Oral Retinoid
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Oral Retinoid
Based on All Available Studies
Strength of Evidence
Note: Use with EXTREME CAUTION: Causes severe birth defects and fetal death.
Oral Retinoid
Side Effects
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®)
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June 29, 2019
clear skin for about a year


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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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

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.  

May 13, 2019
Honest Review of Accutane

All I can say is, if you are on the fence about going on this medication, just try it. You never know how it might affect you until you try it for yourself. 

Don't let all the side effects scare you - trust me I was so scared when I first read about all the horrible things this medication can do to your body. 

I was an acne sufferer for roughly 8 years with no cure or resolution. I tried random creams from the store, antibiotics, retin-a/differin, cindamycin, aczone, weird antioxidant drinks, chemical peels, going dairy and gluten free, light therapy...literally everything you can think of, I tried it at some point with little to no success. I was so frustrated that I finally said, screw it, and went on accutane. Now, I told my doctor that I wanted a LOW dose of the medication (at least to start) just because I wanted to ease into it, and I didn't know how my body would react. 

I'm currently taking 20 mg a day, and I haven't been this proud of my skin since I was literally 10 years old. I can finally wash my face and not feel dozens of painful lumps...and I can finally go out in public without crying that people will make fun of me or judge me for my acne. In terms of side effects, I have had a relatively benign experience with the drug in all honesty, and I'm sure that a lot of it is because I'm on a low dose. All that I've noticed is that my lips get chapped easily, I have dry skin on my hands and arms, and I am ALWAYS thirsty. That's about it. I realize that because I'm on a lower dose that means I will have to take the drug for a longer amount of time in order to completely cure myself of acne, but honestly I am 100% fine with that if it means I don't get the horrible side effects. Literally the ONLY downside to this drug for me personally is the monthly blood draws, as I am TERRIFIED of needles and blood and all things related to needles and blood. But I told myself I would suck it up and do it, if it means I could finally have clear skin. 

Again, if you are on the fence about this drug, please just give it a try. If it ends up not agreeing with you, you can go off of it and then you can say that you tried it. It has changed my life (literally) and I am so glad I gave it a shot. I've only been on accutane for roughly 2 months, and I have already seen a massive difference in my skin. My friends and family compliment me all the time and say that my skin looks like it has made a complete 180. 

Do yourself a favor and just try it!!! More likely than not, it will help you tremendously and you will be glad you tried it. 


April 4, 2019
15 Y/O Girl on Accutane

First off: I never imagined I would be writing a review on this forum, clear skinned. Over the past year or so I have spent a CouNTLess number of hours browsing through many different acne related blog posts and reviews. I don't want to make this too long but here goes.

I have had mild acne since I was 11 or 12. It started out as small bumps on my forehead, to large, cystic pimples that would scar my skin by the time I was 14/15. Over these years I have tried many, many different products because my mum, a long time acne sufferer, was extremely adamant. 

To date I have tries: Zineryt, Dalacin, Epiduo, Doxycyline, tretinion 0.05 and most importantly... accutane.

I live in Australia  so the process of acquiring this drug was unlike many reviews on this forum. My dermatologist prescribed me a 20mg dose every day, that i would take for a year! from what I've researched this is called a long term low dose?? Anyways.. this dose kept any side effects to a minimum. 

I am still on accutane, with around 3 months to go, but all my side effects have been extremely mild. I have gotten the ineveitbale dry lips and skin which is easily alleviated with Vaseline and cetaphil moisturiser. In addition to this, I have gotten the occasional nose bleed and have noticed a bit og back tenderness. I also never really had an 'initila breakut' per se. 

Over my course so far, the improvements in my skin occurred quite slowly so I can't quite say when, which month, I was completely clear. 

I just had my last appointment with my derm and he told me that there is a significant chance that my acne will come back over the duration of the next two years and this is what I am now anxious about. 

But even if it were to come back, I would still be extremely, extremely thankful for this drug. It has completely boosted my confidence and self esteem, so, yes, I will highly reccommned it- just be aware of the side effects and take preventative measures( using moisturizer and lip balm etc.) before you notice the full swing of the side effetcts. 

There is so much more information that I have and would love to share if anyone has questions. I would also love to hear if anyone else has been on a similar dose to mine, or, took accutane at this age. 

Take Care :)

March 20, 2019

18 year old male. Accutane start date 12/17/17  end date 8/17/17.

Okay so i'd like to tell my story here since when i was going through my rough times i had always looked on this page for advice and it really helped me a lot. Now that my acne has disappeared id like to give some insight to anyone else that may be struggling with extreme acne and is considering taking Accutane.

From about the age of 14 years old I had always had regular teenage acne that wasn't extreme or even much noticeable, but even at that time I wanted to get rid of it completely so my mother took me to my regular doctor, and she prescribed me some benzoyl peroxide and erythromycin. They worked at first but after a short while they slowly destroyed my skin after about 2 years of use. It was at this time where I started to try and look for my own treatments for my mild acne. I tried eating healthier and using silicic acid washes to try to keep it under control while spot treating with over the counter benzoyl peroxide. By 2018 I was not able to control it at all and it was getting out of hand. I had acne all over my shoulder’s arms face and back. As a person who is very confident in everything that I do, I felt as though this was holding me back and causing me to be way too self-conscious. That's when I listened to my Doctor and was put on minocycline antibiotics. I stayed on those antibiotics for a while knowing that as soon as I stopped using them my acne would come back way worse than it already was. Seeing that the antibiotics had only slowed my acne down the doctor also prescribed me some Retin- A cream. From all the reviews i believed that retin-a would somehow be the answer to my problems but instead of it getting better before it got worse it literally just ruined my skin and caused it to break out 10X harder for about 3 months. Thats when i said enough is enough because My acne had become extreme and was to the point where the sides of my face were purple from all the zits and the rest of my face was covered in small pimples. Even my back arms and shoulders were extremely bad too. This had a huge toll on my life and held me back from simply feeling good about myself. Sometimes i would even look in the mirror and be somewhat disgusted with myself, but one thing i did not do was give up.I had then learned from searching endlessly online that Accutane was a "cure" for acne. Hearing about all the side effects I was a little worried to use it, but I had no other choice because at this point my acne had become cystic and I was getting about 2 new huge zits every single day.   So, It took me about 4 months but i was able to hang on and finally  get an appointment with a dermatologist, and in our first meeting he recommended that I take Accutane right off the bat considering i had already tried everything possible. But my insurance would not cover it unless I had taken antibiotics for at least 6 months without stopping. I did not want to wait 6 months, so I decided to pay out of pocket for it. That right there was one of the best decisions of my life. Dealing with all the verifications and the tight regulations on Accutane was a hassle but I was finally prescribed 40mg twice a day of Myorisan.

In the first month I noticed that all the small acne on my face and body had disappeared, and I was happy that I didn't go through the breakout phase just yet despite all the back pain I was having and the extreme dryness all over my body and lips, also my eyes were very dry and my whole body was feeling rusty. What I did to combat those side effects was just drink a lot of water and make sure I always had a tube of Aquaphor (you will go through hell if you do not get a good ointment or cream for your lips) on me.

During my second and third month I just kept breaking out nonstop (this is what you would call the initial breakout), but even though it was hard and disheartening I knew that this phase would stop and that is what kept me going. During this time i got the hang of what i was supposed to do to make sure things didnt get worse. Whenever i would shower i would dry myself off then immediately put on lotion so that i do not feel like my skin was going to rip. For my body i used the regular aveeno daily body lotion. But, for my face i carefully chose a light non comedogenic lotion which was neutrogena hydro boost cream. These two lotions literally are what pulled me through my course (along with aquaphor for my lips of course). While on the course you need to make sure your face and body stay moisturized because accutane will completely stop your body from secreting oil.

During my fourth month is when I seen a big improvement, I noticed that the breakouts were slowing down, and my skin was looking the best it had looked since back when I was a kid. I was still breaking out and my derm had told me that the best way to make sure it does not come back was to keep taking it until I did not breakout at all for a good 3 weeks- 1 month. I had a couple breakouts a month up until my 7-8 month where i did not have any at all.

I continued up until my eighth month, and I was finally done with my treatment. My skin was great! finally after such a long time I found something that had helped me. After I stopped, my skin only started to get better, aside from the scarring left by the huge breakouts in the 2-4 months, my skin was healing. Now about 7 months post Accutane I could not be happier. Thankfully my scars have all faded and it’s a huge blessing. I do not breakout anymore aside from few tiny pimples here and there, and over all my skin looks even better than some friends of mine that have not had any acne before! =) Another quick thing that I hope does not discourage anyone that is seriously suffering from acne, is that some side effects of the medication still have not gone away. Such as having to put on lotion to prevent dryness after showers, my skin cannot handle the cold anymore (feels as though my bones and skin are freezing), and my face turns bright red whenever I feel the slightest bit of embarrassment, anger, or surprise, even though I am tan skinned, and I never had that problem before treatment. Other than that, if you are truly looking for a cure for your acne I 100% recommend Accutane because the side effects are worth it especially when you can finally get your confidence and self-esteem back! 10/10 PS: Whoever is reading this stay hopeful and try your best to also stay positive, I know that it can be hard but where there is a will there is also a way!!! btw Neutrogena hydro boost (cream) is a life saver use it in the morning and night on your face and you'll be good for the day. Alright that’s enough typing I’m out...... GOOD LUCKKK!!!

September 27, 2019

Thank you for your comment. I oddly saw clearing in month three. And now in month four having a bad breakout and worried it is not working. So down. But your review gave me hope. 

March 2, 2019
Acccutane + Skinoren

on my 5th day for this treatment, forehead and right cheeks breaking out. Lips not dry. Hope i’ll get through this.

March 2, 2019
long term effects not worth it

After reading these reviews, I am compelled to share some good/bad experience with Accutane.

Full disclosure - I'm the mom and am sharing my son's experience with Accutane. He took his first round at the end of sophomore year in high school. It helped his skin tremendously with the larger pimples he was getting on his face and behind his ears/down his neck. After being off it for several months, the acne started coming back, and also appeared on his back and chest. So round 2. This was in the middle of his junior year and he was growing like a weed. By the summer between his junior and senior years, his skin was completely clear. Then out of nowhere, mid-senior year, his skin started breaking out again....round 3. 
I should mention that each time he took it, the doctor prescribed a higher dose. Unfortunately I don't remember what it was because it was a few years ago. But I DO remember the doctor had him stay on Accutane after the last, higher 6-month dose - I think it was 10 mg every other day. It worked - his skin stayed clear, until....he went to college 2 years ago and decided to stop taking the small dose because his joints were hurting after soccer and he read that could be a side effect. (proud mom moment, he received a partial scholarship at his university for soccer). 
Of course his skin started to break out again after getting off the Accutane, but not as bad as before. We were at a complete loss because nothing else had really helped his skin except Accutane and we were concerned his skin would spiral out of control again. Thankfully one of his housemates told us about a company called Ninja Skincare and now his acne is greatly reduced, almost fully gone for the first time in years. It’s a daily skincare routine and more complicated than taking a pill, so he’s not as diligent as he should be, but enough so he is feeling better about his appearance. Maybe as he gets older he will be more consistent.
Fast forward to his second year now in college and his knees are still swollen and sore. After x-rays, scans, and doctor appointments, they concluded it was from taking the many rounds of Accutane when he was growing and advised he not play soccer for a year to give his knees a rest. It is a total bummer, he is pretty devastated to give it up. We will see how that goes. I have a feeling it will be something that haunts him for a long time.
February 12, 2019
Made me the person I am today!

Just like most people, my acne made me insecure for almost my whole childhood. I began to have acne when I was in 3rd grade until my sophomore year of high school. It got so bad my sophomore year I would cry almost every morning and put on loads of makeup. I was depressed by it and gained a lot of weight as well, which didn't help my skin. When my dermatologist said that Accutane was my last option, I said I wanted to take it. I know the side effects can be serious but all I experienced were bloody noses, dry lips, and some mood swings. As I was taking it, I was working out to loose the weight I had gained. So I sweat a lot, but my Accutane made me as dry as a cracker so after I worked out I never smelled or even sweated that much! I felt like I never needed to shower either! I did though, don't worry. I was on isotretinoin for about 8 months (the average time people take Accutane is 6 months) and I was on a very high dose (I don't remember how high because it was so long ago).  I believe I took cleravis (an off brand) because my insurance was being stupid. Then after a month I started taking Absorica, a really good brand of isotretinoin. Its been about 3 years now and my skin is still crystal clear. If you are struggling with acne, DO THIS. Be prepared to do a lot of work with IPledge and getting tested every month but it is a true gift from God. 10/10 recommend forever.


March 2, 2019

Hi, at what age did you start accutane? Your results look great. I may ask the doctor to have my granddaughter try it, but I'm worried she's too young. 

March 5, 2019

Look beautiful!! So happy to hear good reviews!

November 8, 2019

What month did you see clearing?


February 7, 2019
Wish I took it earlier

I had cystic acne. I finished a 6 month 3 week course (didnt take my last weeks worth). Im 74kg (male), 20 years old and was prescribed 30mg for 6 weeks, then 70mg for the remainder. I was amazed at how little side effects I had. No hair loss, my face barely got dry, my lips did get dryer but were controllable with chap stick in the day and Blistex Relief Cream in the night. I didnt really have an initial breakout, but I would have phases of getting a few moderate spots, then clearing up, then breaking out again up untill about the start of month 5. Then I would only get maybe one small one every two weeks.


So, my side effects:

- My biggest concern was muscular injury. I feel like tret made me more prone to this. I managed to pull my groin playing basketball in month 2, and my rotator cuff in the gym in month 4, each time not really doing anything out of the ordinary. I stopped activities like this for the remainder of my treatment after month 4.

- Classic tret back pain within the first two weeks that stayed the whole course. Quite uncomfortable at times but really no big deal - got used to it and didnt really notice it after a while.

- Dry, painful and scabby inside the nostrils after about 5-6 months, stayed the remainder of the course

- Semi-frequent styes in my right eye after about 5-6 months

- Im pretty sure my eyes got a bit dryer and more sensitive to light, but no big deal at all

- Eczema on my upper arms, but this went away if i remembered to moisturize them.

- In my last 3 weeks I developed a strange kind of back pain different to what Ive mentioned earlier. This time it was in my lower back and would cycle getting worse/better, and still hasnt fully gone away. It gets much much worse the morning after a night of drinking


What I used to help the side effects:

- regular chapstick in the day, and Blistex relief cream at night. This stuff completely heals your lips by the time you wake up, its brilliant.

- Aveeno moisturizer



- I definitely drank more than I should have. I'd say there were 3/4 occasions where i binge drank, and probably 15-20 occasions where I would have maybe 3-7 pints. Then also a good few more occasions where I would have had 1-2 pints. 

- At first I felt the alcohol hit me harder, but after a while it felt no different to drinking pre-accutane. My bloods came back fine, and I felt the same the next morning to pre accutane, no hangover



- Its been 3 weeks since i finshed the course. I was completely clear for the last 1-2 months, but recently ive been getting a few very small spots. Nothing that worries me. So its been extremely effective

- Whilst on tret, your hair is epic. I would barely need to wash it every 2 weeks

- Amazingly I noticed that it also drastically shrank the fordyce spots I had 'downstairs', making them far less noticeable


January 15, 2019

Don't even listen to anyone saying negative things about Accutane. I promise you this pill is completely wonderful, kinda like a blast of magic you know. 

January 2, 2019

I've suffered with combination acne genetically since middle/ jr. high school. I've went to makeup to cover it up because it was an insecurity, I never just always thought I was less pretty because of it but yes I did get down at times because of it. My left side would be worst than my right or vice versa. I tried neutrogena makeup for acne, didn't work too well. I used the green primer to keep my redness down and all. I went to my doctor and they gave me medicine, I fell as if i didn't see a difference in a day or week i would give up! So I tried TCA peel which resurfaces your skin, it did some good but you have to go often! So I was redirected to my dermatologist, I've heard about Accutane!! I've taken it for 4 months and boom great skin, I used Cerva foaming wash with it to keep my skin hydrated as Accutane made your skin dry, on top of that I used Palmers COCO butter. Palmers works so good when I got my lip waxed, while using Accutane it ripped my skin off, I put coco butter on there for a week and now my skin is renewed! I kept Coco butter with me at all times since Accutane dried my lips out so much or simply keeping aquaphor on hand at all times for lips, make sure you put some on before going to bed too(ALOT) or else you will wake up with cracked lips!  However, I am now happy in my skin! I'm still dealing with some texture from scarring but that's nothing that a Couple of TCA or IPLs can't fix! However, I have used Acne.org reginmen before it was pretty good with glycogen so I'm ordering it again just to smooth out that texture! The thing is once you get rid of acne you have to keep treating your face as if you still have it to keep it AWAY!!!




Don't give up if you don't see a change so soon, at least give it a month!



March 5, 2019


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.