after I've given up dairy for a few weeks.
Accutane...never took it because I didn't trust the dermatologist even at 16 to make an appropriate recommendation for me. He was the first person to tell me that diet had NOTHING to do with my skin; and even without evidence, my instinct just tole me that that was wrong. That was when I initially lost all faith in doctors. Do they really believe that our weight is the only aspect of our bodies affected by food? AAAGGHH!!
My experience with Accutane was that the first time I took it, I took it as prescribed. (Here, they want you to take it for as short a time as possible to get the maximum dose sorted out while minimizing the window in which you could accidentally get pregnant while taking it.) That meant 70mg a day. It led to my short term markers for liver damage taking a spike, which I noticed as not being able to hold more than one beer a night (and it would make me sick anyway) so they cut my dose to about 40 mg a day. My side effects once the dose was cut were: alcohol intolerance (I'm not a heavy drinker, but that dose of Accutane made me an obligatory non-drinker), dry lips, dry skin. The last two were manageable with lots of lip balm and lotion. Oh, and I blushed really easily. The treatment completely cleared up the cystic acne I had on my back, chest and arms (like you, I am fairly heavily scarred there) for good, and cleared up my face and neck for a good year.
After a year, it started coming back, so I started with an antibiotic treatment (which I wouldn't do again). Eventually I took a second round of Accutane. Same story, except this time I cut my own dose without telling the doctors (to 20mg a day), for scheduling reasons bla bla bla long story. I noticed that my alcohol tolerance (which I'm guessing as a proxy for liver health) was back to normal at this dose, my dry skin and lips were a lot less annoying, I didn't blush like a 12-year-old girl, and basically I felt like I imagine normal non-adult-acne people feel - good and not constantly worrying about whether I'd wake up with a massive cyst. Again, this worked for about a year.
Keep on rolling the calendar and a year later it comes back, with a vengeance. I tried all kinds of dietary eliminations (though I was not yet paleo) including wheat and dairy, but nothing worked. So I went back to the doctor. This time, not only did I get antibiotics, I got antibiotic-resistant acne. One relatively minor brush with cellulitis and a fever later (my face caused my GP to actually jump), I took a short term course of penicillin to relieve the infection raging in my face and switched antibiotics for the short term. Not long after that, I had to move somewhere where the water was heavily chlorinated - causing my face to dry and crack in seams and spots to develop in the seams. This was back in the USA, where I don't have health insurance and very little cash. I've never felt more helpless since there was almost nothing I could do to treat myself, and Accutane bought straight up would have set me back about $5000.
So finally I ordered scary internet pharmacy stuff from India. I treated myself with 20mg a day most days, but not every day - it worked out to about 80mg a week. At that dose, I had no side effects (other than needing to moisturize, but within reasonable limits there) and no acne. I took it that way for a few months and then left it. Another year passed, and it's back.
That brings us up to right now. As of just two weeks ago, I'm back to my own low-dose, self-service approach. I am not experiencing any side effects other than dryish lips, my liver health (as measured in unrelated checkup) is fine, and I have (since going paleo) continued to tweak my diet in between treatments to see if I can come to a more natural solution. My conclusion that a dietary approach hasn't worked for me in curing adult acne. Instead, I diet and exercise Primal-style as being my bulwark *against* potential long-term side effects - that is, if there are some, I'm doing everything right to combat their consequences. And I'm willing to accept some risks if it means I can have a life that isn't micromanaged by my skin.
So my feeling is that I am going to keep taking Accutane, probably about 40mg a week, and probably for a longish stretch. (Since I've just started, I'm taking a bit more until things stabilize, which is just getting there more or less today.) I'll certainly take breaks from it, but I'm just not willing to take a huge break and micromanage my diet down to orthorexia just to find out if it makes a tiny difference. I feel that not everything can be solved with diet - though a lot of things can, of course, and acne may be one which can be solved through diet for you. Moreover, there are only a few studies out there on low-dose Accutane and its side effects, and only a few countries' health system guidelines which permit Accutane to be taken in this way. Therefore, I choose to use myself as n=1 and note that my side effects are slim to nonexistent and that the benefits outweigh the risks for me. In your own decision making, use caution and be circumspect about any approach you take - if it doesn't work, don't worry about us on the interwebs telling you it should have worked - everybody's different and acne sucks no matter what's causing it.
I was on it when I was in a freshman in highschool. It was my last option. My derm. office was great! Every doctor in there took a turn with me and my parents to figure out what to do. I had done creams, oral meds, washes. I was so upset. Nothing seemed to work. So I started Accutane. My doctors took it very seriously. Blood work every week. The only thing I experienced was being VERY dry. Vasaline was my friend. I was on it the whole and it worked ok. There was talks of putting me on a second round. We all decided to not do a second round, wait a while to see what happened.
After I got off my first round I used the best face wash I could find. Then went down to the mildest soap I could fine. I am on the mildest face soap from Clinquie. No second round of meds.
I still have some scars. But nothing horrible. I get some pimples every now and then.
On Accutane I had many of the side effects you describe (and many worse ones). I stopped taking it early, because I saw what it was doing to my body. It is a chemotherapy drug, it systematically causes premature cell death.
While my acne is not completely "cured", it has improved a lot on the Primal/Paleo diet. And I feel it's eventually going to resolve. The biggest things for me were:
- No grains
- No dairy
- Not washing face with anything, just water (not hot water)
- Low carb (less breakouts)
- Improving gut health (low carb, fermented foods)
I had bad acne since I was about 12 and was put on tons of topical and oral meds until finally when I was 16 I was put on Accutane. I was on that for a year, then was put on the generics of it -- Sotret for a year, then Amnesteem for a year. At the same time, I was prescribed these face wipes (basically like wet-naps) that smelled so strongly like acid that I had to have an oscillating fan directly on my face and hold my breath. I damn near passed out the time I used it in a closed bathroom! When I was shy of 19 years old, I stopped using the meds. (Note: this was way before the more strict rules about how long you can be on this stuff. We didn't need to take pregnancy tests every month; just bloodwork to check my liver monthly.)
My skin was 100% clear for the nearly 3 years I was on the stuff, but I had bad dandruff, dry eyes and cracked, chapped lips. My complexion was still amazing for about 6 months after I stopped, which was eight years ago. Since then I still have acne, but it's not nearly as bad as it used to be. I'm not sure if it's because of the Accutane, because of my Primal ways, or because I'm older.
Funny thing was... even as a teen, my dermatologist told my parents and I that cutting back or eliminating dairy could help my complexion, but we never really took that seriously. Even now, I still consume dairy, though probably 20% of what I used to eat (at most).