Hey, lovely people, I’ve really been slacking on the accutane updates – which, in a way, is a good sign.
Things have been a lot more positive for me since my last update, meaning I’ve been spending a lot less time on my laptop and more time catching up on all the things I didn’t do last year.
But yeah, it’s January 2025 (happy new year my friendddds) and I’ve been on my second course of accutane for almost 8 months.
(If you’re wondering why I decided to do another course, check out this blog or read my two month or four month update).
The side effects are still side-effecting, the dehydration is dehydrationing, but, on the bright side… the skin is skinning (wow, for a thirty-year-old, that was very Gen Z of me.
So let’s jump straight into the accutane deets, including why I switched providers:
My dosage
I’m still on 40mg accutane per month. For my weight (I hover around 62kg), that’s an average dose. Not too low, not too high, meaning I’ve got tolerable (but still not ideal, ha) side effects.
In my last check-up, my dermatologist (the amazing Dr Sree at SkinDoc) said we’d stick at 40mg unless I continue to get closed comedones. If they don’t budge, we might consider going up to 60mg.
My side effects
The side effects are largely the same – dry skin, dry lips, tiredness – so I won’t bore you going through them all individually.
Thankfully, the infected fingernail issue I mentioned in my month four update has completely subsided. It was so weird – I had them for a month straight, migrating from finger to finger – and then they just disappeared. Dr Sree said it’s a known side-effect of accutane, so I felt reassured that there was at least a cause for it.
For the past couple of months, the dry skin has turned into more of an eczema-like problem, particularly on my arms and hands. It’s manageable though, and if I keep on top of moisturising, it doesn’t get too bad. Is it just me who hates the sticky feeling of moisturiser on their body, though?!
In my last update, I also mentioned facial flushing. This still happens, but I’ve found that taking a daily antihistamine really helps.
My results
My skin is doing so much better. It’s weird though, because after having acne for so long – to the point where I would always have three or four inflamed spots on my face – it’s almost like my brain can’t get used to it.
I still wake up, feel my face for bumps and head to the mirror to double-check my skin, which is a behaviour I need to try and budge. I still worry endlessly about getting a new breakout. It’s as if my mind is so used to worrying about it, that it doesn’t know how to fill the gap.
I do still get quite a few closed comedones/tiny whiteheads along my jawline, particularly in the lead-up to my period. They never become inflamed anymore, so that’s a relief. Dr Sree said we’ll continue accutane until I have a month entirely clear of these, though. At the moment, it feels like they’ll never go.
I don’t really mind the closed comedones – as someone who’s dealt with inflamed cystic acne, they seem like nothing. But I do worry that once I’m off the accutane, these closed comedones will turn into big, angry breakouts – so I do really hope they’ll stop appearing in the next couple months of treatment.
On that note, I was also prescribed a topical retinoid called Differin, to use alongside accutane, at my last appointment. My dermatologist said it will help to reduce/treat closed comedones. The only problem is that my skin isn’t tolerating it well at the moment. I’m trying to build up my usage slowly, but even one night per week leads to days of red, peeling skin.
I’ll stick at it though, as I’d like my skin to become accustomed to it before I finish accutane so I can use it as a maintenance treatment for good. I also know that consistent use of a retinoid should help fade my scars (which I have on my cheeks in particular) slightly over time.
Changing from AcneClear to SkinDoc
If you’ve been following my accutane journey, you know I started my treatment with an online provider called AcneClear. While my initial experience was somewhat positive, I later found issues with their prescribing practices.
After doing some research, I found that the doctor prescribing my accutane had restrictions placed on their medical license by the General Medical Council. This included limitations on prescribing accutane, particularly without the direct supervision of a consultant dermatologist.
When I asked AcneClear about the supervising consultant dermatologist (a legal requirement in the UK for accutane prescriptions), AcneClear was unable to provide a name. To me, this strongly suggested that no such supervision was in place. Plus, my requests for copies of my second blood test results were ignored numerous times. So, who knows if these tests were even carried out in the first place.
In my opinion, the importance of safe and responsible accutane prescribing is huge. It’s a serious medication, with lots of potential side effects. I wouldn’t feel comfortable recommending a company that raises such significant concerns about patient safety and compliance with medical regulations.
Following these experiences, I switched to SkinDoc, and the difference in care has been huge. My video consultations with Dr. Sree, an NHS Consultant Dermatologist, are super in-depth and thorough. Each session lasts around 30 minutes and we discuss my skin progress, mental health and side effects.
In contrast, my consultations with AcneClear were brief and felt a little superficial, lasting only a few minutes over the phone. While I won’t deny that the doctor was polite and pleasant, the interactions definitely lacked the depth I now receive with SkinDoc.
I understand that sharing these concerns may seem like ‘outing’ a company, which is something I’ve never done, but it’s super important to raise awareness about potential risks and ensure other acne sufferers have access to safe and reliable treatment options.
So, in short, if you’re looking for an online dermatology service to treat your acne, I highly recommend SkinDoc. They also offer in-person consultations at their clinic, so if you’re in London, you could pop to see them face-to-face.
My mental health
It doesn’t feel right doing an accutane update without talking about my mental health, as it’s been such a rollercoaster. Again, I won’t bore you with a story I’ve already told a million times, but if you’re curious, have a read of my acne & body dysmorphic disorder story.
The good news? I’m feeling so much more like myself. I’m back to socialising, doing things I love, heading to the gym regularly and not being terrified to look in the mirror. For this, I thank a mixture of therapy, accutane (because my skin was the trigger), sertaline (there’s no shame in taking anti-depressants, my friends) and, of course, my friends and family.
I’m by no means ‘cured’ of my body dysmorphic disorder (BDD), though. My thoughts are still very much centred around my skin and, in my head, how bad it looks, especially without makeup. I still engage in a lot of the stereotypical ‘rituals’ and obsessive behaviours typical of BDD (which you can read about in the blog linked above). This does really impact my life and how much space is left in my brain for other, more enjoyable or productive things.
I often wonder how much more I could achieve if my brain wasn’t so focused on my flaws. But, I’m in therapy, and I’m really trying to get on top of it, because if I’m to become a parent one day, I don’t want to pass on these tendencies to my kids.
So, that’s all from me for now. I’ll do another update soon, even though I’m not sure how much longer I’ll be on accutane. If you’re on accutane too, make sure to let me know how your journey is going. I’m sending you loads of love.
