Severe dryness and other skin damage from Accutane, worsened by Adderall

[skintel]

Hello,

I took accutane 5 years ago.  It permanent dried up my face.  I am wrinkling like crazy for someone my age (just 22 years old) -- both fine and deep wrinkles.  My crow's feet look like accordions.  My skin feels thin.  I get extreme inflammation upon contact with water (even cold water).  

I began taking adderall prescribed for ADHD last year.  It has definitely worsened my skin.  But to put it into perspective, I have a classmate who takes 10 times higher daily dose, and is 60 pounds lighter than me and a year older.  I see her almost daily, and I have not noticed any skin symptoms remotely like mine.  Hence, the accutane is the main culprit.

I have tried Omega 3, Biotin, I drink tons of water, shea butter, coconut oil, hiding from the sun...recently started MSM supplements.  My dermatologist prescibed me Lac Hydrin (12% ammonia lactate) because my face was getting rough like sandpaper, and this has made my skin smooth.  However, my skin is so thin, so when my skin feels smooth and freshly exfoliated, it also feels tight and thinner.  

He prescribed me metronidazole cream for the redness.  I haven't noticed any effects.  And I don't understand the logic behind this, because I only have redness from inflammation (and I suspect the thinning of my skin makes this extremely more visible).  And metro cream seems more for surface growths associated with rosacea (since it is anti-bacterial), not the inflammation redness, right?

He also recommended Nutraplus Urea cream (10%).  It also makes my face smoother, but again, same limitations as Lac Hydrin.  

I have seen 3 dermatologists, 1 with PHD/MD credentials.  But these creams don't really seem to be getting to the root of the problem.  

In my personal research, I am intrigued by PPAR stimulators.  One study examined topical GW1514, and it supposedly helped the skin barrier repair processes and thickened some layers or the skin.  PPAR stimulators in diabetic medication is known to have effects on the skin, including stimulating the sebaceous glands (the glands that accutane shrinks).      

Another complication: I have moved to a dry climate from a more humid one.  I am shopping for a humidifier (I picked up a cheapy one from walgreens and it does not seem to evaporate much water).  Any recs or thoughts?

My situation is pretty severe.  I feel like Benjamin Button.  I am going to go off Adderall during winter break and see how my skin responds, but I am only taking 5 mg/day (and the smallest pill size is 10mg).

The damage is only to my face (and my hair as mentioned).  But the rest of my body's skin I am very happy with.  However, I did also experience permanent lessened saliva production and slightly more dry eyes.  

In my research, the literature on skin barrier homeostasis and skin fragility seems centrally pertinent.  My face's waterproofing is deteriorated (when water runs off it, it does not "bead up" like other skin on my body), there is dyshesion, my face feels like in a constant sloughing state (rough, "dusty" surface texture).  My chin and my nose are the only regions on my face that feel preserved (chin feels thick and fine, and the nose can still get oily).  By my forehead and cheeks etc. are dry as the desert.   I constantly slap on moisturizer and creams, but my skin doesn't even seem to absorb these anymore.    

Can someone please help me?  I just don't know what to do.  I have even tried emailing some of the researchers I have read about looking for advice or things to recommend my dermatologist look into (many are affiliated with UCSF, which I live near).  Even if it can't be fixed, I would at least like to fully understand what happened and what is going on -- but even getting pertinent information is difficult...and my science background isn't sophisticated enough to easily sift through the literature, though I am getting better.  

I thought my situation was so severe that it would take something internal to have any effects, but then I stumbled upon the topical PPAR stimulator (GW1514) study, so perhaps there are some topical solutions, beyond these futile creams I have been slapping on religiously to no avail.  

Below is a link to the specific PPAR abstract:

http://www.ncbi.nlm.nih.gov/pubmed/15102088

Peroxisome proliferator-activated receptor (PPAR)-beta/delta stimulates differentiation and lipid accumulation in keratinocytes.
Schmuth M, Haqq CM, Cairns WJ, Holder JC, Dorsam S, Chang S, Lau P, Fowler AJ, Chuang G, Moser AH, Brown BE, Mao-Qiang M, Uchida Y, Schoonjans K, Auwerx J, Chambon P, Willson TM, Elias PM, Feingold KR.

Department of Medicine, University of California, San Francisco, California, USA.
Erratum in:

J Invest Dermatol. 2004 Oct;123(4):806.
Peroxisome proliferator-activated receptor (PPAR) are nuclear hormone receptors that are activated by endogenous lipid metabolites. Previous studies have demonstrated that PPAR-alpha activation stimulates keratinocyte differentiation in vitro and in vivo, is anti-inflammatory, and improves barrier homeostasis. Recent studies have shown that PPAR-beta/delta activation induces keratinocyte differentiation in vitro. This study demonstrated that topical treatment of mice with a selective PPAR-beta/delta agonist (GW1514) in vivo had pro-differentiating effects, was anti-inflammatory, improved barrier homeostasis, and stimulated differentiation in a disease model of epidermal hyperproliferation [corrected]. In contrast to PPAR-alpha activation, PPAR-beta/deltain vivo did not display anti-proliferative or pro-apoptotic effects. The pro-differentiating effects persisted in mice lacking PPAR-alpha, but were decreased in mice deficient in retinoid X receptor-alpha, the major heterodimerization partner of PPAR. Furthermore, in vitro PPAR-beta/delta activation, aside from stimulating differentiation-related genes, additionally induced adipose differentiation-related protein (ADRP) and fasting induced adipose factor (FIAF) mRNA in cultures keratinocytes, which was paralleled by increased oil red O staining indicative of lipid accumulation, the bulk of which were triglycerides (TG). Comparison of differentially expressed genes between PPAR-beta/delta and PPAR-alpha activation revealed distinct profiles. Together, these studies indicate that PPAR-beta/delta activation stimulates keratinocyte differentiation, is anti-inflammatory, improves barrier homeostasis, and stimulates TG accumulation in keratinocytes.  

[maribbar]

hey guys!

i know it´s a very old question but i felt that i should answer anyway. So, my history with accutane is long. When i was an teenage (now i´m 23) i made two cicles of accutane and felt nothing! My skin was totally clear, radiant, amazing! When i was 22, ten years later of my treatment, my skin beggining to have breakouts. WORSE than i never saw before. I researched and try lots of things (take accutane again was the last thing on my head) , the last was an chemical peel who leave my skin a little thin and dry. But that´s ok, my skin stayed clean for almost one year. One years latter, the breakouts returned. And so, whithout other alternatives and persuaded by my dermatologist, i acepted to make other cicle of accutane. I only endured ONE MONTH. I felt my skin burns, so red, just touch my skin to stain it! I gived up. My skin continued thin and dry for months, but i´m not the kind of person that give up easily hahah. Back to my researches, lots of youtube videos and articles and reading an especific article writed by an brazilian doctor and nutricionist (i´m from brazil) about nutrition and dietary supplementation i perceived that the only way to recovered my skin was building a new skin since inside my body to out, with supplementation of vitamins and of course taking hydrolysed collagen. After taking for 3 months (at this moment) i can feel my skin a little more strong and less sensitive.

Here my treatament (made by myself because now i only trust in myself!!! )

1 pill of vitamin C and E/per day

2 spoons of hydrolised collagen/ per day (the most important thing of my treatment) moisturized with juice or water

1 pill of nutricolin (Choline-stabilized orthosilicic acid)/day

3 pills of fish oil (omega 3)

There are many articles and videos on youtube showing the power of collagen hydrolyzed (for skin healthy tips I and III) to build and thicken the skin.

One other amazing product that i used on my face was an amazing ointment called here "hipoglos", but in europe and us and dont know it name. But this ointment is used for babies burns and has retinol, zinc and vitamin d.

It´s all, i REALLY HOPE HELP SOMEONE WITH THIS COMMENT.

[MargaretSchmidt]

I feel for you so much. I took Accutane for FIVE DAYS over two months ago and it is STILL thinning out my skin. I am only 23. I will look like I am in my 40's in no time, and my eyes look sick. My eyelids are like tissue paper and I have never known such devastation in my life. I have had many suicidal thoughts. It is a disgrace that this drug is prescribed. The FDA is completely negligent. If someone is reading this and deliberating about Accutane, as I once was (I almost did not take it), please, PLEASE do not play Russian roulette with your life. Even though statistics are on your side, you could make the biggest and most intractable mistake on your life, one that would have you MISSIGN the days of moderate cystic acne. Acne should be for individuals with SEVERE, SEVERE cysts. Acne induced so much agony, but I did not know true hell until Accutane.

[Iperez]

Do you have rough hands and feet as well? My twin sister got diagnosed with some weird long-named disorder (don't know the name of it). The disorder includes complications when skin is exposed to water...of all things. We all grow ip thinking that water is vital and healthy for us. It is strange to find that some people should have as little skin exposure to H2O as possible... Basically, the parts of the body that get the most exposure to water throughout the day (face and hair in the shower, hands that get frequently washed, and feet that soak in water during daily showers) are found to be the most problematic for people with this disorder.... As for solutions, just keep lathering on re lotions and oils, especially after any exposure to water (if this disorder sounds like something you might have).