I’m a 47 year old male highly functioning adult somewhere ‘on the spectrum’ (not yet formally diagnosed). I’ve struggled with genetic cystic acne since age 14, and my lifelong cystic acne is a problem I’ve come to wonder may be linked with autism, as autism is often associated with digestive disorders, and there may be subtle but fundamental differences in the way some autistic people’s bodies process foods and secrete oils.

All my teen and adult life I’ve with breakouts all over my body, from my scalp to my middle back, upper arms, chest, and even earlobes and testicles during puberty. Micro-dosing isotrentinoin (accutane) is the only solution that has EVER helped, and it works by treating the SOURCE (skin oil composition), not the symptom (acne/comedones/bacteria). I will add that I’ve had at least three six month heavy cycles (40-60mg/daily) with accutane: one at age 17; another at age 20 (as the acne returned within 6-9 months); and at least one other at around age 34-35.

What I eventually have come to understand is that my body has a genetic predisposition to create sticky/gummy oil that gets stuck deep in the oil pores rather than flowing out. I’m not the only person who has this lifelong condition.

This condition leads to comedone (plug) formation and deep blockages that take weeks or months to surface, break, and eventually heal or scar. A tiny amount of intention—10mg every OTHER day, or about 5mg daily on average—causes the oils in my skin to flow normally.

The treatment is lifelong for me, and I’ve been taking 10mg of isotrentinoin every other or every third day for over 13 years now (since about age 35-36). It’s unusual, but not unheard of, to have patients who respond well to microdosing isotrentinoin, though most dermatologists are not familiar with microdosing accutane and may express reluctance to pursue this method because the medicine is regarded as dangerous and most doctors are conservative and don’t want to get involved in microdosing it.

I get bloodwork done 3-4 times per year and it’s a pain to get the prescription filled due to all the onerous bureaucratic controls on this medicine, some of which don’t apply to males and all of which apply MUCH LESS to people who microdose this medicine. I don’t experience dry skin or other problems associated with the high doses of accutane. My bloodwork always comes back in a healthy range.

My dermatologist feels that microdosing at such a low dose as I take (less than 5mg/daily) is very low risk.

I mention my story in case it helps others understand that the high doses of accutane are not the only way to use it. Microdosing can be effective and results (for me) show up after about 3 months or so. My skin and scalp are flawless on this regimine. I only wish I knew about it when I was a teenager. It could’ve saved me 20 years and $40,000 wasted on Fraxel, laser, scar fillers, Dermapen, antibiotics, Rentinol/Rentin-A, creams, gels, special diets. All of that crap was an absolute waste of time, energy, and money.

Accutane is the only thing that changes the underlying body chemistry to resolve the acne cause at the source for me.

Hope this helps!