Accutane permanent cure?

[Ghoul]

Correcting typo after edit window closed:

“ Intermittent dosing also correlates with higher relapse rates, because these biologic effects partially reverse when exposure is stopped before the cumulative threshold *is reached* .” (Not *is not* not reached)

 

[a1b2c3]

@Ghoul is there a mechanism of action where accutane will decrease hyperpigmentation from acne? And do you have any rec’s for anything that may speed that process that are worthwhile taking while on accutane?

If the scars are red (PIE - post-inflammatory erythema) - use azelaic acid. ( I usually use 20%).

If the scars are dark (PIH - post-inflammatory hyperpigmentation) - use hydroquinone 4%. (This one works wonderfully, tested by me).[be very careful and don't use it for more than 2 months continuously].

Additionally, you can use vitamin C serum (look for one that has as an active ingredient L-ascorbic acid, since the cheaper ones use other forms of vit.C, which aren't as good).

Kojic acid / glycolic acid works as well.

Rohit, looking through his catalog, has some creams which include several of the ingredients mentioned above (demelan, for example).

But these are actives that should probably be started after stopping isotret.

 

[Bammdk]

How is the liver toxicity? Is it as bad as it’s reputation?

Doing 20mg E3D. Can’t get smaller gelcaps.

 

[Ghoul]

How is the liver toxicity? Is it as bad as it’s reputation?

Doing 20mg E3D. Can’t get smaller gelcaps.

No, risk is FAR lower than it was initially feared 40 years ago, and unless you start with preexisting liver problems the chance of liver injury is near nil.

Liver enzymes will rise slightly, and I personally think it’s a good idea to avoid additional liver stress from heavy drinking or high dose oral anabolic steroid use, but many derms stopped routine liver tests, just checking once prior to initiation to make sure there isn’t undiagnosed liver disease.

The increase in liver enzymes is typically 10-15%, much lower than many over the counter supplements.

The number of people who see enzymes rise to 3x the upper limit of normal, which is the threshold it’s recommended usage stop, is 0.2%.

Actual reported cases of hepatitis or other serious liver problems can be counted on your fingers. That’s out of tens of millions of patients over nearly 50 years.

So if you want to be as safe as possible , take a baseline blood test to make sure you’re starting with normal liver function (AST/ALT/GGT), then check again 4-8 weeks after starting. If it’s 15% or less higher than baseline, you’re fine. You can reassure yourself by checking again 8 weeks after stopping.

The only serious risk is to pregnant (or who might become) pregnant women. Isotretinoin will cause severe birth defects. (This is only during development, not some genetic change that continues after you stop taking it and it’s completely cleared from your system within a couple of months).

If you aren’t aware, Isotretinoin is essentially a super-potent form of vitamin A. (And you should stop supplementing Vitamin A while on it btw).

 

[Lifting88]

About 8 months after finishing treatment, I started 5mg / daily Accufine with excellent results.

Derms in the US prescribe 10mg off label, every 2nd or 3rd day for anti-aging, but that’s because 5mg doses aren’t available in the US any more.

Isotretinoin sides (like most drug sides) are associated with peak levels, so 5mg / daily is the way to go imo.

I pay less than $10 / box (100 gelcaps) for 5mg Accufine. ~$25-30 for a “cosmetic” treatment this effective is surreal.

Try to take it with some fat / food though. It’s already a minuscule dose, so you want to make sure you’re absorbing it well.

Did you did bloodtest on this dose

 

[Ghoul]

Did you did bloodtest on this dose

Before starting and about 6 weeks after finishing. Normal both times.

I’m not saying that’s the safest way, or even smart, but seeing how low the risk was I wasn’t concerned.

I should’ve tested after starting. On the other hand, I never intended to go higher than low dose in the beginning.

It was only after starting, quickly getting over my “Accutane fear” and seeing all the recent studies that made it clear high dose protocols had the best long term outcomes, and preferring to do this once and be done forever, I changed plans. (Which led to a scramble for more before running out. Lost packs, seizures, I barely managed to not end up with an interruption).

 

[k710]

No, risk is FAR lower than it was initially feared 40 years ago, and unless you start with preexisting liver problems the chance of liver injury is near nil.

Liver enzymes will rise slightly, and I personally think it’s a good idea to avoid additional liver stress from heavy drinking or high dose oral anabolic steroid use, but many derms stopped routine liver tests, just checking once prior to initiation to make sure there isn’t undiagnosed liver disease.

The increase in liver enzymes is typically 10-15%, much lower than many over the counter supplements.

The number of people who see enzymes rise to 3x the upper limit of normal, which is the threshold it’s recommended usage stop, is 0.2%.

Actual reported cases of hepatitis or other serious liver problems can be counted on your fingers. That’s out of tens of millions of patients over nearly 50 years.

So if you want to be as safe as possible , take a baseline blood test to make sure you’re starting with normal liver function (AST/ALT/GGT), then check again 4-8 weeks after starting. If it’s 15% or less higher than baseline, you’re fine. You can reassure yourself by checking again 8 weeks after stopping.

The only serious risk is to pregnant (or who might become) pregnant women. Isotretinoin will cause severe birth defects. (This is only during development, not some genetic change that continues after you stop taking it and it’s completely cleared from your system within a couple of months).

If you aren’t aware, Isotretinoin is essentially a super-potent form of vitamin A. (And you should stop supplementing Vitamin A while on it btw).

Exactly what my Dr told me. Also mentioned outdated research and used the mental health example.

"If your skin looks like shit, your going to feel like shit.."
Of course people who have bad skin conditions are more likely to be more "depressed" than someone who doesnt have to deal with/worry about their skin.

Also idk if you own stock in accufine or with pct24x7 but you should get paid by both for your work on isotreiton alone lol

 

[Ghoul]

Exactly what my Dr told me. Also mentioned outdated research and used the mental health example.

"If your skin looks like shit, your going to feel like shit.."
Of course people who have bad skin conditions are more likely to be more "depressed" than someone who doesnt have to deal with/worry about their skin.

Also idk if you own stock in accufine or with pct24x7 but you should get paid by both for your work on isotreiton alone lol

I should! (But alas I don’t)

Mostly it’s “I was foolish for buying into the fear, don’t repeat my mistake and suffer needlessly for years with acne.”

I was just thinking how nice it is to scratch a back itch without the agony of accidentally scraping a pimple….