Hi there! Thanks for coming to my page. I recently decided to start a blog to, initially, document the crazy dreams I’m having as a result of taking Claravis (accutane). But…I decided to make it something a little more. I figured, while I’m typing, I might as well document my progress or set backs as I go, so I can really understand at the end of the treatment just how far I’ve come. And, while I’m at it, maybe I can help someone else who’s making their decision on if accutane is right for them or not.
There’s a lot to consider – your current health, the severity of your skin issues, what you’ve done already to combat those issues, and if you’re prepared to take on “the storm before the calm,” as I say. I’m going to start at the beginning with all four of those things.
My current health: A previous health issue has me taking double the birth control of a “normal” person. I have a hormonal IUD and I have to take a pill as well. While many women see their skin clear with taking birth control, I saw the opposite happen. I’ve never had “good” skin, but with the medication I was on, I began seeing “hormonal” acne. We’ll get to that in a minute. While I have my hormone issues, I’m currently really an otherwise healthy person. My labs are pretty on-point and I try to eat pretty healthful meals.
My skin issues: As a teenager, I had bad acne all over my face. I’d scrub my face (bad!) and use prescription differin gel from my dermatologist and I never saw relief. Nowadays, I rarely get your typical t-zone pimples. Instead, along my jaw line, neck, scalp and behind my ears I get constant cysts and rash-like pimples.
What I’ve already tried: I used to think my skin was soooo oily – and would treat it with harsh alcohol-based products constantly until I went to the spa for a facial one day. The esthetician looks at my skin with her magnifying glasses and says, “you know your skin is bone dry, right?” I told her no way – it’s DEFINITELY oily. I’m constantly having to blot my face at work. She tells me that’s NORMAL! Everyone should and does experience that – and I wasn’t helping my skin by what I was putting on it. After that, I began to use, again, terrible skin care products that promise to moisturize without making the skin oily. Well, that took me to the other extreme.
I finally went to the dermatologist after webMD told me that I had skin cancer (I didn’t – thanks webMD) to have a skin check. After the “no, Kieran, you don’t have skin cancer” conversation and the “stop using google to self-diagnose medical conditions” conversation, I showed her a recurring cyst behind my ear, which led to a conversation about the hormonal acne. She put me on doxycycline – which was great for my rosacia/redness, but didn’t clear up the acne. She also put me on sulfacleanse, which is a prescription based body wash, and that actually made my skin worse!
I took the doxycycline for a long time and decided that since it wasn’t helping the acne and also makes birth control ineffective that I needed to try something else. One of the options she mentioned was accutane. She explained that accutane here in the US is off the market – but it was voluntarily taken off the market as it couldn’t compete with the generics the US has. There are rumors it was taken off the market due to it being deemed unsafe, however this isn’t true and it’s still available in many countries. The generic she’d put me on is called Claravis, and is 100% identical to the name-brand Accutane.
The Storm before the Calm: Accutane is a commitment for sure. It causes severe birth defects, and therefore you must enroll in a program called iPledge – a pledge to not get pregnant.
First and foremost: you must commit to using two forms of birth control, one of which has to be a barrier method. So, even though I have an IUD and I take the pill, since neither one of those is a barrier method, I had to make a documented promise to use condoms as well. Also, natually, you must receive not just one, but two negative pregnancy tests that are 30-days apart before even beginning the program.
You must also have a blood liver-panel done every 30 days (accutane is absorbed through the liver) and have to take an online quiz (that asks you simple, silly questions like,”you come home from a night of partying and your partner wants to have sex. You realize you don’t have condoms. What do you do?”). The prescription is only given 30 days at a time – so if at any point you fail to meet any of the mentioned requirements, you cannot get the next 30 days of medication.Oh, and you have to pick up the prescription within 7 days or you have to start. all. over.
Since accutane is absorbed through the liver, you also have to watch your alcohol intake. Not a problem for me – I’m not one of those moms who can’t live without their wine. In fact, I very, very rarely drink at home at all. My doctor also told me to take the medicine very day with a meal that has at least 20 grams of fat. At first, I assumed that was maybe because taking it on an empty stomach would cause cramping or sickness – but this is another mistruth. Taking the medicine on an empty stomach makes it harder for the body to absorb the medicine. The more fat, the easier and better it absorbs. So if you’re on accutane and aren’t seeing results, think about what sort of meal you’re taking it with. I told my doctor I’m sometimes on the go, and she said in those cases, do a celery and peanut butter type snack to help the absorption as much as possible.
The last thing that you must know before starting is that before your skin gets better, it will get bad. Real bad. Your body will dry out – everywhere! Not just your face, but your hair, eyes, lips, and everywhere else too! So you must have products to prepare for this (which I will share!). Your body also has to “get rid of” anything it already has in it that accutane doesn’t like. So at some point, probably month 2, you will have a bad breakout that lasts for awhile. Prepare for this mentally. Keep your eye on the prize!
What got me here: I agreed to the Claravis (generic accutane) treatment. I was handed what looked like a magazine of disclosures and was made to watch a video or two about pregnancy prevention (yes, 5th grade sex ed all over). I had to read several pages in the book I was given and sign several carbon copy pages. I was shown a special ID number on my book and was told to take a picture of it with my phone – you need this unique number to to pick up your prescription every month. It’s the way the pharmacy/insurance knows you’ve met all of that month’s requirements.
My doctor explained that I can’t start the prescription right away, since there’s a 30-day wait for two negative pregnancy tests. She told me to stop taking the doxycycline and the sulfacleanse immediately and gave me some sample tubes of acne cream to use in the meantime. She sent me to the lab to have my blood drawn and told me I’d hear back later that day if I was a candidate. Well, that didn’t happen. There were a few mix ups with my labs and I had to have them redone. Since there is a super-strict guideline about the 30-days-in-between-labs rule, we ended up having to push back my follow up a full week to meet the guideline.
That follow up came, had the bloodwork done again, and my nurse sent me online to the iPledge website to register (you have to register with a number you get via snail mail, so check your mail and don’t lose the letter!) and answer my first quiz. I passed – so I don’t know what happens if you don’t (second chance? no chance?).
I was told to pick up my prescription ASAP – again, if you don’t pick it up within 7 days, you have to start all over from pregnancy text #1 again. Well, unfortunately, I got a text from my pharmacy saying that my private insurance didn’t want to pay for the accutane. They needed medical documentation that it was a necessity before they’d pay for it and claimed that a doctor hired by the insurance company reviewed my prescription and couldn’t justify the insurance company paying for it. What?! I called the insurance company, the pharmacy and the doctor a billion times the next day. They wouldn’t speak to each other so I had to relay all the messages. The insurance company told my doctor to fax paperwork, which wasn’t going through for some reason, and then once they got it, they told me it was a 10 business day hold. What? I’ve only got 7 real days – no bueno. I called and managed to have my super nice nurse from my doctor’s office call the insurance and they were able to authorize it over the phone. I was able to start my prescription the next day.
And that’s where we begin…