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Thread: Accutane has cured my flushing

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    Default Accutane has cured my flushing

    I started Accutane in December 2019 after exhausting all other treatments(antibiotics, topicals etc) over the last 7 years. My Doctor suggested low dose accutane at 5mg a day but even this dose caused my flushing to increase slightly. After a two week delay to get generic 2.5mg tablets, I started a dose of 2.5mg a day for the first month followed by 2.5mg every other day for the following three months. Finished the course at the start of May and my flushing is completely gone (been 4 months clear now). Only side effect I had was slightly dry lips, my doctor didn't even take blood test checks because he said the dose was too low. I began to get better after around 3 weeks in and the swelling took around 6 weeks. My Rosacea started in 2013 with extreme bouts of flushing and swelling, cheeks and nose mainly. Main triggers were food and bending/laying down. Never had any papules/pustules or acne.

    It feels strange now being over it, almost like what was all the fuss about. I understand now why people without rosacea view it as trivial. Of course when you have it, it's like the end of the world and I'll never forget that.
    Also this isn't remission, I had previously flushed every day for 7 years, now it's just gone. Since May I have had warm showers, helped my brother painting his house out in the summer sun for 7 hours. I'm eating ice cream and drinking cola (liquid sugar) with no flushing. Also put on around 14 pounds of weight and my skin is not flushing, like a normal person.

    The only thing I don't understand is how this has worked, I've been looking at lots of research about ultra low dose Isotretinoin and, the only thing I have come up with is that at low dose it can normalize the immune response of exaggerated toll like receptors (tlr2).
    Last edited by patrick33; 7th September 2020 at 06:08 PM.

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    That's fascinating. Thank you for sharing your results. I have similar symptoms to you (flushing/swelling on nose/cheeks and laying down is a trigger) so I'll consider trying this in the future.

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    Thank you so much for sharing that information. That is fantastic to hear and I am so happy for you. It is good to hear positive news. Low dose accutane is next on my list to try!! Did you get any tingling / stinging with the flushing i.e. did you feel your facial nerves were involved?
    Last edited by Momof; 7th September 2020 at 08:42 PM.

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    patrick33,
    Thanks for your report. Without a doubt others will be trying your regimen using 2.5 mg generic isotretinoin. I have added it as an anecdotal report to this post, as well as to the list of prescription flushing avoidance treatments in this post. If you could PLEASE come back in six months as well as one year from now and give us an update whether your flushing has continued to be completely gone that would be most helpful. There are many, many rosaceans who have come in and posted saying their rosacea is completely gone or in remission and we never hear from again. Substantiating your report six months and a year from now would be incredibly kind on your part that your treatment regimen you are recommending actually has long lasting results. Please mark your calendar to remember posting in this thread again six months and one year from now. Again, thanks for your post.
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    Quote Originally Posted by patrick33 View Post
    I started Accutane in December 2019 after exhausting all other treatments(antibiotics, topicals etc) over the last 7 years. My Doctor suggested low dose accutane at 5mg a day but even this dose caused my flushing to increase slightly. After a two week delay to get generic 2.5mg tablets, I started a dose of 2.5mg a day for the first month followed by 2.5mg every other day for the following three months. Finished the course at the start of May and my flushing is completely gone (been 4 months clear now). Only side effect I had was slightly dry lips, my doctor didn't even take blood test checks because he said the dose was too low. I began to get better after around 3 weeks in and the swelling took around 6 weeks. My Rosacea started in 2013 with extreme bouts of flushing and swelling, cheeks and nose mainly. Main triggers were food and bending/laying down. Never had any papules/pustules or acne.

    It feels strange now being over it, almost like what was all the fuss about. I understand now why people without rosacea view it as trivial. Of course when you have it, it's like the end of the world and I'll never forget that.
    Also this isn't remission, I had previously flushed every day for 7 years, now it's just gone. Since May I have had warm showers, helped my brother painting his house out in the summer sun for 7 hours. I'm eating ice cream and drinking cola (liquid sugar) with no flushing. Also put on around 14 pounds of weight and my skin is not flushing, like a normal person.

    The only thing I don't understand is how this has worked, I've been looking at lots of research about ultra low dose Isotretinoin and, the only thing I have come up with is that at low dose it can normalize the immune response of exaggerated toll like receptors (tlr2).

    That is great news. It gives hope that maybe something will finally work. It is interesting that this low dose turned out to be the solution when a larger 5mg caused the problem to flare up. As far as I can see, the medication they offer in the lowest version is just 5mg, but you can always split the tablet in half ;D
    This is definitely my next way on the list to get rid of the redness. Some of your symptoms coincide with mine, i.e. the equal of acne never appeared on my cheeks le on the other hand I never noticed redness on my nose. Have you had any other symptoms besides just redness on your face? For me it is still dandruff, acne on my back and KP on my shoulders.

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    It would be interesting to find out what doses of Isotretinoin others have taken for Rosacea on this forum when it didn't help them. Search isn't bring up much on doses as low as 2.5mg a day.

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    Quote Originally Posted by Mknlvi View Post
    It would be interesting to find out what doses of Isotretinoin others have taken for Rosacea on this forum when it didn't help them. Search isn't bring up much on doses as low as 2.5mg a day.
    I was on a very low dose of isotretinion/ accutane for many years for persistent acne. My dose was 10mg a week. Unfortunately I did get severe facial flushing, swelling and pain on my cheeks while I was on it and I stopped taking it. I never had rosacea or any other skin problem other than acne prior to this. I would definitely proceed with caution as this drug has exacerbated facial flushing in some people and increased sensitisation.

    I think it's a tricky balancing act. As it clearly does have an anti-inflammatory effect but also can actually make the flushing worse. The few accounts that I have read where it has had a positive impact for erythematotelangiectatic rosacea it seems that the condition just returns once you stop the drug. So you really need to be on it indefinitely which of course increases the risk of side effects.

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    Quote Originally Posted by Brady Barrows View Post
    patrick33,
    Thanks for your report. Without a doubt others will be trying your regimen using 2.5 mg generic isotretinoin. I have added it as an anecdotal report to this post, as well as to the list of prescription flushing avoidance treatments in this post. If you could PLEASE come back in six months as well as one year from now and give us an update whether your flushing has continued to be completely gone that would be most helpful. There are many, many rosaceans who have come in and posted saying their rosacea is completely gone or in remission and we never hear from again. Substantiating your report six months and a year from now would be incredibly kind on your part that your treatment regimen you are recommending actually has long lasting results. Please mark your calendar to remember posting in this thread again six months and one year from now. Again, thanks for your post.
    I'll post back in the future if it ever comes back.

    About some other points people have made, even 5mg every other day increased my flushing/redness.
    2.5 mg was fine though so if anyone else is going to try this and has type 1 flushing as their main symptom I would start with 2.5mg (and if that is too much then 2.5mg every other day).

    Also i'm not surprised Accutane can bring on or cause Rosacea in some cases, you read about people with acne taking crazy doses in the 60-80mg range.
    I have been 4 moths clear now and four months since stopping Accutane with no signs of Rosacea.

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    i'm tempted to give it a go as ive seen elsewhere accutane having positive effects with type 1. Like in the comments ive also seen negative reviews however. I myself took the drug (i assume at a much higher dose) when i was younger for acne, and have seen a lot of accounts of people actually blaming it for the onset of their type 1 rosacea.

    i see it as a last resort as such, but having tried pretty much everything from clonidine, propranolol, every cream going, pdl etc i feel like im at a bit of a loss and a bit desperate.

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    Quote Originally Posted by joeychaps123 View Post
    i'm tempted to give it a go as ive seen elsewhere accutane having positive effects with type 1. Like in the comments ive also seen negative reviews however. I myself took the drug (i assume at a much higher dose) when i was younger for acne, and have seen a lot of accounts of people actually blaming it for the onset of their type 1 rosacea.

    i see it as a last resort as such, but having tried pretty much everything from clonidine, propranolol, every cream going, pdl etc i feel like im at a bit of a loss and a bit desperate.
    I definitely think it's worth a try if you have exhausted all other options. However, Prof Chu who initially diagnosed me did say that he had seen quite a few patients develop flushing and red skin from taking accutane. He even had a protocol of prescribing anti-malarials for the treatment of accutane induced flushing. If you do a search on these boards there are many threads about it. I'm not sure it's fair to say that most of those people are blaming accutane for their flushing.

    I was on an ultra low dose and I still got flushing while I was on it and I have a dark olive skin tone with no family history of rosacea so not likely that I would've ever developed this condition.

    I don't know what your rosacea is like but if you have flushing and any pain have you tried hydroxychloroquine, mirtzapine or duloxetine? There's also micro botox that can help.

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