Accutane/Roaccutane Update: One-Month Mark!

It has been one month! Time really flies and I can't wait to finish the entire course. I'm slowly awaiting the arrival of smooth, pimple-less skin!

I'm going to be systematic about this, so that you guys have an easier time reading and finding material that you want to know about straight away. Much better than my usual ride-off-in-all-directions writing manner.

Scroll all the way down if you want to skip the chunks of text and just see the current skin condition progress.

Dermatologist information

A/Prof Cheong Paek Yean

Cheong Medical Clinic Specialist Medical & Skin Clinic

76 Jln Jurong Kechil, Singapore 598589

Consultation hours: Mon to Thurs 9am to 1pm, 7pm to 9pm. Fri to Sun 9am to 1pm. Closed on public holidays. 

My mom also has problems with her skin and she has many clinic recommendations. She highly recommended the above clinic. My siblings also have been to the clinic multiple times when they were ill (not skin-related). 

Dr Cheong was incredibly knowledgeable and he was also very assuring. Before making my diagnosis, he went through the causes and types of pimples with me, and the many forms of medication that can help fix the problem. I told him that I took antibiotics before (doxycycline) and it only worked a while. It was then that he explained to me about isotretinoin (or accutane/roaccutane) and how it's usually a last resort, but would almost always work. 

Side effects were also explained - dry lips, dry eyes, muscle aches, nose bleeds and birth defects. There was a long list of side effects, but he only focused on those with higher percentages of occurrence and the most serious side effect - birth defects. I signed a consent form to declare that I understood that I must not become pregnant while on this medication and for one month after the end of the treatment.  Then he prescribed one month's worth of medication for me (first 15 days on 20mg and next 15 days on 30mg), his own brand facial cleanser and moisturiser, and a lip balm. 

When I was about to leave his room, he patted me on my shoulder and said it was a great decision for me to find him and that soon my skin would be clear, He told me again and again to not worry because the pimples would go away soon. Very encouraging lor. :') 

Total cost for first visit

S$304 (consultation fee + 1 month's worth of medication + facial cleanser + moisturiser + lip balm)

Getting accutane/roaccutane in Singapore

I guess it varies clinic to clinic, but it's definitely easier to be on accutane/roaccutane course in Singapore than in the US. I read that female users in the US have to go through a long list of tests and also be put on the iPledge programme. For me, I was prescribed the medication like any other illnesses after signing the consent form. The entire visit was done in 1.5 hours. 

Skin condition prior to being on accutane/roaccutane

• Hormonal acne mostly on the jawline and both cheeks. 
• Painful cystic acne before menstruation which would take ages to go away. 
• Forehead and nose were almost always clear of pimples. 
• Blackheads on nose, but nothing too serious. 
• Very oily skin, especially on the nose, both cheeks and chin. 

Weekly updates

Week One (1-7 January 2016)

• I experienced the initial breakout very quickly. By day 2, I had 6 new pimples, but I wasn't too bothered because I had suffered worse in the past. My eyes were so dry on day 2 and 3, like as if there were sand particles in my eyes. The eye drops helped only momentarily, and I slept most of the 2 days away. Luckily, they were weekend days. On the third day, I had a slight fever and I had soreness all over my body. Also, I had diarrhoea till day 5. The initial breakouts continued and I couldn't resist popping some of them. One major difference - popped pimples heal much faster. Towards the end of the week, my diarrhoea turned into constipation (very frustrating haha) and my chin was clear, but my forehead was infested with pimples. 

Week Two (8-14 January 2016)

• Muscle aches stopped and my body felt normal. Lips and eyes were still dry. Initial breakouts still going strong. I was incredibly self-conscious this week because no amount of makeup could cover the many bumps on my face. My face felt itchy and prickly and I felt ugly. But gotta press on man. 
• This was also the week I was in Bangkok with Kengyang. I had my first anxiety attack and I totally believe it was caused by the medicine. What happened was while walking back to the hotel after a full day of shopping, I saw a stall vendor empty her trash by the roadside, and this eeky, liquid trash almost splashed on me. Something in me snapped, and I started breathing heavily. I tried to contain it, but once I was in the hotel room, I saw how messy Kengyang's side of the table was and I burst out crying. Oh my gosh, I really cried like a baby and obviously I scared the hell out of Kengyang. 
• By the end of the week, I had so many painful pimples (definitely more than 10) and they were sooooooo itchy. Lips and eyes were no longer dry because I drank a lot of water (like more than 2 litres daily). 
• Positive: Skin is no longer oily. Makeup stays intact for a full 12 hours, and sometimes more, with no touching up needed and no shine detected. Great!

Week 3 (15-21 January 2016)

• I found out that my roaccutane medication is in the "List of Controlled Drugs" in Dubai. My company is heading there at the beginning of March for a gathering, so that means either I get permission from their Ministry of Health to bring 4 pills into the country, or I just stop taking the meds for those 4 days. I wonder what will happen if I stop? I will ask my Dr Cheong on my next appointment. 
• Finally upped dosage on the 16th day (20mg to 30mg) and the initial breakouts have slowed down. The pimples were not popping up fast and furious like the last week. Skin's starting to get flaky so I introduced Innisfree Green Tea Seed Serum into my routine. 
• This was also the week that I realised how dry my scalp was. My hair looked fabulous and voluminous ever after 1.5 days of not washing! Yay!
• Day 18 was the day I started having bone aches, especially my tail bone. Getting out of bed was so difficult. I stocked up on Omega 3 pills and those has helped tremendously. 
• Towards the end of the week, my pimples stopped coming out in groups and the bumps were gradually flatted. Makeup applied much better. 

Week 4 (22-30 January 2016) - Technically more than a week, but yay it has been a month!

• I had a dry-lip disaster at the beginning of the week. My lips were so swollen and red and painful :( No matter how much water I drank, my lips were still peeling. Lip balm didn't really help that much. 
• I also started to have dry patches on my upper arms. My huge, previously unused stash of body moisturisers is finally out of the dungeon!
• This was the week I experienced the horrors of over-exfoliating. While on this medicine, it's best to stay away from exfoliants, be it a physical or chemical one. But of course, silly me wanted to get rid of the dry patches on my skin, so I used a physical exfoliant (face scrub) AND a chemical exfoliant (Natural BHA) and BAM the next day I had red bumps all over my face. I knew those bumps were not acne because I had so many of them around my eyes as well. No pus, no pain. Just FREAKING ITCHY and very ugly under makeup :( Time to stop exfoliating for good man. Why am I always doing stupid things??
• Tail bone aching still there. It's especially worse the morning after a workout session.
• I also had my usual premenstrual syndrome and I don't think any amount of roaccutane can defeat the powers of period acne. So yes, I have a few here and there. Nothing worrisome though. 

Tests done on second doctor visit
It was a really quick blood test; maybe less than 15 seconds. My test results came out 3 days later and I was all good to continue with the medication. I had quite a scare because my period came one week late this month, and usually my period comes on the dot, every 28 days.  So when the nurse called me and said I was "all clear", I was super relieved because that meant I wasn't pregnant.

Dr Cheong also helped get rid of a couple of active pimples. The way he did it was so different from the anyhow-pop method from facial salons. His was fast and accurate. No skin-dragging at all. It was painful, but only for those couple of seconds.

I was then given 2 more months worth of medicine. I'll be back for my third consultation in 60 days' time!

Total cost for second visit
$478 (consultation fee + 2 months worth of medication)

Skin condition progress

Now that I'm looking at these photos, my skin condition really did improve in 30 days! Sorry to scare you with my terrible skin, but hey visual proof more impactful than mere words!

Also, please pardon the different lighting conditions in both occasions.

List of improvements in 30 days:

• Skin is not oily anymore. 
• Large pimple on upper right lip area is completely gone. 
• Amount of tiny raised bumps have decreased significantly. I'm most happy about this because makeup application is so much easier and smoother now.

Skin concerns in 30 days:

• Pores are more obvious, and blackheads are VERY obvious. But Dr Cheong said that it's expected since all the blackheads are in the process of being "pushed out". 
• Skin is very much redder. Not a major concern though because I use foundation daily anyway.
• Fresh new pimples on both cheeks, but I noticed that pimples heal much faster. 

Centre

Left cheek

Right cheek

So far so good~ I'm looking forward to the day when I can step out of the house with no makeup on. I can see the light at the end of the tunnel!!

For those of you who are also on the accutane/roaccutane journey, or are planning to start one, press on!! The first couple of weeks will be a nightmare because of the "purging" process, but after that, your skin will gradually look better and better. Acne, be gone forever please!!