Accutane and Acne (Days 1 & 2)

Yesterday, I received my first prescription of Amnesteem (isotretinoin), which I will refer to as isotretinoin or Accutane, because that is how I know it best. Isotretinoin is a treatment for severe acne. Over the last 4-6 months, I have developed eruptions of antibiotic-resistant cystic acne along my jawline and forehead, that any teenager would be proud to call his/her own; however, I haven't been a teenager in over 12 years.

First of all, I had to sign a document, called iPledge, stating that I understand there are copious amounts of risks involved in this systemic treatment. I can have anything from a stroke to a child born with severe mental and/or physical deformities (more on that later), even though, I am a guy. In addition, I am to be subjected to monthly lab work to measure my cholesterol and triglyceride levels.

This particular brand of isotretinoin comes in a cute little pack of ten pills with a silhouette of a pregnant woman and a big red circle with a slash through it on the back of each individual pill container. It includes a warning, in case the picture was too ambiguous, that states in bright red, capital type: "WARNING TO FEMALE PATIENTS: DO NOT GET PREGNANT." That is really charming to say the least. Of course, the effects to an unborn child are anything but cute. In a side note, my mother was looking at the packaging, which shows crude graphics of what can happen to an unborn child if the mother takes isotretinoin during her pregnancy. Mom thought those were things that could happen to my head and organs while taking the medicine. I had to laugh out loud over that. I'm a bit bigger than a zygote.

Five p.m. yesterday marks the anniversary of my first dose of 40mg. Since I am not a teenager, I am starting out by taking one pill a day, instead of the usual two pills per day.

So, what have I experienced thus far?

Day 1

1. In mere hours after my first dose, I noticed a curious taste in my mouth. I can't describe it really, other than to say it is a combination of bitter, sweet, and sour. It is like my taste buds are tasting things that aren't present. It got better as the I got closer to my next dose. I haven't really noticed it interfering with how I taste my food as I eat. It is just poignantly present between meals.
2. During the night, I was subjected to a period of intense fear and paranoia. I woke up feeling like I was being crushed by the world and that maybe my acne wasn't so bad. Perhaps, that was me in a semi-sleeping state of delusion.
3. I had some wildly vivid dreams that I do not care to share, after I settled down from my state of panic.

Day 2

This morning, call me a liar if you must, I noticed that many of the cysts on my face had shrunk and were no longer painful to touch. It is as if the swelling has reduced. Of course, the hyperpigmentation is still obvious, but hopefully that will fade, too. If not, thank the gods for concealer.

I took my second dose of isotretinoin around noon today, in an attempt to get it into my breakfast/lunch schedule. (It is best taken with food.)

1. I woke up with a nagging headache, which is unusual for me.
2. As the day has gone on, I have noticed that my muscles feel a bit more stiff. The palms of my hands and the soles of my feet feel bruised and are slightly sensitive to touch. Of course, they look perfectly normal to the naked eye.
3. I have noticed my sinuses, via my nose, are starting to feel dry and irritated.

Hopefully, I can continue the treatment. My dermatologist told me to experiment with how often I take the pills, not to exceed two a day. She recommended that I may take one a day, skip a day or two, and eventually try two per day, once I feel more confident. Of course, I need to see what the long-term side-effects of this treatment may be.