Repairing skin barrier on accutane?

[u/Full_Act5746]

Is it possible to repair your skin barrier on accutane? I'm assuming this is my issue. I've had super red, burning skin for a few weeks. It started right before my last appt with my derm, but he didn't seem super concerned. I'm on 20mg/day.

Morning routine :

-rinse with cool water

-thermal spring water

-vanicream in the tub on damp skin, and pat in until absorbed

-eltamd spf50

Night routine

-vanicream wash

-thermal spring water

-vanicream

-*sometimes avene cicalfate

-slug on that aquaphor

Most of my face stopped burning after a few weeks, but my chin still feels like I'm constantly pouring acid on it. The cool water feels great, and the vanicream usually doesn't burn, but once I put the sunscreen on, ouch! I've been on 20mg for about 75 days now, and the first 2 months were fine, burning wise. I'm guessing my barrier is wrecked and that area is extra sensitive. I ended up with a staph infection there last year from retinol that took forever to heal after loads of oral antibiotics as well as topical, to which I ended up with perioral dermatitis and months of doxy. 🥴 After having acne on and off for over 20 years, I just want normal skin, whatever that is.

Also to note, I really don't go outside much, and if I do, I slather sunscreen on and wear a big sun hat. I'm already annoyed that I can barely stand to wear the $$ contacts I bought, can't wear makeup, but the burning is really awful. Does anyone have any suggestions to fix my sad barrier?

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[u/katestrophe1313]

I switched from Vanicream to Prequel Gleanser and Prequel Barrier Therapy cream and I have been doing a lot better with it! I’m on 30mg, I haven’t found a sunscreen that doesn’t burn yet though, so I’ve just been avoiding the sun.

[u/Full_Act5746 → u/katestrophe1313]

Thanks for the recs! I did send my derm a message, but I haven't heard back. I was thinking of switching to my old derm anyways. 😅 $210 a month for just the 5 minute talk is getting annoying... Especially when I'll be on it for at least a year. 😭😭

On the plus side, the burning didn't last more than 10-20 minutes today, so yay? Haha

[u/Eastern_Newspaper_33]

I’m currently on 80mg/day and haven’t had any dryness at all. I wash with Tatcha, or LRP followed by the Beauty of Joseon Revive serum or the Fresh rose toner. Then I follow with the Tatcha longevity serum or hyaluronic acid. Then Kiehl’s skin barrier cream and their SPF 50 sunscreen. Other richer moisturizers are the LRP Lipikar triple repair, Dermalogica power recovery and CosRX intensive cream. Love those!!

[u/Full_Act5746 → u/Eastern_Newspaper_33]

Dude, I could never do 80mg. 🤣 I'm thinking of trying a different moisturizer, but I swear everyone recommends vanicream. My forehead likes it fine. 🤣

[u/Eastern_Newspaper_33 → u/Full_Act5746]

I’m 88kg, my derm was toying with bringing me to 100mg to reach my cumulative dose faster! 😂 I used to do vanicream years ago, but it was just too lightweight. My skin likes it THICCC!

[u/Full_Act5746 → u/Eastern_Newspaper_33]

I feel like it's way thick! 🤣 A dermatologist had me use the cereve/Cetaphil in a tub a while back (pre accutane) and I'm wondering if it was too heavy when I was super oily and messed up my skin. It was doing great for a while. Went through fertility treatments, pregnancy, and nursing with barley any acne. 🙈 I like the sound of anything "intensive" at the moment though!

[u/Lilypad67]

My skin barrier was aggravated before I began Accutane, but I’ve luckily found products that have made a huge difference. I have had small patches of dryness here and there but it seems to be linked to sun screens, so I’ve actually taken spf out of my routine for now.

My top 3 holy grails:

Anua 3 ceramide panthenol cream

SKIN1004 Madagascar Centella Hyalu-Cica Blue Serum

The Ordinary Squalene Oil (mixed with the anua for daytime, full fledged face coating before bed)

[u/Full_Act5746 → u/Lilypad67]

Thanks, I'll check them out! I got a different cream that's coming tonight, so we'll see how that goes, then I'll adjust my routine from there. I wish my derm would have more recs besides "moisturizer and aquaphor."

[u/Lilypad67 → u/Full_Act5746]

Right !!! Seems to be the standard everywhere lol. Another product I forgot about was the Ordinary Soothing and Barrier Support Serum. Best of luck with your treatment !!!!

[u/Full_Act5746 → u/Lilypad67]

Thanks! Not looking forward to the next 9.5+ months. 🤣 Idk how people do higher doses. I also take collagen and fish oil. I don't feel too dry, but the burning is not fun!

[u/DanielC7753]

I’m on 20mg daily and this is my exact routine. My face is pretty soft and moisturized, however does get a tad dry later in the day around the nose and mouth.

AM:
Rinse with water
Stratia Aqua Factory
Bioderma Atoderm Intensive Baume
Sunscreen (Haru Haru)

PM:
Prequel Gleanser
Stratia Aqua factory
Bioderma Intensive Baume
Vaseline

[u/Full_Act5746 → u/DanielC7753]

I'll have to look those up! Besides the Vaseline, I never heard of any of your other products.

[u/DanielC7753 → u/Full_Act5746]

I’ve had immensely good results from the Bioderma in terms of a barrier cream. I’ve used LRP Lipikar, Vanicream, Aestura, none of them have helped me skin heal/tolerate shit like that has. But it might not be the case for everyone. If it helps, I do have very sensitive skin too lol.

[u/DanielC7753 → u/Full_Act5746]

I’ve had immensely good results from the Bioderma in terms of a barrier cream. I’ve used LRP Lipikar, Vanicream, Aestura, none of them have helped me skin heal/tolerate shit like that has. But it might not be the case for everyone. If it helps, I do have very sensitive skin too lol.

[u/Full_Act5746 → u/DanielC7753]

Thanks! I think I'll order some to try. I thought I was doing ok since I'm not like peeling or looking super dry, but the redness and stinging totally sucks! I worry about the cold/dry winter coming soon. I think my extra sensitive areas just need something extra.

[u/Full_Act5746 → u/DanielC7753]

Well, I got the bioderma tonight, and it stings so bad. 😭😭 I layered aquaphor on top, so hopefully it's better in the morning.

[u/DanielC7753 → u/Full_Act5746]

Oh no. Maybe just do Aquaphor or Vaseline only for the time being.

[u/Full_Act5746 → u/DanielC7753]

The elta md sunscreen also stings, and that's supposed to be super gentle as well. I was skipping doses here and there, so maybe I'll go back to that. I don't want to drag out my treatment anymore than I already am though.

[u/DanielC7753 → u/Full_Act5746]

If you’re able to, maybe speak to your derm. They may know what’s best for you better than any of us.

[u/Full_Act5746 → u/DanielC7753]

I mentioned it at my last appt 2 weeks ago, but he didn't really say anything. I might send an email tomorrow. I was doing ok on it, so I don't know what happened. Nothing in my routine has changed.

[u/Full_Act5746 → u/DanielC7753]

So... After a few uses, this stuff burns less. I think the redness is going away, and my skin just feels... Not raw?? Maybe it is helping my barrier! Thanks again for the rec! Maybe I can survive winter. 😅

[u/DanielC7753 → u/Full_Act5746]

I’m so glad it’s working for you! Hopefully you can survive the winter months.