My Acne Journey: Roaccutane Treatment! (Part 3)

As I ended last week, I ended up getting referred and seen by the dermatologist within the space of two weeks. I am so thankful the process was quick and painless and then to have all my treatment done privately was great, especially when I had a busy life with shifts and university. It meant it was much easier to select my appointments and also, the phlebotomist queue was always fairly short.

So roaccutane is somewhat of a last resort for acne treatment. It's drug name is actually, Isotretinoin and it is a treatment for severe acne that comes in capsules. It acts by normalising sebum (aka oil), preventing clogged follicles and reducing bacteria, redness and swelling in. It all sounds great, however it has a wide range of severe side effects and because of that, it require specialist prescribing and monitoring. On top of the usual acne treatment side effects, it also has the highest suicide rate of any medication with extreme depression, can cause sever liver damage and also has major risks in pregnancy.

At every appointment, I had to take a monthly pregnancy test. I wasn't sexually active, I was still a virgin and despite them knowing I was also training to be a midwife, this still wasn't enough. If I didn't have a negative test result, I wouldn't have got the treatment. You also had to sign an agreement at the start to ensure you were on birth control, with mine being abstinence. You're also told not to get pregnant until 6 months after finishing any treatment but after researching, I wanted to play it safe so I always said a year.

You also had to have regular blood tests. I had these on month 0, 1, 2, 6 and 9, then 3 months after finishing. This is mainly testing your liver function results as it can interfere with metabolism. If at any point in the treatment these were being affected outside the normal ranges, you would be taken off the treatment, or at the very least have the dose reduced. I was told at month 2 that they were suppose to be fasting but no one had told me that before so my results ended up being a little off as the first 2 were not fasting, however, by 3 months after they were back to month 0 levels so I'm hoping they're back to how they were. They were never affected outside normal range but did go a little lower throughout the treatment I believe. One of the things I did find frustrating was that they wouldn't tell you the full results; I'm sure for most people they don't really care but I was really interested so it was a little disappointing.

The dose varies and the maximum daily amount is equivalent to your weight, so mine was 75mg, but also you have a maximum total dose for the entire treatment course based again on your weight. These means that you can't be on the treatment indefinitely. However, you can have another course and restart the process in a years time. I started treatment slowly and worked my way up, which is the best way to find the working dose level. I know that a lot of people go straight to their highest for the fastest results, but that can also be the main reason for the side effects. My regimen went as follows:

  • Month 1 = 20mg 
  • Month 2 = 30mg
  • Month 3 = 50mg
  • Month 4 = 60mg 
  • Month 5 = 70mg
  • Month 6 = 75mg
  • Month 7 = 75mg 
  • Month 8 = 75mg 
  • Month 9 = 75mg
  • Month 10 = 75mg

Taking the tablets was probably the most difficult part for me and I don't take it for granted when I ay that. I know so many people really suffer and struggle through their treatment course. The medication varied in sizes so they ranged from 5mg, 10mg and 20mg tablets, meaning at the end I was taking 5 tablets with my evening meal.
In terms of side effects, I didn't have any side effects the first month and then the second month, I noticed I got really dizzy, had stomach cramps and got nauseous if forgot to take the medication with food and ended up taking them late. I often had to lie down in the middle of wherever I was (stairs, floor, bedroom) for a few minutes before I could function again when the wave passed. I quickly learnt that if I had forgotten to take them, to have a few biscuits with them instead, although after a few months, it quickly became the norm and routine.

Other than that, I got really dry hands during the time I was on placement. The wards were blisteringly hot and I was washing my hands constantly, especially the few weeks where I was always on inductions, so they did end up getting really hot. I invested in some hand cream, but at my next appointment, they also prescribed me Dermol Lotion 500ml. It was a huge bottle and can only be prescribed so cost £8.10 but worked wonders. I took it with my to community and luckily the hospital already had one, and then I used the other in my bathroom.

The other part of my body that suffered was my nose. My nose was always so dry and itchy and I still have no idea why. On the rest of my face, I used complete Senegence skincare, including Nangai Oil every evening to help with hydrating and scarring. I honestly swear by this product and although it may have prolonged my treatment course, I think it stopped me from getting the cracked super dry skin, which I was very thankful for.

Like I've said, I am very lucky that the drugs never affected my mood, tiredness, functioning ability etc. In fact, friends and family said that I got nicer but I think it's more so that I just got more confident in my own skin, which leads us to what everyone wants to know, the results!

I really didn't see any changes until month 3 when my dosage was upped to 50 mg per day. That is when I really started to suffer with the dry hands and nose, but also the outbreaks. They say it gets worse before it gets better and trust me, it does. I woke up one morning and had awful red, inflamed, cystic acne all over my cheeks. I remember wanting to call in sick to university and take a day off because I couldn't face anyone. Of course I couldn't, and I didn't but I wore about 3 layers of foundation and kept wafting my hair in front of me the rest of the day. I skipped archery for the entire week. But honestly, that was probably the worst of it. From there it got better and after a week, my skin was back to producing the normal acne. I had a few painful cystic ones over the next few months but not the covering I used to get.

Month 8 was just about to arrive and I was so excited to tell my doctor - actually I was seeing the nurse by this point - that I felt ready to come off it, when I got another breakout, almost as big. I had this conversation with her, and she agreed to stay on it for longer. The next month while I hadn't had big breakouts, I was still getting quite a few regular spots so I asked to stay on another month which she said yes to, but due to reaching my maximum dose, it would be the last. I accepted that and was hoping for the best.

Nothing much changed over the last month and I was actually quite disappointed because the results weren't what I was hoping, or expecting to be completely honest. When I explained this, she comforted me in the knowledge that over the next 6 months, the skin will continue to improve and scarring will reduce dramatically. I went away feeling somewhat sombre but hopeful...and she was right!

By 6 months completion, I hadn't had any spot at all for 2 months and now, just over a year on, I only get the odd spot every so often and it really it nothing major. With a little concealer and foundation it's completely gone and I couldn't be happier. I am so much more confident in my own skin. Whilst the last few months have been in lockdown, I've left the house with no makeup and never felt better. I have noticed a few more spots over the last few weeks but I think that's from poor eating, lack of sleep and somewhat because I haven't been wearing makeup, which means I constantly play with my face.

I would just add that about half way through my "recovery" time, I've started doing a thorough evening routine and using high quality skincare, which I think has also benefited the results too.

I know I had somewhat of an "easy ride" with my roaccutane journey but I think it's important to share this story - my story - because so many of the stories out there are heartbreaking and often off-putting. I just want to say there is hope at the end of the tunnel and not everyone's journey is a complete and utter nightmare. You're looking at someone who refused to take pictures for 5

I am a little disappointed that I never took before and after pictures but I do have pictures of me before WITH MAKEUP because I wouldn't take pictures without, and you can see all the bumps and lumps and sores all over my face, especially my forehead and chin. In comparison to the year after finishing photos which are both with makeup and without makeup.

I look back at the before pictures and it actually makes me so sad. That was a girl who hated everything about her face, she was in pain most days, struggling to sleep because her face hurt to lie on, and spent hours getting ready in a morning. I literally want to cry thinking of what I could have so much earlier, if I wasn't so scared of all the side effects and afraid of what others would think of me being so vain. Now, I look so much happier and I brush my hair out of my face...I even wear my hair up and out of the way, whereas before I used to use it as a curtain! Also, strangely I look less wrinkly...

Part Way Through:
End without makeup:
End with makeup:
Going into year 24 and I couldn't be happier with my skin right now. I'm going to share my some more skincare posts soon, including my skincare routine and also all about dermaplaning, which I've now been doing for the last almost 6 months too! Of course, the month of June is coming to an end and so is daily posts, so I think I will more than likely be going back to my 4 days a week posting instead so no Skincare Saturday's but I'm so thankful and proud to have shared my acne journey to date so far. 

Has this helped you? Have you used roaccutane? Are you considering roaccutane? Let me know in the comments below!