I have just started my first ever course of Accutane. I have been put on 20mg/day with the view of reviewing this (i.e. upping the dose) after the first 7 (!) weeks. I am 6’3" and weigh 90kg (198lbs).
My acne is not as bad as it has been (I am 22 in April – it peaked at around 17, where strict diet control & antibiotics pretty much erased it up until last summer, where it reoccurred and refused to be beaten by antibiotics). It is most persistent on my back/shoulders (cystic), but it is also regular on my face (cystic and non-cystic).
My question is – does 20mg seem like an unusually low dose to start out on for seven weeks? Especially given my size/height? Everything I have read online seems to point towards a minimum of 40mg/day starting dose, and the successful cases seem to have all been on high doses. Patients on smaller doses (20mg-40mg max throughout the course) seem to be more likely to experience a recurrence of acne later in life.
Any thoughts on this? I am only on day two so obviously nothing has kicked in yet, so it’s hard to say how I will fair with the side effects/positive effects. 20mg for 2-4 weeks seems a good idea to ensure there are no adverse reactions, but my gut instinct is to increase the dose after week 4 or so if everything is OK.