A few comments before I share my journey, please talk to your derm or specialist if you think you are eligible for isotretinoin/roaccutane. I can only speak for myself and share my personal experience.
Roaccutane is a VERY powerful drug. It makes your skin dry, your joints painful, dries out your pores/sebum, can create teratogenesis (defects in embryos) and can mess with your mental health, if you have a mental health history (I do). It’s not something to be taken lightly. Any form of Vitamin A should NOT be taken when trying to conceive, or while pregnant/breastfeeding and you shouldn’t get pregnant while on the medication. So monthly blood tests (to check your liver is working well) and pregnancy tests are essential. These are normally administered by your doctor depending on where you get this prescribed.
I got it prescribed in Greece but then had to do my blood tests, so my GP in London referred me to a dermatologist via the NHS, which is normally a very long process. While I’m incredibly grateful to get a referral so easily (for some people it takes months), I really hated going to the doctor. It felt impersonal and he didn’t take my mental health seriously. He even said “if you’re not suicidal it’s fine”, which is INCREDIBLY insensitive. Thankfully I have the support to take these comments lightly. As I mentioned in one of my monthly updates (below), my mental health was seriously affected. I have a history of depression and anxiety, which might be the reason why, but please don’t treat your mental health lightly when on the medication. It’s hard to know how much it’s really affected you, but it’s better to be careful and take note than not.
If you need support please speak to someone. If I can help, message me. Now let’s get on the monthly overviews, I started on 40mg.
SPF50 DAILY
Loads of hydrating products
Gentle cleansers
Lip balm! The only thing that ended up working for me was nipple cream (pure lanolin). Check you’re not allergic first! I didn’t really wear lipsticks, occasionally tinted lip balms.
I mention a lot of Cerave, because they are gentle, non-irritating and get the job done! If you shop via Look Fantastic, remember I have an (affiliate) discount on many brands, use LFTFFANI here. Check out my full routine and dermatologist’s recommendations on the piece I wrote for PopSugar HERE.
A good thing to remember: spots get worse before they get better. That’s normal! Don’t freak out, please! Believe me I know it’s hard and it can take a toll on your mental health.
A bit of peeling and itching started after 7 days. I somehow thought it would be a good idea to fake tan! Patchy skin hello. With some extra layers of my face cream the peeling was under control.
By week 2, I was itchy all over my arms, legs, and thinking it might be connected to the medicine. I ensure I use body cream nightly to combat this. I have also started to get dry eyes, which can also happen. I’ve been using sparingly an eye gel that’s very potent and apparently the only one that works in such a situation.
Within week 3 and 4, breakouts were going down, no new spots, not too much dryness. I had my first appointment with a dermatologist who discussed upping my dose next month. As dosage depends on weight, you can go up as long as a doctor suggests so.
Comparing my starting point with the end of month 1: my skin might not look clearer, but it certainly is. The reason for that the medication will bring *every*single*spot* to the surface, before the skin clears up. The thing is, I don’t mind this part of the treatment, maybe because I knew it was coming. The first time I went on this medication (in 2011) I wasn’t expecting it and it really affected my mood, psychology and mental health.
I’ve had my first blood test now, and seeing the doctor end of the month. After that the blood tests need to be done every 3 months, or sooner if the dose is increased. The reason for that is the liver processes the medication and it needs to be monitored to ensure everything works well.
A quick mention on the cost of accutane/roaccutane. Via the NHS each prescription cost me around £9, these were normally monthly prescriptions. If you are in the UK and don’t pay for prescriptions, you won’t have to pay for this one either. As a comparison, in Greece, each pack of 30 tablets costs €9+ depending on the pharmacy.
Month 2, I developed acute dermatitis (itchy rash) on the side of my arm. I reluctantly removed all jewellery (there was loads) and reminded myself to ACTUALLY moisturise my whole body every day. The cold in London does not help the situation here! Every sebum gland will dry up so taking care of your body is essential.
This month I’ve really noticed the drying, but not of the skin, lips mainly and the cold doesn’t help. But also my nostrils are so dry I almost get nose bleeds – I’ve got a moisturising nose spray that helps. My eyes have felt watery for weeks and I put drops a couple of times during the day. I’m not wearing lenses which would make it worse but they feel really dry as it is.
On month 2, I’ve been really thinking about the mental health aspect of roaccutane. I had a great chat with @raquelsmx on the subject who suggested I keep track of how I’m feeling each day particularly the “low” days. Not gonna lie, it feels like they’ve been loads this month but can’t be sure it’s down to the medication or a combination that includes the weather, work, etc. If you’ve felt the same please message me! It’s simply not discussed enough!
This month I saw the derm who upped my dosage to 50mg. The higher the dose, the worse the effects – so a little more drying than before etc. But you also finish the course quicker.
Apart from two spots on my right cheek not much has changed and last month’s breakouts are healing.
No major issues with the 50mg dose. BUT – My lips have been drier than before but I haven’t been as good with applying lipbalm through the day and I’ve also been picking the dry bits when I was feeling stressed which isn’t the best! Nostrils and eyes are good. I still apply eye drops but not as religiously as last month (4 times a day).
Mood wise I’m not in the best space of mind but let’s be honest, the whole corona situation isn’t the best for anyone’s mood so I wouldn’t be able to say if this has anything to do with the medication.
My muscles and joints (especially around my ankles) are still sore every day, constantly, but I feel it the most the moment I wake up and take the first steps. After that I get used to it and I think I’m more use to the general soreness. I free like a grandma!! I randomly found out my collagen protein helped me with my muscle pains!
A full month of quarantine (hey corona) and in mid-April I was told I can’t get another prescription. I know there are more important medications that people need and prescriptions that are life saving – BUT – I didn’t feel it was fair to cut my roaccutane course in the middle, with NO warning. The dermatologist told me that since the 27th of March they’ve stopped roaccutane prescriptions, they don’t know for how long. I know he probably has hundreds of patients, but I feel like I should have been informed at the end of March and not mid-April, a week before my current prescription finished. He said private derms can still give prescriptions, otherwise I should split up my medicine and make it last longer. So instead of 50mg a day, I should do 40mg.
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He also said my GP would prescribe me a cream – adapalene (a retinoid, which I’m very familiar with) to use topically. Obviously it’s not the same thing. I’d then have to go back to 20mg and slowly increase and my treatment would take longer, instead of being done in June.
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He didn’t tell me why they can’t give prescriptions. After a lot of stress I managed to receive some from my mum from Greece. While waiting I had to split up the pills I had, so for about a week I was taking 20mg and the last few days 10mg a day.
Joint pain remains and it’s a little worse. It could be because I’m exercising a bit more than usual. My nose has been unbearably dry!! Some days it was so painful and dry that it was bleeding. I think it’s due to hay fever and blowing my nose. Applying cream every night helped. My pigmentation is better this month, but the focus is of course on spots first, then pigmentation!
Because of the prescription issues last month, I was on 20mg for a few days before going back on 50mg. Going back on 50mg made my joints and muscles more sore for a few days. Now I’m back to the “normal” level of joint pain, which I feel mostly around my ankles when I stand up after sitting down for a long time.
I’ve changed derms though not sure how, my initial doctor ghosted me. He never showed up for my monthly appointment (done over the phone) but in the meantime I had an appointment with a different doctor at another hospital. She asked me to come in the hospital as I had to sign 3 different forms to ensure I understood that I shouldn’t get pregnant etc etc, to have a blood and pregnancy tests and get my prescription.
She said I got 2 full months to go, I thought it would be less, but essentially I’ll be done in mid-July. Hay fever isn’t helping my nose dryness but some days are better than others!
In theory I’m done this month, completing my full dose towards the end of July (on the 22nd). I didn’t think my lips could *be* any drier (in Chandler’s voice) and as much as I LOVE the sea, it doesn’t help one bit!
I now have to apply lip balm even more often and you might be able to see my lips have bled. Fun times.
Other than that I haven’t noticed any changes this month. I can’t wait to finish as I’m pretty certain it’s negatively affecting my mood and thoughts and overall mental health.
Also I got only one new spot, which I was quite surprised by, as I wasn’t meant to be getting new ones now. I’m thinking the sea/salt/spf combo is to blame but who knows 🤷🏻♀️
Since I’m back home, I’ve planned to see my dermatologist (the one who initially prescribed the medication) and I’m hoping she agrees I’m almost done. I also have a phone appointment with my London dermatologist towards the end of the month, though I’m not sure how she’ll be able to decide if I need to stop or not, without seeing me.
Happier, glowier, a new spot has popped up the day I was finishing my medication but thankfully my doctor said it’s fine and no need to take any more!
As I said last month, my lips were suffering!! You can see the blood on the left photo (From July). The only thing that helped was pure lanolin from the pharmacy which is often used for sore nipples!!! Well it worked a treat.
Nostrils also super dry. I don’t wish this upon anyone! So uncomfortable.
I had someone ask me about my joints and I think they are much better, not as sore and painful as in the past few months. They still hurt a bit (especially my ankles) when I stand up after a long period of sitting.
My mood is certainly better but I know for a fact it’s because I’m back home in Greece that I’m overall happier. Try it! 100% money back guaranteed
As you can see in the close-ups my pigmentation around my mouth is getting better. That stupid mark next to my nose is SO slow to fade, but otherwise, it’s all good.
