Isotretinoin (a.k.a Accutane)

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After a 15+ year war against acne, I have finally raised the white flag.

A few weeks ago, I started Accutane.

Actually, technically Accutane is a brand of isotretinoin which is no longer on the US market. Isotretinoin is the generic form, and there are now several other brands available. A few weeks ago, I started Amnesteem.

Isotretinoin (still most commonly known and referred to as Accutane) is a pretty serious drug. It is known for these things: you ARE NOT ALLOWED to get pregnant while taking it, it can cause severe depression (including thoughts of suicide), and it can permanently cure acne. Forever.

Acne has cursed me for many, many years. I have tried almost every kind of over-the-counter, all-natural, and extreme prescription treatment available, even including lasers, light therapies, chemical peels, microdermabrasion, dermaplaning, micro needling…you name it, I’ve tried it. Except for isotretinoin.

You see, isotretinoin is widely known for its scariest side effects: those of severe birth defects and those of severe depression. While becoming pregnant is not exactly a concern of mine for a number of reasons, if you’ve glanced at the About section of this site, you may already know that mental health is one of the most important parts of life to me. It’s something I take extremely seriously, and is also something I have personally struggled with for a mentionable portion of my life. In fact, maintaining positive mental health is the primary reason I have become so dedicated to and passionate about this healthy lifestyle that I strive to live and love to promote.

For that reason, alone, I have been so opposed to (read: afraid of) isotretinoin.

But, I recently stumbled upon an Instagram account of the isotretinoin journey of a girl who teaches at my favorite workout joint, and her story inspired me to give “Accutane” some consideration. I began researching it, learning more about it, reviewing other people’s stories and experiences on YouTube, blogs, and other sources online. All of it actually made me really excited at the prospect of a successful (and permanent!) treatment, easing my fears and even making me wonder why I’ve waited so long to consider it! (Fear, is the answer, which makes me consider all the other things I’d wonder why I waited so long to start if I wasn’t so afraid — but that’s for another post).

Since moving to Nashville, I’ve been to one dermatologist, who retired about a month after I saw him —  and that was about five years ago. Since then I’d been uploading pictures and checking boxes of concerns for a dermatologist through the YoDerm app, off and on, without a notable amount of success (obviously, or else I wouldn’t be considering isotretinoin). That relationship ended about a year ago, after a few months of tretinoin (basically, topical Accutane) was causing a very uncomfortable reaction on my face, and the last resort before Accutane (which I was very opposed to at the time) was Sulfamethoxazole (Bactrim), a prescription antibiotic which I picked up from the pharmacy but was too afraid to actually take after reading reviews of it online. In short, I’d have to take it long-term (I’m against taking any kind of medication long-term), it would be very harsh on my body (like those commercials where the side-effects of certain medicines are worse than the symptoms or diseases they’re meant to treat), and worst of all, apparently my acne would return with a vengeance if I ever stopped taking it — and if I was desperate enough to go BACK on the medication, apparently it wouldn’t even work anymore. Yeah. No thanks.

So that prescription has been sitting on the top shelf of my medicine cabinet for over a year, and I’ve cleaned up my diet again, started taking my exercise and skincare regimens more seriously, committed to more water intake and better sleep — but you’d never know any of that by the look of my skin. My body and mind have responded greatly — but my skin has had no response. If anything, it has continued to get worse. So, after dipping my toe into the world of Accutane, not only did I discover it isn’t nearly as scary as I’d thought it was, but it actually brought a warm ray of hope. I decided to take the plunge.

After googling dermatologists in Nashville, I chose the top-rated office that is also lauded for cosmetic dermatology (since I already know I’ll need help with scarring and discoloration after my isotretinoin treatment is over and would prefer to stay with the same doctor, since they’ll be familiar with my skin and treatment) — and its location is convenient to home and work (a very important factor with the increasingly horrendous traffic here in Nashville). I requested an appointment and was able to be seen within the week!

The days leading up to my appointment, and especially the day of, I was excited and nervous. Ultimately, by the time I went in, I had already made up my mind. When the nurse asked for my acne treatment history, I walked her through all of the treatments I’ve already been through — any I’d forgotten, she asked about, and I had tried it. It even surprised me how many failed attempts I’ve had at treating my acne over the years, running through it all in one 3-minute conversation. When the doctor came in, after discussing my history with the nurse, I almost started laughing when one of the first questions she asked me was, “Has anyone ever talked to you about Accutane?” (She did refer to it as Accutane, but I knew that was because most people are familiar with “Accutane,” not “isotretinoin.”) I smiled, somewhat relieved, and told her that was why I was there. (I was a little afraid she would want to try all of the other options with me herself, first, before deciding isotretinoin is a good option for me).

After looking at my skin and reviewing my treatment history, I think it was pretty obvious I’m just about the perfect candidate for isotretinoin, with my severe cystic acne that has been unresponsive to other treatments. She talked me through the treatment program, explained all of the side effects, asked about my mental health history and that of my family, we went over the requirement of two forms of birth control and the iPledge program, and she gave me a lab order for initial blood testing. I signed all of the paperwork promising to use the two forms of birth control and to not get pregnant, not to donate blood during the treatment, not to share the medication, etcetera. I took my first pregnancy test, she enrolled me in the iPledge program, and the 30-day waiting period began.

A welcomed wave of hope embraced me. Within a few days, I had my blood tests done and sent back to my dermatologist, and since I’d booked my follow-up for exactly thirty days later before leaving my initial appointment, I spent those next thirty days researching isotretinoin (borderline obsessively), learning about side effects, ways to manage them, the best skincare products and other Accutane survival tips (dry eyes, nosebleeds, humidifiers, etcetera). I researched how to take the medication for best absorption, how dosing works — I wanted to learn everything, to be the most prepared, and to have the best chance of a successful treatment!

From what I’ve read and seen from others, this won’t be an easy journey, but I have a lot of hope that it will well be worth it.

To follow my isotretinoin (Accutane) journey, subscribe to this blog and the Healthy Bitch YouTube channel!

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