Oral Retinoid
Reviews
3.9
2791 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
15.5%
2
7.3%
1
6.6%

Used Isotretinoin (Accutane®)? Rate It:

Choose from 1 to 5 stars
September 18, 2010

Pros:

It works! Oil free, clear skin without the need to cover it up with make up!

Cons:

Aside from the typical dry skin/lips...
-Rash/Eczema on hands, arms and now legs
-Nausea and other digestive disturbances
-Pain in low back, hips and elbows
-Losing more hair than usual
-Really irritable mood!
Recently my eyes have become more red and dry. They look and feel really irritated. My liver enzymes/Cholesterol are high.

My skin looks fantastic but I am giving up after 3 months due to all the side effects. Some people feel that you can't put a price on clear skin, but I feel that you can't put a price on your health!
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May 9, 2010

Pros:

Beautiful skin. Lost a little weight.

Cons:

Major depression (I wanted to kill myself), Made me crazy, overaggerate, and angry..I lost a couple friends because of it. Dry eyes..but I had contacts and it made my eyes water all the time. Dry scalp and skin. Very tired all the time. Couldnt concentrate. Bad anxiety. Bags under my eyes. My cons outweighed the pros..Unfortunately :(

I took accutane twice..the first time my acne started to come back after three months and then I took it again with the same side effects and stopped through my 2nd course because I couldnt deal with them all over again. and I was only on 10-20mg the whole time. I love how it made my skin look but I dont think I would ever take it again. Its not for everyone. Please look more into it before taking it.
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April 25, 2010

Pros:

improved skin

Cons:

dry lips, thinned hair, random rashes, very dry irritated eyes, body aches, HEADACHES almost everyday, embarrassing dry skin if you don't moisturize every few hours,

I was on accutane for the last 6 months at 60 mg a day, and did not see results untill 5 months in. I am currently on my 7th month and was bumped up to 80 mg a day. I have fewer pimples, and STILL have cysts that are just starting to go away, Now im left with stubborn clogged pores and open pores from previous acne (that still tend to be active) since Ive been bumped 20 mg in dose I find Im so intensely irritable and have random breakdowns which has been concerning me.Lately I've also lost my appetite but it might be from stress? This is NOT a drug to be taken during university years at least in my case, I cant think clearly and have a careless attitude, preventing me from my studies, which is not like myself. I'm on the edge of dropping out. Although my skin has gotten a lot better, it is still rather problematic, and will most likely continue a few more months if my blood tests are good. but I'm losing my patience, nothing else has worked so Im sticking to it. plus Im praying for the success most others have, which gives me a little hope
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January 6, 2010

Pros:

got rid of my acne

Cons:

was the worst 6 months of my life, dry eyes (couldn't wear contacts while on it/a few months after, though I can now), felt lethargic, lost appetite, couldn't go out in the sun, would get red after 10 minutes (not really an issue for me since I am pale and never made sunbathing a hobby but for some people I'm sure it would be a big deal). Back aches, dry lips (manageable with vaseline applied continuously)

My acne severity is listed for what it was pre-accutane. now i would consider it to be very light, yes I do get pimples occasionally, but its been a little over 2 years since I took accutane and my acne is both a million times less and more manageable when I do get it, ie actually goes away when I use topical treatments. I was miserable while on it, but ultimately its the only thing that worked for me and if my acne came back I would use it again. only use it if you have tried EVERYTHING else.
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July 19, 2014
Not nearly as scary as I'd feared.
I'd had varying levels of acne since I was 12 and had exhausted every possible solution - antibiotics, topicals, birth control, gluten-free dieting, spironolactone, etc. Some of these treatments would improve my skin for a few weeks or months, but nothing ever lasted. Starting in my mid-20s, doctors started mentioning Accutane as a possible solution, but I'd heard such awful stories about it that I always resisted. Fast-forward to my 30th birthday. I had just gotten off spironolactone, which had worked marvelously for my skin but had also caused an allergic reaction. I decided that I was at the point that I would do ANYthing to finally and emphatically rid myself of acne, so I marched into my dermatologist's office and demanded Accutane. To put it briefly, Accutane was a miracle drug for me, and I experienced only the most minimal (and manageable) of side effects. I had to remain vigilant about skin/lip dryness, but so long as I moisturized faithfully and kept my lips slicked with Aquaphor, it was totally manageable - nothing worse than I experience during, say, a normal mid-Atlantic winter. I also experienced some joint and muscle achiness, but this was only inconvenient, not dehabilitating. At the four-month mark, my dermatologist noticed that my liver enzymes were starting to increase, so she reduced my daily dosage until I finished the course a month later. (They returned to normal after I ended the medication.) This had been my biggest fear - I didn't want to cause any lasting damage to my body - but the beauty of the monthly blood tests is that your doctor should catch any problems before they become irreversible. I've been off for five months now, and I haven't had a single cystic zit since; the worst acne I've seen is a few tiny, non-inflamed zits along my hairline that often pop up before my period. I would still describe my skin type as "oily," but it's not nearly as oily as it was pre-Accutane. And I've had no lasting side-effects or problems - I would absolutely do this all over again, and I feel silly for being so fearful of trying Accutane in the first place. My one key piece of advice: Try to find a dermatologist who is experienced with Accutane. I was fortunate enough to find a doctor who specializes in cosmetic dermatology, so she had the Accutane processes down pat - she told me exactly which cleansers and moisturizers to use, what dietary adjustments would help, etc. (She also put me on an awesome retinoid after, which has helped - along with at-home peels - get rid of the nasty scars and dark spots that remained after Accutane.) I had sworn to myself that I would post my experience with Accutane here, because I had stalked this message board for weeks before starting my course and found the information very helpful. I want to add to the chorus of voices who took Accutane successfully and are glad they did!
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July 16, 2012

Pros:

Clears acne
Reduces Scars
SELF-ESTEEM

Cons:

The side effects*
Taking Isotretinoin will be difficult regardless.
*with up-keep the side effects are tolerable, also because your skin is clearing nothing feels better than acne going away, only people who have acne can understand this phenomenon

I AM JUST LIKE YOU. I read all of these reviews before I went on this medicine. Before Isotretinoin I tried Doryx, Solodyn, Ampicillin, Bactrim DS, and Every topical that big pharma has produced during each oral course of treatment, now after a 6-month 40mg/day course I am acne free and the red marks fade quickly. The key is to do it right, blood tests are a given and side-effects. So research Vitamin A toxicity and you'll see to take the vitamins (D,E, Calcium) that compensate for the large amounts of Vitamin A which is the cause of ALL of the symptoms. Moisturize to keep your skin from becoming one of these review horror stories. Use the lip moisturizer Aquaphor by Eucerin (The larger bottle is cheaper as opposed to the small tubes which have an artificially high price). Fish oil is also a necessity to keep your joints from becoming too dry (Joint pain horror reviews should have taken this). Jojoba oil (oil from plant that is the closest to human sebum but has antibiotic properties so it won't make you breakout) is what I put in my hair to keep my scalp moisturized and it prevented dandruff. Probiotics (Healthy,Acidophilus bacterium) will keep your digestive functions running and keeping you from constipation and irritable bowel, I got hemorrhoids for a few weeks because I wasn't taking my probiotic (resulting in harder stool and means I pushed harder while pooping and then got a swollen vain, it's okay guys my face is clear). And lastly is sun exposure, don't turn into a vampire like people here say, just use a high SPF sunblock such as Neutrogena Ultra Sheer and apply when you go outside to avoid damage. Don't have any illusions, You need to be prepared to go through the treatment and have to do it the right way with blood-tests and proper self-up keep. Bottom-line is You can do it. I did and it was when I was at my lowest so I know that you'll pull through it as well. Good luck and God bless
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February 14, 2012

Pros:

It worked

Cons:

Redness
They always miss my veins in the blood tests haha

I rated my acne as severe. It was. But accutane cleared it. You might have questions. Try asking a doctor, instead of google. You'll get better answers. I wont have to come back to this site again! So, Good Luck.
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December 12, 2011

Pros:

- dramatic change after one month (now I have like 10-15% of what I had before
- skin isn't oily, maybe a little change with hair oiliness
-feeling so much better
-don't have to think so much about make up because it 'stays' on my face, also I need less of it

Cons:

-chapped lips
-dry hair(had to change my shampoo and use some conditioners to moisturise it)

As everyone here I have had acne for a long time (it started when I was 11, now I'm 18) and I tried all topicals and over-the-counter stuff. I was twice on Tetracycline (first time for 2 months and the second for 5 months). It helped but only for a little while and then it started to get worse and worse (again). It became so bad, especially on cheeks that I didn't go out even to school for some time (and then I went to a doctor who hopefully was more professional and she prescribed me accutane). I was very nervous but I wanted to tried it. Things people write in the Internet about it can bring you down, but now it's been a month and side effects for now are only chapped lips (completely manageable) and slightly dry eyes (I wear contacts and it's ok). I see DRAMATIC change. After few days my skin wasn't oily at all, amazing feeling. I had mild initial breakout but it's like pimples that are under the skin are coming out, so it's not depressing, because when they vanish, it looks better. I had a lot of pimples and cysts and now I have a few which are actually vanishing, and a few nodules, with make up no one would say that I have problematic skin and it's the first month. (!!!!!!!!!!!) The skin is less red and it looks far more 'normal', like a skin of a normal person. I would say that if your acne isn't super severe, it would probably go quite smoothly. If your skin doesn't have a tendency to become dry you don't have to worry about this dryness. I use cetaphil and everything's ok, skin isn't flaky. But my friend always had dry skin and with accutane it became actually problematic. For me, a person very concerned about my looks it seems as a drug that can change my life, concerning all this stress and tears and things I could have done but I didn't because of acne. I will post after I finish my treatment.
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September 26, 2011

Pros:

Perfect Skin!
Free treatment on NHS as I was under 16
No relapse - spots have not come back at all

Cons:

Extremely chapped lips
Very dry skin in nostrils
Sunlight sensitivity
Weight gain from birth control (it was mandatory for me to take it)
Blood tests every month

After suffering from acne for about five years until the age of 15 and trying every possible medicine out there, I finally broke down in tears in my doctors office and begged her to admit it wasnt just 'a part of puberty' but something serious. She finally referred me to a dermatologist, who immediately offered me roaccutane. He talked me through all the risks which im sure you will be aware of now, and I decided to go for it - I literally had nothing else to try. For me the worst part of the experience was the blood tests each month - I am petrified of them. Another downside was the mandatory birth control - I went up a clothes size from this which shook my confidence a bit, and two years later i still havent shaken that weight off! I was fortunate enough not to suffer any serious side effects such as mental problems or joint ache. My skin didnt become dry, however my lips took a big hit. Chapstick didnt do a thing to help and they were so scabbed and painful i literally couldnt smile sometimes without splitting the skin on my lips. I finally ended up using Aloe Vera gel which was basically a miracle product, i highly recommend ANYONE to use this as it sinks straight in to the lips instead of sitting on top. I would shed a layer of skin on my lips everyday and since coming off of Roaccutane it is no longer a permanent problem but when the temperature drops they dryness does return (not to the same severity but still a lot worse than ever before i started Roaccutane). I also remember that my skin inside my nose was very inflamed and dry, and although it sounds disgusting i would have to pick my nose many times a day just to feel a bit more comfortable. For the first three months I was on 50mg a day which reduced to just 20mg for the final two months. Two years later my skin is still great, no relapse for me. As i live in the UK and was under 16 my treatment was 100% free - easily the best decision i have ever made and highly recommend
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June 30, 2011

Pros:

Clears Acne 100%
Clears Blackheads 85%
Cures oiliness temporarily

Cons:

Acne may return
Dryness, minimal hair loss
Sensitivity to sun

I was lucky enough to experience on a small amount of side effects. I had dry lips (my skin wasn't even excessively dry) and some hair loss which now is growing back one month later. I am not sure if I am 100% cured of acne but I would recommend anyone with severe to moderately severe acne to try this. Yes, there are side effects but honestly, I held off of Accutane for so long because of the negative reviews I read. Honestly, most people come online to write about the product because they had a bad experience. The large population of people who do not experience anything drastic just live on happily ever after and do not bother. Take it from me, this drug is worth it. I say this and I had no insurance. I got insurance half way through my course and still ended up paying about 2k. If you have insurance and bad acne, you should not wait any longer. Please do yourself a favor and take Accutane. If you are scared, consult your dermatologist about possibly starting off with low doses. I did this and found it to be more effective and I suffered no initial breakout. If you have tried almost everything and nothing has worked, there is no reason for you to skip this because of "side effects." I used to talk people out of taking Accutane until I took it myself. I now advocate it. Good luck!
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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.