Accutane permanent cure?

[white-boyka]

my nose that were beginning to look like pits (something I noticed introducing moderately high DHT’s) have almost closed entirely and are pushing out sebaceous filaments in mass. My nose feels like sandpaper, I guess? It’s honestly a breath of fresh air.

does it look smaller/thinner?

 

[Ghoul]

So a few days from finishing up month 1 and I’ve definitely become a bit addicted to the progress. I bumped it to 180mg the last few days, and tbh, it’s manageable, but the dryness is on a whole different level and I’m not sure it’s something I want to manage long term.

@Ghoul I’m surprised to already report that pores on my nose that were beginning to look like pits (something I noticed introducing moderately high DHT’s) have almost closed entirely and are pushing out sebaceous filaments in mass. My nose feels like sandpaper, I guess? It’s honestly a breath of fresh air.

My cysts that from previous experience would take 6-12 months to begin to flatten (eventually leaving a small indent) are beginning to go away. I almost wish I had done this a long time ago, even as a prophylactic measure for managing AAS induced acne.

Those sebaceous filaments coming out of my nose was the weirdest, but most satisfying part of the entire process. My nose visibly shrunk, those pores hadn’t been that clean, ever, and ultimately the pores shrunk to the point of disappearing. It was unexpected and the visual improvement was dramatic.

For anyone who doesn’t know what this is, imagine thousands of black and white heads being pushed out from behind, emerging as strands, making your nose look like it’s covered in hair. It’s caused by the sebaceous (oil) glands shrinking, making the entire pore tighten down, squeezing out all the contents (they emerge as dry filaments, not an oily mess). It’s incredible.

AAS makes those glands grow larger, so most of us have enlarged pores above and beyond what DHT normally does to enlarge them. When they shrink, skin looks much smoother and significantly younger.

 

[white-boyka]

AAS makes those glands grow larger

is that specifically due to dht? or test alone (test + dut) can cause that also?

 

[Ghoul]

is that specifically due to dht? or test alone (test + dut) can cause that also?

Both. But DHT 80% vs test 20%.

https://www.mdpi.com/2073-4409/14/10/747

 

[Cman90]

Those sebaceous filaments coming out of my nose was the weirdest, but most satisfying part of the entire process. My nose visibly shrunk, those pores hadn’t been that clean, ever, and ultimately the pores shrunk to the point of disappearing. It was unexpected and the visual improvement was dramatic.

For anyone who doesn’t know what this is, imagine thousands of black and white heads being pushed out from behind, emerging as strands, making your nose look like it’s covered in hair. It’s caused by the sebaceous (oil) glands shrinking, making the entire pore tighten down, squeezing out all the contents (they emerge as dry filaments, not an oily mess). It’s incredible.

AAS makes those glands grow larger, so most of us have enlarged pores above and beyond what DHT normally does to enlarge them. When they shrink, skin looks much smoother and significantly younger.

Looking forward to this. Hopefully it can shrink down my giant shnozer lol. Got some accufine on the way.

How long did it take for this to start happening?

 

[Ghoul]

Looking forward to this. Hopefully it can shrink down my giant shnozer lol. Got some accufine on the way.

How long did it take for this to start happening?

I think it was around 2 months, about 100mg ( 50mg 2x / day).

 

[pheno609]

Looking forward to this. Hopefully it can shrink down my giant shnozer lol. Got some accufine on the way.

How long did it take for this to start happening?

Probably dose dependent. If you are running 180mg per day, it'll happen within the first month i would assume. But low doses like 10 or 20mg would take much longer

 

[ekim]

Thank you very much for this thread, Ghoul. I'll be starting Accufine next week. I am 52 and tired of dealing with my super oily skin and the damn zits that still can randomly appear anywhere (even on my ear lobes or inside my ears and nose entrance). I want to do the "max" protocol and be done dealing with this shit once and for all. I am 225 pounds.

1. What should my starting daily dose be?
2. How often should I increase my dose and by how much?
3. What maximum daily dose should I try to get to?
4. Is 23,000 mg the grand total I need to get to in the end (length of time to get there doesn't matter, right?)?

My goal is to push this to the max, get it over with as quickly as possible, and achieve the most optimal long-term results.

 

[Ghoul]

Thank you very much for this thread, Ghoul. I'll be starting Accufine next week. I am 52 and tired of dealing with my super oily skin and the damn zits that still can randomly appear anywhere (even on my ear lobes or inside my ears and nose entrance). I want to do the "max" protocol and be done dealing with this shit once and for all. I am 225 pounds.

1. What should my starting daily dose be?
2. How often should I increase my dose and by how much?
3. What maximum daily dose should I try to get to?
4. Is 23,000 mg the grand total I need to get to in the end (length of time to get there doesn't matter, right?)?

My goal is to push this to the max, get it over with as quickly as possible, and achieve the most optimal long-term results.

Very similar to me, worth every stick of lip balm and back ache. Only regret was waiting as long as I had.

I was extremely cautious (hence why my journey started as “low dose” then once I realized fears were exaggerated, scrambled to buy more to shift to “high dose” as evidence proves that most effective, and safe). I did want to “get it over with as fast as possible”, it’s not the most pleasant experience, but as the comment above, you get “addicted to the progress”.

I started 10mg / 1x day after eating something with fat (breakfast). 5 days.

Then 10mg / 2x day (20mg/day) 5 days (Not as concerned with fat for second dose, but having with meal is helpful, so time of second dose varied to align with meal.

Then 20mg morning 10mg evening (30mg/day) 5 days

Then 20mg / 2x day (40mg/day) 5 days

Then 30mg / 2x day 5 says

40x2 , 50x2 , 60x2 etc every 5 days.

If sides were rough, I might not increase until 6 or 7, 10 days at the most.

Once I got to around 180mg / day sides did not ease off, and I started climbing back down (far easier then the climb up). I decided an extra 2-3 weeks to reach the cumulative total was worth the relief of sides I had enough of by that point.

Going down, even at high doses like 140mg day had virtually no sides.

So it’s essentially waiting for sides to ease, then increasing when they do, then repeat. As I said, for me, 5 days things would ease off. (2nd day after higher dose was worst).

It’s all up to you and what you can tolerate.

MAX DOSE should not exceed 2mg / kg, though you don’t have to go that high, it’ll speed things up if you can, bringing discomfort to an end sooner.

Yes, 23,000 is enough. Try to make 50% the 40mg dose, 25% 30mg, then the rest split 10/20 for cost effectiveness and dosing flexibility (large doses are cheaper per mg.).

Length of time (within reason) isn’t a crucial factor, but I’m glad I pushed as hard as I could to get it over with. Recovery takes about a month (ie lips / eye dryness returning to normal).

Avoid excess sun, you can burn easily, and skin will be fragile(thinner) temporarily, nothing very abrasive. Careful with adhesives like bandaids).

 

[Cman90]

Very similar to me, worth every stick of lip balm and back ache. Only regret was waiting as long as I had.

I was extremely cautious (hence why my journey started as “low dose” then once I realized fears were exaggerated, scrambled to buy more to shift to “high dose” as evidence proves that most effective, and safe). I did want to “get it over with as fast as possible”, it’s not the most pleasant experience, but as the comment above, you get “addicted to the progress”.

I started 10mg / 1x day after eating something with fat (breakfast). 5 days.

Then 10mg / 2x day (20mg/day) 5 days (Not as concerned with fat for second dose, but having with meal is helpful, so time of second dose varied to align with meal.

Then 20mg morning 10mg evening (30mg/day) 5 days

Then 20mg / 2x day (40mg/day) 5 days

Then 30mg / 2x day 5 says

40x2 , 50x2 , 60x2 etc every 5 days.

If sides were rough, I might not increase until 6 or 7, 10 days at the most.

Once I got to around 180mg / day sides did it ease off, and I started climbing back down (far easier then the climb up). I decided an extra 2-3 weeks to reach the cumulative total was worth the relief of sides I had enough of by that point.

Going down, even at high doses like 140mg day had virtually no sides.

So it’s essentially waiting for sides to ease, then increasing when they do, then repeat. As I said, for me, 5 days things would ease off. (2nd day after higher dose was worst).

It’s all up to you and what you can tolerate.

MAX DOSE should not exceed 2mg / kg, though you don’t have to go that high, it’ll speed things up if you can, bringing discomfort to an end sooner.

Yes, 23,000 is enough. Try to make 50% the 40mg dose, 25% 30mg, then the rest split 10/20 for cost effectiveness and dosing flexibility (large doses are cheaper per mg.).

Length of time (within reason) isn’t a crucial factor, but I’m glad I pushed as hard as I could to get it over with. Recovery takes about a month (ie lips / eye dryness returning to normal).

Avoid excess sun, you can burn easily, and skin will be fragile(thinner) temporarily, nothing very abrasive. Careful with adhesives like bandaids).

Did you get labs done regularly to monitor LDL/HDL, ALT/AST, etc.?

I'm guessing you avoided using any hepatotoxic compounds during your course of the accufine?

 

[Ghoul]

Did you get labs done regularly to monitor LDL/HDL, ALT/AST, etc.?

I'm guessing you avoided using any hepatotoxic compounds during your course of the accufine?

I had a baseline test, coincidentally a routine blood panel a month before starting.

Everything was normal and I didn’t test again until 2 months after finishing (everything was normal).

I completely avoided alcohol, I don’t use oral AAS, and have no history of liver issues.

From a number of studies, it seems the previous regime of monthly testing is unnecessary, creates “needless stress” from elevated but transient and clinically insignificant elevations, and when problems were found in a tiny minority, alcohol almost always plays a role.

At one end of the “new Accutane protocol” spectrum some derms only check baselines before starting, and if no indicator of liver issues, it’s not checked again unless there’s some sign of a problem. The risk of an issue of anyone without a preexisting issue, avoids alcohol (and any known hepatoxic compound like oral AAS) seems infinitissimaly small.

The most common “happy medium” is baseline and again around two months in.

https://jamanetwork.com/journals/jamadermatology/fullarticle/2471551

But of course I’m no doctor. It’s your body and risk tolerance. If this seems unwise to
you for any reason, better to err on the side of caution. It’s helpful to understand what represents an acceptable “abnormal marker” and what indicates a problem that would warrant stopping treatment.

IMO if you know you can’t avoid drinking while doing this, I wouldn’t even start. Same for orals or any hepatoxic compound. If you’re using herbal supplements, better check to see if they’re hepatoxic. Some are bad enough they’re banned in certain places (red yeast rice for instance). As far as I’m aware, the only, and still extremely rare, accutane induced liver injury cases in otherwise healthy people were caused by alcohol use.

 

[ekim]

Thanks for your response, Ghoul.

I'll report back when I'm done.

It sounds like I'll need to stop even my just couple of glasses of wine on the weekend and COMPLETELY avoid alcohol. Bummer. But, if that's what it takes, I'll do it.

 

[Cman90]

I had a baseline test, coincidentally a routine blood panel a month before starting.

Everything was normal and I didn’t test again until 2 months after finishing (everything was normal).

I completely avoided alcohol, I don’t use oral AAS, and have no history of liver issues.

From a number of studies, it seems the previous regime of monthly testing is unnecessary, creates “needless stress” from elevated but transient and clinically insignificant elevations, and when problems were found in a tiny minority, alcohol almost always plays a role.

At one end of the “new Accutane protocol” spectrum some derms only check baselines before starting, and if no indicator of liver issues, it’s not checked again unless there’s some sign of a problem. The risk of an issue of anyone without a preexisting issue, avoids alcohol (and any known hepatoxic compound like oral AAS) seems infinitissimaly small.

The most common “happy medium” is baseline and again around two months in.

View attachment 365374

https://jamanetwork.com/journals/jamadermatology/fullarticle/2471551

But of course I’m no doctor. It’s your body and risk tolerance. If this seems unwise to
you for any reason, better to err on the side of caution. It’s helpful to understand what represents an acceptable “abnormal marker” and what indicates a problem that would warrant stopping treatment.

IMO if you know you can’t avoid drinking while doing this, I wouldn’t even start. Same for orals or any hepatoxic compound. If you’re using herbal supplements, better check to see if they’re hepatoxic. Some are bad enough they’re banned in certain places (red yeast rice for instance). As far as I’m aware, the only, and still extremely rare, accutane induced liver injury cases in otherwise healthy people were caused by alcohol use.

Thanks a lot, I really appreciate your contribution on this. I look forward to having clear skin.

 

[Ghoul]

Thanks for your response, Ghoul.

I'll report back when I'm done.

It sounds like I'll need to stop even my just couple of glasses of wine on the weekend and COMPLETELY avoid alcohol. Bummer. But, if that's what it takes, I'll do it.

I mean that’s me.

Do plenty of people still drink in moderation without issue? Given the extremely low rate of liver injury, I’m certain that’s a yes.

Do some derms prescribe Doxycycline, a potentially brain swelling / blindness inducing interaction requiring a multi week washout period between stopping the antibiotic and starting accutane? Yep, to my shock, with no damaging incidents reported in the literature. (I didn’t wait a full 2 weeks, just 1, and every slight headache for the first couple of weeks had me wondering if my brain was a goner…)

I came into this terrified of everything the Accutane mythology had to offer. Nothing but permanently dry lips, sandpaper eyes, IBS, and a liver transplant in my future, and it all worked out for me, and apparently, for 99.999% of everyone else too.

The primary risk seems to be once you start down this road, you’re committed, whether it’s mildly unpleasant or a world of suck, for months, or you quit and suffered for nothing.

 

[l2play`]

Accutane worked great for me during my time completely off. Ran it for a few months and made sure to reach the recommended accumulative dosage per body weight. Past year started up again and bacne came back after years of no issues. Currently using a BP wash every night before shower, leaving it on for 20mins and it’s under control.

 

[adrenalytic]

I think I'm gonna hop on the high dose train. I've been microdosing (10 mg/day, then 10 mg/BID, now 20 mg BID) and have noticed a little reduction in DHT induced acne on my shoulders and back but still getting chest and, more recently, facial acne. But it's not the relief I'm looking for so I'm gonna kick up the juice. I bought a bunch of 40 mg blisters from PCT24x7 should be here by the end of the month. Until then I have like six 20 mg blisters to keep me going.

My question is this. Is the recommended "cure" dosage based on actual body weight or ideal? My body weight fluctuates a lot from AAS. So this continues to be a moving target. Like my ideal body weight for my height is something like 180 lbs. I currently weigh 220 because I'm a fucking beast. Going to be hitting a cut at the end of the month and shooting for 205 goal weight. So what is my target cumulative dose?

 

[Ghoul]

I think I'm gonna hop on the high dose train. I've been microdosing (10 mg/day, then 10 mg/BID, now 20 mg BID) and have noticed a little reduction in DHT induced acne on my shoulders and back but still getting chest and, more recently, facial acne. But it's not the relief I'm looking for so I'm gonna kick up the juice. I bought a bunch of 40 mg blisters from PCT24x7 should be here by the end of the month. Until then I have like six 20 mg blisters to keep me going.

My question is this. Is the recommended "cure" dosage based on actual body weight or ideal? My body weight fluctuates a lot from AAS. So this continues to be a moving target. Like my ideal body weight for my height is something like 180 lbs. I currently weigh 220 because I'm a fucking beast. Going to be hitting a cut at the end of the month and shooting for 205 goal weight. So what is my target cumulative dose?

Cumulative is weight based. When in doubt err on the high side and be done with it.

100kg. X 220mg =0.22mg =22000mg

It’s not like your eyeballs will fall out by going over because of weight fluctuations. The very highest levels in studies are 290mg / kg so there’s plenty of leeway, and imo, better to go over a bit, where permanent success is more likely than under, than risk having to go through it again down the road,

Intermittent on/off half assed doses are just courting failure and lengthening the amount of time sides have to be dealt with. Once and done should be the goal.

 

[k710]

The pain in the ass of going through a dermatologist is this drug requires monthly doctor visits for dosage adjustments, multiple blood tests throughout for liver values, lipids, etc… even though through my research I have found the raise in these values to be relatively benign and cease upon stopping use of the drug. I wouldn’t gas myself up on a gram of injectables and an oral and booze on the weekends while taking this, but if you have a solid regimen in place to mitigate potential sides, it’s seriously a relatively benign drug.

Saw my dermatologist the other day, checked up on my skin and asked me if I was happy with current result. I currently have chest, back and upper arm acne flared up and although its better than the original full body breakout I had, its still pretty noticable and my skin isnt "intact". Said if I was fine with the oitments and washes that I could continue, but he still thinks accutane would be a better solution to my case. Im leaning towards agreeing with him since im never acne free and using test is just exasterbating it (no plans on stopping test use).

The protocol is covered by insurance, but like ghoul mentioned I believe its up to the 180mg/kg cumulative dose. Start at 20mg/day and tritrate up as tolerable by 20mg with the goal of hitting 80mg/day to finish treatment in 6-8 months. Mentioned needing starting labs and a set of follow up labs. After he wouldnt need to check labs unless there were concerns or at the end up treatment.

I spoke to my coach and she recommended microdosing accutane and utilizing glutathione along side it. My acne really isnt that bad and it does clear up pretty well when im ontop of it 100%, but for example I ran out of Panoxyl bodywash for 4-5 days and things flared up quickly. A week back on panoxyl and still trying to clear it up.

Torn because I feel like id be a great candidate for microdosing since my problems are relatively manageable, but I also dont want to be spewing toxic loads for longer than needed.

My thoughts right now are to go through Derm and hopefully break down tablets to microdose instead of following the full regime and seeing how my body reacts to it. If im cleared up and fine, ill keep rolling with it. If I discover sides arent as bad, I can always bump up the dose.

Do you just track how many mgs youve taken until you hit cumulative dose?

Thanks again for all the great info in here. Appreciate you all

 

[Ghoul]

Saw my dermatologist the other day, checked up on my skin and asked me if I was happy with current result. I currently have chest, back and upper arm acne flared up and although its better than the original full body breakout I had, its still pretty noticable and my skin isnt "intact". Said if I was fine with the oitments and washes that I could continue, but he still thinks accutane would be a better solution to my case. Im leaning towards agreeing with him since im never acne free and using test is just exasterbating it (no plans on stopping test use).

The protocol is covered by insurance, but like ghoul mentioned I believe its up to the 180mg/kg cumulative dose. Start at 20mg/day and tritrate up as tolerable by 20mg with the goal of hitting 80mg/day to finish treatment in 6-8 months. Mentioned needing starting labs and a set of follow up labs. After he wouldnt need to check labs unless there were concerns or at the end up treatment.

I spoke to my coach and she recommended microdosing accutane and utilizing glutathione along side it. My acne really isnt that bad and it does clear up pretty well when im ontop of it 100%, but for example I ran out of Panoxyl bodywash for 4-5 days and things flared up quickly. A week back on panoxyl and still trying to clear it up.

Torn because I feel like id be a great candidate for microdosing since my problems are relatively manageable, but I also dont want to be spewing toxic loads for longer than needed.

My thoughts right now are to go through Derm and hopefully break down tablets to microdose instead of following the full regime and seeing how my body reacts to it. If im cleared up and fine, ill keep rolling with it. If I discover sides arent as bad, I can always bump up the dose.

Do you just track how many mgs youve taken until you hit cumulative dose?

Thanks again for all the great info in here. Appreciate you all

Just to be clear, the cumulative timeframe isn’t infinite. Much more than a year and the “memory” effect drops off, so you can’t stretch out 10 rounds of microdosing over 5 years and get the equivalent results of one continuous period of treatment to reach the same cumulative dose.

 

[bigforyouben]

My thoughts right now are to go through Derm and hopefully break down tablets to microdose instead of following the full regime and seeing how my body reacts to it. If im cleared up and fine, ill keep rolling with it. If I discover sides arent as bad, I can always bump up the dose.

The pharma isotretinoin will be gel caps, so you won't be able to break them down.