I plan to write this up in a separate post, but I may as well drop this here in case anyone's going down the accutane route. Order some ivermectin tabs when you order isotretinoin. After my accutane cycle was over, I noticed my otherwise clear skin was still blemished here and there by pimples that weren't acne, more like very tiny bumps and blisters.
Long story short, I discovered they may have been caused by demodex mites that live in pores and feed on cells and sebum, which all of us are infested with to one degree or another. They induce a whole host of skin issues, from pimples to rosacea. It seems very few dermatologists are aware of this, which blows my mind.
You can't wash them off. It's not a hygiene issue, though the more oily your skin (or moisturized) the more prone you are to them. Right after accutane while your skin is still very dry seems an ideal time to get rid of them.
Eight weekly doses of .2mg/kg completely eliminated the blemishes, But not before it got worse, which is normal (called the "die off effect", since they release bacteria when they die).
When you know what to look for you realize you can see their fucking tails (take a pic, zoom in, and they're tiny white specs, which can easily be mistaken for a whitehead) as they emerge from pores.
Demodex pustule:
View attachment 313943
4 weekly doses ivermectin later:
View attachment 313944
4 weeks after that completely healed and inflammation eliminated, leaving skin clear and even toned.
View attachment 313947
Demodex mite is an obligate human ecto-parasite found in or near the pilo-sebaceous units. Demodex folliculorum and Demodex brevis are two species typically found on humans. Demodex infestation usually remains asymptomatic and may have a pathogenic ...
pmc.ncbi.nlm.nih.gov
They spread from human skin contact, shared bedding etc, so if you have a partner probably a good idea for both of you to do it at the same time. Again, almost all adults have these, and while they don't always cause symptoms, they don't serve any useful purpose either, Just a parasite, The eggs only live for two weeks, so 8 weeks of treatment is enough to completely eliminate them.