Oral Retinoid
Reviews
3.9
2786 Reviews
Oral Retinoid
Efficacy
87%
Based on All Available Studies
Strength of Evidence
1
2
3
4
5
Note: Use with EXTREME CAUTION: Causes severe birth defects and fetal death.
Oral Retinoid
Side Effects
High
Oral Retinoid
Acne.org’s Real World Take
The nuclear option. It works reliably and provides long-term remission of acne, and even severe acne, in about ⅔ of people who properly take an adequate dosage. However, it permanently and irreversibly changes the skin and the body forever and users may experience long-term side effects for the rest of their lives. It’ll nuke it, but there is no going back.
Oral Retinoid
How to Get It
Have a dermatologist? Make an appointment to get this medication. Don't have a dermatologist? See The American Academy of Dermatology Physician Database to find one.
Read All About Isotretinoin (Accutane®)
Compare To Other Treatments
5
37.1%
4
33.4%
3
15.6%
2
7.4%
1
6.6%

Used Isotretinoin (Accutane®)? Rate It:

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June 15, 2017
My Accutane Experience: Female, 25. Cystic, hormonal acne + body acne.
Hello everyone! I've been meaning to post an 'Accutane Experience' write-up for a while now, as I spent years of my life trawling through this website, reading up on everyone else's experiences. All of the posts and reviews have given me hope, occasional dread, and mostly a whole lot of comfort in knowing I wasn't going through the agony of acne alone. I hope this post can provide some of that same hope and comfort to anyone suffering with acne and thinking about going on accutane. I've been off accutane for a month and it's one of the very best decisions I've ever made. It's an extremely freeing feeling: the shackles of cystic acne have gone, and my self regard, hunger for life and confidence have taken their place. I want this review to be as helpful and succinct as possible, so before I get too poetic, here goes. My type of acne: Face: Hormonal and cystic; concentrated around the chin and jawline. Every month or so I would get huge, marble-shaped cysts. I'd hold warm compresses to them and stay in my room all night. Sometimes, my skin would be clear. But that wouldn't last. Body: Mostly concentrated on shoulders, chest and upper back, with a few on my lower back too. Occasionally cystic, but mostly whiteheads. Often very red and sore. I have small but noticeable keloid scars (or perhaps hypertrophic? I'm not sure of the difference. In any case, the scars are raised) left on my chest, and a medium-sized one right on the very tip of my shoulder. Wearing strappy tops is still a bit of a worry for me, sadly. Things I've tried: - Antibiotics (tetracycline) on and off for almost 9 years. - Apple cider vinegar. I seeeriously doubt this works. - Cutting out dairy. Meh. Didn't see much difference. I missed cheese. - Birth control pills on three separate occasions. Hated all three times. Cried every day. Acne didn't change, or got worse. Time on accutane: 4 and a half months. It's short, I know. But my derm was pretty confident I didn't need it any more as my skin improved so drastically. Also, there's a study into the cumulative dosage method not being the most accurate. I'll give you a link if you want. Dosage: Month 1 20mg Month 2 20mg/40mg on alternate days Month 3 40mg/60mg on alternate days Month 4 - 4 and a a half 40mg/60mg on alternate days Summary Month 1: Honestly, my skin was pretty clear when I took my first dose. I was having a good skin month. But I knew it wasn't long before the acne would come back ' plus, I'd been on the waiting list to see a derm to get accutane for about 4 months, so I was taking the damn thing no matter what! Anyway, my skin stayed clear. I noticed the tiny, tiny blackheads on my nose I've had FOREVER creeping to the surface. I'd gently exfoliate, and eventually, they just disappeared. They're still gone now. The only side effect I had in Month 1 was flushed skin. Month 2: A couple of zits here and there, but nothing worse than I normally get. I had a lovely line of spots on my shoulder... I started to notice my joints aching a little. Month 3: I basically was a huge hypochondriac this month. I convinced myself I had intracranial hypertension due to a couple of headaches and a bit of dizziness. I did have really achey joints at this point, but it was bearable. Dryness kicked in: my make-up looked a bit flakey and I was constantly putting chapstick on. I got a cystic spot on my chin around my period. Month 4 to 4 and a half: Skin looked great. Same side effects as before. I was lethargic, dry and achey. I went back to the derm, they congratulated me on how great my skin looked (and gave me useless advice on scarring, but that's another story). I left his office without another prescription and went on holiday to Milan the next day. I might have spent a little too much time in the sun drinking Aperol Spritz. Oh well. Now here I am, with the smoothest, clearest skin of my life. Key takeaways: The biggest thing is that it was literally fine. I had none of the terrifying side effects; my mood, if anything, was better because I was so optimistic about my clear-skinned self. I simply didn't think about the fact I was on accutane as much as I thought I would. In fact, I hardly ever thought about it. I just got on with my life, and ultimately, nothing was different except for the amount of chapstick on my desk at work. Also, I didn't consider how much the consistency of my skin would change. It's so soft! I can't stop stroking my chin and back. I'm aware that my acne might return, and I would take accutane again if it did. But I'm very hopeful that I'll be one of the lucky ones that doesn't get it again, or at least I get "normal" acne instead of cysts and body acne. Honestly, I just don't wanna give up cheese again. My only question to you guys is: Any advice on raised scarring? My derm was truly useless and told me I'd simply never have normal skin and to try Bio Oil. Should I go to a clinic, look at getting some kind of procedure done?
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May 11, 2017
Just finished my 2nd course of Accutane, currently clear
Like the title says. I will return to this post and edit it to give 5 stars only if the clear skin is permanent this time. After my first course of accutane, which was a low dose of 20 and then 30, I was clear for about two months or three months before I got acne back again, concentrated on my chin and jaw area. Originally, I had pretty severe acne, maybe moderately severe to severe. I started getting acne when I was 11 and I am nearly 21 now. My acne worsened when I was on lithium medication for my mood-- I'm not on lithium now. Accutane does work, and I would recommend it. During my first course of accutane, I was blissfully clear skinned. I did not have an initial breakout. And I did not have side effects other than slightly chapped lips. Maybe it was because my dosage was kind of low, because I'm a lightweight person. So I just did my second course, and that went blissfully well, too. No initial breakout, no side effects. My skin got a bit dry near the end of the course. This time, my second time, I started with 40 and took 40 all the way through. I hope that this time, the acne won't return.
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May 10, 2017
It works, but side effects can get annoying
I was put on accutane due moderate acne that was not responding to any antibiotic treatments. I ended up being on 60mg accutane for 4 months (im male, 19 years old and 150 lb). The medication starting working very quickly, and within two weeks my face was completely oil free for the first time in years. In terms of my acne I didn't start seeing any major improvements until around the end of month 2. By the end of my fourth month, I had completely cleared up. Be warned though, DO NOT pick at your acne while on this medication, no matter how tempting. Accutane makes your skin considerably thinner and so any picking can and will leave you with red/brown marks on your face long after your pimples have gone, I learned this the hard way. Aside from the marks, my face is still clear two months after the end on my course, although it did get oily again. My doctor did also put me on 0.01% Retin-A for maintenance and for fading the red/brown marks. Despite my success in regards to my acne, the side effects while on this medication were a pain. While I didn't get any of the rarer, major side effects (eg depression, diarrhea, etc), I did have numerous other side effects. The biggest one for me was dry, red eyes, throughout my course. I had dry eyes before accutane, but I was not prepared for the constant pain my eyes were in throughout my course. Over-the-counter artificial tears did not help at all. If you have a similar issue, I suggest you visit an eye doctor like me, as the steroid eye drops prescribed (Lotemax) helped alleviate some of the burning/redness. Aside from dry eyes, I had the typical dry lips, rashes on my arms (moisturizing daily helped), a dry throat, and minor joint/back pain. All in all, I would go through all the side effects again, as Accutane really did help my stubborn acne. That being said, I would advise others to look at all the potential side effects before taking this medication, as Accutane may not be worth it if you don't have severe, or moderate-persistent acne.
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May 6, 2017
Accutane just didn't work for me
I must be the 1% accutane didn't work for :( I'm a girl, and this is more common to happen with girls due to hormonal acne. I think another issue is I picked the ENTIRE time while on accutane, and maybe if I had never picked my skin would have healed. Now here's why I'm giving accutane 2 stars. Before accutane, I never really broke out on my cheeks. But during accutane, I started breaking out a ton on my cheeks (which scars the worst on my face), and it never ended. It's subsided, but I still break out on my cheeks. Accutane worked wonders on my 2 older brothers, so if you have severe acne I say give it a go. My acne honestly wasn't bad at all, to be completely honest I think my picking caused my acne. Unfortunately, nothing can really fix that. The only reason I went on accutane is because I was allergic to all antibiotics for acne and nothing topical worked. I'm now on Retin-A and it seems to be working well :)
May 3, 2017
Accutane changed my life in all aspects
Back in highschool, I used to have really bad, uncontrollable acne. I've tried almost everything; topical creams, face masks, oral meds, doxycycline, etc. My face was so oily, gross and cakey as well, because of makeup. It only made it worse. My parents decided to take me to a dermatologist. My derm said I had moderately severe hormonal acne back then, so she prescribed (Ro) Accutane 20mg. I was 15 (f) at the time and I took it for 5 months. I didn't know anything about it. My derm mentioned only the most common side effects and gave me a kit full of sample moisturising products and lip balms. The first couple of weeks were HELL for me, as expected though, because my derm said Accutane will make your acne worse, before it clears up your skin. I had all of the common side effects: extremely dry cracked lips, dry skin, back pain, dry hair, and even nosebleed (only once). My skin was also sensitive to sunlight, so I had to slap on heaps of sunscreen. I didn't wear any makeup (only lip balm and moisturisers) during the time I was on Accutane, I just allowed it to do its work. As for depression, I didn't really feel depressed during that period. At that point, I didn't really care about exposing my bare, acne-filled face in school or in public either, as I only cared about the results. After about 4 weeks, I noticed that my skin started to get better. The bumps on my face were smaller and my face was less dry. My acne basically cleared up within those 5 months. Fast forward to this day, I'm about to turn 20 and my skin is still great. Of course I still get bumps here and there, especially during that time of month, but those bumps are much more controllable, than the bumps I had when I was 15. I was so happy and still am, because Accutane literally changed my life. I can still leave the house without feeling embarrassed, to this day. My relatives and parents would constantly tell me that my skin looks great. To those who are taking/considering Accutane, my advice is to not think about the side effects too much, as that will only give you anxiety and demotivate you. Negative thoughts won't do your skin any good. Think about good outcomes as it's much better for your health! However, that doesn't mean Accutane is not a serious drug, because it definitely is. I suggest seeing a dermatologist to explore a range of options. Talk about it with your derm. They're there to help you. That's all, I guess. Good luck on your journey to clear skin. I wish that you also become a success story. :) PS: Don't think about buying it online! I've read one of the reviews here by someone who bought Accutane online and calculated their own dosage, saying that it's given them positive results. It seems convincing, but it's absolutely dangerous. It might even be a fake review, who knows... PPS: Good luck!
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April 18, 2017
2 months in.......
Male. 6'1". 155lbs or 70kg. 18 years old. 1st month: 40 mg side effects: dryness, minor lower back pain, a little bit of stomach problems, tiredness. 2nd month: 80 mg side effects: dryness, bearable back pain, tiredness, unmotivated (not too extreme), dream like feeling. i am familiar with this dream like feeling because of my anxiety. but it has gotten abit worse because my anxiety towards the medication is high. I have had anxiety for around 7 years. one of my biggest fears i always worry about is going insane (crazy). and i noticed one of the possible side effects were psychosis. so i'm constantly worrying (every day all day) about what if i'm going crazy. i've had these what if i'm going crazy thoughts for years, but it has gotten worse bacuase of the possible side effect of accutane. to the point where i get stressed and feel mentally drained or ruins my day. how possible is psychosis on accutane? is my dose too high? other than that i feel okay, the side effects are bearable.
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April 15, 2017
For Anyone Concerned About Trying This Drug
I want to begin this by saying that i was in your position. I had bad acne. I'm writing this to provide some insight to what it's been like the last 3 years after my course of accutane (some information that i would have eaten right up before i started treatment). Let me start off by saying - this drug works. For most, if not all of middle/high school, I had very bad acne that was resistant to doxycycline, minocycline, proactiv, Murad products, benzoyl peroxide, sailicylic acid, and all the wipes i could get my hands on. You more than likely will be free from acne at least for a few years after treatment, and it's absolutely wonderful! Being able to walk around without having to check mirrors for a new red/white bump on your face is as great as you think it would be. Looking back it seems like i was a completely different person. You're probably thinking: if it works so well, why the lackluster rating then?! This drug works wonders but there is absolutely a reason as to why they're so serious about prescribing it. They are very cautious because this stuff is freaking legit - it alters your body in a permanent way. Once you've finished your course there is no going back. In fact, at the time of writing they still do not understand exactly how it works - but it affects acne. This was originally made to be a drug for cancer patients (yeah, people that had nothing left to lose and were willing to try something that could potentially debilitate them if it meant surviving! crazy right?) So I went on the medication and throughout the course felt nothing but the normal side effects of dry lips, skin, nosebleeds, dry eyes and easily scarring (just a scratch on accutane can turn into a permanent scar hah, i have a few reminders). Things went through without a hitch and i was acne free! I would notice people staring at me, and if i could guess what they were thinking it would be "How in the hell did that pizza face get porcelain clear skin?!" Strangely, the side effects of this medication slowly ease their way into your life after treatment (the effects are permanent after all). Expect something along the lines of joint pain, gastrointestinal issues, and mental health dips. These tend to be the most serious. When people get these issues they disregard it as natural, how in the world could they be associated with something they took 3, 5, even 10 years ago? Long story short in convincing you this are legit, the original manufacturers of accutane (Roche) went out of business due to lawsuits and had huge payouts of millions upon millions of dollars to peoples lives they had negatively changed (mostly focusing on permanent gastrointestinal issues). I could talk about this for hours but to avoid making it THAT lengthy, here's the summary: I can't stress enough how EXTREMELY important it is for you to consider these potentially permanent side effects. When i took it i couldn't care less about side effects, all i wanted was my acne to be gone! But there are people who used to play sports, ran, and workout - now experience severe pain by simply walking due to joint issues (and it's seemingly permanent unfortunately). If your acne isn't really that bad, or could go away within a couple of years normally, it is up to YOU to consider taking this drug. There are dermatologists out there who will prescribe this to people with just a few pimples, which is unecessary given how serious the side effects could be. Read up on peoples experiences years after their treatment and make an informed decision!!! God bless :)
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December 15, 2017
Your comments are right on the money , long term side effects are REAL , and can be life altering. This drug should only be used for Severe cystic acne , not for a couple of red spots that’s criminal it really is . Even for severe acne all other avenues must be exhausted before going on chemotherapy because that’s what it is .
April 9, 2017
Sort of worked, only while I was on it
I went through an accutane treatment when I was 16. I am 28 now. I recall being extremely dry, and no moisturizer would help. I also remember being so depressed that I asked for help and went on antidepressants shortly after my accutane round (about a yearish). My skin cleared up while I was taking it, but the drawbacks were not worth it. My acne returned as soon as the treatment was over. I know now I have hormonal acne and rosacea so perhaps Accutane wasn't the best choice. I personally think it's too severe of a treatment for anyone under 18 - heck, for any age really - and if you are considering it, please go through all other possibilities first, like getting a blood test done for hormonal imbalances and attack the acne that route. I also suggest seeing an esthetician as they can do some amazing, cleansing facials. It won't solve the problem permanently but it's a far more enjoyable experience than Accutane - you are pampering yourself and won't be poisoning yourself with vitamin A. Plus de-stressing can help with acne ;) My acne is exactly the same as it was before I took it. I don't mean to sound doom and gloom - this is simply my perspective on it. It could work beautifully for you if you have severe cystic acne that is unresponsive to hormonal treatments. Just be wise and perhaps see it as a last resort.
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March 20, 2017
Scary side effects
I had been working with my dermatologist for nearly two years when she suggested I take Accutane to combat my persistent acne. I am a woman, (a young woman at the time) so I was given two large packets of warnings and agreements, contracts practically stating that I understood the risks I was going to be facing etc, etc (these contracts I had to sign). It was vital for my doctor to know that pregnancy while on this medication was absolutely unlikely and I was put on birth control and (would have been) required to take monthly urine and/or blood tests to prove that I was not pregnant (and that my liver was not failing me). I did more research, very in-depth research, a few weeks before I was due to start taking Accutane. I read that Accutane was originally introduced some years ago as a cancer drug but was a failed cause. Now, whether this is completely true or not.. it scared the life out of me. Reading the side effects listed in the packets given to me also made me feel as though risking my health was NOT worth it. So I decided not to go forth with the treatment. Luckily I found the Acne.org Regimen and my skin is completely blemish-free because of that. I strongly recommend exhausting all of your options before considering Accutane, especially if you are a (romantically active) girl or woman. In my personal opinion, a drug so harmful that it can cause absolutely horrific birth defects is a drug not taking a chance with. Be wise in your choices please and think about it thoroughly! Best wishes! :)
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November 2, 2017
So you never actually tried it, but still giving a one-star review? Your not a researcher, and your discouraging other people from using Accutane because of the research that "may or may not be true." This is a review forum, not your opinion.
March 16, 2017
i didn't complete treatment
I used it for 2 months but didn't complete the dose because I traveled and couldn't get supply. I've been off accutane for almost 2 months. Can I continue with the dose or I'll have to start all over? My acne was clearing but it seem to be coming back
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.