Hey everyone, I hope you’re doing well and having a great week so far. This post will be slightly deeper and more raw than my previous posts. As a matter of fact, some of the details I’ll be sharing with you are so personal that I’ve been putting off writing this post out of fear. Even though part of me feels very vulnerable sharing this information online. There is another, strong part of me that knows the time is right and that the information/ my story could possibly help someone. This post is so long that I’ve split it into two parts. I’ll post them together as I think it makes for more enjoyable reading.
So if you’ve read my introductory post, you’ll know that I took a medication called Accutane for the treatment of acne a few years ago. The five and a half month course of treatment changed my whole life. I know that sounds like a big statement to make but it’s true.
Desperate for clear skin I abandoned my usual way of dealing with things and decided to see a dermatologist for further advice. I actually made an appointment to enquire about laser treatment and the thought of taking medication hadn’t even crossed my mind. Actually I hadn’t even heard about Accutane at that point.
I went to see a dermatologist privately so that I wouldn’t have to wait for an NHS referral. The morning of my appointment I remember feeling really upset with how my skin looked and the fact I needed to leave the house without makeup so that the doctor could see my skin properly. After flicking through a few magazines in order to take my mind off it, I was called into his office.
Basically, he immediately dismissed my idea of getting laser treatment and instead began to tell me about an ‘amazing treatment for acne with an extremely high success rate.’ He told me I would be an ideal candidate and that it would most likely leave me with clear skin. The doctor then mentioned that there were a list of possible side effects but that most of them were extremely rare. He mentioned that the drug had been linked to mental health issues in rare cases but nothing had been proven and that people are usually depressed because they have acne so the medication actually helps. He proceeded to explain that I would get dry skin, lips and hair and that I would need to use sun protection as your skin becomes fragile and photosensitive whilst on the medication. Another thing that was mentioned was the fact my skin would probably get worse before better and that it would go through an ‘initial breakout’ that would pass. Even though I knew this I felt comforted by the fact he told me all of the patients he had treated had responded positively.
Accutane is the most common brand name for a drug called Isotretinoin. Other brand names include Roaccutane, Claravis and Oratane. It is a retinoid which is a derivative Vitamin A. In layman’s terms, Accutane decreases both the size and activity of the sebaceous glands. When less sebum is produced there is a smaller chance that your pores will become blocked leading to acne (well that’s the idea.) I was informed that I would need monthly blood tests to monitor my my liver enzymes and cholesterol, making sure they’re at safe levels as well as to check some other biomarkers. The dermatologist then told me I must not get pregnant whilst on this medication because it causes birth defects. Not it might but it will (that alone should have told me all I needed to know.)
After being told these two important and quite shocking pieces of information, I probably should have politely declined and walked right out of his office. Unfortunately I didn’t. Instead I followed his instructions and provided a urine sample (to prove I wasn’t pregnant) and signed a form. I was then given a prescription for 5.5 months at a dose of 40mg per day. (One 20mg pill in the morning and one again in the evening.) The dose was calculated based on my body weight at the time.
In hindsight, I would have made a very different decision that day. However, in that moment the positives were standing out far more strongly than any ‘possible’ and ‘unlikely’ negatives and so I went ahead. Plus, at that time having acne was affecting my self esteem and social life so much that I was desperate for a solution. In my own head my thought process went something like this ‘Take this for a few months- dry skin-dry lips-dry hair-clear beautiful skin-happy.’
That’s me being honest with you. Of course I don’t think that now but at that time I felt I would be more beautiful, lovable, worthy and successful if I had clear skin. To be honest, I know there will be people reading this that completely understand what I mean. The very next day, I filled a glass of water and held the oval shaped pill in my hand. I won’t lie, I was nervous but I decided to focus on the great outcome that I believed was coming my way and downed the pill.
Two words; Initial breakout. Yeah, that hit me full force about 3-4 weeks into the treatment. My face was so sore and inflamed and there was nothing that seemed to calm it down. My lips were super dry and always peeling and my skin became noticeably dry even though it wasn’t that oily to begin with.
To be honest, I didn’t notice any other side effects until December 22nd. Yes, I remember the date because of how awful it was. I had gone out the previous night for a couple of Christmas drinks with my sister and friends. We had a lovely time together and remember feeling more confidant as my skin was improving and looked really good that particular evening. On the morning of the 22nd I woke up and immediately noticed that my face felt hot and there was a burning pain. When I looked in the mirror I couldn’t believe what I saw. Both of my cheeks were bright red and glowing. It looked like eczema (which I had never experienced previously.) Not only did it look horrific but it was hot to the touch and really, really sore. I emailed my dermatologist and he confirmed that it was eczema and told me to keep it hydrated and to email if it changed significantly or worsened. Basically over the course of about a week, my inflamed cheeks began to weep then crusted over so I had two massive red, crusty areas of skin covering the whole cheek area of my face on both sides. My face was swollen due to inflammation and all in all, it was an ordeal. A few photos were taken but I felt so ugly that I (stupidly) deleted them. All I can say is a friend called over and almost started crying when she saw me.
The eczema cleared up over the space of about a fortnight. I had a little bit of a rash on my hands that would come and go but I used to just moisturise it a lot with some coconut oil. Looking back I think a slight increase in hair shedding started sometime in late January but at the time I didn’t think much of it as it was ever so slight. Feeling happy that my skin was clearing up, took my focus off the fact I was a little run down and catching a couple more cold type bugs than usual. Then again it was winter so I thought nothing of it, looking back now I could tell I was starting to become run down from the effect of the Accutane. Towards the end of the course, I remember mentioning to my mum that my eyes were extremely dry, bone dry actually and something that stands out is the fact that I mentioned to her that I couldn’t cry. My joints were becoming stiff and achy too and I was bruising really easily but I was so close to the end and was determined to finish. My face must have been inflamed and sore in January too because I was originally meant to fly out to Santiago, Chile to meet my friend Jack but ended up changing my flight to March. Actually, my skin was really fragile and pink in colour after finishing the treatment. I also remember having an area on my upper lip that was cut and sore and seemed to be retaining more water in my face.
Roll on March 19th- I had completed Accutane and was about to leave the country to start a new adventure. I presumed that I’d be backpacking around South America for at least a year. Feeling smothered by small scale Cornish living, I was looking forward to hitting the road. I love to travel and explore so this was an exciting prospect for me. Deep down I knew I was running away from a few things though. I had been through a stressful time in my personal life and I suppose I wanted to escape to something new.
My adventure started at Bristol airport with a bang. A shoe lace on one walking boot got stuck in a hook on the other. Before I had time to think, I feel to the floor really sharply. I had my backpack on my back, a rucksack on my front and a side gym type bag on one shoulder. The weight of the bags propelled me forward too. It was literally so painful and so embarrassing at the same time. People didn’t know what to do and were trying not to laugh (I don’t blame them, it must have been hilarious to watch!) Luckily, the rest of my travel went well and I arrived safely at Santiago. Apart from being pulled to one side on arrival and having all of my bags searched (thanks to one piece of fruit and a sniffer dog) everything was good.
Myself and Jack stayed in central Santiago for the first part of the trip and it was here that I began to experience problems. The day after arriving I noticed that the area around my spleen hurt a lot. I put it down to the fall I took at the airport, thinking it was bruised ribs. Even though, I felt it was something more. I took some ibuprofan for the pain and carried on. We did a lot of moving around and I had to keep topping up on factor 50 sunscreen which was annoying. I did notice that I was feeling just ‘off’ and more tired than usual but though I’d soon adjust. Weeks went by and we moved through the countries bus by bus. Chile, Argentina, Uruguay, Paraguay, Bolivia, Brazil and Peru. I just wasn’t feeling myself and even though I could see so much beauty around me, something wasn’t right. It was when we were in Buenos Aries that I really noticed that my hair was falling out. It was thinning all over and every shower I would lose fistfuls. I found it so distressing but kept thinking it would stop soon.
By the time we got to Miraflores in Peru, I looked unwell. I was fatigued, pale and had a sickly appearance. I had also been in bed unable to move for days with some sort of infection. My joints were not just stiff but sore and I was experiencing pain in my hips, knees and lower back. The most worrying change though was the significant and rapid decline in my mental health. I don’t know how it materialised but all I know is that when I was in Peru I was feeling really depressed and very anxious. I had been sending emails back and forth to my mum and the dermatologist as the continuing increase in hair loss was worrying ad upsetting me beyond belief. Things came to a head when I was video calling my mum from the bathroom floor of our Peruvian hostel. I was distressed and crying my eyes out. In this moment, I knew that I had no choice but to book my return flight and to head home.
See you all soon for part 2!
Rebecca
knowledgetonourish 