My Accutane Purge Experience The Drug of Last Resort

By Kali Kushner

Why I Took Accutane

I can remember clear as day the exact moment I KNEW I wanted to go on Accutane. I was on vacation in San Diego with my husband visiting family; I had just washed my face and I was getting ready for bed. My skin had been bothering me for a year up until this point, I was 20 years old and just started developing cystic acne out of the blue. I had tried everything to get rid of it, from antibiotics and light therapy to good ole fashioned toothpaste ( Don't use toothpaste, please).

Anyways, I had just walked out of the bathroom without any makeup on when my nephew yelled "what's on your face? Why is it dirty?" Ouch, salt in the wound feeling is the best way I can describe it. He was two, and kids speak whatever they see you know?

Although it didn't carry malicious intent, after that incident I was very determined to figure out what the heck was going on with my acne. I scheduled a dermatologist appointment as soon as I got home from vacation.

On the day of the appointment, I thought maybe if they didn’t think it was that bad then I wouldn’t have to do anything too serious for my skin. Too bad my dermatologist took one look at me and said "Accutane". 

 I was terrified, overwhelmed, excited, nervous; really just a whole whirlwind of emotions all at once. I started crying at my appointment, I think from relief - thus began my journey on Accutane, which is the name brand of Isotretinoin.

What's Accutane?

My dermatologist started explaining Accutane to me.  It's a powerful derivative of Vitamin A. The way it works is by shrinking your oil glands and reducing the amount of oil produced in skin.  She told me 85% of people stay completely clear for life, however the reality is that a relapse may occur more often. She continued to describe it to me like eating a bag of carrots every morning and every night. For me, that seemed harmless enough.

After trying just about every acne treatment out there, I decided that Accutane was my last resort. At this time, I firmly believed that if this didn't work, nothing would.

What Dosage Of Accutane I Was On

My dermatologist prescribed me a fairly high dosage for my weight, I was on 60 mg of Accutane for 5 months.

After a hectic month of blood tests, I pledge questions, and pregnancy tests on October 30th, 2015 I was ready to get started.

Accutane Can Cause Purging

I have heard of the dreaded Accutane purge and it is true that Isotretinoin can cause purging.  The fact is that any form of Vitamin A or retinol can cause purging. 

The reason why an Accutane purge could happen is because of a temporary increase in skin irritation and inflammation, or from the increased rate of skin turnover that Accutane typically causes.   When skin gets inflamed from the Accutane, it tends to cause more acne breakouts leading to purge period. 

When skin turnover increases while on Accutane,  the acne and clogged pores that aren't visible yet are coming to the surface faster and all at the same time.

Since Accutane can cause purging, that could be the main reason why some people may have their skin appear worse while first starting Accutane. Purging typically happens within the first month of starting Accutane and acne starts to appear better afterward as the treatment continues. 

The good thing is that a purge on Accutane is temporary.   Not everyone may experience purging on Accutane either and it's quite common to not have a purging stage. 

 

My Accutane Experience Month by Month

Accutane Month 1

During this first initial month I was excited beyond words. I had been struggling with cystic acne for about a year at this point and I completely forgot what it felt like to be comfortable in your own skin. I was never, ever embarrassed of who I was as a person, but acne did make me self-conscious from time to time.   But hey, nobody’s perfect right?

I worked in a retail clothing store that year and I couldn’t even bare to look at my skin under the fluorescent lighting. If I did I would get lost in the mirror pointing out every indention and bump to myself. I guess that I didn't realize how chronic my acne was back.

If you gain anything from this experience of mine, have it be that you don’t have to settle with who you are today, you can always change, you can always better yourself, and you can always grow. If you feel stuck, don’t give up, just keep trying and stay positive.

Did I Experience Purging On Accutane? 

During my first month on Accutane, I started purging for about a week but then my skin cleared up rather quickly. 

Within the first four days my eyes, nose, and hair had dried up drastically. Some active zits I had were drying up too-so I was PUMPED (to say the least).  This was the first small amount of progress that I had experienced in over a year with my skin. 

I did have to stop taking Accutane for about 2 weeks during my wisdom teeth removal, which my dermatologist and oral surgeon both approved of.

Psychological: No changes in mood.

 

Accutane Month 2

There wasn't much change from month 1 to month 2.  My dermatologist promised me that Accutane would be my cure all and I had no reason not to believe a medical professional, right?

During this month I was still breaking out but I started to build my confidence up again. I wasn't dodging mirrors anymore and I was becoming much happier with my appearance, loving myself regardless of the condition my skin was in. Slowly but surely, I knew I was on the right track to recovery.

Physical Side Effects: My lips were extremely chapped and I was still consistently breaking out but I continued to hold onto hope for days of clearer skin.

During this month I started to really feel the side effects of this drug. Accutane made me feel very very tired.  I felt sluggish, all of the time. I'm talking falling asleep while driving, falling asleep in class, heck even falling asleep while standing up tired. Yes, all of those things did unfortunately happen during Accutane.

Psychological: I was starting to feel stronger mentally. I also felt like my anxiety was slowly going away, which again, was one of the main reasons I went on this drug. For the past year I was struggling with anxiety and experiencing panic attacks pretty frequently but unable to determine the cause until this month. I remember putting the pieces together in my head like a puzzle that was sitting in front of me the whole time.

"Duh of course my acne is giving me anxiety" I thought. I was extremely uncomfortable (literally physical pain of cysts popping) and that had been consuming me for too long, not anymore.

There are some studies that state that many patients on Accutane may have anxiety and depression disorders, but most notice an improvement on them. For people who's mental state deteriorated, it seems to be linked to an increase in experience severe physical side effects too. 

Accutane Month 3

I was so excited to finally see more of the positive effects of Accutane by month 3. I not only began to notice significant changes in my hyperpigmentation, but my acne seemed to stop getting worse too.

I could see that my acne breakouts were gone, but now my acne scars looked a million times worse than the ones I began with. When I expressed my concern to my dermatologist she pointed out the fact that now my acne started to disappear so, I was able to more clearly see the acne scars.

For some reason that actually made me really happy, I could deal with scars. It was the deep raging intolerable spots that I couldn’t bear any longer. I felt as if I could finally see the light at the end of the tunnel, plus month 3 is usually called miracle month so I was over the moon with my results.

Physical Effects:  Extreme tiredness 3 month into Accutane and chapped lips. I had a new side effect: teeth clenching.

I started to experience lower back pain starting month 3 of Accutane and I dealt with it until the end of my course. I also started to get random joint aches, but I didn't take any pain relievers. 

if you do take Accutane just be prepared to experience all of the health problems of a 90-year-old, all day, every day.

Psychological: During this time, I had extreme emotional responses from Accutane. I was burning bridges with many people in my life after normal everyday activities. I knew it was the Accutane but decided to ignore how it was making me feel since I was finally seeing results. 

Friends I had for years I told I never wanted to talk to again, and I even began lashing out at my husband for no reason at all. Thankfully he understood and many of those friendships have been rebuilt, but STILL! Not cool 'Tane, not cool.

Accutane Month 4:

On month 4 of Accutane, I found the courage to travel outside my house without any makeup. This was a HUGE step for me. Part of my confidence came from the weekly pictures I was posting on Instagram at the time, I could physically see my skin improving and I had a killer acne support system.

Physical: I had all of the common Accutane side effects at this point. Dry skin, dry nose, dry eyes, tiredness, joint pain and achy back. I also had a small loss of appetite. The loss of appetite only lasted for about a month until I got my normal appetite back.

Psychological: I was continuously mad at my friends and family for absolutely no reason. I had such a short fuse about everything, I was like a ticking time bomb. I told myself that there's no way Accutane would affect my mind, but the truth is that it can affect you mentally and you can't control how Accutane makes you feel. 

Accutane Month 5:

During month 5 of Accutane, I was straight up pumped!  I was nearing the end of my course. I've also developed this thing where my face gets a "hot" flash.

Basically, whenever I'm tired, drank too much caffeine, eat a large meal, or just too hot my face becomes bright red and every single indentation is visible. This side effect continued to happen after Accutane for a whole year after, until I cut out dairy and caffeine completely. So in all, I believe my body was trying to tell me to chill out and quit eating garbage!

Physical Side Effects: I had all of the physical side effects from the previous month and my skin was SO dry I developed a rash on my chin. This rash reappeared and disappeared every time my husband and I would kiss. If his beard just ever so slightly touched my face it would almost instantaneously flare up into an angry red color. Also the hot flashes, continued on.

Psychological:  At month 5 of Accutane, The extreme emotional effects went away, I didn’t feel anxiety, and I didn’t feel angry. However I did begin to experience brain fog on month 5 of Accutane.  I thought "Great, it's dumbing me down that’s why I don’t have anxiety anymore because I'm not overthinking like I used to."

My family told me I was being ridiculous but guess what! Accutane does decrease brain activity. While you're on Accutane, brain activity in your orbital frontal cortex (where your personality and other fun traits lie) can be decreased by 21%. Shocking, but I knew my initial hunch had to be right. Always trust your gut instinct. If you're interested, you can read more about that here.

Accutane Month 6

I went in for my final Accuatane checkup and told my dermatologist I was happy with my results even though I had one spot last month. I had already reached my goal cumulative dosage of 120 mg/kg at this point but she insisted that we do a final month just to give anything else going on under the surface a good ole kick in the rear

I figured sure, why not?  I was already almost done so I thought one more month wasn’t going to hurt and it would probably only give me better results! 

Physical: I had the usual side effects of joint pain, lower back pain, and exhaustion. Also, working in retail while on Accutane has been much harder than I expected, I had to cut back on my hours quite a bit because of the physical exhaustion and physical tasks took me longer.

Dealing with customers while having a super over emotional response to everything was something else.  I cut back from 35 hours to 20-25, luckily my finances at the time allowed for this change.

Psychological: Nothing new going on over here, still felt a little foggy brained but my mood continued to improve while I tried to workout. When I say try I mean going on 1 or 2-mile walks, Accutane wiped all of my energy so I felt lucky if I could even get that much out of day.

Other than that, I wasn’t able to do any major physical activity while I was on Accutane because of my stiff joints, sore back, and extreme tiredness.

My Long Term Effects From Accutane

Accutane left me with some long-term side effects that I don’t really talk about too often but, I think it's important to share that this drug can impact you life-long.

Light Sensitivity

I still experience sensitivity to light, it takes my eyes a while to adjust and I almost always need sunglasses while I'm out in the sun or I can't see too well. If I don’t have sunglasses I just have to squint my way through the day and most of the time end up getting a headache.

Poor Night Vision

Another side effect that stayed with me is decreased night vision. I didn’t experience this to an extreme extent while I was on Accutane but it really started bothering me afterwards. All in all I just I can't see as well when compared to how my vision was before I started the drug. Sensitive to light during the day, and poor vision at night, I'm basically convinced I can't too well at all.

Did My Acne Come Back After Accutane?

10 months after finishing my course of Accutane I began to relapse. At first it was just one small cystic spot around my period, but over the next few weeks they started to multiply. Two, four, eight cysts! Okay, that’s the last straw I'm going to my dermatologist to see what the heck is going on. 

I felt hopeless, Did I need a second course? I needed answers and what she told me was exactly the opposite of what I wanted to hear, that changing my lifestyle and diet would have no impact on my skin. ( Which there is a lot of evidence now that suggests otherwise. ) She informed me to stay clear I needed to be on another course of Accutane, at an even HIGHER dosage.

I told myself after the first course I wouldn't do it again and I'm lucky to have such a strong support system like my husband who agreed that a second course was not in my best interest.

I decided if it didn’t work the first time, why would I put myself through a second course? Repeating the same action and expecting a different outcome is the literal definition of insanity. I went against her wishes and changed my lifestyle and diet. And guess what? It worked. I still get small spots every now and then but they go away super quickly.

Final Thoughts After Surviving Accutane:

I finished my last Accutane pill May 8^th, 2016 and my cystic acne returned January 30^th, 2017, just shy of 10 months. Many people ask if I regret taking Accutane because it did not completely clear me long term, and my answer is: no. I am a firm believer of everything happening for a reason, the good, the bad, and the ugly. You have to embrace all of it in life to truly live fully. If I wouldn’t have gone through this Accutane experience, then I wouldn’t have discovered my passion for natural skincare and holistic health.

It was nice to rely on a drug short term to gain the initial clarity of my skin, but it's been even more gratifying to work every day towards healing my acne from the inside out.

Thinking back now, it's funny to me that my Instagram account myfacestory almost didn’t happen. I made the account for myself, to track my progress and side effects throughout Accutane. I was planning on taking weekly photos on my phone and then at the end comparing them all together to see the difference in my acne, redness, and texture.

But I think it was after a conversation I had with my sister, that I decided to track my progress on Instagram so she could watch my acne disappear too. At first, I was private, I didn’t really want anyone to follow me for a month or two until I knew how the drug would affect me.

I wasn’t trying to be anyone's inspiration because I didn’t see it as being strong or brave, I was doing it purely from a scientifical standpoint to collect my own data. I didn't really understand what people meant by me being an inspiration for a LONG time, probably up until a month ago. I wasn’t embarrassed by myself or ashamed because I didn’t have anything to be embarrassed about.

Sure, acne made me a little self-conscious at times however I knew that it wasn't the end all be all, but some people don’t. And if you're one of those people looking at my photos and my confidence helps you in any way feel better about your skin or about yourself in general, I am proud to be your inspiration.

Consider This Before Taking Accutane

Accutane is a form of retinoid (vitamin A) which is used to treat severe cases of acne, it should be given as a last resort if other acne treatments have not been successful (e.g. benzoyl peroxide, topical retinol, salicylic acid).

Accutane Is Not Guaranteed To Clear Acne

Most take Accutane as it seemed like the only guaranteed way of permanently getting rid of acne and that it only has to take a few months.  (Note that the length of treatment time can vary from anywhere between 4 – 8 months, depending on the extent of your acne and the dosage of the tablets). 

It is recommended to do your own research and think if you are willing to go through its side effects.  The improvements do take time and results will vary from skin to skin.  Again, it is your choice and your dermatologist's choice together. Don't ever feel like you have to do it because of them or because someone else wants you to. Only take it obviously if you want to, if you feel like it's what you need.

Accutane Before and After Photos

 

  

 

References:

The Use Of Isotretinoin On Acne: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/

Accutane Brain?https://www.jwatch.org/jd200505240000001/2005/05/24/accutane-brain