Extremely dry skin recommendations (Accutane skincare routine)

[jjwhite]

Any recommendations out there for moisturisers/skincare products for extremely dry, sensitive skin?

I've just started taking Accutane (oral isotretinoin) for acne which makes your skin extremely dry and sensitive. It also makes your lips peel like crazy and your face flush red. I haven't started getting these side effects yet, but I'm bracing myself for them and starting to adapt my skincare routine in anticipation.

Any suggestions on products/routines etc?

At the moment I'm thinking:
-wash face once a day in the evening (I currently use Elemis tri-enzyme cleanser)
-avoid hot baths/long showers
-moisturise immediately after washing (currently: Eucerin dry skin face moisturiser)
-lip balm (Carmex, Nuxe, Burts Bees on rotation)

I sometimes use Clinique moisture surge spray as a kind of hydrating toner before applying makeup in the morning - concealer seems to stick better to that than bare skin.

My basic mission is to keep my skin as moisturised as possible so that I can still wear makeup without it peeling off/looking horrid.

Any thoughts/recommendations/experiences appreciated :-)

[LazyDoll]

Hi,
I started Roacutane at the end of December.
My routine now is very basic and very stripped down.
Wash with Simple or Dove soap and tepid water.
Moisturise with E45.
Lips (and nostrils-ouch!) with Elizabeth Arden 8 hour cream (lips hourly!)
Also just bought Dermalogica spf 50 sun cream as sun/wind sensitive.
The peeling stopped (bar nostrils/lips) after a few weeks and I can wear make up again now without it gathering in every crevice!!
How's your other side effects?!

[oOJJOo]

Thanks so much LazyDoll - can't tell you how nice it is to hear from a fellow Roaccutane user!

I only started a few days ago, so no side effects yet. I'm bracing myself for the dry lips/skin/nose/eyes and then the aches/possible headaches. Fingers crossed I don't get unlucky with any of the more horrible, rarer ones.

How has it been for you? How's your skin looking? That's great that you can wear makeup now. That's my main concern - that there will be a long period of time where my acne/pigmentation is still bad but my skin is really dry and I can't then wear makeup. Concealer has been my crutch this last few years - and I'd really struggle to go out in public without it. Yet, as you say, it looks so bad when your skin is really peeling.

When did you find your skin first starting to peel/get dry?

Thanks again for replying :-)

[LazyDoll]

Lovely to chat to you too!

It's a serious drug and I posted on here with apprehensions prior to starting it but after really positive feedback and a really supportive GP I made the jump!!

I had almost immediate symptoms of very dry eyes and used hypromellose 0.3% eye drop which helped loads.

My lips have been very dry the whole time (although they are usually very dry this time of year) and I am constantly rubbing off the dry skin with a warm flannel and slicking on tons of EA.

The whole face dryness probably started after a couple of weeks (as the kind of purge settled down!) I had more little spots in the first couple of weeks.

I had weaned myself off foundation/tinted moisturiser a year ago in the hope it would improve my skin (it didn't) but wanted to use it to cover the first couple of weeks worse skin but it was just too dry and stuck in every dry flake (even ones that weren't visible to the naked eye!!) I used my normal concealer and this had to do!

Luckily that didn't last too long (2 weeks maybe at its driest) and I noticed other positive changes. Tmi here but blackheads and also 1 milk spot started to be expelled on their own...kind of pushed out to the surface. And washing my face actually felt like someone else's face...much smoother softer skin. Also my pores are almost invisible now and I haven't had a cystic spot (my main issue) since I started.

I did get a massive thirst in the early days and also recently (6 weeks in?) felt like I was sleep walking through the day and felt very sluggish. Although I seem to be much tireder than usual and have had a few more headaches it's nothing so far that I can't cope with compared to the alternative (enormous painful cysts that caused swelling/bruising/scarring).

I had initial pre Roac blood tests and have had some 1 month in shuck showed a borderline abnormality so need more tests at the end of the month. I'm hoping I can stay on the drug however as after 25 years this is the only thing that's truly made ANY difference to my skin.

Have you any side affects yet? How was your dermatologist appt? Mine was pretty disinterested soon glad I have a great GP.

[Indecisivejo]

Lazy doll what is the name of that dermalogica sun cream please?

[LazyDoll]

I spoke to my beautician who specialises in problem skin and she highly recommended it. You can mix it with normal moisturiser/foundation too (obviously would reduce SPF).

[Indecisivejo]

Thank you. How do you rate it? My skin is highly sensitive/reactive! Do you get any stinging? Do you apply it on top of moisturiser or instead of? Also is there a reason you don't use any of the derm cleansers/moist etc? Sorry for questions

[LazyDoll]

I only got it this weekend (good old Amazon) and have only used it once. I run and I've found the wind/sun exposure whilst out is causing my skin to react more due to the Roac. Getting very flushed mainly. Hoping this will help.

I plan to use it instead of if running/out for full day or mixed with if only popping in and out of the sun.

In regards to the derm cleansers etc I was using Paula's Choice when I got prescribed Roac and my derm recommended cutting right back on the cleansers etc and just let the drugs do their stuff. Tbh as my issue is purely cystic acne they weren't doing an awful lot anyway and it feels TOTALLY liberating to go back to basics!!

[LazyDoll]

I also use E45 shampoo as have been getting a bit of a dry scalp too...on the plus side went 4 days without washing my hair the other day as doesn't seem to get greasy at all now!!

[oOJJOo]

I can’t tell you how useful it is reading your posts LazyDoll! I’m feeling really encouraged, having felt very apprehensive before because of all the side effects.

I’ve gone and stocked up on eye drops, lip balms and moisturisers this weekend. I even went to the optician for an eye test and got myself some glasses just in case I can’t wear my contact lenses because of the dryness.

Looking at my skin this evening it doesn’t look too bad, although I can feel lots of bumps/nodules under the skin which I imagine will come to the surface in the next weeks as the accutane starts to kick in. I’m trying to plan work and social commitments in such a way that I can work from home while the dryness and acne are at their worst (sad I know!!)

I also think I’ve been a bit headachy and had a dry mouth in the evenings, but nothing too noticeable so far. I will report back though and let you know how I’m getting on. I’d love to hear about your progression too :-)

So my appointment with the dermatologist was quite a positive one. I felt a bit like I was going into a business pitch, trying to talk her into prescribing me the medicine! She was quite sensitive to the emotional effects of acne which made a change from some of the doctors I’ve seen in the past who seem to think acne is a minor skin condition (correct!) without any psychological effects (incorrect!!). So it was really nice feeling like I was being listened to.

I’m quite apprehensive about all the blood work/subsequent dermatologist meetings - but I suppose they’re there for a good reason. My last blood tests showed I had low iron, although I don’t think they’d take me off the pills for that? What was the borderline abnormality that made them falter (if you don’t mind me asking!) I would imagine its the liver/kidney/lipids that would be cause for concern.

So are your spots more or less cleared up now at 6 weeks? You must be so thrilled…

[AllPizzasGreatAndSmall]

Don't assume your skin will get really dry, when my son was on it his skin didn't and certainly didn't get flaky, and his skin had not been oily to start with.

His main side-effect was constant dry, flaky lips and also dry nostrils when he went up to the full dose. He used Elizabeth Arden 8 hour cream and Apivita lip balm, M and S used to sell this brand but unfortunately don't anymore.

[AllPizzasGreatAndSmall]

Forgot to say he only used Cetaphil cleanser and moisturiser on his face, nothing with anything 'active' in.

He also had no problems with dry eyes.

[RapunzelStyle]

When I was on it, my spots dried up within a fortnight.
I had the whole range of side effects though - nosebleeds, peeling lips, sensitive to light, dry eyes, sore muscles and joints. Totally worth it though.
I recommend blistex lipbalm and avene skincare (available in boots).
Good luck!! :-)

[oOJJOo]

Thanks for all the advice everyone :-) Still no side effects, but I don't appear to be having the dreaded initial breakout either (touch wood!)

That's really encouraging to hear that about your son AllPizzas - fingers crossed I'm as lucky as him!

[Ididnthearanything]

Ive had it in the past, at a low dose. Amazing stuff and the relief of not seeing spots!

EA lip 8hour stuff was the best I tried. Carry it with you.

My derm recommended only La Roche Posay Toleraine range. The more basic/fewer ingredients the better.
I had v few side effects, vague muscle aches, dry lips, nowt else.

Good luck with it. It is fantastic stuff. You will love the results.

[oOJJOo]

Ididnthearanything that's so encouraging - thank you. I'm so thrilled to be finally taking it. I'm preparing for the worst with the side effects, and then I can be pleasantly surprised if I get off lightly!

If my skin really clears up it's going to be such a great boost to my confidence - so fingers crossed :-)

[LazyDoll]

Hi oOJJOo,

It's great for me to chat about it too! I'm starting to feel I'm boring 2 particular RL friends silly with my tales of niggly side affects!!

I don't think it's sad at all to plan round your possible outbreak. Been there done that many many times! That's why we're on this stuff now to hopefully put an end to all that I guess!

I see another poster had eye sensitivity and I'm currently sunglasses shopping as my eyes are sensitive too (again they have always been a little light sensitive though so it's more exacerbating that than total new symptoms)

My ESR was slightly raised (inflammation in blood) re test Friday to see how it is a month later. Dr happy for me to continue and review next test results.

Glad you have a supportive derm! I also went in thinking I'd have to persuade him but he didn't even let me finish my sentence before he was writing the prescription so I met with my own GP as had a LOT of concerns I wanted alleviating.

How long have you suffered with your skin? Have you decided what cleansers etc to use?

Mine has had a 2nd flare up recently. Nothing compared to how it was and relatively superficial. No cystic ones but it's definitely heading in the right direction. I do have a killer headache today but it's hard to distinguish sometimes what's Roac and what's the end of half term etc!!!

Is there a way we can PM?! Would be great to have someone to chat too!!

[lurkingfromhome]

I was on it two years ago for six months. The side-effects can really vary a lot - I did have the peeling lips (I think everyone does) but other than that my skin wasn't particularly dry. I obviously stopped using all my glycolic-based skincare but I didn't experience any of the chapped face/peeling body/sensitive eyes that I'd read about. It honestly wasn't nearly as dramatic as I'd feared.

I did have the aching joints and muscles and fell asleep on the sofa at 9 every evening but that was perfectly manageable and so worth it .

Feel absolutely free to PM me if you want to talk through anything about my Roaccutane experience (or "journey", as they'd call it if I was on The Acne X Factor ).

[LazyDoll]

Lurking it's VERY reassuring to hear how tired you were! I feel like I am permanently sleep walking I'm SO tired!

[lurkingfromhome]

It was weird - I felt fine all day and had no problem getting up for work, or even doing a full day's work. As soon as I'd had dinner, though, it was like a switch going off in me and I just passed out in front of the telly. Had an amazing two-hour nap then went to bed for a full night's sleep .

[NameChangeEr]

For lips, burts bees, burts bees, burts bees. A tube everywhere, in the pocket/car/handbag/beside the bed.
It saved my lips and was wonderful.
Also moisturiser with SPF or just sun cream on face, even if just in the car

[LazyDoll]

I'm at 8 weeks now and it's only just hit in the last week or so. Hopefully it'll be like the other side affects and pretty short lived. Coping with 3 DCs (8,6,4) plus work is exhausting at the mo!

[oOJJOo]

LazyDoll Yes I’ll try and work out how to PM you and that way we can stop boring our RL friends and other MNers with our accutane chat! Great to have someone else on the same ‘journey’ though (lol lurkingfromhome I love the idea of an Acne X Factor!) In short, I’ve had persistent inflammatory acne around my jawline for 5 years, and have tried the lot - creams, lotions and potions, antibiotics, contraceptive pill, dianette, and nothing will shift them. I’ve honestly spent way too long fretting over them, and I’ll be so relieved if this treatment is going to clear them for good. I think my quality of life will sky rocket! As per my OP at the moment i’m washing once a day using Elemis cleanser and then applying a decent layer of Eucerin moisturiser. Otherwise I’m trying not to overcomplicate things. My skin seems drier today, and I think I might need to start moisturising in the morning too. Are you moisturising twice a day at the moment?

Lurking that’s so reassuring to hear about your experience… I’ve heard so many scare stories so it’s great to know that for some people, the whole ordeal was much less dramatic!

NameChangeeR I love the Burts Bees one - I’ve got a tube of that and then some Nuxe and Carmex and will rotate them all. You’re right about the SPF. I absolutely love the sunshine and I’m gutted that I wont be able to do my usual basking this summer (although probably for the best!)

[JoanDarc]

I am on month 6 (hopefully last month) and think my skincare routine has definitely minimised any awful dryness.
For lips the absolute best thing I can recommend is aquaphor ointment/balm (not the lip one) I also use this on any severe dry patches including nose lining and it has been fantastic.
Cleanser is cetaphil Cleanser for dry/sensitive skin and for moisturiser I swear by the Avene Rich Skin Recovery cream.
Using the combination of the above has meant my skin hasn't felt dry and when I run out (especially the Avenue moisturiser) my skin feels really tight and itchy and any sub I try doesn't cut it.
The medication has definitely worked for me, I now leave the house without make up on, which I never thought I would do, I just pray the results stay when I finish this!!
Good luck!

[AllPizzasGreatAndSmall]

I'm not sure if you should be using the tri-enzyme cleaner as it is a resurfacing cleanser; I know it can increase sun sensitivity and combined with the Roaccutane it could be too much.

[LazyDoll]

JoanDarc I'm looking at your skincare routine and wondering if the Simple soap is too drying for me. Will check out the Cetaphil. Thanks

oOJJOo I am moisturising twice a day with E45 although I wasn't at the beginning. I also continued with the Paula's Choice cleanser for the first couple of weeks until the dryness kicked in then stopped it altogether. I use Sudocrem only for any breakouts but am definitely open to advice as my dermatologist offered non so I'm free styling!

It's great to hear others experiences