Accutane permanent cure?

[Banana Joe]

The best long term outcomes for acne, besides the 220mg/kg cumulative dose, were achieved when treatment continued for 50 days after full clearance.

Treatment - as in my full treatment dose of 15mg or whatever I deem appropriate?

As to collagen, based on the study I linked, the genes that renew collagen behave like switches. They need a certain intracellular retinoic acid concentration to trigger collagen synthesis. Pulses above that threshold transiently induce collagen synthesis and suppress MMP-9 (collagen degrading enzyme) more effectively than constant sub-threshold exposure.

The daily low dose is more effective at skin improvement the upper layers. But there is still a positive impact on collagen, it's just slower.

So pulsing means better skin elasticity, and constant low dose means better skin cell renewal?
I wonder if I should switch to 20mg ed to keep that switch triggered daily?
If so, if aiming for 5mg ed, couldn't/shouldn't I go for 2x20mg e3/4d??

There still seems to be a certain benefit form using Tretinoin cream additionally, or is that not the case?

Thanks!

 

[AlexDavis43]

only one way to find out.

keep it pushing

or run 5mg yearly and see if you'll eventually get injured

For cystic acne, bacne, pimples on your shoulders etc: Accutane > Retin-A

For basic facial skin appearance, a more 'youthful' look etc: Retin-A > Accutane

Accutane is systemic, goes everywhere in your body; why use that when you just want an effect in one very small area that's easy & convenient to target with a topical (your face), and there is better evidence for (Retin-A)

 

[Ghoul]

Treatment - as in my full treatment dose of 15mg or whatever I deem appropriate?


So pulsing means better skin elasticity, and constant low dose means better skin cell renewal?
I wonder if I should switch to 20mg ed to keep that switch triggered daily?
If so, if aiming for 5mg ed, couldn't/shouldn't I go for 2x20mg e3/4d??

There still seems to be a certain benefit form using Tretinoin cream additionally, or is that not the case?

Thanks!

The "continue therapy for 50 days" was based on a meta analysis of dozens of other studies. All other things equal, if treatment continued for at least 50 days after clearance, retreatment in the following 10 years or so was less likely. Most treatment protocols titrate up to a certain dose and stay there, without going back down. So presumably, whatever dose they were on was continued. they don't go into more detail than that.

The theory on pulsing is it prevents retinoic acid receptor downregulation that constant exposure causes. You'd need much more than 20mg if they downregulate, and there's some evidence collagen production can shut down (temporarily) from constant high level exposure to retinoic acid.

The relative effects of each type of "cosmetic off label" isotretinoin regimes is this:


5 mg Daily (Low-Dose Steady)
• Reduces oil on skin and hair
• Tighter and clearer pores
• Evens tone, reduces red areas
• Reduces fine lines
• Smooths skin texture
•. "Fresh" overall appearance
• Very gentle, minimal dryness
• Easy to maintain indefinately

20 mg Three Times Per Week (Pulse Dose) all the above plus:

• Stimulates collagen and firms skin
• Softens mild wrinkles
• Improves elasticity
• Visible improvement after a few months of use
•. Some mild side effects possible. •. Small increase in AST/ALT possible. .
•. Safety beyond one year not established.

 

[Banana Joe]

For cystic acne, bacne, pimples on your shoulders etc: Accutane > Retin-A
For basic facial skin appearance, a more 'youthful' look etc: Retin-A > Accutane

Accutane is systemic, goes everywhere in your body; why use that when you just want an effect in one very small area that's easy & convenient to target with a topical (your face), and there is better evidence for (Retin-A)

If 80/20 rule applies, I'd rather take a pill, and not have to apply the cream.
Call me lazy, but this whole drug taking thing quickly becomes a part time job, if you take it really seriously, multiple injections a day and all that jazz.
I also want all my skin to stay youthful.

Still not sure if I should not just do both for maximum rejuvenation.

The "continue therapy for 50 days" was based on a meta analysis of dozens of other studies. All other things equal, if treatment continued for at least 50 days after clearance, retreatment in the following 10 years or so was less likely. Most treatment protocols titrate up to a certain dose and stay there, without going back down. So presumably, whatever dose they were on was continued. they don't go into more detail than that.

Ok, I guess that it is a tie then. I guess I will probably start to slowly taper off after 1 month?!

The theory on pulsing is it prevents retinoic acid receptor downregulation that constant exposure causes. You'd need much more than 20mg if they downregulate, and there's some evidence collagen production can shut down (temporarily) from constant high level exposure to retinoic acid.

The relative effects of each type of "cosmetic off label" isotretinoin regimes is this:
5 mg Daily (Low-Dose Steady)
...
20 mg Three Times Per Week (Pulse Dose) all the above plus:
...

Ok, I guess then 20mg it is.
I am still undecided if I should go with if I should go with e3d or e2d then. Doing it in an alternating manner would fuck too much with my head.

 

[SnowyMiami]

I feel yah. Especially because everyone online is saying how amazing GH and how it's the fountain of youth. But even small doses fuck me up. Maybe I'll just try 1iu again as I age for health purposes.

UGL GH <> Pharma GH

 

[AllbrandNew]

Just bumped up my dose to 120mg/day from running the last month or so at 80mg/day. It took nearly that long to get the skin dryness somewhat manageable, so I'm certain I'll be fighting that fight again at this dose. Outside of that, just chapped lips and thinking about buying stock in Aquaphor.

On a ridiculous side note: I was just prescribed doxycycline hyclate by my urologist, who was aware I am on accutane. I thought tetracyclines were a no no, and checked later to verify. Sure enough there is an interaction and now I have to wait for this dude to call back and prescribe something else (Cipro I assume).

 

[Ghoul]

Just bumped up my dose to 120mg/day from running the last month or so at 80mg/day. It took nearly that long to get the skin dryness somewhat manageable, so I'm certain I'll be fighting that fight again at this dose. Outside of that, just chapped lips and thinking about buying stock in Aquaphor.

On a ridiculous side note: I was just prescribed doxycycline hyclate by my urologist, who was aware I am on accutane. I thought tetracyclines were a no no, and checked later to verify. Sure enough there is an interaction and now I have to wait for this dude to call back and prescribe something else (Cipro I assume).

Oddly despite the dire warning of potential brain swelling, numerous derms still prescribe doxycycline while their patients are on accutane, often to reduce so called "purge" effects.

 

[AllbrandNew]

Oddly despite the dire warning of potential brain swelling, numerous derms still prescribe doxycycline while their patients are on accutane, often to reduce so called "purge" effects.

Funny you mention that, as I came across a number of references saying the same. I still called them, but no response as of yet. Seems like there are other options that are less risky for the 10 days they want the course to run.

 

[Jeffholio5]

Funny you mention that, as I came across a number of references saying the same. I still called them, but no response as of yet. Seems like there are other options that are less risky for the 10 days they want the course to run.

I did some research on this after learning these two shouldn’t be mixed (on this forum, always learning new stuff here which is fantastic) azithromycin was one of the recommended antibiotics as well as bactrim, might be more though.

 

[dinfar1337]

I did some research on this after learning these two shouldn’t be mixed (on this forum, always learning new stuff here which is fantastic) azithromycin was one of the recommended antibiotics as well as bactrim, might be more though.

i've been precribed both.

the accutane pharma paper clearly states they shouldn't be mixed at all.

also my derma warned me to just throw the old stuff completely out.

 

[ChemBB]

UGL Accutane permanently cured my AAS-induced acne, I only ran it for a short period because the sides were intolerable

100% worth it

 

[BendigoShafter]

UGL Accutane permanently cured my AAS-induced acne, I only ran it for a short period because the sides were intolerable

100% worth it

How long and what dosage? I'm getting UGL Accutane just in case. I went through a course of Accutane and tetracycline about 30 years ago (side note: geez) and am hoping I won't need much to kill acne now.

 

[Ghoul]

The issue with the tetracycline class antibiotics and accutane seems to be that for a very small number of people with other risk factors (Obese, younger women) it can trigger high intracranial pressure on the brain because spinal fluid isn't draining properly . Around 0.3% chance. So for most, no issue, but if someone is one of those few, and they ignore symptoms of increasing brain pressure (headaches in morning, visual anomalies) and persist with both antibiotics and isotretinoin, they can become blind. We're talking low single digit number of cases out of millions. This is typically with high dose antibiotics used for long periods of time. Doxycycline seems to be the least likely of tetracyclines to cause it, so some derms are ok with short courses of it in people without risk factors, as long as they're warned to watch out for symptoms and stop taking the antibiotics immediately if they appear.

Most of the debate is how long of a "washout" period should people have after stopping antibiotics and starting accutane. Many derms seem fine using no washout period, and just stopping one and beginning the other. Personally that seems sensible to me.

 

[totaljuicetakeover]

It did for me but it only lasted a couple years. Im getting acne again from trenbolone sandwhich now on my back again so I will run another course. It works but also is a bitch to be on.

You had to get back on because you can't just hop on and off, you have to complete a full cycle of (150 mg/kg). Takes so long because you can realistically only safely go up to 80mgs a day. The full cycle has to be completely to fully nuke oil glands.

 

[ChemBB]

How long and what dosage? I'm getting UGL Accutane just in case. I went through a course of Accutane and tetracycline about 30 years ago (side note: geez) and am hoping I won't need much to kill acne now.

Oh man, it's been almost 10 years, but I want to say 60-90mg for no more than 10 weeks?

 

[vic892]

Hi all,
first, thanks for this very informative thread.
Do you think a slow approach, like max 50mg ED, would work? To reach 200 mg/kg would be a full year.
I'll try to reach 100 mg ED if sides are not high
so far cheapest source for EU seems Driada,
or buy raw powder, but I don't know if it needed some particular rules to store it.
Thanks

 

[quarter]

Hi all,
first, thanks for this very informative thread.
Do you think a slow approach, like max 50mg ED, would work? To reach 200 mg/kg would be a full year.
I'll try to reach 100 mg ED if sides are not high
so far cheapest source for EU seems Driada,
or buy raw powder, but I don't know if it needed some particular rules to store it.
Thanks

I was on in my mid-30's because of TRT induced cystic acne. I couldn't tolerate the sides at more than 60mg a day and had to be on for 11 months to achieve the "complete" course. It works, but lord help me, fuck accutane.

 

[Mike-Larry]

Anyone know if you can still use accutane after it expires? I bought some with an expiration of 2027. I don’t need it yet, bought it as precaution.

 

[Banana Joe]

Lastly I was on 17mg, and am now stuck in this purgatory nirvana, the acne got worse and has now stabilised at being a bit worse than it was before I had started the treatment.
I wanted to up the dose to 20mg anyway, but I now I wonder if I should go to 25mg and then raise again to 30mg. I already have dry skin on my limbs, I don't want it to become dryer.

Any thoughts on this?

 

[Cookie Monster]

I know a few users on another forum who would microdose accutane or switch to tretinoin/Tazarotene and maintain and have good quality skin after using accutane at high doses.
also know a few people who use anti androgens as a cream for acne such as ru58841 or winlevi (however u spell it)