Roaccutane - recommendations for dryness

[BrokenWing]

After a long wait Ds(19) is starting Roaccutane next week and I am filling up my boots online basket so i know what to recommend to him if he needs anything for the common dryness side effects. He already mentions itchy skin coming out of the shower with Dove shower cream, and has slightly dry/watery eyes so expect both will get worse while on roaccutane.

I feel a bit clueless, I have checked loads of past threads that recommend e.g. aveeno, but there are lots of aveeno moisturisers and I don't know which one is best while using roaccutane and what to avoid! I would really appreciate all advice to get him onto the right products he will need.

Lips (and up nose?) - Blistex relief cream seems to be a clear recommendation
Shower - AVEENO® Dermexa Daily Emollient Body Wash?
Moisturiser body - Aveeno Dermexa Daily Emollient Cream?
Moisturiser face - What should he be using while on roaccutane?
SPF50 - recommendations?
Eyes - Hycosan Extra Eye Drops?

I know he needs to drink lots of water, any other advice welcome!

I’m really glad it’s going in the right direction for him, but sorry to hear the side effects are so troubling. Does he drink? I seem to recall the derm telling me it was important not to drink much, although I did mess this up massively on a few occasions.

Is it possible the tiredness is uni-related?

He is 2nd year uni and is more relaxed, enjoying the course this year more than last year (too much partying last year impacting work/needing resits!), he doesn't seem overly concerned, doesn't study much at home (does it in library between lectures) so has evenings to do his own thing, and marks on assessments are going much better this year than last.

He does drink, but not too often or over do it. The dermatologist told him, being a student, he didn't expect him not to drink but just don't over binge too often. Last time he had a drink was 7 days ago (previous weekend) as has had other things on. His uni friendship group don't overdo it when out drinking as it is too expensive - they are saving for holiday(s) - maybe 4-5 drinks tops. Work is less hours than usual just now because hospitality trade is less in Jan/Feb - but he is fine money wise. They are all strongly anti drugs so no concerns there. They are all in "training" (go out for a short walk 🤦‍♀️) for the Glasgow kilt walk in April.

He says it is a strange feeling, as even going to bed early, sleeping all night, he still feels this tiredness as a constant. He was working until 2am this morning, he enjoys work as a bar steward with 2 uni mates so they have a good laugh, and says he doesn't feel any more or less tired this morning after late working and less sleep. I'll maybe watch for a few days and if it keeps up tell him to put in an e-consult with the GP for advice, I'm not sure how/if he contacts the private dermatologist outside of appointments.

4 weeks x 20mg and 16 weeks x 70mg now. Two weeks of current prescription left to go.

The tiredness passed by after a couple of weeks, perhaps it was the Roaccutane or perhaps something else. No new spots for a while (except one cracker on his forehead last week which only lasted two days), but skin has a way to go to heal, especially on his shoulders and chest.

The last time he was at the consultant he was given a 10 week x 70mg prescription and told if "it works" he can cancel the next appointment which is now in two weeks time. Typical teenager didn't ask for a definition of what "it works" means and what to do after. I think it has worked because he is no longer getting new spots and the rest are gone so should be ok to stop......

What happens next? What did your dc/you do after Roaccutane? Go back to normal face washes or keep using acne prone skin type washes to try to prevent it coming back? Or are there products to help healing the dark red pin pricks that have been left?

I did roaccutane at age 21. I've been using similar products ever since (10+yrs) as most commercial products can risk causing or aggravating acne prone skin. So that means

• cetaphil or cerave cleanser and moisturiser

• NOTHING with oil in it

• any face products must be non-comedogenic

• use E45 shampoo until dry scalp clears up

• use a good intensive lip balm

If it's any consolation, mine didn't clear up totally until the last few weeks of treatment. It got worse before it got better and I was so scared it wasn't going to work. Then it worked and then my skin renewed for weeks after, it was like having baby skin, just wonderful (wonder if his scarring will go naturally as a result? A lot of mine did).

Spots came back about 6/7 years later which is common, so you have to keep on top of good skin care and not get complacent.

The dryness has never totally gone away - think my hair and scalp are drier these days, and lips for sure - but so worth it for the hell I went through having acne.

You really must not drink alcohol at all whilst on roaccutane. As I remember, the treatment puts a strain on the liver. It's a very intense treatment on the body... honestly... I would not mess about with the advice on drinking etc. and 70mg is quite a serious dosage. He could read up on people with suspected lifelong effects from roaccutane if not taking it seriously enough!

It’s a long time ago, so things may have changed, but I was prescribed Differin immediately after coming off Roaccutane.

My dd 13 was prescribed differin as even after 6 months treatment the acne hadn't completely cleared. It's a lot better now months on although she started to get some big pustular ones coming back. She was still using the intensive moisturisers so we stopped those and she started to use LRP effaclar duo. This has improved things.

Would also be interested to know about treatment for scarring. They said as she's so young that the skin should renew and the scarring fade but would be good to know the options in case it doesn't.

You say he has no new spots, but does his skin look clear? I'd probably go to the appointment and see what the dermatologist says -it would be a shame to stop if another few weeks would mean an even better result.

I’d definitely go to the appointment, if skin is only just starting to clear they may keep him on it for another couple of months. It would be a shame not to get the full effect especially with side effects, better to make sure he can avoid going through it all again.
I’ve done it years ago and my daughter is currently on it, 1 x month at 20mg and 4 months @ 40 mg. Dermatologist indicated that she may be on it for another 40 mg 2 month dose to finish, so 7 months in total. My understanding is effectiveness is based on total cumulative dose for weight.

Took all your advice and ds went to dermatologist today and after 4 weeks x 20mg and 18 weeks x 70mg he can stop the roaccutane.

Dermatologist has said he has had a really good result, the red dots will clear on their own, his lips (TMI alert - which look terrible in the corners because they go so dry and he keeps picking them!) will heal. Dr said the effects will continue over the next couple of months until all the roaccutane is out his system.

Told him to just use non oily face wash, moisturiser and sun screen and if the spots do return not to leave it until it gets really bad before going back. Said Differin was not needed for him.

Thanks for everyone's advice through his treatment!

Hopefully the effects are long lasting for him and it doesn't come back, either way so far it will have been £500 well spent! (~£400 for the private roaccutane prescriptions, ~£100 for lip salves, lotions etc. My work health insurance paid for the consultations x 4).

Glad to hear that he's had a positive result OP. My DS has been on it since January and is having good results although there's still a way to go. Thanks for the update, bet your son is pleased x

So pleased he’s had a good result from it! I used products that were as gentle as possible for a good six months or so after treatment while my skin recovered. I wouldn’t use stuff formulated for acne, just a gentle cleanser and moisturiser.