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The first four days…

So here I am on day five of my accutane treatment. Day 1 was nothing, of course. No immediate side effects. So let’s start with day 2.

Day 2 (Thursday): It was hard to remember not to take the accutane in the morning with the rest of my medicine! I almost forgot it has to be taken with a fatty meal. But I caught myself and waited for lunch since my breakfast is usually just coffee. All day Thursday I was complaining that my hands were dry, not realizing that it was already the effects of just two pills taken, drying my skin.

Day 3 (Friday): I again took my pill at lunch. Hands were totally dry, but luckily my coworker had a hand cream that I borrowed/stole from her throughout the day. A little later in the afternoon, I had an itch right in my smile line on my cheek/near my nose. I scratched it. As I lowered my hand from my cheek, I noticed blood on my finger. This simple scratch had made my face bleed. I mentioned this to a friend of mine later that night, since she had taken accutane before. She reminded me that I needed to moisturize like crazy. This is when I connected the dots – my chapped lips, bleeding face, and dry hands were the dryness already taking place. I had no idea it would happen so fast.

Day 4 (Saturday): I woke up from three really crazy dreams.

Dream #1: I dreamt that my friends 2 year old daughter wandered off from the house. We looked everywhere for her and we just weren’t finding her. I was desperate in the dream, but was frustrated that my friend (the 2 year old’s mom) was so calm. Why wasn’t she upset that her daughter was missing? She kept saying, “Oh, she’s done this before. She’ll show up on the porch in a little bit.” I kept looking and wouldn’t give up, even if my friend was so calm. Eventually, the baby showed up on the porch. My friend had a satisfied smirk on her face. “I told you she’s done this before.”

Dream #2: There is a sushi bar in my hometown that is on the 2nd floor of an old building, so the stairs are pretty steep and uneven. In my dream, I was going to go get sushi. But in place of the normal staircase was a ropes course. I couldn’t get up to the sushi bar no matter how hard I tried. I kept falling over and over again, and everyone else was completing the course with ease.

Dream #3: I was invited to a Lularoe party (insert eyeroll here). I hate these things, but for some reason in the dream I wanted to go because food was provided. I went, I ate my food, and then snuck out without being pressured into buying a billion dollar pair of leggings that will rip in 3 wears anyways. As soon as I snuck out, I remembered that I left my golden crochet hook at the party. I had to figure out a way to sneak back in, then out again, without buying any leggings! By the way, I don’t crochet. Well, to sneak back in, guess what I had to do!? The ropes course from dream #2!! Needless to say, I woke up before I ever got my hands back on that golden crochet hook again.

Pretty weird. I’ll post tomorrow about the weird dreams I had last night..this was a side effect I didn’t know in advance, but from my google searches, crazy vivid dreams are somehow connected to accutane.

I did make a point to go out and buy a TON of products to moisturize my skin. I’ll post about them in a couple days 🙂

 

 

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The beginning…

The road leading to the decision to start accutane.

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.

acneacne2

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…

Shower Products and Routine

Hi all! I wanted to share what I’ve been doing at night (and will also share what I’ve been doing in the morning) now that I’m a little over a week in. I did a lot of research before investing in products and honestly–I started out by throwing out anything in my bathroom that is alcohol-based or contained a lot of gross ingredients. I did this because:

a) it needed to be done. All girls know you collect gift lotions and shower gels and rarely are able to use them all.

b) I didn’t want to be tempted or lazily use a product that will be harmful or dry out my skin

I also subscribe to Sephora Play (which is like a Birchbox) and made sure to update my settings to reflect dry skin so I can try out new products each month. I’ll keep you updated on those!

Okay, so heres what I’ve been doing – and don’t wait to start this routine. Start it as soon as you begin the accutane, so you are ahead of the dryness!

I’ve found that the Cetaphil cleanser doesn’t do much for removing eye make up, so I start out in front of my mirror with a cotton ball and Yes to Coconut Ultra Hydrating Cleansing Water. It’s gentle for eyes and gets the make up off pretty easily. This product you can get at really any drugstore, but you can get it online here. The appeal to this product for me was how not only is it a make up remover, but it actually helps to moisturize your skin.

Cleansing Water

Next, I take a shower. This took a couple days to get used to, as I’m typically a morning-shower-person, but I felt like taking the shower at night really set the pace for a new routine that I’d stick to.

A lot of people who use accutane report hair loss or thinning hair. This is likely due to the hair drying out and breaking off. So, it’s important that you keep your hair hydrated. I did a lot of research on this one. I landed with OGX brand Renewing Argan Oil of Morocco Shampoo and Conditioner. Again, products you can get at any drugstore, though here is the link for the shampoo and here is the link for the conditioner if you want to buy online.They’re both sulfate-free, so if you have color treated hair like I do, they won’t mess with that.

Note: There is a version of this shampoo/conditioner that is the “hydrate” version – probably smart to get that one. I started with “renewing” because I felt I already have some hair damage that needs addressing.

Shampoo and Conditioner

When I’m in the shower, I go ahead and wash my face. Any one you talk to who’s been on accutane typically swear by 3-4 products. One of the common ones you hear about is Cerave. It is a hydrating cleanser formulated by dermatologists for severely dry skin. There is a foaming version of this cleanser too, but from my research I’ve found that the foaming version isn’t as strong of a hydrator. And again, this product can be found anywhere, but you can get it online here.

Cerave

Okay, one last product I use in the shower, and this is one I could NOT find in a regular drug store. It is a Dead Sea Mineral Mud Soap Bar. It is chemical-free, organic, natural and contains activated charcoal and essential oils. For the animal lovers, this particular brand is also cruelty free and vegan.

The reason I went with this particular soap is that it’s formulated to help with acne AND dry skin – but also it’s formulated to help with redness/rosacea, which is one thing the accutane does NOT help, but I do have. When I use this soap, it leaves my skin feeling SO soft and replenished. LOVE IT! Again, I haven’t found it anywhere locally, so I bought it online here. I almost went with a more-expensive version of this bar from Sephora, but I noticed it wasn’t formulated specifically for dry skin so I went with this one.

Dead Sea Soap

I will say one thing I am MISSING from my shower routine since I started peeling is some sort of gentle exfoliant. Once I have that figured out, I’ll make sure to share. I know when you are on accutane, you need to avoid any sort of micro-derm type exfoliator as you will easily scratch and/or damage your skin. If anyone has any recommendations, please let me know!

 

 

 

Days 5-8

Day 5 (Sunday): Nothing crazy to note here, except continued crazy dreams. One was a dream about a school shooting I was trying to prevent (unsuccessful – no one believed me). I remember seeing this guy planning it, not trying to hide it. My strategy was to be on his good side, without being an accessory. I would babysit his younger brother, thinking if the brother liked me, I’d be spared in the shooting. I saw the shooter at school that day and he had an umbrella with a duckhead for a handle. We had a firedrill, which was a part of his plan. As everyone evacuated the school I was trying to discreetly warn every teacher, every adminstrator to get everyone far away from the school as fast as possible. That umbrella was actually a gun, and no one believed me. I woke up before seeing anything terrible.

On the other side, my other dream was about April the Giraffe. You know, the Giraffe that’s been pregnant for a million years. Even though the zoo she’s at promised they would not intervene with letting nature take its course, the zoo forgot they were on camera (they have a streaming video to YouTube) and began to “secretly” induce labor–yet everyone saw it happen on YouTube. Outrage ensued.

Day 6 (Monday): Woke up from another vivid dream of being very, very pregnant (I AM NOT). I would look down at my stomach and see a literal outline of a baby foot sticking out my side. Let’s not talk about that dream anymore 🙂

This is the first day I’ve noticed actual skin peeling/flaking off on my face, specifically my nose and forehead.

Day 7 (Tuesday): Yay! First day without waking up from weird dreams. I’ve still got some peeling going on on my forehead and nose.

What’s new is that the part of the sides of my nose that attaches to my face next to the nostrils (does that have a name?) is BURNING and ITCHING BAD! I put some product on it throughout the day. I’ll share my products later. Also, I feel like I’m seeing some improvement in my skin. While I do feel like I have a couple budding cysts on the sides of my chin, what was visible is clearing up really well.

Day 8 (Wednesday): The side-nostril action is worse! SO ITCHY! I also have some itchy patches on my scalp. I’m so glad I started my moisturizing plan early – cannot imagine what it would be like if I hadn’t.

One other thing I didn’t know to be prepared for: inner ear dryness and itch. DO NOT USE QTIPS! You need every bit of wax you can get inside your ear to combat the dryness – you can’t put moisturizer in there! My ear is flaking skin and I gave in and used a Q-Tip to itch the inside of my ear. Made it SO much worse. Learn from my mistake! Also – don’t use any drops that have alcohol in them!

Okay – stay tuned. I’m going to share the products I’m using to hydrate my skin and my routine.