If you struggle with chronic, severe acne, chances are that your everyday run-of-the-millspot treatmentjust doesn't cut it. Fortunately, there's an effective acne-fighting medication that dermatologists have been recommending for decades: Accutane (a.k.a. Isotretinoin). However, before you consider this treatment, it's important to understand what it entails, from when to expect results to possible side effects — and everything in between.
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Keep reading for our complete guide to understanding and using Accutane.
How It Works
"Accutane affects your skin and body in a number of different ways, one of which is by decreasing the size of the oil-producing glands in your skin, known as sebaceous glands," Dr. Laura Marinelli, microbiologist and scientific advisor atEllis Day Skin Scienceshares withInStyle. "This decrease reduces the amount of oil your skin produces, which effectively starves the acne-causingC. acnes bacteria that live in your pores. However, by doing so, Accutane also makes your skin much dryer and more sensitive, meaning that after a course of Accutane, it may be in need of some serious TLC."
And the impact may not last forever. "Accutane helps to reduce the number of C. acnes on skin, but they can creep back up over time," Dr. Marinelli adds. That's why she also suggests developing an alternate skincare plan for the duration of the treatment along with taking the medication.
How to Use
While on Accutane, your skin becomes extremely sensitive, therefore limiting the types of products you can use within your skincare routine. In the morning, Dr. Marinelli suggests washing your face with agentle cleanserthat won't strip the skin, followed by a non-comedogenic moisturizer and sunscreen to nourish the skin and add in a layer of UV protection. You may also incorporate a serum before your moisturizer, but be sure not to use any that contain high concentrations of AHAs/BHAs orvitamin C, as it may cause irritation. "At night, you can repeat this same routine, without the SPF," she adds.
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What to Expect
The thing about Accutane is that it typically purges your skinbeforeit begins to work, essentially meaning that your acne is going to get worse before it gets better. In my case, my skin was constantly dry and required consistent hydration, the corners of my mouth and inside of my nose would crack and bleed, my joints would ache, and my head would hurt almost all the time.
The first time I used the medication, my day and nighttime routines were very simple. I stuck with the basics:Cetaphil Gentle Skin CleanserandDaily Facial Moisturizer, as recommended by my dermatologist. I was also advised to stay away from any heavy exfoliation or products that were not made for sensitive skin.
I've been prescribed Accutane at two different points in my life. The first was during my senior year of college — a time when I wished that my acne days were long gone.
The rigorous requirements that are involved with taking Accutane definitely made my life quite difficult. Not only did I have to deal with having monthly blood work done, traveling back and forth between cities for dermatologist appointments, and unexpected medical costs, but the physical and mental toll that Accutane took on me wreaked just as much havoc.
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Imagine this: you have just started your first week at an internship with a well-known PR agency on their fashion and beauty team. You want to try to look your best every day and seemingly blend in with all of the stylish women around you, but it literally hurts to put makeup on your face. Not to mention, you also are attending a fashion business school, where your whole look from head to toe is silently judged by your peers on a daily basis. There are some days when you don't even want to go to class or your internship because you are breaking out so badly and are embarrassed to show your face. This was me during the fall of 2018 as I had Aquaphor glued to my hand along with a full bottle of water at all times to deal with the dryness caused by the meds.
The mental and emotional component of being on this medication truly tests you in ways you might never have thought of otherwise. So preparing yourself for these side effects is crucial if you and your doctor decide Accutane will be the acne treatment for you.
While I was on it, I tried to indulge in my favorite activities. I made sure I took walks outside when the weather was nice (with SPF protection, of course!), I got my favorite snacks and tried to relax as much as possible. I found that trying to distract myself by watching movies and reading up on other people's experiences helped me cope when I was having a particularly bad mental health day.
After nearly six months of constant agony and annoyance in relation to my skin, there was finally a breakthrough. All of a sudden, my skin began clearing up, and my pimples all started to fade away. What I was left with was certainly not a blank canvas due to the scarring and discoloration caused by previous breakouts, but I was happy to see progress nonetheless.
For the next eight months or so, my skin was in a place I had never imagined it would be: clear, glowing, and improving by the day. I began to have some professional skin treatments done (i.e. chemical peels) and was loving all the improvements I was seeing in my overall complexion. Then, I went off of Accutane.
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Post-Accutane, your skin should be pretty low-maintenance, but it may take some time to adjust. I developed an entirely new skincare routine and was trying out new products that I could finally withstand now that I was off of the medication. At the time, I was using theTatcha Rice Polish Foaming Enzyme Cleanser,Skinceuticals C E Ferulic Serum, andFirst Aid Beauty Ultra-Repair Cream. The Tatcha powder cleanser offered light physical exfoliation that my skin could handle. The Skinceuticals serum was given to me by the esthetician I went to for the chemical peels, and it really helped with thedark spotsthat were left behind from my acne. As for First Aid Beauty 's cream, it helped to keep my skin hydrated and soft.
However, a few months later, my acne slowly began to creep back. After trying out several different remedies, I made the difficult decision to restart Accutane, something I had hoped I would never have to do. This time, though, I knew what was ahead of me. I was prepared to roll with the punches, ready for round two — and all the subsequent side effects — from incredibly dry skin and hair to headaches and mild joint pain.
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Now that I've passed the finish line, I'm incorporating products likeThe Ordinary Azelaic Acid Suspension 10%andThe Ordinary Niacinamide 10% Zinc 1%into my routine. I'm also usingKiehl's Ultra Facial Cream SPF 30,The Ordinary "Buffet" Serum, andOle Henriksen Banana Bright Eye Cream
Despite the side effects and discomfort, I found Accutane to be an excellent solution for my long-term acne. If you decide to give it a try, you'll definitely want the guidance of a good dermatologist to help you through — especially when the side effects get intense. I was able to stick it out, and I'm so glad I did.
Frequently Asked Questions
How long does the Accutane purge last?
After beginning treatment, one in five patients gets a bit worse while one in 500 gets much worse. The remaining get better.Purging typically doesn't last more than six weeks, so consult your dermatologist if your skin is still not getting better beyond that point.
Can Accutane cause depression?
There is anecdotal evidence that some patients who take Accutane develop mental health conditions, such as depression. However, more research is needed to determine whether Accutane can cause depression. Dermatologists recommend that patients who exhibit any symptoms of depression or another mental health condition on the medication, stop taking it immediately.
Does Accutane cure acne forever?
Isotretinoin can treat severe acne and is a cure-all for about half of those who take it. Most patients will take Accutane for about four to six months, but some may need it for up to a year.
In the first few weeks after completing isotretinoin, your skin is still likely to be red, flaky and sensitive. Therefore, it is best to keep your routine simple. Stick to a gentle non-comedogenic cleanser, a gel/lotion based moisturiser and a daily sunscreen.How do I make sure I don't get acne after Accutane? ›
There are several things that I think are important in a skin care regimen after isotretinoin therapy. These include the following: daily sunblock, a gentle cleanser, a daily moisturizer, and semi regular to daily use of a topical retinoid.How do I hydrate my face on Accutane? ›
So, here's your Accutane care guide:
Mix equal amounts of Aquaphor and Egyptian Magic and apply a generous amount on all areas of your face and body, concentrating on areas where you are experiencing the most itching or dryness.
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Your acne will start to improve in one to two months, and the vast majority of people are clear at the end of treatment. However studies have shown that 80% to 90% of patients experience relapse within 12 to 24 months.
Some people do experience worsening if they have long-standing acne. This is usually due to purging, in which the isotretinoin pushes out dead skin cells and debris. Because your skin can become red and dry, the medication sometimes makes acne look more inflamed and obvious.What lotion should I use while on Accutane? ›
In the evening use a gentle, non comedogenic moisturizer such as Cetaphil night cream or Neutrogena deep moisture night cream. In the morning, use a good sunscreen such as Elta MD or Vanicream. If your lips are very dry, we recommend using Vaseline or Aquaphor throughout the day.How many times should I moisturize on Accutane? ›
You should also apply a non-comedogenic moisturiser three times per day. Use a light product in the daytime such as Cerave Moisturising Lotion for Dry Skin Cetaphil Lotion, Aveeno Lotion or Cerave Lotion, and a heavier product at night such as Epaderm Ointment or Cerave Moisturising Cream for Dry Skin.Why do you have to wait 6 months after Accutane? ›
Patients with thick sebaceous skin may notice a thinning of their nasal skin with Accutane therapy as well. However, Accutane has also been linked to delayed wound healing. Therefore, patients need to discontinue Accutane for at least 6 months before any elective surgery involving the skin, including the nose.Does skin continue to improve after Accutane? ›
Isotretinoin has a great advantage over antibiotics, in that four to five months of treatment usually leads to marked clearing of the acne and acne scarring. These improvements in the skin continue to occur, even after the Isotretinoin is stopped.Does oily skin return after Accutane? ›
Usually the skin oiliness does return, but may not completely return to the degree it was before. Most patients find this is an additional benefit of the treatment.
plan to avoid hair removal by waxing, laser skin treatments, and dermabrasion (surgical smoothing of the skin) while you are taking isotretinoin and for 6 months after your treatment. Isotretinoin increases the risk that you will develop scars from these treatments.What foods should you eat with Accutane? ›
The “with food” is important because this medication is better absorbed by the body with consumption of food. Specifically, it is best absorbed with consumption of fatty foods. I recommend patients take their pill twice daily with some type of fat–nuts, cheese, avocado, meats or fatty fish such as tuna or salmon.How do I not purge during Accutane? ›
“While it's impossible to completely avoid a skin purge when using new therapies like isotretinoin, retinols, or acids, the trick is to go slow,” says Dr. Gabriel. Introduce new products one at a time, and if irritation pops up, space out applications to every other day.How to safely drink on Accutane? ›
Do not drink alcohol while you are taking ISOtretinoin. You may have unpleasant side effects such as fast heartbeats, warmth or redness under your skin, tingly feeling, nausea, and vomiting. Check your food and medicine labels to be sure these products do not contain alcohol.How long is the Accutane purge? ›
Accutane will make you purge for the first 2-3 months before you start to clear, during this time the skin on your entire body will be weak, thin, and cracked. After 5 or 6 months your Rx will expire and you still have about a 25% chance of your acne returning.Does Accutane remove acne scars? ›
YES, the best thing about Accutane is that it prevents acne scarring because it is highly effective in clearing up acne.Does Accutane ruin hormones? ›
Isotretinoin can cause alterations in the adrenal hormone levels. Hirsutism and menstrual irregularity can be observed during treatment follow-ups.Does dairy affect Accutane? ›
They advise avoidance of all dairy products both during and after their treatment with isotretinoin.When is Accutane at its worst? ›
Worsening acne is a temporary side effect: When you start taking isotretinoin, acne can worsen for 1-2 months before it begins to clear. This happens with many other acne treatments.Does Accutane affect you mentally? ›
Depression can be a severe side effect of Accutane. Doctors usually tell people to stop taking the drug if they experience depression. Awareness of depression and mood changes with Accutane helps detect psychological side effects early. In some situations, depression may persist despite stopping this medication.
The short answer: No. "Unfortunately, Accutane cannot actually shrink your nose," said Dr.Can I wear makeup on Accutane? ›
If you want to wear makeup while using acne medication, apply the acne medication first. Yes, you can wear makeup, but you'll want to choose it carefully. Some cosmetics can cause acne.Is it hard to get wet on Accutane? ›
A few medications known to hinder your ability to get wet include antihistamines, Accutane, and antidepressants.Do scars fade after Accutane? ›
While Accutane is exceptionally helpful for acne, it does not heal scar tissue. Other modalities, such as chemical peels and the carbon dioxide laser, are effective in treating damaged scar tissue.Does Accutane make you gain weight? ›
People sometimes mention weight gain or weight loss when talking about Accutane. However, the FDA do not currently list weight change as a side effect of this drug.How many months does it take for Accutane to clear up acne? ›
Four to five months of Accutane treatment usually leads to clearing of acne. It is a potent medication that is very effective for nearly all types of breakouts.How do you get rid of acne scars after Accutane? ›
- Topicals. ...
- Lasers. ...
- Fillers. ...
- Facials. ...
- Pigmented Scars: PIH and PIE. ...
- Textural Scars: Atrophic and Hypertrophic. ...
- Salicylic Acid and Glycolic Acid. ...
- Benzoyl Peroxide.
Some people can develop serious skin rashes from taking Accutane. If you develop a rash, especially one that's accompanied by a fever or by blistering or peeling skin, stop the medication and contact your healthcare provider right away.Does Accutane permanently change oil glands? ›
How Accutane Works. Put simply, Accutane permanently shrinks your oil glands. Because people with acne produce more sebum than necessary, the elimination of the excess causes your skin to stay clear because your pores no longer get clogged.Does your hair stay dry after Accutane? ›
Isotretinoin can cause dryness that takes a while to settle after stopping. In many patients it does but one might need to be a bit gentler on t he hair for 3-6 months than they might have otherwise.
The dryness of the skin is usually not a problem for most patients, as most patients with acne have oily skin anyway. However, some patients will experience dryness and peeling of the skin on the face. You can try regular moisturizers to combat this dryness. This dryness will disappear once the Isotretinoin is stopped.Why is my skin getting bad again after Accutane? ›
Some people do experience worsening if they have long-standing acne. This is usually due to purging, in which the isotretinoin pushes out dead skin cells and debris. Because your skin can become red and dry, the medication sometimes makes acne look more inflamed and obvious.Does Accutane clear skin forever? ›
Accutane is an effective way to defeat a severe acne problem; but are its results permanent? Most of the time, the answer is yes. For the vast majority of patients who take Accutane, severe acne never returns. There may be an occasional breakout, but those occurrences should be minor and uncommon.Will my oily skin come back after Accutane? ›
Usually the skin oiliness does return, but may not completely return to the degree it was before. Most patients find this is an additional benefit of the treatment.What products to use after Accutane? ›
Say goodbye to your drying products and hello to your new super gentle skin care! Since Accutane does the heavy lifting, keep your routine simple: a gentle cleanser, a non-comedogenic moisturizer, and don't forget sunscreen. Also, favor so-called hypoallergenic treatments to minimize the risk of an allergic reaction.Does Accutane make your face slimmer? ›
A: There is no evidence that Accutane causes skin thinning. Accutane causes the skin to become fragile, or more sensitive, due to the decrease in oil production. People wrongly attribute this fragility to thinning.Does Accutane shrink your nose permanently? ›
The short answer: No. "Unfortunately, Accutane cannot actually shrink your nose," said Dr.