Prior to starting treatment, Brian’s acne was particularly serious . “I had large, nodular cysts and tonnes of blackheads covering my entire face, and tonnes of whiteheads as well.”
He started out at 40 milligrams of Accutane (the popular name for the drug Isotretinoin) per day. After six weeks, he had a huge breakout , which he says is to be expected: whatever acne you have before starting treatment is going to get twice or three times as bad when the drugs begin to take effect. “It sort of ignites your acne, so it got way, way, way worse.”
It took more than six months for Brian to see some positive results. It was around week 30 that his skin began to clear up: the treatment worked on the whiteheads first, then started acting on the cysts, then the blackheads, and finally the redness in his skin. He also did his own research at the same time, and from week 30 onwards began to cut meat and dairy out of his diet.
“I was trying to figure out what was going on, why my face wasn’t clearing up yet when other people had started seeing success by week 30,” he says, “and I found that my whey intake, my protein intake, which is made up of whey, and whey is made up of dairy, all of that is known to trigger acne. So when I took that out I started to see my acne clearing up very quickly, and then it worked in conjunction with Accutane and actually cleared up fully.”
At his highest, Brian was taking 200 milligrams of Accutane every day, for about 15 weeks, then slowly began to reduce the dosage towards the end of his treatment, and ended up at around 60 milligrams per day. “I was basically taking two treatments all at once,” he says.
During the 70 weeks, Brian went through a range of side effects, from extreme skin dryness which would cause his lips and face to crack and even bleed if he smiled or yawned, to an increased sensitivity to light. He also had pain in his back and joints that he’d never had before, and began to experience a loss of strength in the gym, although he wasn’t reducing his calorie intake, in fact he was eating more calories than usual. Even after treatment ended, the back and joint pain and dry skin persisted, although Brian notes that there are other, much more serious side effects from taking Accutane which aren’t discussed enough, including depression and a greater risk of cancer.
The acne also came back after treatment, which Brian says can happen up to 50 percent of the time. “A lot of people think it’s a 100 percent success rate and then you’re clear forever, and that’s not the case at all.” While his skin wasn’t as sensitive to artificial sweeteners or creatine as it had been, the big triggers, such as dairy, still caused huge flare-ups.
“I finished up Accutane and then I felt like I might have more freedom to eat whatever I wanted, so I started including protein bars and some dairy here and there, and every time I did, within 24 to 48 hours I’d feel a cyst begin to form, then they would stick around for 2 to 12 weeks after they fully formed,” Brian tells Men’s Health.
“Eventually I decided to experiment with a plant-based diet,” he says. “I figured if removing dairy helped so much, then removing meat and whatnot would help too, as I felt that the hormones in the meat and dairy were having an impact on my acne. My cystic acne went away, and the more regular pimples started to go away as well. That was a bit over four years ago, and since then I’ve been fully vegan and it’s kept my acne at bay. I still get the occasional pimple here or there but never a cyst and my pimples move along a lot quicker than they did.”
He adds that this is just what worked for him, and that it is a personal choice. And as for Accutane, given the range of dangerous side effects, he says: “You should use it as an absolute last resort.”