bruno - health

Accutane: First Week

2026-06-26T00:00:00+00:00

Introduction</h2>
After much deliberation and inner fighting, I have started an accutane course to treat my chronic - but moderate - back acne. My journey with acne has been complicated, with lots of physical and mental scarring, and I’ve always seen jumping on accutane as a last resort when I couldn’t handle it anymore. Well, I couldn’t handle it anymore.</p>
During my quest for the medication, I encountered many doubts which were eased by spending hours reading other’s experiences - hello Reddit! I now want to give back to the community and share my own journey so far. I’ll be covering my history with acne, when I finally decided that I needed accutane, how I went about getting it here in the UK, and how treatment is going.</p>
I hope this post helps you as countless others have helped me. Let’s get going.</p>

My Acne History</h2>
Nothing is certain but death and taxes, and in my case, acne. I have had acne for as long as I can remember. It’s been an ever-present “feature” (bug?) in my life.</p>

Teens</h3>
During my teens, I mostly recall it affecting my face. Of course, almost every teenager struggles with acne, but mine was always worse than my peers’, and I know how much those years of constant comparison affected me then and now. I saw myself changing behaviours: avoiding looking in the mirror, avoiding having the lights on when in the bathroom, avoiding taking pictures. I remember how any joke or small jab at my appearance would make me feel so small, so worthless. And I felt so powerless to change it, too. My family always struggled with money, and I couldn’t go around buying expensive skincare or afford private dermatology.</p>
My dad eventually got a well paying job in France, and took me to a derm in Portugal. I actually did go on accutane back then, around the age of 14. Thinking back, it is somewhat wild how easy and non-regulated the process was: I showed up to a private dermatology appointment and came out with a prescription. No blood tests, no mental health screening, no promises of a future follow-up. I don’t even think I did a full round of six to nine months, just took a box or two and called it a day.</p>
But boy did it work. My face cleared up like a charm and I got my confidence back. For the first time I actually felt pretty. I not only accepted being taken pictures of, but was actually enthusiastic about it! I had people calling me cute! And, especially if you’re a guy, you know how rare and confidence boosting those simple comments are.</p>
My back never really cleared up, however. My bacne was mostly lots of “small dots” and some big pustules (not cysts). It started really bothering me at around 2020, as I began going to the gym more often and felt conscious about wearing sleeveless gym wear or changing in the locker room.</p>

Early Twenties</h3>
Now, I consider myself a “fixer”. I see a problem, I will do everything in my power to fix it. And I actually did! For a time, at least. Using a salicylic acid spray and a benzoyl peroxide wash, I eventually got it to clear up. I was showering twice a day, morning after the gym and before bed, applying the BP in both showers and the spray after the first one. It was time consuming and it was expensive. But it worked</em>. I had the best skin ever. I had defeated acne. I was victourious</em>. My Instagram was brimming with gym-fueled mirror pics. I was living the life.</p>

Currently</h3>
But nothing good lasts forever. I got complacent - and tired of spending so much money and time - and winded down the routine a bit. You have no idea how much I regret doing so. This was also around the time I was finishing my PhD and changing cities for my first ever real job. I am sure the added stress didn’t do me any favours. My bacne came back mid 2024, and even going back to the good old routine did not fix it this time around. My GP had me try azelaic acid (finacea) and duac (BP + clindamycin), but none of these made a dent, either.</p>
And as the acne came back, so did the toxic behavioural changes. Avoiding mirrors once more, pictures became rarer, and so did YouTube videos. I feel conscious about hugging friends, about having my girlfriend touch my bare skin when we cuddle. Every single time I sweat, I feel disgusting and afraid of new blemishes. None of this is healthy</em>. None of this is normal</em>. But it’s easy to let these thoughts creep in slowly and you can’t see them as problematic. It’s insidious. I felt myself becoming diminished, as I couldn’t do everything I wanted with my body out of fear my skin would complain. It is no way to live.</p>
I felt myself breaking.</p>
The Keloid That Broke the Camel’s Back</h2>
And eventually I did and made my mind up about going on accutane.</p>
On top of the previous routine no longer working, the strongest reason was the development of a keloid scar on my upper sternum. For those fortunate enough to not know what a keloid is, it’s a raised scar that significantly grows out of the original wound. Now, you can imagine my horror when I realise I have this scar right in the middle of my chest, and it’s getting bigger! I remember being sat at an Ikea restaurant (mhmmm those Swedish meatballs) and googling “scar that keeps growing”. I half expected google to tell me there was no such thing. I felt my blood turn cold and nearly had a panic attack when I started reading about these growing bastards.</p>
The NHS doesn’t do anything about keloids, as they are purely cosmetic and the UK is skint. I ordered these steroid plasters from Japan, and have managed to keep the scar relatively small and stop its growth. I plan on dealing with it more aggressively after I take care of my acne.</p>
What did not stay in check was its mental impact. Every single time I have a pimple on my chest, no matter how small, I start panicking and thinking it will form a keloid. It is exhausting</em>. It got to the point where I was terrified of taking my shirt off as I might spot a new spot and I’d spend the remaining of my day overthinking about having one more skin problem to deal with.</p>
Getting Accutane</h2>
If you’re in the UK, you know how hard it can be to go on accutane. You must give everything</em> else a try, including three rounds of oral antibiotics and you will most likely wait months for a dermatologist. I did not want to go through this process, so I decided to bite the bullet and go private.</p>
Individual Circumstances</h3>
I have some small counter indications for accutane that kept me in fear of being rejected the medication. None of these ended up being a problem, but I am sharing them here so that if you suffer from them, you can hopefully feel more hopeful.</p>
I have familial hypercholesterolemia, which means my cholesterol level is very</em> high. Even while being medicated with a statin, it is still slightly higher than it should be. Accutane can mess up with your liver and lipids, and so I was scared I’d be denied treatment. My screening blood results came back only slightly out of range, and my derm was not concerned at all.</p>
I was also concerned about an initial purge to result in more keloids, but I decided that the risk of not treating the acne was higher. My derm offered to prescribe me additional medication if I suffered a strong purge to reduce the risk of scarring.</p>
I go the gym six to seven days a week to weight lift, and I was scared of joint pains or damage. I was recommended to increase my intake of healthy fats and omega-3 to help my joints out.</p>
Finally, my acne simply isn’t severe and I was worried it wouldn’t be “bad enough” for accutane. Thankfully, the derm understood how much my acne affects my quality of life and that I had already tried nearly everything to treat it. More recent accutane guidance also emphasises its use in moderate but resistant cases of acne, especially when the risk of scarring is high.</p>
Finding a Derm</h3>
As mentioned, I decided to go private. I looked at a handful of clinics in my city, but could not find any reliable reviews or recommendations of the physicians. Eventually, I came across skindoc</a> (I am not sponsored in any way and I paid for everything myself).</p>
I found multiple extremely positive reviews of skindoc, with some rather detailed ones on Reddit. I decided to enquire their support team with all my doubts and was impressed by their responsiveness. They detailed every aspect of the treatment procedure, from screening, first appointment, prescriptions, blood tests, and all costs. Overall, I was looking at around £1000 for a six to nine months course, depending on if I’d have to pay for my blood tests or not.</p>
With everything pointing to a positive experience, I booked my first online appointment on the 4th of June for the 12th of June.</p>
The Wait</h3>
I wanted to make sure I had everything in place to start the course as soon as possible. I went to my GP and asked for the required blood tests - LFT, GGT, FLP, and FBC. Thankfully, my GP is already familiar with my acne struggles and agreed to support me with NHS blood tests during my treatment, reducing my overall costs.</p>
I got them back and everything was as I expected it, with the slightly elevated lipid profile. The GGT was missing, and I had to go for another</em> blood test (I hate needles). My health provider is amazing and got me a same-day blood test booked for the GGT, which came back perfect and perfectly in time for my appointment.</p>
The Appointment</h3>
skindoc offers you multiple dermatologists to choose from. I went with Dr Sree as every single review spoke well of the man. I am happy to say that all the good talking is warranted: it was incredible.</p>
He listened to everything I had to say, didn’t dismiss my experiences nor my concerns. He made adjustments to my individual circumstances and reassured me where he saw I was doubtful. We agreed on a plan for the next two months before I take another blood test and have a follow-up to make any necessary adjustments.</p>
I got my first prescription delivered on the 16th of June, and that’s when I took my first pill. Less than two weeks from booking to starting, which is faster than I could ever hope for.</p>
How’s It Going</h2>
Honestly, I haven’t noticed much of a difference in my acne yet, but that’s expected. I am writing this on the 26th of June, and I just took my tenth pill after a delicious lunch. I am starting out slowly on a low dose of 20mg a day, so it’s really quite early to see any meaningful results. My lips are starting to crack, but rest assured I am already loaded on aquaphor.</p>
The biggest impact so far has been to my mental health. A positive impact, that is. I no longer take ages in the shower applying creams and sprays to my back. I no longer fret about getting a bit sweaty exercising. I no longer question if I am doing enough or using the right product. I have confidence in the process I started, and I am excited to see its results. I am already the happiest I’ve been in a long, long time.</p>
Conclusion</h2>
I like to say that we can withstand every low period in our lives as long as we see a path forward, as long as we see a line going up. For a long time, I didn’t see a path to improve my acne, and that ruined a lot of my confidence. I now see that path, and I am walking it as I write this. I am hopeful once more.</p>
May I get there soon.</p>