Roaccutane: miracle acne cure?

You may associate acne with teenagers, when hormones are in flux during puberty. But acne in the over 40s is far more common than you might think as similar hormonal choas happens during perimenopause and menopause.

In fact it’s common in older women. A study showed that over a quarter of women in their 40s and 15% over the age of 50 had acne.

Some have persistent acne, which some specialists class as a chronic disease. Others get late-onset acne for no obvious reason, which could be caused by hormone imbalance during the perimenopause and menopause.

I’m an acne sufferer. It started in my mid-40s and, having been successfully treated by a dermatologist with creams and antiobiotics, I enjoyed a few years with only minor breakouts. Clear, healthy skin is bliss.

What non-sufferers do not often appreciate is just how unbearable it can be. It’s not just that it looks horrible – there’s nothing nice about lumps, bumps, cysts and heads of any colour – but it’s painful, too.

You know an eruption is going to happen, the telltale throb, the reddening anger in the lump deep in the skin. The unmissable profile sticking out from your face which grows and hurts, even at night when you roll on it and it wakes you up. And you look at your diary events coming up, worrying that a breakout’s going to happen at the wrong time. And it does.

Then you’re in a cycle of covering it up. There’s no real disguise, it’s just there making you feel conscious and unclean. But it’s nothing to do with cleanliness. I’m bordering on OCD, have always looked after my health and skin and I love my regular facials.

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Getting to the root cause

And then you get to a point, which is where I was in May, when there appears to be no real alternative. Antibiotics and creams don’t work – they’re maintaining breakouts, not clearing the acne long term – and you have to accept the inevitable. Either put up with acne for life or get to the root cause.

Cystic acne leaves scars. I have too many already to risk more and, as I plan to live for at least another 50 years, I might as well take action now. Besides which, my doctor and dermatologist won’t give me any more antibiotics, they only limit the inflammation and no amount of topical cream would help in the longer term.

Roaccutane: risk or relief?

So in May, I was prescribed Roaccutane and begin treatment the following Monday. I had some blood tests done at the hospital and I have regular appointments booked in every month. They do monitor you carefully, that’s reassuring in one way and also a reminder of the risks.

As one of my friends said, it’s a bit like having braces, they don’t look great but time passes and afterwards you’ll be glad you did it. Here’s hoping!

Scary stuff for me. I’ve been Googling of course and the side effects stated from others leave me with dread that I’m going to end up looking like the crypt keeper with every drop of moisture sucked out of my body. As if menopausal symptoms aren’t enough to cope with…

There’s very little balanced information about acne in mid-life and Roaccutane to help me understand it more. Just lots of scare stories – I’m trusting the professionals on this one and stepping out with the belief that a few months of side effects mean I can live the rest of my life acne free.

Five months on and nearly halfway through the treatment

I’ve had a few symptoms but the pros are definitely outweighing the cons.

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I’ve lost a lot of skin from my lips and ears (that was odd), and it didn’t look pretty. The early weeks/months were worst and when I tried to increase my dose my top lip swelled to a cartoon-character proportion. Think Marge Simpson, with my top lip sticking out well away from my face. My family consoled me that at least I’d know what I’d look like with lip injections!

I was warned about how dry my skin would be. Of course, in my 50s I was a bit worried about this, the thought of whether my natural oils would ever return. I expected accelerated ageing.

I needn’t have worried. So far my skin has just as much moisture as before, in fact I’m convinced my skin is better, smoother.

My eyes have been dry and I had a spate of them looking bloodshot, but eyedrops sorted it out. And in the early days I had a few nosebleeds, but they passed as quickly as they came.

BUT, the big thing is I’ve had no low moods, which they always ask me about at the monthly appointments. And so many people told me about the psychological risks of this drug. Friends telling me they didn’t let their children go on it because of the link with suicide. My dermatologist thinks these risks have been overplayed by the media.

My holiday this year was fabulous, I continued with the treatment and was delighted (and relieved) to have had no outbreaks, no spots. Nothing. I didn’t sunbathe, as your skin is more sensitive to the sun when you’re on Roaccutane, so it was high factor cream under an umbrella mostly. Still I got a bit of a glow.

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On the fabulous side, as a natural greaseball, my hair has dried out a little and doesn’t need washing every day.

What I’ve learnt so far

Keep things in perspective when you’re reading scare stories on the internet. The dermatologist explained everything, including the risks and everything he said was right.

True, I’ve had some symptoms, but in the scheme of things, compared to a lifetime of breakouts and scarring, they were not that big a deal. The dosage can be adjusted too, I had mine reduced when I had symptoms. There is an option to have a higher dosage for a shorter period or smaller dosage for longer. The analogy I was given was that it’ll still have the same effect and I can choose between the rowing boat or speed boat. I chose the former.

I’ve been using Eucerin facecream, which is lovely and simple and actually it has kept my skin very well hydrated. You can only use creams with no active ingredients but I plan to return to my favourite Environ when this is over.

I’ll write up my full experience when I’ve completed the course, but where I stand right now, I’m inclined to say that Roaccutane is a wonder drug!