Acne and Accutane

Ever since I was a teenager, I've had pimples. Unlike my brother at the time, my acne was never really bad. But about six months ago, I had a bad flare up that has refused to go away. Right now my face is the clearest it's been since August, but it still isn't clear. I've been taking an antibiotic to try to control it, which I have also done in the past. And while it's slowly getting back under control, like I said it hasn't cleared up. So my doctor gave me to a referral to a dermatologist. I met with the dermatologist yesterday, and after some discussion, he agreed to put me on Accutane.

I'm not going to lie, Accutane scares me. It has a lot of side effects, many of them quite serious. But while weighing the pros and cons of the drug, with both my parents and my brother (who was on the drug years ago to clear his acne up, and is a pharmacist), I think I am going to take it. I'll be on it for six months, and will have blood work every month to make sure nothing is going wrong (one of the more serious side effects is liver damage, which generally corrects itself once you are off the drug). The really bad side effect is depression and suicide thoughts (this link has not been proven and if it exists, effects >1% of people who take Accutane according to the literature I've read. It's a small chance, but it does exist). Another side effect I read about is possible decreased night vision. That one bothers me (as anything with my vision bothers me), but again, generally it is reversed if you stop taking the medication.

For people with diabetes, Accutane poses its own problems. I read online that it can make your blood sugars harder to control. That's troubling enough on its own, especially since I feel like my glucose has been alright lately (and I've just figured out skiing!) but I think I will mention this to my Diabetes Education team (and will maybe request monthly meetings with them or at the least emails, just to help me through). The other really troubling side effect for people with diabetes is that Accutane may increase cholesterol. While I've never written about it here before, my doctor has found that I have elevated cholesterol levels (because I have diabetes. If I didn't, my cholesterol levels would be on the higher end of normal. It seems to run in my family). So that was a really troubling revelation. But I found some advice on a website that eating low G.I. foods may help keep your glucose in check. Eating healthy and exercising may also help keep my cholesterol down, so I've convinced my household to get on board with that (and my dad has promised that if he's going to cheat, he will cheat outside of the home, so that will greatly help me (who has terrible willpower!)

As to the depression, I think healthy eating and exercise should help keep my mood elevated. I know I've been depressed before in the past (not clinical depression and I did not have to take anything for it. I also have never had thoughts of suicide), so I'm helping that will help. I'm also going to try to write every day during the months I will be taking Accutane. I participated in NaNoWriMo this past November, and was extremely happy and productive during that month. I am hoping that writing every day (what I want to be writing - to that end I have a couple of projects underway) will help keep my mood elevated. I will also have video games and good old reading to help in that regard. As well, my main support network either is notified or will be notified, so they will be keeping an eye on me. And since I still live at home, I'll have people around should I need help. Although my mom has made me promise to tell someone if I start to feel depressed, knowing that I tend to keep my feelings to myself.

I still have about a month to decide if I don't want to take the Accutane. But at this moment, I think that taking it is a good idea for me. Yes, the drug scares me. But I have the people and resources to help me get through it safely.