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Accutane Advice, Before & After photos, and Dosage Information

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Hey y'all! BeenThereDoneThat and I (as resident Post-Taners) compiled a great Accutane Advice list. This basically covers everything you need to know from real human beings who have taken Accutane. If you have taken Accutane and see something we missed, please PM me and I will add it to this list! I want to keep the topic closed, however, because I don't want it junked up with posts that belong in the forum below. :) Good luck with your course and don't hesitate to ask questions!

FIRST AND FOREMOST: DO NOT TAKE ACCUTANE UNLESS YOU ARE UNDER THE SUPERVISION OF A LICENSED DERMATOLOGIST. Acne.org does not recommend or condone self-medicating with any prescription drug, ESPECIALLY Accutane. This drug is FDA-monitored in the United States for a reason - a treatment of Accutane, as with most prescription drugs, can be dangerous or fatal if taken improperly or unmonitored.


-Don't expect to be clear in a week, or even a month. Accutane takes TIME to work. Every single day there are people posting about how they've taken Accutane for 3 days with no results. People need to understand that it takes time, sometimes people break out through their entire course and don't clear until the course is over. It's unusual to clear quickly, not the other way around.

-Never go ANYWHERE without chapstick! Ever...ever...ever...ever. It SUCKS. I recommend anything from Bath & Body Works or Burt's Bee's because they all taste yummy, aren't super shiny, and have awesome staying power! Those are recommended for lips that are only chapped, not wounded or cracked (the peppermint oil in Burt's Bees can actually do more harm to those with cracked/wounded lips). Dr. Dan's Cortibalm and Aquaphor also come with highest recommendations because they can heal open wounds on the lips from peeling or cracking.

-Wash with a very gentle cleanser (Dan's new cleanser does an excellent job!) - time duration: just long enough to lather your face and rinse off. ~10-15 seconds! Don't overdo it because your face gets irritated so easily.

-Oil of Olay Complete with SPF is a great moisturizer - not greasy, and has sunscreen - your skin gets extremely thin and sensitive while on accutane! Don't skimp on SPF!

- For the generalized redness that sometimes occurs (often called "Tane-burn") BTDT used Clinique's Exceptionally Soothing Cream for Upset Skin with good results (subbed it for moisturizer).

-Baby yourself on accutane - get lots of sleep, drink lots of fluids, eat food that is good for you. Treat yourself like you have the flu for 6 months! Your body is under a lot of stress.

-Keep yourself hydrated! Accutane is dehydrating, and the early effects like minor headaches are almost always caused either by general dehydration or by dry eyes. Your eyes can be dry without actually feeling dry to you and that can cause piercing headaches. Get some good eyedrops and put some at home, some at work, some in your bookbag, whatever. BTDT liked Refresh Liquigel. TG liked Visine Tears for mildly dry eyes.

-Always take accutane with a fatty meal - it is a vitamin A derivative which is fat-soluble, and it absorbs into the body much more efficiently when it has fat to bind to. In fact, if you read the insert it will tell you that taking the pill without food decreases absorption up to 50%. Recommendations - olive oil, nuts, avocado, oily fish such as salmon, and dairy products

-The Olay in-shower moisturizer is great because you don't have to wait to put on your clothes since it rinses off.

-Don't exfoliate any part of your body more than once every week or two. Your skin can't handle the microabrasions. Actually, I would avoid exfoliating at all costs because it is so traumatic to your skin, but if it is absolutely necessary, don't do it more than once every two weeks.

-If you get little weird dry patches on the skin (often on the backs of hands) they are probably Accutane-induced ezcema. Use an over the counter hydrocortisone cream on the patches until they seem like normal skin again (this should only take a few days), then use a normal moisturizer to prevent it from happening again. If you moisturize properly from day one you can prevent it all together.

-Fish oil supplements seem to greatly ease Accutane-induced joint aches.

-Keep lots of bandaids - your skin is going to crack, peel, tear, and otherwise become damaged extremely easily. Expect this side effect!

-Keep a photo journal if nothing else, even though it can be painful to look at the pictures - you won't believe how far you have come.

-Be aware that you might get an initial breakout. Most derms won't tell you this because it is disheartening to think your skin will get worse before it gets better. (It will likely get oilier before it gets drier also!) BUT ... it will be all over with in just 2-3 weeks!

-Don't add too much to your regimen - if you let it, accutane will do its job!

-DO. NOT. WAX. NO WAXING. Be hairy, depilate, shave, do threading, pluck - just do not wax. It will destroy your skin - I have heard horror stories to the nth degree. No salon will wax you if they know you're on accutane. What happens is the skin is so paper-thin that when the wax strip comes off, so does the skin.

-No tattoos, microdermabrasions, or surgeries while on tane or up to six months after without specifically talking to your dermatologist first.

-Don't go to the tanning bed. TG went to the tanning bed a full 4 months post tane, was there for only 10 minutes, and burned so bad she peeled for a week. It was AWFUL. It is just NOT a good idea. Being pale for a few months is a whole lot better than being in THAT much pain. Mystic tan seems to do a really great job.

-For an itchy scalp, Neutrogena TGel is recommended to soothe the itching and get rid of the dandruff.

-A common side effect is decreased ability to focus in school. Be aware of this before attempting to start Accutane within a difficult semester. For a generalized list of side effects see www.rocheusa.com or www.fda.gov

Here is a link to the Acne.org before and after accutane photos list:

Before and After Accutane Photos

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Well, I know I'm a beginner here, and this may be redundant, but one thing I have noticed is a surplus of people asking if they have or are taking the right amount of accutane. Although an easy concept, sometimes it takes a simple step-by-step explanation to get people to understand it. The following is what is generally conceived as the right amount, but there are always exceptions. If your numbers do not match up, DO NOT alter your intake of accutane by any means, unless you consult with your dermatologist first.

Now, on to figuring it out.


1) Go weigh yourself, as painful as it may be.

2) You need to convert your weight to kilograms (kg). This conversion is simple - multiply your weight in pounds (lb), by 0.4536. Here is a link if you do not have a calculator, or just are plain lazy: http://www.thehaws.org/convert.shtml

3) The general accepted rule is that you should be taking 1mg of accutane for every kilogram you weight. So if you weigh 80kg, you should be taking 80mg of accutane each day.

4) If you want to figure out your LONG term intake value, you need to take how many months you are supposed to be on accutane, and multiply it by 30. So, for instance, if you are supposed to be on accutane for 5 months, multiply 5 x 30 and get 150.

5) Multiply your weight in kg by your final number in step #4, and you will get the maximum number of mg's you should take in your entire accutane career. To get your minimum, simply subtract 1 month from step #4, and re-multiply. You should end up between your minimum and maximum intake value.


To make it easier, I'll show you an example of what I should be taking, step by step.


I weigh 180 pounds.

So 180lb x 0.4536 = 81.648 kg

My dermatologist assigned me...80mg of accutane a day!

I am supposed to be on accutane for 5 months.

5 x 30 = 150.

150 x 81.648 = 12247.2mg

At the end of my dosage period, I should have not taken MOREthen 12247.2mg of accutane.

To get a range, I need my minimum.

4 x 30 = 120.

120 x 81.648 = 9797.76mg

At the end of my dosage period, I should have not taken LESSthen 9797.76mg of accutane.


So, I need to be taking 80 mg a day, which I am.

At the end of my dosages, I should have taken a total mg of accutane between 9797mg and 12247mg of accutane, which I am on track to do if I follow my daily dosage requirement.


There ya go.


What if there is a pause during treatment? How does that affect the dosage?

If the pause is less than the time it takes for serum levels of isotretinoin to return to normal (approx 3 weeks give or take a day or so), then consider it as part of the same course for calculating cumulative dosage.

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3) The general accepted rule is that you should be taking 1mg of accutane for every kilogram you weight

That is the middle-of-the-road dosage and many derms do aim for that, but the real dosage guideline is somewhere between 0.5mg/kg up to 2.0mg/kg. Many derms start low and build up to higher dosages, and some tend to use a higher dose like 1.5mg/kg for people who fit the "on-label" definition of severe, recalcitrant, nodular/cystic acne and for people who are not responding well. Lower dosages are more common for "off-label" use - i.e. for people who's acne is not as severe.

Statistically speaking, you have the best chance of acheiving long term remission if your course gives you a total cumulative dose between 120-150mg/kg.

You add up all the milligrams you have taken then divide by your weight in kilograms.

A simple example: say you took 40mg for 6 months. That's 180 days x 40mg = 7200mg total. If you weigh 150lbs = 58kg, then that's 7200/58 = 124mg/kg.

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5) Multiply your weight in kg by your final number in step #4, and you will get the maximum number of mg's you should take in your entire accutane career. To get your minimum, simply subtract 1 month from step #4, and re-multiply. You should end up between your minimum and maximum intake value.

I have several comments about your post.

1) As beentheredonethat mentioned, your assumption is based on the average 125 mg/kg. However doctors prescribe anywhere from 120 mg to 150 mg/kg depending on the person. Therefore, you cannot derive the true number if you do not know what your derm has set as the ratio.

Also I have never heard anyone state that there is a maximum intake for your entire Accutane career. If this were true, than people could not get go on multiple courses.

2) When we are prescribed Accutane - no one, including the derm knows exactly how many months you will require. Therefore, you cannot know what your minimum and maximum months at the beginning and middle of your treatment.

It is not my intention to criticize you, but if people start calculating your formula than many will end up thinking their doctors are messing up their treatment.

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