Adult Acne + Roaccutane: My Experience

My skin issues started with cystic acne when I was around 23. Previous to this my skin had been perfect. This may sound like an exaggeration but even as teenager my skin had been clear and smooth. I took it for granted, of course, never thinking there would be a day when this was no longer the case. When the first cyst appeared on my cheek I thought it was an freak occurrence that would vanish as suddenly as it had appeared. Six weeks later I had seven; three on one cheek, four on the other. This was no pimply, surface level rash. The cysts were large, painful, lumpen intruders, solid as frozen peas and with no intention of healing. Thus began a war of attrition that would last almost two years. I tried alternative therapies, tweaking my diet, medical facials, antibiotics and…nothing worked. Or rather, nothing worked completely.

I tried my best not to let it get me down and for the most part I really succeeded. Ok, I would tell myself, you have some minor, cosmetic issues on your face. Big deal. You’re not really going to let yourself get sad about some…spots. Then I would put on my favourite coat and flounce out the door, congratulating myself on my perspective and positivity. Other days were not so easy. Summer could be particularly difficult. On one memorable occasion I had a daytime event to go to and it was so unbearably hot that as soon as I put my make-up on it started to migrate around my face like a melting toffee apple. My industrial strength setting powder, heretofore a valued friend, reacted with my sweat to look dry and cakey. Trying to get my concealer to stay in place was like trying to nail water to the wall. I felt so frustrated and hideous that I burst into tears and pretended to have cystitis so that I wouldn’t have to go. I was more comfortable letting people think that I had a urinary tract infection than adult acne. That was the first time I felt I could really understand how damaging acne can be. I realised how with a little less self confidence to start with, with less money to spend on treatment and with less kind, complimentary people around to reassure me that a bag on my head would be overkill, my cystic acne could have made me feel that low every day. It wasn’t because I was especially tough that my low days were rare, it was because I was lucky.

It was around this time that I decided to go on Roaccutane and I think it’s important to say right off the bat that it worked. To google the drug is to find an bottomless well of physical and psychological scare stories and that was not my experience. I didn’t develop IBS, Crohn’s Disease or depression. Indeed when I realised I had found something that was finally working for me I felt deliriously happy. That being said, Roaccutane is a complex medication. It is, in layman terms, a highly concentrated dose of Vitamin A. While other common medications for acne such as Tetracycline can be prescribed by a GP, Roaccutane will only be prescribed by a dermatologist. In the UK, an NHS dermatology referral can take 3-6 months. To go privately is infinitely quicker but, obviously, incurs a cost. Prices will vary from clinic to clinic but as a rough estimate based on my own experience, six months of private appointments and private prescriptions can cost in the region of £2000 spread over the length of the treatment period.

While I didn’t suffer any serious side effects from Roaccutane there are definitely ways to make the process both more efficient and more comfortable. This is the advice that I would pass on to anyone commencing a course:

Pre:

  • Get on birth control. Roaccuntane is extremely harmful to a developing foetus and before commencing the course you must sign a contract to say that you will not get pregnant and that you will incorporate a hormonal form of protection. It makes the process more efficient to have this taken care of prior to the first dermatology appointment so that the prescription can be made out immediately. I opted for the Mirena coil but the contraceptive implant or pill are also recommended. The risk to pregnancy ends one month after taking the final Roaccutane pill.
  • Wear matte lipstick everyday. You’ll miss it when it’s gone.

During:

  • NO WAXING EVER. No lasers, no chemical peels, no retinols, no going outside without a high SPF. Your skin will fall off.
  • As touched on above, Roaccutane will make your lips so dry that, without a moisture barrier, they will absolutely crack and bleed all over your face. Lipstick is out, lip balm is in. Blistex Relief Cream is the best that I found. I bought countless tubes and had them in every handbag and coat pocket I could possibly wear. Be without it at your peril.  Dr.Paw Paw is also great but at three times the price, why bother. 
  • Roaccutane will also make the rest of your face very dry and even (horrors) flaky if you don’t implement a proper care routine. Use a moisturising cleansing balm twice a day. I continued to use a mild 5% glycolic acid (my obsession with acids is well documented) with the blessing of my dermatologist and I believe that it helped hugely to prevent any flaking but I should point out that general advice says to avoid acids while on the medication. I then used a hyaluronic product to boost moisture (The Ordinary range is extremely affordable and contains far higher concentrations than many leading brands) followed by Cicaplast Baume B5. This cream is soothing, moisturising, aids repair and comes in two forms; standard and SPF50. This product is essential. If using the standard cream, I finished with The Body Shop Skin Defence SPF50 which I love and still use everyday. 
  • Rounding out the dryness effect is probable dandruff. Once it starts it’s hard to shift so head it off at the pass by using anti-dandruff haircare for the duration. I liked the festive, ginger smell of this one but for the most part they’re all the same.

Post:

  • By the end the course my skin looked amazing but, far from being excited to come off the medication, I felt anxious. The idea that the cysts could come back was horrifying so, on the advice on my dermatologist, I started taking Accumax. I still take it now and don’t know if I’ll ever stop. It is a skin support supplement high in Vitamin A that many use as a more gentle (a.k.a slower) alternative to Roaccutane. There is no prescription necessary and it can be ordered online. Whether it works or not I can’t actually say as my skin was clear when I started taking it but the way I see it, it can’t do any harm. 
  • About a month after finishing the course I started to incorporate more concentrated acids back into my routine and currently find Biologique Recherche P50 to be the most beneficial for my skin. The ingredients exfoliate and strengthen the skin while helping to regulate sebum production. I have also found it helpful in fading any lingering marks. My hope is that by incorporating these elements into my routine my skin will remain clear.

I wanted to write about my experience of Roaccutane without labelling it a cure because of course, medication works differently for everyone. Only a dermatologist will know who it’s right for (and sometimes even they are stabbing in the dark) but I can say that, for me, it worked.

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