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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February 15, 2015
Roaccutane
After suffering with persistent acne for 7 years I finally got referred to a dermatologist. My first appointment was in oct 2014 and I got prescribed doxycycline. Not sure why as I have been on this before! He was very against me going on roaccutane as I have suffered with depression in the past. Had my review 2 week ago and this time was a different dermatologist as the previous one had left (thank god!). She straight away recommended roaccutane. Had my blood test done 20 mins later and picked up my prescription the next day. I have never felt so relieved to pick up medication!!! The thought of knowing I was on it was a weight off my shoulder instead of having to beg for it which I had to first time around with the previous dermatologist. I'm now going in to my second week of 20mg and my skin is so dry already and my lips too but my skin has cleared up dramatically already :) I had to go to boots today to buy cetaphil and wow that stuff is brill! Didn't sting or burn like most moisturisers do to my sensitive skin. I am also using burts bees lip balm as carmex wasn't working for me (felt very grainy on my lips). If any of you people are suffering then please ask for roaccutane. And also not all dermatologists are sympathetic :/ I'm just so glad that the second one I seen was female and empathetic as she sympathised with me and knew that I needed this treatment so don't be put off with only one dermatologists opinion!! (You can ask to see a different person). I'm using less make up as previously I would cake it on and even then you would still see the lumps! My foundation is very expensive (Estée Lauder double wear - which is brill for coverage by the way) and with me using less is a pricey bonus :) I'll keep you updated but if you have any questions then I'm here. I know how horrible it is to suffer with acne - physically emotionally and socially!! Hope this helped x
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February 9, 2015
for severe acne- this is the cure!
i had severe acne when i was in high school- it was awful- i tried everything- until my dermatologist and i agreed that it was time to try accutane. I have to say this should be the end all be all for acne sufferers. the months that were ahead of me were tough- fortunately i had a great support team including my mother and my dermatologist- the peeling, the dry lips- it was all worth it in the end- my skin looked and felt amazing- it is a rough road but much worth it! i have not had horrible severe acne (going on 9 years since my last treatment)- please make sure that you go over everything with your doctor- prepare for what is ahead, and keep going, there is a lot of support out there for this and i highly recommend you go over this clearly with your doctor
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February 5, 2015
Best decision ever
I'm a 17 year old girl and I had constant issues with my skin before accutane. I would get the occasional cystic zit and besides those I just had constant break outs where I would get 5-10 new zits a week. I had tried just about EVERY medication on the market from topical to oral. They all seemed to lessen the breakouts for a few months until my body got used to them and the acne returned. My daily routine consisted of caking on makeup to cover my acne, only making it worse. At night it took me about an hour to get ready for bed because of my lengthy skin care routine. These topical gels just caused my face to become very oily on top of the oily skin I already had. And I mean oily. My face looked like I just jumped out of the shower. I finally got to the pont where my dermatologist recommended me for accutane and let me tell you that was the best decision I've made in my entire life. I went on accutane and after about 3 months I started seeing a lessening in the breakouts as well as a complete loss of my oily skin. I was on accutane for about 7 months and at the end of my accutane journey I had not gotten a zit in about 3 months(a miracle for me). I have now been off accutane for about 5 months and my skin still looks impeccable. In fact, it's still getting better. Now, if I get a zit it goes away within 3 days and does not leave a mark. I now simply use lotion for skin care with the occasional retin-A on a small zit and that is it. It now takes me 10 minutes to do my makeup where it used to take me 30. I Know this sounds cheesy but its such an amazing feeling to look in the mirror and see your natural beauty as opposed to the 10 zits on your face. I am so much more confident and I still do not have oily skin until the end of the day( and only mild). I highly recommend accutane. I was extremely worried about the sideeffects and impact on my emotions but I did not have any problems during my accutane course(despite blood tests, gross). I did however have extremely dry skin especially when young my dosage from 40 every day to 40 one day 80 every other day. Be aware, a small nudge against a wall will peel your skin off. Keep a lotion on your skin and make sure you use sun screen!!!!!!! I burned even with spf 100. Also if you get a zit, DO NOT SQUEEZE. I know, that's the oldest cliche but on accutane it's super important you don't squeeze because it will peel off skin around the zit leaving a large scabby scrape on your face that is very hard to cover(it looks awful). If you do get one of these put aquaphor on it and leave it for as long as possible( overnight is recommended). Do it evey day until it goes away(should take up to 4-5days). Aquaphor was my best friend on accutane. Anyways, overall message: I HIGHLY recommend accutane. It was the best decision I've made in my life thus far. I feel so much more confident and beautiful.
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January 31, 2015
Best decision I have ever made
I am a 32 yo female who has had worsening cystic acne from about 25. Having progressed through all the usual over the counter products and also prescription medication like retin a, my GP referred me to a derm for the 'last resort'. And I am so glad she did- 6 months later I have perfect skin for the first time in years. I took 20mg a day for the first months and 40mg a day after that (I am finishing my course in the next month or so). I have experienced a number of the usual side effects- dry lips, headache for the first two weeks, and occasional eczema on my hands when I don't moisturise enough- but none of them have been unmanageable. Remembering to drink lots of water and moisturise, moisturise, moisturise are the key. I was scared to take this medication for so long because of all the negative press, however I wish I had taken in years ago. If you are considering this medication I would suggest finding a good dermatologist and talking through the pros and cons with them to see if it might be a good fit for you. And if you decide it is, go for it and don't look back! A note on costs- in Australia this medication costs me around $35 for a box of 60 20mg capsules.
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January 28, 2015
Took accutane 32 years ago, really glad I did
I just turned 50. Accutane was new at the time I tried it. I suffered severe acne on my face, back, and chest that was getting progressively worse despite all treatments. It was painful, embarrassing, and pretty much ruined most of high school for me. I started accutane when I was 17/18 and was on it for 6 months with regular monitoring and blood checks. Side effects were similar to others with headaches, joint aches, dry lips and skin, and sensitivity to sun. I recall there was little improvement for the first 4 months. In fact I was so frustrated I started taking more than prescribed. Luckly my Dr discovered this quickly and freaked me out with descriptions of all the dire consequences that result from taking too much. After I completed treatment, all acne was gone for at least a couple years. It felt amazing. I would get occasional pimples after that but nothing compared to what I experienced before treatment. I am a healthy fit male and I don't believe I have suffered any long term side effects. My sons are hitting teen age years now and if I see them starting to experience severe acne like I did, I will aggressively push the accutane route.
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January 26, 2015
Accutane (isotretinoin) experience, still grateful
For anyone who is experiencing moderate to severe acne, do not let anyone convince you that it is unreasonable to suffer extensively from this disease. Acne is a real problem; and anyone who doesn't understand this concept, needs to experience uncontrollable bacteria erupting from their face or other body parts for several years. I empathize with acne sufferers because I experienced the agony and disruption my cystic acne caused when I was 14 years old. Life as as a teenage female was hard enough and I am sure it's much harder now. Even as a 46 year old after all of these years, I continue to believe Accutane prevented a much worse outcome. Having stated my opinion, it important to respect Accutane. As with any drug, adverse effects exist. One must fully understand the detailed information that accompanies Accutane. Dangerous side effects may result in some patients taking this medication. Therefore, specified rules have to be followed. I never missed scheduled labs or dermatology appointments for triglyceride, pregnancy, mood monitoring, etc. There are other side effects such as dry lips, dry forearms, and extreme sun sensitivity. Although these effects were minimal for me compared to the agony during the days of my cystic acne; I still treated this medication delicately. If considering this medication, please consider risks vs benefits. Make sure other acne treatments have been tried & failed, and maintain an open & trusting relationship with your dermatologist. Looking back I would never change my decision to take Accutane. Fortunately, I had a very open relationship with my mother & dermatologist. I also was not sexually active during treatment-Accutane is teratogenic; meaning it WILL cause severe birth defects if pregnancy occurs during or around treatment. This medication changed my life. My face would be permanently scarred without Accutane. I hope it remains available to change another person's life for the better.
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January 22, 2015
acne for over 2 decades
I am 39 years old will be 40 this year, I am writing this to share my experience with other people who have or are struggling like me. I have tried everything nothing has worked, I started having acne at the age of 12, it was bad in my teens got even worst in my twenties tried diannette which worked really well after 10 years on it I started having gross angioedema of the face lips tongue hands and feet after a few trips to accident and emergency I got off it. My Gp still insists theres no relation. had my children in my thirties, suffered unbelievably severe acne, by this time I was an expert at covering up. not even husband could see me without make up. I would go to bed with make up, when he fell asleep would go wash it off, wake up before h im to apply make up so he did not have to see the mess called my face. I have been on antidepressants not because I am really depressed but because I am fed up and down about the acne. after many battles with my GP I finally got him to refer me to a dermatologist, I was after Accutane. I know all the risks but the possibility of the next two decades of my life in this state is unthinkable. I have started Accutane I am in my first week. my lips are a bit dry, my acne is getting worse as the moment but I am covering up and hanging in there. hoping for the best. I am on 20 mg for two weeks then 40 for two weeks bloods then 60 mg for the remainder of the treatment. the plan is to have bloods every 4 weeks. to anyone out there with persistent acne, do not wait as long as me to get help, feeling horrid about acne is not frivolous, acne can really make one unhappy, insecure, and depressed. I will keep you updated about my experience.
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January 20, 2015
My accutane experience!
I did Accutane a couple of years ago after suffering with acne for YEARS. I was really nervous about taking it (I remember reading these forums all the time and doing a lot of research) and I'm sure there are a lot of people out there that are doing the same thing, so I feel like I need to write about my experience. This is my first time back on here since I finished Accutane (because I haven't thought about acne since!) but I felt like I needed to write something...because it might help someone else! I'm 25 now. I had a little bit of trouble with acne in high school, but started to get progressively worse during my freshman year of college. I tried everything...OTC products, changed makeup, stopped wearing makeup, antibiotics, spironolactone, dietary changes, prescription topicals...EVERYTHING. I still have two grocery bags full of leftover acne treatments. 4 years later...graduation and my acne had gotten so bad that I felt embarrassed to do job interviews, and it made me really self conscious around people. I like to run, and I think I actually got used to my face burning when I worked out (those topicals are rough!) My dermatologist finally brought up Accutane after she said there was literally nothing else I could try. Honestly, I thought Accutane was out of the question because I knew I had to be on birth control...which I basically can't do because I have Factor V Leiden (clotting disorder, estrogen-based BC puts me at risk for clots) The doctor I went to was comfortable with prescribing Accutane as long as I pledged to be abstinent while being treated, which at the time wasn't an issue for me (apparently not all derms are comfortable with this...my sister saw a dermatologist who refused to prescribe it unless she took BC) Another obstacle was cost. My insurance wouldn't kick in for prescriptions until I hit my deductible. So I paid out of pocket for the first two prescriptions (~$700 each...could've got a new laptop or something instead, but whatever) After that I think they were about $50 for each prescription. My dermatologist said the higher dosage (60mg I think?) actually costs less than the 30mg dosage...so she ended up prescribing me 60mg, but told me only to take it every other day. Long story short, it took a few months and a lot of lotion and lip balm, but 6 months later I was acne-free (and years later, I still am!!!) I think I was still getting zits until around month 5, so it definitely took some patience. But it made such a difference in my life. As far as makeup, I wear nothing on my face now except a tinted moisturizer and undereye concealer (because I DON'T NEED IT! It's fantastic!) I use Cetaphil facewash and moisturizer at night...no more money wasted on products that don't work. I get the occasional small blemish when I have my period, and that's it. It's honestly been a life changer. By the way, Eucerin lotion and Aquaphor lip balm worked best for me...your skin and lips really dry out. I had some trouble with dry skin patches that turned into a rash on my arms at one point during treatment (kind of looked like eczema)...dermatologist gave me an rx for Triamcinolone cream which cleared it up. The only weird side effect that I had was some trouble with mild lower back pain during treatment, but it resolved itself shortly after I finished. And yeah, the ipledge program and labwork every month is a pain, but if you have trouble with bad acne you know it's a small price. My bloodwork results stayed perfect throughout treatment, by the way...I think my total cholesterol went up a few points, but it was also pretty good to begin with! So yes, Accutane can be a dangerous medication and it should be properly monitored, and people should be fully aware of the risks. Risk vs. benefit...this med is reserved for people who have tried everything else. All meds have side effects, most have warnings about problems that they CAN cause. You'll probably read horror stories in your research about people that had bad luck with Accutane, but not every medication is right for every person. There are horror stories about pretty much any medication on the market. But if you're at the end of your rope like I was, it really is worth a discussion with your dermatologist. Changed my life! Good luck everyone!
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January 14, 2015
MUST TRY!!
Hi, I have been on isotretinoin for 5 months now and it really made a difference. In the beginning my face was just COVERED in pimples and it hurt. Me and my doctor tried many things;Tretinoin , Doxycycline, Tazorac, Keflex and Benzoyl Peroxide. Nothing worked, so my doctor ( Dr.Cernik ) said she had two more options either another anti-biotic or Accutane, So I choose Accutane because i was through with anti-biotics they gave me terrible stomach cramps. So she prescribed the Accutane and I started with 30mg once a day, for the first couple Days I ha the absolute worst stomach pain i had ever experienced, also some insomnia but then it was over. I went back to the Doctor 1 month later and she told me to take 2x30mg a day. That time it was fine. by this time I am experiencing some acne relief. by month 4 1/2 I was completely clear i was taking 2X40mg a day then and ever since have not had any trouble. Tottaly worth a shot
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January 12, 2015
No Regrets
Today I take my last Accutane pills. I've been on the medication for 6 months (40 mg a day for two months, 50 mg a day for four months). The generic brand I took was Amnesteem. Before taking the drug I was pretty scared but having suffered from acne for over 10 years on a consistent basis I was at my wits end. I read tons of reviews before taking the plunge and promised I'd write a review when I was done to help anyone else. It's scary, no lie. No one wants to have lifelong horrible bowel side effects or joint pain. But I think overall if you lead a healthy lifestyle and take the proper dosage according to your weight you should be fine. All medications out there have side effects you just have to decide how important clear skin is to you. For me, I knew I was sick of the struggle. Of course I had good days where I was like "Maybe I'm finally outgrowing it!" and then the next day I'd have a new pimple. Acne kind of sends you on this emotional roller coaster and no one understands if they haven't experienced it on a daily basis. (I hate when someone who never gets acne complains about having one tiny pimple. I "figuratively" want to punch them in the face.) My acne throughout the years has been a variety. The worst is the ones that are so far under the skin you can't pop them. If you do they scar you for life and if you don't they take a month to go away and still leave you with a mark. There is no winning when it comes to acne. So after trying a lot of other things, including peroxide, Differin, Tretinoin cream, Oxy, Doxycycline, Nature's Cure, and Proactive (worked at first then made my face worse), I went to a hormone doctor. She recommended Accutane and said she had even been on it in college. I told her my fears and how a prior dermatologists had warned me against it, but she encouraged me that the side effects were minimal. She was right. (She also had put me on birth control to see if that would help...it didn't.) Side effects I endured were dry lips, a very dry nose that led to my nose bleeding, and some dry skin. My dry skin was very minimal which I was worried meant it wasn't working but my dermatologist assured me I was just lucky. I also had the occasional joint pain at my hip but it was livable. For most with pretty bad and consistent acne you will have scarring and red marks, but supposedly those start to heal after the course is done and even though they aren't pretty, they're better than the alternative of having more acne, which in the end will only leave you with more scarring. You've probably heard about the initial really bad breakout. Mine wasn't too bad and only occurred on my forehead. Other users are right too, it really takes until the fourth month to see total clearance. Right now I'm proud to say I am completely clear. I really hope it stays that way. I can live with the occasional normal person breakout but I don't want to have to go back to how it was. If I do that will be very unfortunate, but I still will not regret my decision to go on Accutane. At least I can say I tried and won't have to wonder "what if" if in ten years I still have acne. Some pointers: There is no need to wash your hair more than 2 times a week, unless it is smelly, because it will hardly get oily. Cetaphil is a good moisturizing cream. Cetaphil Gentle Skin Cleanser is great to wash your face with. I'd try to minimize washing to once or twice a day so your skin is not more prone to dryness. Aquaphor Healing Ointment is great for the lips and can also be used on the skin, but note that it does not rub in well and may leave your face looking greasy. Dr. Dan's Cortibalm lip balm works wonders and was specifically made for those taking on the Accutane journey. Drink lots of water. ( I drink around 6 bottles a day) Stay away from alcohol. I also recommend going to a dermatologist you trust and has good reviews. The one I went to was not very thorough and the staff never seemed to know what they were doing. Go somewhere that really wants to help you and will make the process easier instead of harder especially since you have to see them once a month for every month you're on the pills and if you're a girl they have to take a pregnancy test at their office. The process is tedious and you want to make sure you go to a doctor who knows what they are doing and has your best interest at heart. Last but not least, stay positive and know that you deserve the right to not have to worry about waking up in the morning and looking in the mirror, scared as to what new spot you might find.
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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.