Accutane permanent cure?

[ekim]

I'm on day 12 of Ghoul's high-dose protocol (shooting for 23,000 mg). I've gone from 20mg to 80mg incrementally (quickly, though!). The only side effects have been very slight dryness of my lips, hands, and nose (both inside and around the nostrils). I was expecting more severe side effects, but maybe I'm just not far enough into this yet. I'm going to continue my every-three-day-increase and bump to 100 mg tomorrow.

Do the side effects pretty much scale linearly? Or, am I going to pass some kind of threshold where the side effects jump up significantly?

 

[adrenalytic]

I'm on day 12 of Ghoul's high-dose protocol (shooting for 23,000 mg). I've gone from 20mg to 80mg incrementally (quickly, though!). The only side effects have been very slight dryness of my lips, hands, and nose (both inside and around the nostrils). I was expecting more severe side effects, but maybe I'm just not far enough into this yet. I'm going to continue my every-three-day-increase and bump to 100 mg tomorrow.

Do the side effects pretty much scale linearly? Or, am I going to pass some kind of threshold where the side effects jump up significantly?

Be careful. I ramped up fast too. It was going great...until it wasn't. Developed dermatitis on my hands, face and taint. This was when I hit 80 mg too fast. Had to back down.

 

[ekim]

Be careful. I ramped up fast too. It was going great...until it wasn't. Developed dermatitis on my hands, face and taint. This was when I hit 80 mg too fast. Had to back down.

Thanks for the heads-up. Do you remember how long you had gone before that occurred? I'm now wondering (based on what you said) if I should just hold here at 80 mg for a while. Although, I have no idea how long.

 

[adrenalytic]

Thanks for the heads-up. Do you remember how long you had gone before that occurred? I'm now wondering (based on what you said) if I should just hold here at 80 mg for a while. Although, I have no idea how long.

I was doing every 5 day increases. The dermatitis showed up a couple days after the increase to 80. First appeared on the backs of both my hands and then my cheeks became enflamed a few days after that. Taint and balls became irritated from chafing during cardio.

All have since resolved and I'm on 100 mg (about to move to 120) but I'm taking about 10 days in between increases now. Seems to be working.

 

[BendigoShafter]

Was on derm prescribed accutane 7-8 years ago. Can't remember for how long or what dose I got to before I had to stop.
I was definitely at a high enough dose to get noticeable sides.
My acne was helped a lot and there has definitely been a lasting effect.
Would this count towards my cumulative dose somehow?

From my research, no. You have to start over.

The treatment regime is the same when doing an initial treatment and treating a recurrence. Cumulative total target is the same.

I'm in the same boat but my first round was decades ago.

 

[DublinMeUp]

From my research, no. You have to start over.

The treatment regime is the same when doing an initial treatment and treating a recurrence. Cumulative total target is the same.

I'm in the same boat but my first round was decades ago.

Reading through the thread from the start, somewhere between page 10 and 15 @Ghoul mentions it does count iirc. Maybe he learns that that's untrue later?

Anyway been thinking about it. Will take me time to find an affordable source and I can't start til the first week of Feb due to other life stuff anyway. I don't want to be "blasting" in the summer.

I have a friend of a friend here who can get me small amount of pharma grade, via an actual pharmacy so I'm thinking I'll just do 40 per day to treat my TRT induced acne.
Then after the summer either go through my derm or self administer 150-200mg/kg.

Thoughts on that plan? Is it OK to low dose for a few months then run the cumulative "cure" cycle 6 months later?

 

[Cman90]

Reading through the thread from the start, somewhere between page 10 and 15 @Ghoul mentions it does count iirc. Maybe he learns that that's untrue later?

Anyway been thinking about it. Will take me time to find an affordable source and I can't start til the first week of Feb due to other life stuff anyway. I don't want to be "blasting" in the summer.

I have a friend of a friend here who can get me small amount of pharma grade, via an actual pharmacy so I'm thinking I'll just do 40 per day to treat my TRT induced acne.
Then after the summer either go through my derm or self administer 150-200mg/kg.

Thoughts on that plan? Is it OK to low dose for a few months then run the cumulative "cure" cycle 6 months later?

This is my exact plan. Is it ideal? No. Is it better than getting r**** by the sun and not being able to take your shirt off all summer long? In my opinion, yes.

But also depends on acne clearance. If I run 40mg for several months and my acne is still purging, I'll just have to keep going and be a vampire all summer.

Ghouls last statement on the topic was the cumulative dose resets after a year or something like that...

 

[AllbrandNew]

Just following up here since I am, surprisingly, coming close to the end of my Accutane run. Did some math, and if I move up to 160mg/day from 120mg/day I'll be done with the 220mg/kg in 2 weeks, which is great since I have other medical shit going on now and again shortly anyways.

Couple things that I learned, that may not apply to others:

Titrating up seems to have a window of whether sides will increase. I.E.: Moving from 40mg/day to 80mg/day was when I got all the usual sides, but bumping from 80mg/day to 120mg/day netted no significant difference in sides.

Same is true for coming down to 80mg/day from 120mg/day. I was hoping to get a little sides relief, but it really didn't change at all over the course of 6 weeks or so.

I got a lot of joint pain/discomfort, which really kind of snuck up on me. Same with nosebleeds. That started to happen occasionally at 80mg/day and slightly more often but still somewhat rare at 120mg/day.

The soft tissue dryness was the worst of it though. Lips constantly chapped, the nosebleeds, eyes really dry for about a week when upping dosages, and even other areas that I didn't even think of became dry/chapped at times.

I have had acne for my entire adolescent and adult life, and finally have had clear skin for the first time consistently. The course of medication sucks, but I wish I'd have done it 20+ years ago.

 

[Cman90]

Just following up here since I am, surprisingly, coming close to the end of my Accutane run. Did some math, and if I move up to 160mg/day from 120mg/day I'll be done with the 220mg/kg in 2 weeks, which is great since I have other medical shit going on now and again shortly anyways.

Couple things that I learned, that may not apply to others:

Titrating up seems to have a window of whether sides will increase. I.E.: Moving from 40mg/day to 80mg/day was when I got all the usual sides, but bumping from 80mg/day to 120mg/day netted no significant difference in sides.

Same is true for coming down to 80mg/day from 120mg/day. I was hoping to get a little sides relief, but it really didn't change at all over the course of 6 weeks or so.

I got a lot of joint pain/discomfort, which really kind of snuck up on me. Same with nosebleeds. That started to happen occasionally at 80mg/day and slightly more often but still somewhat rare at 120mg/day.

The soft tissue dryness was the worst of it though. Lips constantly chapped, the nosebleeds, eyes really dry for about a week when upping dosages, and even other areas that I didn't even think of became dry/chapped at times.

I have had acne for my entire adolescent and adult life, and finally have had clear skin for the first time consistently. The course of medication sucks, but I wish I'd have done it 20+ years ago.

Thanks for sharing. Glad you made it through!

 

[BendigoShafter]

Good to hear. How long did it take you? When did you start to see serious results?

 

[JustJake]

Reading through the thread from the start, somewhere between page 10 and 15 @Ghoul mentions it does count iirc. Maybe he learns that that's untrue later?

Anyway been thinking about it. Will take me time to find an affordable source and I can't start til the first week of Feb due to other life stuff anyway. I don't want to be "blasting" in the summer.

I have a friend of a friend here who can get me small amount of pharma grade, via an actual pharmacy so I'm thinking I'll just do 40 per day to treat my TRT induced acne.
Then after the summer either go through my derm or self administer 150-200mg/kg.

Thoughts on that plan? Is it OK to low dose for a few months then run the cumulative "cure" cycle 6 months later?

Taking a low dose now and bumping up later should be fine, there are several studies that have concluded that low dose regimens are effective and a 2025 cohort study of almost 20,000 patients found "daily dose was not associated with decreased risk of acne relapse or isotretinoin retrial among those with conventional and high cumulative dosages".

I'm not aware of any studies that found starting at low dose and then moving to high dose hindered progress.

If you're following a cumulative dosing and worried about how effective it will be going from low to high, you can always increase your cumulative dose target, up to 220mg/kg. Lower cumulative doses have been shown to have higher incidence of relapse. Cumulative doses over 220mg/kg may have no additional impact on relapse.

Some researchers have suggested that duration of treatment (after complete resolution) is a greater predictor than cumulative dose and some studies have shown that shorter duration overall has a higher incidence for relapse. Taking it for longer may actually improve your outcome and I don't know of any evidence that it will hinder it.

If you aim for a minimum cumulative dose of 150mg/kg but also continue for 2 - 3 months after complete clearance, regardless of cumulate dose, you will probably have the greatest chance of avoiding future acne. Some studies have shown as little as one additional month significantly reduces recurrence.

 

[2ndchancesNK]

Thanks for the heads-up. Do you remember how long you had gone before that occurred? I'm now wondering (based on what you said) if I should just hold here at 80 mg for a while. Although, I have no idea how long.

The climb in dosages is the biggest pain in the ass of this whole thing. Everyone’s response is so individualized that it’s just a shot in the dark. Taking it slow is the best bet to avoid sides of course, but if you choose to climb quickly be prepared.

I’m between 7-8k total mgs right now shooting for just 12-15k mgs so almost there, and what I recommend is this:

- good moisturizer as many times per day as possible
- at night, moisturize and then an emoliant like aquaphor or cerave healing ointment to lock moisture in
- aquaphor for the lips is a god send — forget the other chapsticks
- humidifier at night and all day — keep the moisture up
- SPF every single day, especially if in a warmer climate

I feel I could have maintained 180-200mg a day if I was a work from home person, but my job makes it impossible to do all the above. It just wasn’t worth it. 120-140mg is manageable for me and I’m just looking forward to titrating down below 100mg over the next few weeks as I titrate up my AAS.

 

[AllbrandNew]

Good to hear. How long did it take you? When did you start to see serious results?

I started Accutane on Sept 1 of 2025. I had been prescribed an antibiotic before that as I finally had enough and opted to see a dermatologist. They put me on the antibiotic and a cream and a gel (tretinoin and dapsone) which was stupid expensive and not covered via insurance. My skin improved quite a bit then, but still had not completely cleared.

I went through the purging at that time, so did not have that happen when I started the Accutane.

I should be done at the end of the month, and that's running a bit over the 220mg/kg goal. I plan to run 5mg of the Tretiva brand after for maintenance, at least for some time.

Edit: I just realized I ordered more 40mg with a bunch of other items that is due to arrive shortly. Have to decide if I just want to hold it just in case whenever I can run a cycle again or run this course out further...

 

[2ndchancesNK]

I started Accutane on Sept 1 of 2025. I had been prescribed an antibiotic before that as I finally had enough and opted to see a dermatologist. They put me on the antibiotic and a cream and a gel (tretinoin and dapsone) which was stupid expensive and not covered via insurance. My skin improved quite a bit then, but still had not completely cleared.

I went through the purging at that time, so did not have that happen when I started the Accutane.

I should be done at the end of the month, and that's running a bit over the 220mg/kg goal. I plan to run 5mg of the Tretiva brand after for maintenance, at least for some time.

Holy shit dude, big time congrats! Reaching that 220mg/kg over 5 months takes some grit and steel balls for sure.

I’m halfway through week 10 and the results are really starting to hit for me with noticeable weekly changes. I unfortunately had a few spots pop up in problem areas on my face in the first month and thank god those are beginning to fade out with nothing new appearing. I’m looking forward to the next 6-8 weeks and finally dropping down to that 5-10mg daily dosage for awhile.

Sorry if you mentioned it previously, did you run Tretiva throughout or Accufine? I was considering ordering the Tretiva because in the grand scheme of things, the drug is already so damn cheap.

 

[AllbrandNew]

Holy shit dude, big time congrats! Reaching that 220mg/kg over 5 months takes some grit and steel balls for sure.

I’m halfway through week 10 and the results are really starting to hit for me with noticeable weekly changes. I unfortunately had a few spots pop up in problem areas on my face in the first month and thank god those are beginning to fade out with nothing new appearing. I’m looking forward to the next 6-8 weeks and finally dropping down to that 5-10mg daily dosage for awhile.

Sorry if you mentioned it previously, did you run Tretiva throughout or Accufine? I was considering ordering the Tretiva because in the grand scheme of things, the drug is already so damn cheap.

I should have outlined that, so thanks for asking. I ran the Accufine for the course and opted for the Tretiva for the maintenance since at 5mg it was almost like getting the 40mg Accufine for 1/2 price and each box will last way longer at the maintenance dose. Per mg it sure isn't cheaper but that was my dumb logic for changing lol.

You'll absolutely be happy with the results as they come. The girls have commented on how soft/smooth my skin is (aside from the dry spots that popped up here and there) and I was only using moisturizer at night and after a shower. The bulk of the face dryness went away about 2/3 of the way through the course, which was a surprise to me.

 

[2ndchancesNK]

@JustJake That’s basically the approach I’m taking. Get to that 120-150mg/kg range and then coast for a couple months at low doses.

Don’t get me wrong guys, the 100-200mg range is great for building the cumulative dose quickly, but it requires a bit of pain and suffering along the way. That’s why I seriously commend @AllbrandNew. Doing the math, I would need another 15-20 weeks to reach 220mg/kg and I seriously don’t think I could do it.

 

[Photon]

can accufine/accutane be frozen? Left some in the car for about 6 days, it probably froze since most other things i had in there did? Is it still good @Ghoul

Yes
You can store them in the freezer

 

[adrenalytic]

@JustJake @AllbrandNew @2ndchancesNK

So I don't normally get pimples. It's only on cycle with harsh DHTs. I've been wondering, assuming full course of 220mg/kg, will I have to deal with dry skin for life when off cycle or does sebum production normalize whether on or off cycle?

 

[2ndchancesNK]

@JustJake @AllbrandNew @2ndchancesNK

So I don't normally get pimples. It's only on cycle with harsh DHTs. I've been wondering, assuming full course of 220mg/kg, will I have to deal with dry skin for life when off cycle or does sebum production normalize whether on or off cycle?

Most reports I have read suggest that your skin will become less dry in the weeks following the end of your accutane course. I suspect AAS usage and particularly DHT’s in general will play a role in increasing sebum production, but I think your skin will still be all around less oily to a degree.

Given our AAS usage, we definitely fall into the group with a higher risk of relapse. That’s one thing for certain. If you do a deep dive, women with PCOS are likely to need multiple courses of accutane given their hormone imbalances, which is exactly what we are doing to an extent, just on a voluntary basis. I have read anecdotal reports of people running across dry spells every once in awhile, in particular with the lips.

 

[AllbrandNew]

@JustJake @AllbrandNew @2ndchancesNK

So I don't normally get pimples. It's only on cycle with harsh DHTs. I've been wondering, assuming full course of 220mg/kg, will I have to deal with dry skin for life when off cycle or does sebum production normalize whether on or off cycle?

I know I can't answer that with any certainty, but if it helps in any way: I was on about a gram of gear for a chunk of my Accutane run and it made almost no difference to my skin. My hair got that dry, coarse feel, but skin was no more or less dry/oily on or off more gear. My skin currently on 120mg is only a tiny bit dry and I'm running 140mg Test only for the time being. If it stays this way forever I wouldn't mind as it's really mild this far into the treatment.