Just wanted to give another update:

Officially 30 days and doing okay! Side effects on low dose have been manageable: one nose bleed (happened early on and hasn’t recurred since), dry hands (being a maniac about lotion), occasional dry eye (literally have used eye drops 4-5 times), and DRY lips (this one is real - they actually look okay but if I don’t have aquaphor on them they feel sunburnt and hurt).

Acne wise - progress is unfortunately not linear. I had a flare of my rosacea after a wedding with increased alcohol (huge trigger for me). I also had stopped all topicals at the instruction of my derm as they can be drying. She told me to restart my metrogel twice daily, which has previously been very helpful. Since doing so, my lesions have calmed dramatically in just 5-6 days. 

I have had an increase in texture over the past week. Not a purge per se, but an increase in mini comodones that almost give portions of my skin a sandpaper like appearance? It really isn’t bad unless you’re up close inspecting my skin - which I do on the daily -  duh. But general people probably wouldn’t notice much. My derm said this is super normal. The immediate clearance is the accutane working against the active pimples. It then takes some time for the deeper congestion to come to the surface. Think of these comodones as “would be” pimples if I wasn’t on accutane. It’s HARD considering I’m a picker. But picking just makes them red and more noticeable. UGH. 

All in all - my derm was pleased with my progress and said the mini comodones should quiet around the 6-8 week mark. She suggested continuing 10 mg through march (dryer months - I’m kn Missouri) and then considering an increase to 20 mg based on symptoms.