Accutane

Accutane is used to treat severe steroid-induced acne, particularly cystic acne that doesn’t respond to conventional treatments. It’s especially valuable during heavy androgen cycles when sebum production increases dramatically.

Dosing Protocol

1. Standard Bodybuilding Dosage:
   • Beginner: 10-20mg daily
   • Intermediate: 20-40mg daily (split into two doses)
   • Advanced: 40-60mg daily (only for severe cases)
2. Administration:
   • Always take with your largest meal containing fats (significantly improves absorption)
   • Split doses AM/PM for amounts >20mg/day
   • Avoid vitamin A supplements (risk of hypervitaminosis)
3. Cycle Duration:
   • Minimum effective cycle: 8 weeks
   • Standard cycle: 12-16 weeks
   • Maximum continuous use: 20 weeks (requires liver function tests)

Critical Stacking Considerations

1. With Oral Steroids:
   • Requires enhanced liver protection (add TUDCA 500mg/day)
   • Avoid other hepatotoxic compounds (especially 17-α-alkylated steroids)
   • Increase water intake to 1.5x normal
2. With Injectable Cycles:
   • Monitor lipid profiles monthly
   • Consider adding omega-3s (4-6g/day) to counteract triglyceride elevation

Side Effect Management

1. Dermatological:
   • Preventive measures:
     • Humidifier at night
     • Petroleum-based lip balm (applied hourly)
     • Ceramide-rich moisturizers
   • For severe dryness: 2% hydrocortisone cream (limited use)
2. Systemic:
   • Monthly bloodwork (ALT, AST, triglycerides, cholesterol)
   • Night vision checks (retinoids affect rod cells)
   • Mood monitoring (rare depression risk)

Post-Cycle Skin Maintenance

1. Sebum Regulation:
   • Continue topical retinoids (tretinoin 0.025%)
   • Use niacinamide serums (4-5%)
   • Maintain low-glycemic diet
2. Scar Management:
   • Microneedling (post-accutane)
   • Vitamin C serums
   • Silicone gel for hypertrophic scars

Contraindications

1. Absolute:
   • Pregnancy (Category X teratogen)
   • Active hepatitis
   • Hypervitaminosis A
2. Relative:
   • History of depression
   • Pre-existing hyperlipidemia
   • Competitive athletes (may affect night vision)

Pro Tips

• Start dosing 2 weeks before beginning steroid cycle
• Use oil-free sunscreen daily (SPF 50+)
• Keep a skin hydration log
• Cycle off for ≥6 months between courses

Conclusion: While not an anabolic agent, Accutane is essential for serious bodybuilders managing steroid-induced acne. Its powerful effects demand respect – proper dosing, monitoring and ancillary care are crucial. Always obtain through legitimate channels and never share medications due to the serious birth defect risk.