Seeking Guidance on Isotretinoin and Reactions to Topical Treatments
Hello everyone, I’m a 20-year-old woman in need of some guidance. In the past, I relied on antibiotics to manage my acne, which were effective until I discontinued them, leading to a resurgence of breakouts. My new general practitioner here in Belgium has now prescribed me isotretinoin at a dosage of 20 mg. I have struggled with acne for approximately 5 to 6 years, predominantly affecting my chin and jawline, and my skin is quite oily, sensitive, and prone to breakouts. Recent blood work reflects a CRP level of 60.3 and an ESR of 37. Previously, another doctor recommended I try Epiduo, a combination of benzoyl peroxide and adapalene, but the experience was far from ideal. My skin reacted poorly, becoming burned, flaky, and even exuding a yellow secretion. The aftermath has left me with scars, and I experience discomfort in hot weather. My skin feels out of balance, and I’m hesitant to apply additional products. As I prepare to begin isotretinoin, I am anxious about the possibility of a purge phase that I’ve heard about. Could starting with a dosing schedule of every other day help mitigate side effects? Are there any alternative approaches to make the treatment more tolerable for sensitive skin? I would appreciate everyone sharing their experiences with isotretinoin. Thank you!
Answers (1)
2/9/2026, 7:50:41 PM
OpenHealth AI
It's understandable to feel anxious about starting isotretinoin, especially given your previous experiences with acne treatments. Key points to consider are that isotretinoin can be effective for severe acne but comes with potential side effects, particularly for sensitive skin.
Explanation:
Isotretinoin is a powerful retinoid used for treating severe acne that hasn't responded to other treatments. It's known to decrease the size of sebaceous (oil) glands and reduce skin oiliness. While some people do experience an initial "purge" phase, where acne seems to worsen before getting better, this doesn't happen to everyone. For someone with sensitive skin like yours, it's wise to be cautious.
Your high CRP and ESR levels indicate some level of inflammation, which might be worth discussing with your doctor as it can affect how your skin responds to treatments.
Next Steps:
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Start Gradually: If your doctor agrees, consider starting isotretinoin every other day. This can help your skin adjust to the medication and may reduce the intensity of side effects. Always consult your healthcare provider for specific dosing recommendations.
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Skin Care Routine: Adopt a gentle skin care routine that includes:
- Mild Cleanser: Use a non-comedogenic, sulfate-free cleanser to avoid further irritation.
- Moisturizer: Apply a simple, fragrance-free moisturizer daily to help combat dryness.
- Sun Protection: Use a broad-spectrum sunscreen with at least SPF 30 daily, as isotretinoin can make your skin more sensitive to sun exposure.
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Monitor Reactions: Keep track of how your skin responds to isotretinoin and any changes you experience. This log can be very helpful for follow-up discussions with your healthcare provider.
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Discuss Other Options: If side effects become too bothersome, talk to your doctor about alternatives or supportive treatments that can complement isotretinoin, like specific moisturizers or gentle topical medications.
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Maintain Open Communication: Stay in touch with your healthcare provider regarding your experience. They can adjust your treatment plan based on your tolerance and skin's reaction.
Your journey with acne is challenging, but with proper management and support, there is hope for improvement. If you have further questions or need more information, feel free to ask!
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