Isotretinoin (Accutane®)
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Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought...

Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought to clear acne primarily through its ability to permanently reduce skin oil (sebum) production.

Isotretinoin is available in capsule form and is usually taken twice a day. Your physician will prescribe an initial dose, and this dose may increase or decrease depending on the response to treatment and side effects.

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1
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Used Isotretinoin (Accutane®)? Rate It:

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December 11, 2006

Pros:

Does clear up acne for a short while.

Cons:

Extremely dries you out. Lips are the worst. Toward the end I got bad headaches.

I took accutane twice... yes twice. The first time it worked wonderfully (except for the expected dryness... the lips dried out the worst... you need to use more than just lip balm... i found that aquaphor healing ointment from eucerin worked wonderfully for dry lips.. i actually still use it!) I was on the treatment for the reccomended 20 weeks or whatever it was. About 6 months after I got off accutane, I started to break back out again. My dr put me back on and it worked some but again soon after i was broken back out again. Also, towards the end of the second time I got horrible head aches... I've never had migraines but im pretty sure thats what they were. They stopped as soon as i stopped taking accutane. Long term effects: dry skin. you dont hold a tan as long. slightly more sensitive skin. accutane helped the current breakouts while i was on it, but not future ones. Maybe its just my stubborn skin b/c ive heard of a lot of people that this has worked on.
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November 24, 2006

Pros:

clearest skin ever.

Cons:

dry dry dry and initial breakouts before clearness

I've been on this for seven months now, and I've never been happier with my skin!! It's incredible. It dries EVERYTHING out, and its kind of gross. but I would rather have my classmates call me a green anole than a pizza face. try it out and wait it out.
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October 22, 2006

Pros:

wonderdrug for acne

Cons:

severe side effects

I've taken accutane twice. It cleared up my skin tremendously the first time, but the acne came back a year later. I started taking it a second time at a smaller dose, but the side-effects were much more severe. I had noticeable hair thinning, dry lips, and developed severe depression. Please read everything you can before taking this drug. As of this September, it has been linked to depressive behavior in rats (I used to think the depression of patients was a result of their acne). It has also been shown to cause permanent changes in sections of the brain that are associated with depression. If you are like me, you will probably still do whatever you can to get rid of your acne. But remember that acne usually goes away with time, whereas severe depression, once you're in it, is very difficult to cure and can be much more debilitating in every aspect of your life.
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September 12, 2024
Product used: Absorica (Isotretinoin)
Positive Review
Worked well for my condition. No side effects except for dryness.
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April 11, 2024
Product used:
Dangerous and useless for hormonal acne
It helped somewhat while I was using it, but the acne never fully went away. Upon stopping the medication, the acne eventually came back full force.
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Francesca D
October 4, 2024
Gosh that’s good to know, thanks. My dermatologist discussed a medication to even out my androgen levels, pending a blood test. Apparently this is the hormone responsible for persistent acne. But she thought Isotretinoin would be effective, too.
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September 4, 2023
Product used: Absorica (Isotretinoin)
Really think before taking
It worked for 5 years. My skin looked amazing but then I had the worst outbreak. It was the dreaded pizza face. My acne was worse than before going on Accutane. And they don’t tell you that after Accutane, acne doesn’t heal smoothly. The acne left deep deep scars. Deep pits that no cream will ever take care of. And men be careful, my ex got erectile dysfunction after using Accutane in his 20s.
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Francesca D
October 4, 2024
I head no idea this could happen. So sorry this was your experience, but thank you for sharing. I’m also looking at a longer term medication that evens out androgen levels for hormonal acne.
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January 20, 2020
The only thing that every worked; but it came at a price!

I have always had terrible cystic acne growing up that started when I was around 9-10 years old. Over the years I tried every damn treatment you could think of but nothing would get rid of it, or even get it under control. The products I tried would all just clear it up a little bit, but not enough to really notice much of a difference. I had an extreme morning and evening regimen of vigorously washing my face and putting acne creams on. If I ever once forgot to wash my face or put the creams on, I would wake up with the worst breakouts of my life the next day. I absolutely could not forget or skip a day, ever. I took birth control for my acne, but it only helped a small amount. I always thought once I got out of highschool the acne would just go away eventually, but it never did. Finally at age 23 with a face full of zits, I thought, ?This is it. This acne is never going away.? And I started looking into more drastic treatments. This is where the accutane came in. Let me tell you this was no walk in the park. I went through the hardest 6 months of my life while taking this stuff. It made my lips and skin soo unbearably dry. Describing it as uncomfortable would be an understatement. If I ever left my house without vasoline, I was absolutely screwed. My lips would get so dry that they would stick together and I couldn?t even get my mouth open. One time when they got stuck together, I forced them apart, and the skin from my bottom lip got pulled off and was stuck to my upper lip. It was bad, and nasty to be quite honest. I felt sooo tired all the time. I would sleep for 12 hours and wake up still feeling exhausted. I felt so fatigued. I am a full time college student, and school got extremely difficult while I was on this stuff. I just could not for the life me concentrate, and was always falling asleep in class. I couldn?t find time to get homework done and study because I was always so exhausted. I ended up failing TWO classes while I was taking this stuff. And I had never failed a class before in my life! I was also experiencing memory loss, which honestly freaked me out a bit. I was constantly forgetting things, leaving things at people?s houses, forgetting to do things, which is very unlike me. It also caused me to gain a ton of weight! Which was terribleeee. The weight gain was probably the worst part for me. I would literally go days without eating and STILL gain weight. I was always starving, but was always afraid to eat because I was blowing up like a balloon. I probably gained over 30 pounds during the 6 months I took this stuff. And then as soon as I stopped taking it, the weight fell off without me even having to try. 

However, despite all the terrible side effects, I still have to say I feel it was worth it. My acne was controlling my life, and I finally feel free now. I think what I like most is not having to do a full face of make up every time I leave the house. It feels like a true gift, because I always hated wearing make up. I no longer have to wash my face or put acne products on at all. It?s been about six months now since I stopped taking accutane, and all the side effects are gone. I?m back at my normal weight, and my skin is still completely clear. As others have mentioned, please be very aware of the side effects. If you can, try to take it during a time when you don?t have too much going on in your life. Also, you can pretty much expect to have no dating life whatsoever while taking this stuff, so be prepared to spend some time alone. 

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January 13, 2020
Acne Came Back After Two Courses

This drug was amazing and cleared my skin on both occasions rapidly. Side effects are not fun but you do it because its only for 6 months and then its 'cured' (sigh). Not the case for me at all. On both occasions the acne came back after 6 months. I am now 26 and I now and my acne is as bad as it ever was and is clustering on completely new parts of my face. How much I wished that this was my cure and this nightmare would be something of the past.

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Vixxy
March 24, 2020

exactly my story. 

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09ifes
July 18, 2020

Did you take the full dosage of 120-150mg/kg? Did you skip doses? Did you consume it with fatty foods?

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June 29, 2019
clear skin for about a year

Hello, 

When I was 14 years old (slightly over a year ago) I was prescribed a six month course of isotretinoin by my dermo. It worked great while on it but I had EXTREME back pain to the point that I went to my General Practitioner to check if I had scoliosis. My Dermatologist was hesitant to prescribe so it took me about a year and a half to even start. Now a year later my acne is back and still considered moderate but VERY stubborn and nothing seems to work, so in my case I had clear skin for about a year and now my skin is horrid and my Dermo told me that my 'standards are just too high." I don't think it was worth the back pain and chapped lips. 

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S.J
July 16, 2019

I went through the exact same issue. Had clear skin also for about a year after using  oratane (isotretinoin) for 6-8months. It's back now so I hope this skin regimen on acne.org can help me

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kennah
November 8, 2019

How long did it take for you to be clear.  I'm end of Month 5 and still getting small breakouts.  I will say parts of my face haven't broke out in a month, but still quite a few on nose, and side of nose.  

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September 2, 2018
My miracle
I never suffered with acne as a teen, I guess I was lucky. My skin wasn't perfect, but it was blemish free. When I hit 20, everything went downhill. My hormones went crazy. Suddenly, it was as if my face was as out of control and there way nothing I could do to maintain it. I tried various products, microdermabrasion, light therapy, Tetracycline and a number of intense and EXPENSIVE chemical peels. For about 3 months, the tetracycline worked, then my acne came back with a vengeance. It was the worse I had ever seen it and suddenly I couldn't look at myself. I couldn't look at other people, I became anxious, shy, sad - I felt ugly. I began facial peels. I must of had at least 10-12 checmial peels( which did help). Slowly my acne began to improve, but it was still there, only not as aggressive and at a cost of £90+ a peel I couldn't continue using them. I learnt about accutane from the sk:n clinic where I was having my chemical peels; by which point my acne was graded as modular pustular acne - not nice, I know. Anyways, I continued having chemical peels for about 5 months,having at least 2 a month, before I demanded to be referred through my doctors to a dermatologist (only registered dermatologists can proscribe accutane in the uk and i just could not afford to fund it privately) I was rejected at first. I went back ofcourse, kicked up a fuss and told them how depressed I was. I finally got to see a dermatologist and straight away was given accutane. My first appointment, they preached about not getting pregnant, checked I wasn't already, checked my weight and just wrote me a prescription. I though it would be more difficult, but once I got to that stage it was fairly easy. I was told that I would need monthly appointments, needed to go on at least two forms of contraception (although I didn't because I can't have synthetic hormones for medical reasons), would need to keep an eye on my mental health and come back every four weeks for an up-dated prescription. I started on 20mg a day for 4 weeks- no problems, no difference. I increased to 30mg for 4 weeks then 40mg. I started to notice I was no longer breaking out, like at all. I had no side effects at first. My dose increased to 50mg a day. The skin on the back of my hands began to dry, like scales. My lips split, like they reallllyyy split. My eyes became so dry and gooey and I was going through at least one bottle of eye drops a week. They're not exaggerating when they tell you to moisturise ( personal preference, cetaphill - it's a life saver and can be used on your face and body) I started to get backache, really badly. I became nauseas. All my blood test came back fine and within 6 months I was off accutane and spot-free. I'm the happiest I've been with my skin in over 24 months. The only side effect I'm still suffering with currently is backache but I've only been off accutane for 6 weeks. Despite the side effects , I would go back on it tomorrow. Roaccutane changed my life, for the better. It's a life saver and I don't regret going on it.
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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.
Find a Doctor Using The American Acacemy of Dermatology Website

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.
Find a Doctor Using the American Society of Plastic Surgeons Website