This is the before Accutane, and this weeks progress side by side for a better look at the progress:

Before - Start of 1st week Oct. 17,2004 -  60mg/day of Accutane.

4th week Nov.15,2004 - 60mg/day & 1st steriod injections and prednisone treatment.

(His left side seems to be clearing up faster than the right side at this point, but looking better!)

14th week January 25, 2005 - Increased to 80mg/day 9th wk, & 2nd steriod injections & prednisone treatments -

(Still many red marks to deal with, but no new breakouts for over 3 weeks. Keeps getting better.)

 Happy New Year's David, you look marvelous !!!   love, Mom

Week 1-

Today (Oct. 17, 2004) my son has used Accutane for his 3rd day. He is now just beginning to feel a little dry. His blood test were very good. Not a whole lot to report at this time. He is taking 20mg Accutane at night, and 40mg at day. After days of research, and weighing the benefits to the possible side effects combined with the fear of further permanent scarring, I agreed to have my son use accutane. I will be posting his progress weekly along with my personal feelings on his behavior changes if any. For now he seems very optimistic and happy. Unstead of him hanging out in his room unseen until dinner time, I am noticing him socializing with us more. He is watching TV with US, and even doing his homework in the living room!!  I feel maybe he is responding to our concern and help in following thru with an acne treatment that will hopefully prove to work. He will also be setting up a personal web-site. He has agreed that sharing his personal feelings, and experiences could help others. I'll keep you posted.  

His daily routine from the first day is:

•  Carmex Lip Moisturizer w/ Sunscreen SPF 15 - 24hours a day, 7 days a week
•  Neutrogena Oil-Free Acne Wash "Pump", (our dermatologist said NOT the BAR)- wash 2 to 3 times a  day.
•  Neutrogena Sensitive Skin Sunblock SPF 35- while outside in the sunlight. Our dermatologist recommended (Neutrogena Sheer SPF-45), however, we haven't found it yet.
•  Curel Healing Moisturizing Lotion -  On body and face.
•  Vitamin "E" 400iu - 1 per day to help the healing.

Week 1 Pictures:

Inflammatory Nodule (Cystic) Acne

This developed over a 1 year period of time using over the counter acne products and topical gels. The scarring under the right ear is one of the scars that will remain.

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Week 2-

Oct. 28th, 2004. My son has been using Accutane for 2 weeks now. He is noticing alot of dryness on his lips and cheeks. He continues to use Carmex and Vasoline around the clock to help prevent his lips from cracking. His entire body is becomming itchy, and he is noticing some dandruff.  So far his acne seems to be about the same. I see he has lost some of the redness on his face. As far as his mental attitude, he is still in good spirits, and continuing his daily routine faithfuly. Due to some further research on help from other patients that have used Accutane, he will be adding to his routine some periodic oatmeal facials and baths. I'm told this is helpful in soothing itchy skin. I'll keep you posted on it's effectiveness with the itching.

His daily routine, week 2:

•  Carmex Lip Moisturizer w/ Sunscreen SPF 15 - 24hours a day, 7 days a week
• Neutrogena Oil-Free Acne Wash "Pump", (our dermatologist said NOT the BAR)- wash 2 to 3 times a  day.
•  Neutrogena Sensitive Skin Sunblock SPF 35- while outside in the sunlight. Our dermatologist recommended (Neutrogena Sheer SPF-45), however, we haven't found it yet.
•  Curel Healing Moisturizing Lotion -  On body and face.
•  Vitamin "E" 400iu - 1 per day to help the healing.

These were added to his routine this week:

• Oatmeal facials and baths (once or more a week) to sooth the itching.
• Icing his face after cleansing for a couple minutes to close up the pores.

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Week 3:

Nov. 4, 2004. This was an interesting week for my son. He first off wanted me to remind every one to "NEVER FORGET YOU LIP BALM". He has become so dry now, that just one day at school with out his lip balm he became very uncomfortable and noticed his lips hurting. His face & elbows are very white when he wakes up from the chapping now and he is finding himself using lotion alot more frequently. The oatmeal facials & baths are soothing to the skin, but only for a short time. The exciting news is that although he had a few new boils in the beginning of the week, his overall acne is looking about 30% better !!!! (I will be downloading some new pictures soon). As far as side-effects go, he has experienced only the dryness. He claims to feel great, and continues to be in good spirits. Since the vitamin E (1 pill @400iu) has not caused any nausia, I think I'll have him increase it to 800iu, (2 pills-1 i@ morning, and 1 @ dinner). I read in many places now that 800mg of Vitamin E is very helpful. I'll keep you posted on his progress. For now, we are both feeling good about his Accutane treatment and hope the side-effects remain minor.  Well, that's about all I can think of to report this week. Good Luck to all you out there!!!

His daily routine, week 3: ( Increase Vitamin "E" to 800iu's)

•  Carmex Lip Moisturizer w/ Sunscreen SPF 15 - 24hours a day, 7 days a week
• Neutrogena Oil-Free Acne Wash "Pump", (our dermatologist said NOT the BAR)- wash 2 to 3 times a  day.
•  Neutrogena Sensitive Skin Sunblock SPF 35- while outside in the sunlight. Our dermatologist recommended (Neutrogena Sheer SPF-45), however, we haven't found it yet.
•  Curel Healing Moisturizing Lotion -  On body and face.
•  Vitamin "E" 400iu - 2 per day to help the healing, 1 @ morning, & 1@ dinner.
• Oatmeal facials and baths (once or more a week) to sooth the itching.
• Icing his face after cleansing for a couple minutes to close up the pores.

Week 4:

Nov. 12, 2004. This week was not a great week for my son. First, there has been a Warning out about using Vitamin "E" while on Accutane, claiming taking Vitamin"E" with Accutane can offset the results of Accutane. My son has been taking 400IU's from the start, and I just increased his up to 800IU's this week. When I was informed of the controversy, I immediately called his dermatologist. She was not aware of such warnings, looked into and called me back. Her reply was 400IU's a day would be just fine. Many accutane patients have been using Vitamin"E" to help in the healing (my understanding). Our support group has been involved in finding out more information, some of them spoke with their dermatologist, and there was a varity of recommendations. Some derm.'s said Vitamin"E" makes no difference at all with the treatment. Some said 400IU's every other day. Some said 400IU's every day. So with that, we are more confused than ever. It is important to these acne patients that their treatment is sucessful as possible. The worries of the unknown is stressful as it is for these patients. They are all attempting to gather the most helpful advice they can in order to achieve the best results. Such controversy is fearful! My best advice in this matter is talk with your dermatologist, get answers and assurances from your dermatologist. Each case is different, each patient is different. For my son, I am seeing results this 4th week, yet we both are aware the ever dreaded breakout can occur any day now. I am keeping my son on 400IU's a day (instead of the increased 800IU's) as recommended by his dermatologist.

Last bit of worry. My son just realized he will be out of Accutane on Sunday. His blood test are not scheduled until Friday, since the appointment with the dermatologist isn't until Nov. 18th. It takes 3-4days to get the blood test results back. A calculating error by the appointment desk! My son is very un-comfortable with this, since he already is not satisfied with the speed in seeing results. He will be without Accutane for several days. Nothing like adding stress due to the carelessness of the appointment desk, and my not catching it! You can imagine it will not happen again, I just hope my son suffers no consequenses due to this. NEVER ASSUME ANYTHING!!!! I assumed the appointment desk could count 30 days!!! WRONG!

That's my update this week. I will try to load some new pictures soon. I do see results. I think maybe for my son it's just not fast enough.

His daily routine, week 4: (  Vitamin "E" to 400iu's)

•  Carmex Lip Moisturizer w/ Sunscreen SPF 15 - 24hours a day, 7 days a week
• Neutrogena Oil-Free Acne Wash "Pump", (our dermatologist said NOT the BAR)- wash 2 to 3 times a  day.
•  Neutrogena Sensitive Skin Sunblock SPF 35- while outside in the sunlight. Our dermatologist recommended (Neutrogena Sheer SPF-45), however, we haven't found it yet.
•  Curel Healing Moisturizing Lotion -  On body and face.
•  Vitamin "E" 400iu - 1 per day to help the healing (See my post! There is some controversy on this)

Week 5 -

Nov. 19, 2005 - Well, yesterday was my son's appointment. His blood test were ok, but his cholesterol levels are climbing from 159 last month to 205 this month. Putting him on the borderline risk factor. With that, a low cholesterol diet is in order. Many said eat oatmeal & cheerio's for breakfast and drink green tea. (de-caf). His dermatologist gave him 6 steriod injections in the larger cysts. I didn't like watching, I could see the pain. She also put him on 10mg / day for 10 days of prednisone. His acne is being a bit stubborn, yet I can see results already. She is also keeping him at 60mg of accutane this month since he is taking the prednisone.

My son's behavior is still a bit apprehensive. He is wishing it gone yesterday. He is willing to suffer what ever side effects and pain is involved to have success in getting rid of his acne once and for all. I see no evidence of depression other than the anxiety of still having acne.

Side effects to date:

Dryness of lips, face, elbows, and knees - so far the Carmex Lip Balm & Curel sensitive skin moisturizer is helping.

Itchy dry scalp. His derm. prescibed "Derma-Smooth/FS", it's to be rubbed in the scalp at night time, and washed out in the morning. You wear a shower cap through out the night. My son liked that idea. Figured keeping his hair off his face would be helpful. Other people thought T-Gel was also effective for dry scalp.

Daily Routine - same as Week 4-

No changes other than taking prednisone for 10 days & using Derma-Smooth for 10 days for his scalp.

Week 6-

Nov. 26, 2004- This was a remarkable week! The steriod injections combined with the 5 days of 10mg/day of prednisone did wonders on those large cysts my son broke out with 2-1/2 weeks after using accutane. The cysts are nearly gone, just red marks were left behind. He hasn't shown any signs of new breakouts this week, I pray that continues to stay the case. The Derma-Smooth/FS shampoo treatment completely cleared his dry scalp. He is very happy with the results. The even better news is that he is eating his oatmeal every morning to help lower his cholesterol. He is concerned about being taken off the accutane if his cholesterol levels continue to climb. As I'm studing cholesterol and triglycerides, I am realizing just how poorly I am feeding my family. I will be adding a page focusing on proper diets & lowering cholesterol and triglycerides shortly.

Side Effects-

Nothing new to report. The dry scalp is under control with the help of the Derma-Smooth/FS treatment. Still very dry around the mouth. The Cetaphil seems to be keeping it from itching.

Daily Routine- (same as Week 4)

•  Carmex Lip Moisturizer w/ Sunscreen SPF 15 - 24hours a day, 7 days a week
• Neutrogena Oil-Free Acne Wash "Pump", (our dermatologist said NOT the BAR)- wash 2 to 3 times a  day.
•  Neutrogena Sensitive Skin Sunblock SPF 35- while outside in the sunlight. Our dermatologist recommended (Neutrogena Sheer SPF-45), however, we haven't found it yet.
•  Curel Healing Moisturizing Lotion -  On body and face.
•  Vitamin "E" 400iu - 1 per day to help the healing (See my post! There is some controversy on this)

Week 7-

Dec. 5, 2004- Well I knew I should not have mentioned no new breakouts. My son had a new cyst this week. The largest yet. He was so upset, he asked (commanded) me to take him to the derm. that day and get another injection. I explained the prednisone should still be working through his blood system and all should be ok. Wow, luckly the cyst started to shrink down the next day, and by the 3rd day all that is left is the red mark. My new concern is his tiredness, lack of strength, and pains. He was out snowboarding for practice, and took a spill. He mentioned he didn't have the strength to control the icy conditions, and didn't hit the ground very hard. He couldn't figure out why it hurt so bad. He could barely walk. Many patients in my support group sware by MSM for body aches. I'm going to have my son try it. These people checked with their derm.'s, and said it was ok to use MSM while on accutane. I will check with my son's derm. as well.

Side Effects to date:

Chapping around the mouth & Lips.(Week 1)- Cetaphil is helping on the face, Carmex w/sunblock on lips.

Dry scalp (week 5)- Derma-Smooth/FS shampoo (prescription) worked wonders. I'm told T-gel is good also.

Fatigue & weakness (week 7) - Lots of water, and will try MSM

Behavior (week 7) - A little short fused. Frustration and anxiety due to new breakouts and fear of having to stop the accutane treatment. Tired.

Daily Routine: (same as week 6, adding MSM for this week until his body starts adjusting to the accutane) I'll keep you posted. I'm told about the 3rd month the body starts adjusting, and some side effects will reduce. Also Advil as needed for the immediate pain after falling.

Week 9-