sillyt
locked in syndrome
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How to minimize isotretinoin sides
The following content does not promote or condone any of the mentioned activities below, read at your own risk.
Isotretinoin 20mg/day with a meal containing a high amount of fat,
Desloratadine 5mg/day,
Omega-3 1g/day
Take until your skin is 100% clear and then continue taking it for 2 more months.
Desloratadine 5mg/day,
Omega-3 1g/day
Take until your skin is 100% clear and then continue taking it for 2 more months.
Introduction
Recently I've started isotretinoin and after my research compiled the following "stack" to minimize sides while maximizing the benefits. I wanted to write this guide since I haven't seen anything similar on any of the forums and partly outdated regiments are still being recommended. Also I won't go into any of the basics like spf in this guide.
Traditionally, you would take 0.5 to 1.0mg/kg/day until you reach a cumulative dose target of 120–150mg per kg of your body weight. This frequently causes extreme dryness, joint pain, fatigue, and severe acne purges.
Modern studies strongly support a low-dose approach (typically 20mg/day fixed, or 0.25-0.4mg/kg/day). It yields comparable 24-week results to high doses but with much better patient satisfaction, meaning you won't feel as miserable during your course.
(https://www.ncbi.nlm.nih.gov/pubmed/22016276)
Group A is traditional dosage, group B is a low dose protocol. No significant difference in acne score change.
As mentioned before, a low dose protocol has significantly higher patient satisfaction due to lower sides.
As you can see here the rate of relapse (acne coming back after the course is finished) is not significantly higher in the low dose group compared to the traditional one, more on how we are going to minimize the chance of a relapse later.
(https://pubmed.ncbi.nlm.nih.gov/21114478/)
Okay so now we've established that a low dose protocol (20mg/day which typically comes out to 0.25-0.4mg/kg/day) mogs the traditional protocol (the exception is if you have severe acne, in that case a traditional dosage (0.5-1mg/kg/day) is probably still the way to go). Now let's get to the additional stuff to further reduce sides.
(https://www.ncbi.nlm.nih.gov/pubmed/22016276)
Group A is traditional dosage, group B is a low dose protocol. No significant difference in acne score change.
As mentioned before, a low dose protocol has significantly higher patient satisfaction due to lower sides.
As you can see here the rate of relapse (acne coming back after the course is finished) is not significantly higher in the low dose group compared to the traditional one, more on how we are going to minimize the chance of a relapse later.
(https://pubmed.ncbi.nlm.nih.gov/21114478/)
Okay so now we've established that a low dose protocol (20mg/day which typically comes out to 0.25-0.4mg/kg/day) mogs the traditional protocol (the exception is if you have severe acne, in that case a traditional dosage (0.5-1mg/kg/day) is probably still the way to go). Now let's get to the additional stuff to further reduce sides.
You are going to want to take Omega 3 daily. In this study they used soft gel capsules at 1g/day.
This is going to help stop your triglycerides/cholesterol from spiking, and it essentially hydrates you from the inside out, significantly reducing dry eyes, cracked lips, and nosebleeds.
This is going to help stop your triglycerides/cholesterol from spiking, and it essentially hydrates you from the inside out, significantly reducing dry eyes, cracked lips, and nosebleeds.
When you start isotretinoin, your body triggers a massive histamine and inflammatory response, this is what causes the accutane purge and facial redness. In order to minimize this as much as possible we are going to be taking an antihistamine daily. You should use a second generation antihistamine such as desloratadine (5mg/day) which is what was used in this and most other studies.
As a bonus this even seems to speed up how fast your acne clears up.
Significant decrease in total lesion counts when using both isotretinoin and desloratadine compared to just isotret.
Occurence of flare-ups (purges) are significantly reduced.
Again, increased patient satisfaction.
(https://pubmed.ncbi.nlm.nih.gov/25081735/)
As a bonus this even seems to speed up how fast your acne clears up.
Significant decrease in total lesion counts when using both isotretinoin and desloratadine compared to just isotret.
Occurence of flare-ups (purges) are significantly reduced.
Again, increased patient satisfaction.
(https://pubmed.ncbi.nlm.nih.gov/25081735/)
Traditionally people would use the Cumulative Dose Target as a dosing guide for isotretinoin. You would aim to reach a total ingested amount of 120–150 mg per kg of your body weight and then your course was considered finished.
Recent scientific consensus has shifted away from this. We now know that the risk of acne relapse relates more closely to the duration of continuous sebaceous gland suppression rather than hitting an arbitrary milligram target.
So what should you do?
You treat until your skin is 100% clear, and then you continue the medication for exactly 2 more months.
Continuing for an extra 60 days after complete clearance ensures the sebaceous glands are shrunk and "reset," lowering the chance of a relapse.
Because you are using a low dose, hitting clearance + 2 months will naturally take longer. Expect a low-dose course to take 6 to 9+ months rather than the traditional 4 to 5 months.
Recent scientific consensus has shifted away from this. We now know that the risk of acne relapse relates more closely to the duration of continuous sebaceous gland suppression rather than hitting an arbitrary milligram target.
So what should you do?
You treat until your skin is 100% clear, and then you continue the medication for exactly 2 more months.
Continuing for an extra 60 days after complete clearance ensures the sebaceous glands are shrunk and "reset," lowering the chance of a relapse.
Because you are using a low dose, hitting clearance + 2 months will naturally take longer. Expect a low-dose course to take 6 to 9+ months rather than the traditional 4 to 5 months.
Thanks for reading
