Discussion tretinoin alongside isotretinoin (1 Viewer)

[Darktriad]

ive been using accutane and its still not enough for my skin

i know chatgpt says not to, and the general consensus is one or the other, but can i possibly use tretinoin alongside my isotretinoin? ive been using accutane for a few years now and it hasnt been enough. i have rlly oily skin.

 

[Synapzyzz]

high iq advice

it looks like he has subclinical hypothyroidism, his TSH is fucked up at 6.58, he is going with an endo next week. The thyroid is crucial for hormones and skin amongst many other process such as metabolism and etc

 

[Nardicus102]

350 ng/dl test (ropefuel) at 20YO

if what your saying is true than you sebaceous glands are jus very sensitive in general.

 

[Synapzyzz]

any other factor that you could be possibly not taking into account? any hormonal or thyroid issues?

Nardicus102, start to read from here.

 

[Nardicus102]

it looks like he has subclinical hypothyroidism, his TSH is fucked up at 6.58, he is going with an endo next week. The thyroid is crucial for hormones and skin amongst many other process such as metabolism and etc

Good work Doc, saving lives out here. Gave him a free consultation and forwarded him to a Specialist

 

[Nardicus102]

Nardicus102, start to read from there.

Hyper sensitivity could be the only cause. If his test is low, hes DHT will also be in the normal to lowish range as well. im guessing hes not on anything, and the chances he's a tumor on pituitary gland driving his igf-1 levels thus increasing oil production is also very low fucking doubt that.



Im curious how healthy he is tho, but if he truly is healthy hes gonna have giga run Isotrent forever, Dut will help but I doubt the oil mechanism from DHT itself is the main cause which goes back to him jus having naturally hyper senstive glands which goes back to the only tool being accutane.

He needs to run a full course high dose (100-120mg) for like 8 months straight, cause it seems his glands keep reverting back to normal state and increasing oil production meaning his dose wasnt effective enough for him to get the results he should have gotten

What is OP's height and weight ?

 

[Synapzyzz]

Hyper sensitivity could be the only cause. If his test is low, hes DHT will also be in the normal to lowish range as well. im guessing hes not on anything, and the chances he's a tumor on pituitary gland driving his igf-1 levels thus increasing oil production is also very low fucking doubt that.



Im curious how healthy he is tho, but if he truly is healthy hes gonna have giga run Isotrent forever, Dut will help but I doubt the oil mechanism from DHT itself is the main cause which goes back to him jus having naturally hyper senstive glands which goes back to the only tool being accutane.

He needs to run a full course high dose (100-120mg) for like 8 months straight, cause it seems his glands keep reverting back to normal state and increasing oil production meaning his dose wasnt effective enough for him to get the results he should have gotten

What is OP's height and weight ?

no idea, he gave me his bloodwork but told me to be discrete so i can't share it sadly, however, i analyzed his bloodwork and all markers are normal, nothing stands out besides TSH, which is what concerns me as it is well, high at 6.58.

 

[Synapzyzz]

first of all i need to tell you i'm not a doctor, second i have great news and bad news to tell you, the great news is that all your bloodwork is mostly unremarkable, nothing really stands out, no signs of diabetes, kidney/liver dysfunction, anemia, infection, or major hormonal imbalances, all biomarkers are within normal ranges except for the thyroid function, here's where the bad news come in, as for what it seems your a have subclinical hypothyroidism, your TSH is fairly elevated at 6.58, now the thyroid function affects a lot of stuff, hormone balances, skin cell turnover and the epidermal barrier function amongst a lot of other things and also how the facial oil glands behave, as this bloodwork doesn't have an antibodies test it's not possible to tell the cause behind your hypothyroidism, it could be either an autoimmune disease, iodine deficiency, medications etc, the thyroid is one of the most under looked causes of severe cystic and chronic acne and has a direct correlation and causation with acne, now this is as far as i can help you cause im not a doctor, but i would 100% suggest you go with an endocrinologist cause subclinical hypothyroidism can become worse over time and affect your brain chemistry and libido cause it affects the SHBG. Mark as solution.

Nardicus102

 

[Synapzyzz]

Hyper sensitivity could be the only cause. If his test is low, hes DHT will also be in the normal to lowish range as well. im guessing hes not on anything, and the chances he's a tumor on pituitary gland driving his igf-1 levels thus increasing oil production is also very low fucking doubt that.



Im curious how healthy he is tho, but if he truly is healthy hes gonna have giga run Isotrent forever, Dut will help but I doubt the oil mechanism from DHT itself is the main cause which goes back to him jus having naturally hyper senstive glands which goes back to the only tool being accutane.

He needs to run a full course high dose (100-120mg) for like 8 months straight, cause it seems his glands keep reverting back to normal state and increasing oil production meaning his dose wasnt effective enough for him to get the results he should have gotten

What is OP's height and weight ?

a tumor in the pituitary gland is not the only cause, could be a iodine imbalance or an autoimmune disease, perchlorate poisoning, chronic stress, etc. That's why i referred him to a endocrinologist, we can't really tell what's up without more analysis and bloodwork.

 

[Nardicus102]

Nardicus102

Wait this actually makes alot of sense and very possible. OP def needs to address the following.
Hypo thyroid usually does the opposite I thought tho, cause ive had it one time, n it made feel a bit more dry .

a tumor in the thyroid gland is not the only cause, could be a iodine imbalance or an autoimmune disease, perchlorate poisoning, chronic stress, etc. That's why i referred him to a endocrinologist, we can't really tell what's up without more analysis and bloodwork.

Pituitary Gland* which will increase IGF-1, when igf1 binds to the sebaceous glands on the skin, it becomes oily, but again your right this super fucking unlikely.
His cause is jus hyper sensitive glands in general, they get overstimulated by small stimuli AKA low androgen

Thats is why im curious on his height and weight, cause if hes been on accutane for that long with those doeses, me must have had a relapse of treatment where the glands came back to original size which can happen when dose isnt pushed high enough for individual

 

[Synapzyzz]

Wait this actually makes alot of sense and very possible. OP def needs to address the following.
Hypo thyroid usually does the opposite I thought tho, cause ive had it one time, n it made feel a bit more dry .


Pituitary Gland* which will increase IGF-1, when igf1 binds to the sebaceous glands on the skin, it becomes oily, but again your right this super fucking unlikely.
His cause is jus hyper sensitive glands in general, they get overstimulated by small stimuli AKA low androgen

this is were i wonder if clascolterone or a topical anti androgen could potentially solve the issue

 

[Nardicus102]

this is were i wonder if clascolterone or a topical anti androgen could potentially solve the issue

He should way def try that over adding trent on top of already micro dosing accutane

 

[Synapzyzz]

He should way def try that over adding trent on top of already micro dosing accutane

yeah, the thing is I'm not sure it would work cause he had already ran dut at 1mg if im not wrong, and well nothing changed.

 

[Synapzyzz]

He should way def try that over adding trent on top of already micro dosing accutane

that's why I'm betting on him going to the endo to check his pituitary and overall is TSH, the thing is that the pituitary gland can severely affect the way skin reacts to hormones, specially androgens as the thyroid function regulates skin cell turnover, the epidermal barrier and also how the facial oil glands behave. Maybe when he get's his meds and revert it, his thyroid function might go back to normal levels and might potentially fix the sensitivity issue, regardless the low dose isotretinoin mega course (maybe permanent?) seems like his best bet, that and getting his meds to regulate the thyroid function.

 

[Nardicus102]

yeah, the thing is I'm not sure it would work cause he had already ran dut at 1mg if im not wrong, and well nothing changed.

No fucking way that guys on Dut 1mg and has that low of test

Yea accutane is the only fix here, no other fix can be made for sure. High dose for 8 months will suffice so relapse has less likely hood of happening

 

[Nardicus102]

Something is not adding up with OP here

 

[Nardicus102]

Cause Dut can increase Test by 15% alone, so without dut your telling me would be hypogonadal and still have oily skin ??????

Yea its true, all roads due to lead back to accutane

 

[Synapzyzz]

Something is not adding up with OP here

we really are moving like doctor house and his team rn trying to figure out whats going on lmao

 

[Synapzyzz]

that's why I'm betting on him going to the endo to check his pituitary and overall is TSH, the thing is that the pituitary gland can severely affect the way skin reacts to hormones, specially androgens as the thyroid function regulates skin cell turnover, the epidermal barrier and also how the facial oil glands behave. Maybe when he get's his meds and revert it, his thyroid function might go back to normal levels and might potentially fix the sensitivity issue, regardless the low dose isotretinoin mega course (maybe permanent?) seems like his best bet, that and getting his meds to regulate the thyroid function.

my judgement says the thyroid function might be the key to solving all of this because of what i discussed here:

 

[Synapzyzz]

Cause Dut can increase Test by 15% alone, so without dut your telling me would be hypogonadal and still have oily skin ??????

Yea its true, all roads due to lead back to accutane

being a few ng close to hypogonadal and still having acne is what concerns me too, he has to have super super sensitive sebaceous glands and skin overall.

 

[Nardicus102]

my judgement says the thyroid function might be the key to solving all of this because of what i discussed here:

I really want a update on this case, when he does follow through with a endo,

I dont know what states hes in but seeing a Endo can take months sadly

 

[Synapzyzz]

I really want a update on this case, when he does follow through with a endo,

I dont know what states hes in but seeing a Endo can take months sadly

he has the appointment next week and promised to keep me updated.

 

[Nardicus102]

being a few ng close to hypogonadal and still having acne is what concerns me too, he has to have super super sensitive sebaceous glands and skin overall.

Its the most likely cause, which requires a higher isotrent dose for lower chance or relapse which is what happened to him

 

[Nardicus102]

he has the appointment next week and promised to keep me updated.

Oh shii hes fucking lucky, will stay tuned

 

[Synapzyzz]

Its the most likely cause, which requires a higher isotrent dose for lower chance or relapse which is what happened to him

i think the dose might not be the problem but rather the course time, i think low dose iso for some years might fix it forever, without really compromising liver function tbh.

 

[Darktriad]

Cause Dut can increase Test by 15% alone, so without dut your telling me would be hypogonadal and still have oily skin ??????

Yea its true, all roads due to lead back to accutane

i did dut for 3 months to see if anything changed, nothing did

ive ran accutane for probably over 2 years now, daily usage of 40-60mg

outliers exist