Since my last post in October, my skin has improved dramatically. It's still not perfect, not as much as I would like it to be--I still have acne scars and open pores, but if I get pimples they come and go quickly, and they're always small and hardly ever cystic. When I was taken off Isotane for a few weeks, my skin wasn't as oily as before--while I'm sure the cooler weather this time of year is an attributing factor, I also know that certain changes I've made to my life have affected my skin very postively.
So what did I do? It's a really long story.
First of all, I went to a dermatologist. Yes, it's still the best way to get your skin to clear--after all a dermatologist knows best since they went to school for their profession, probably along with several seminars and whatnot.
Back in October, my skin was really in breakout mode, not to mention extremely oily and quite sensitive. I did everything I could to get my skin problems under control (used gentle cleanser, kept my hair out of my face and so on), but nothing was working. I was quite lucky that while we were at the mall with my family (and my cousin--a doctor), my cousin told my father that we should consult with the dermatologist in the building across the street. He reluctantly agreed.
After my brother and I got facial treatments, the dermatologist saw us. She immediately suggested that both my brother and I take Isotane (isotretinoin). She gave us doses of 20 mg a day. Luckily since my cousin was with us, the dermatologist gave us a courtesy discount. Along with the Isotane, I was to use a gentle cleanser (she gave me Avene Cleanance Soap-Free Gel Cleanser) and apply an AHA lotion on my face after cleansing (I use NeoStrata). The dermatologist recommended that I come back every month or so for a facial, as well.
Fast forward a few weeks, my skin had already visibly cleared. I still had a few bumps, but after getting a facial, they disappeared and pretty much never came back--except for the ones on my jawline, which probably won't disappear because I have a habit of resting my jaw/chin on my hand. I saw the dermatologist again, and she lowered my Isotane dose to 10mg a day.
A few more facials and I arrived where I am now--with hardly any blemishes left, except for a stubborn bump on my cheek and a few remaining bumps on my jawline. I'm finishing off the last of my Isotane--still at 10mg a day, then I'm going to rely on topical treatments from then on (just the AHA, actually).
So how did the combination of Isotane and AHA work for me?
First of all, what is Isotane/Isotretinoin? [**NOTE: I don't claim to be an expert. What I write here is based on a) research, b) what I've been told by my doctor, and c) personal experience.]
There are many different brands of Isotretinoin. I took/take Isotane. People from other countries might recognize it better by the brand Accutane (now Roaccutane).
Isotretinoin is a retinoid, a derivative from Vitamin A, and is normally found naturally occuring in small quantities within the body. It is a medication with different uses, but it's most prominently used for the treatment of severe acne that is non-responsive to topical treatments. It is extremely effective in controlling sebum production and acne because it shrinks the sebaceous (oil) glands in the skin, therefore inhibiting the formation of comedones. The shrinkage of the sebaceous glands is temporary, but in most cases, acne will not return for years or on a case by case basis, will not return at all.
It sounds perfect, doesn't it? But there are side effects. Firstly, it is a known teratogenic--meaning if you get pregnant or are pregnant while taking oral isotretinoin, your child will be at high risk for major birth defects. This is why before I was given the treatment, I was given a waiver to sign--to use birth control if sexually active (which I'm not) and to confirm that I'm not pregnant during that time. If you are looking to get pregnant, you have to wait until at least 1 month after using the drug before you try to conceive.
Other side effects include but are not limited to: dry lips/nose, dry skin (lesser oil secretions), dry hair, increased skin sensitivity, and if improper dose is given, you might get symptoms similar to that of Vitamin A toxicity. Prolonged usage can also cause liver damage. Therefore, it's best to take the drug under close supervision of your dermatologist.
To answer your question, the only side effect I got was dry lips. I was on a high fat diet then, and I drank at least a litre of water a day.
(For more information, visit http://en.wikipedia.org/wiki/Isotretinoin)
Now, what is AHA?
AHA is short for Alpha Hydroxy Acid. They are a class of chemical compounds that may be either naturally occuring or synthetic. They are well known for their use in the cosmetic industry and usually found in products claiming to reduce wrinkles/fine lines/the signs of aging, and improve the overall look or feel of the skin. They are available in professional applications as chemical peels--glycolic peels and so on. The most common AHAs are glycolic acid, lactic acid, citric acid, and mandelic acid.
I only had experience with topical AHA lotions in the concentration of somewhere in between 5-10%. Topical AHA products reduce cell adhesion in the top layer of the skin, promoting exfoliation of the outermost layer of the skin for smoother texture. It's also kind of like a micropeel. After 3 months of using AHA lotion, I noticed that my darkest acne scars have pretty much disappeared. I don't know what the effects are for higher concentrations--you're going to have to do your own research for that. I don't want to give any information that I don't have any experience/actual knowledge of.
The side effects of AHA include (most commonly) mild skin irritations, redness and flaking. The severity depends on the concentration of acid you use. Most importantly, the use of AHAs increase photosensitivity to the sun, so you're more prone to sunburn and sun damage. To counteract this side effect (even if I wasn't sure if I even had this side effect in the first place), I started using an SPF 50 sun block on my face.
(For more information, visit http://en.wikipedia.org/wiki/Alpha_hydroxy_acid)
AHA and Isotretinoin worked together in a combo for me because the AHA helped clear and lighten my dark marks/acne scars while at the same time helping to prevent comedones. The isotretinoin worked from within to get rid of almost all my acne/pimples and the oiliness (although this effect is temporary).
Of course, this wasn't the only reason why my skin started improving dramatically. Just a few weeks ago, my dermatologist stopped my treatment of Isotretinoin for a while so she could observe if my skin would break out again, and so on. She said to expect that my skin would be oily once more (a fact I was sad about). Preparing myself for this, I decided to wait things out and see how my skin would be without the isotretinoin.
I was surprised to find that my skin in those weeks became oily--but nowhere near as oily as I was before. Back then I had to use five oil blotting sheets every few hours or so..and after the isotretinoin I hardly had to use one blotting sheet for a day. My skin still became shiny, of course, but still, nowhere near as bad as before where I pretty much looked like a greased pan. Why did my skin not get so oily when I wasn't on the treatment?
Simple: In December, I decided that I needed to change my lifestyle and get healthy. The first thing I did was cut the oily, unhealthy food that I took in. It's surpising how much a healthy diet can help your skin. I also began exercising everyday--I don't know if this helped, but yeah. Haha.
Since October I've been noticing little things that really help my skin. So I figured I'd share, just in case. But of course, what works for me might not work for you, so be careful and don't overdo it. So here are my tips:
- Be gentle to your skin! I CANNOT stress this enough. Back then I thought that to get rid of the oiliness of my skin, I had to use all those incredibly drying products in the market. I would jump from product to product because they didn't work, made me oilier, and so on. Use a gentle cleanser formulated for oily skin and don't forget to moisturize. Don't jump from product to product right away, wait at least a month to see the effects on your skin.
- Diet - I cut out the junk food completely. Back then I could eat a whole bag of chips in a day, sometimes even two. Now I can't even bear the thought of eating chips. Once in a long while I'll let myself have a serving, but never more than a handful. I completely cut out soda as well. Fruits and veggies are really helpful, so don't forget to eat a lot of them!
- If you think you really need to, see a dermatologist. They'll know what's best for your skin. The costs might be kinda high, but you'll find that it'll all be worth it in the end. In connection to this, FOLLOW EVERYTHING YOUR DERMATOLOGIST SAYS.
- Sleep - I've been trying to get my 8 hours a night lately. At the very least I get myself 6 hours of sleep. It's very helpful and healthy, not only for your skin. You'll also feel a lot more energized in the daytime.
- AHA - if you don't have access to products with AHA in them, your best bet is to get a lemon, and cut it in half. After cleansing your face, rub the lemon half on your face and leave on for five minutes. Rinse off afterward and continue with normal routine. For a bonus cooling effect, stick the lemon in the refrigerator first!
- Vitamin A - try to increase your intake of this, but be very careful to keep within safe dosage. Vitamin A toxicity is not good.
- Don't touch your face. Cannot stress this enough. Only touch your face after you've cleansed your face and your hands and are applying product to avoid irritation, etc.
- Keep makeup tools/applicators/products clean. Because it's dusty where I live, I make sure every cosmetic product I own is stored where the dust cannot get to it.
- And last but not the least, SUNBLOCK!!
I'm sorry for the length of this post, but I hope you at least found it informative and useful. :) For those with skin problems, good luck!! I'm still working on my skin but so far so good. :)
Here is the information for my dermatologist, for those who are curious/interested.
Claudia Y. Samonte, M.D., FPDS
Mobile #0920 921 5715
Unit 216 Royal Place Building, Don Antonio St. Commonwealth (fronting Ever Gotesco Mall)
Sat 10am-12nn by appointment
Tel. No.: 951-0969
Delos Santos Medical Center
201 E. Rodriguez Sr. Avenue Room 257
Mon & Thurs 2pm - 6pm
Direct line: 412-1379
Tel No. 723-0041 loc. 5141
St. Luke's Medical Center
E. Rodriguez Sr. Avenue Rm. 1401 North Tower Cathedral Heights Bldg.
Tue. 10am-2pm, Sat 1pm-5pm
Tel No. 723-0101 loc. 5141
M1 Level, Trinoma Mall, North Ave.
Tel No. 916-6095