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:

Choose from 1 to 5 stars
October 20, 2013
LIFE SAVING

Pros:

Clears you of all acne, everywhere
Brings back confidence
Works well

Cons:

Expensive
Dry lips
Dry face, and extreme sensitivity to sun

I was so depressed. Let's start with my whole life story. I was always that cool kid in middle school, tons of friends, every girl liked me, barely home cause I was always with friends. My freshman year I was the same, totally fine. Then sophomore year came, I started to get acne. My brothers had it too in their high school years, so I was like well crap, I better start treating this stuff. I was put on bactrim. That never did anything. Finally summer after freshman year my face was SOOOO bad I knew I had to do something. I never left the house all summer except for vacations, and only with certain friends I knew wouldn't judge. I had people always calling to hangout and I couldn't. ACNE RUINED MY LIFE. Then I took accutane.... First 2 months were extreme dryness, and my face would hurt. Then month 3 and 4 came along and I couldn't be happier to this day. I am literally 100% clear of acne, all I have is scars left over, and even those are about gone! I am so happy !! I reccomend to everyone, if you have bad acne, the results outweigh the side effects!!!!
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October 16, 2013
Nervous
I am a 35 year old female and about to start Accutane for the first time. I have had cystic acne for as long as I can remember. Some years have been ok and some have been miserable. This past year was the worst, my acne is unending. I have tried everything...EVERYTHING. Finally my derm said she had nothing left to offer except Accutane. I am so nervous for the side effects...any have any thoughts on this?
October 14, 2013
Serious results, with a serious price

Pros:

got rid of all my acne!

Cons:

dryness
acne scars
lack of concentration

I took accutane 50mg pills for 5 months when I was 17 y/o. I have to say my acne was not severe, but I had literally tried EVERYTHING... every cream, antibiotics, all that useless stuff that never worked. By the end of my 5 month cycle (which was ended a month early by my dermatologist, due to my increased lack of concentration and ability to focus) my acne was completely gone. It's now 5 months later and still, no acne minus a random small pimple here and there around the time of my period. The side effects I experienced felt horrible during those 5 months, however. My skin was so sensitive, I would have brutal looking scratches on my body from simply drying myself with a towel. I had the typical extremely dry lips, dry skin, and constant nose bleeds from a dry nose. My night vision decreased significantly and my vision worsened quite a bit (only while on the drug, returned to normal after). The worst side effect that I noticed about 1.5 months into treatment was a lack of focus and concentration. When I finally told my dermatologist about this he was quite concerned and wanted me off the drug. Since then, everything has returned back to normal. Accutane has also left me with terrible acne scars on my face, and I mean red marks all over the side of my face that broke out the worst, and also scars on my body due to my skin being so sensitive and not healing as fast anymore. All in all, I couldn't be happier with the results but being on accutane was definitely a terrible time for me.
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October 14, 2013
Accutane came with a price

Pros:

Completely rids your acne, clears your face up
Completely rids ANY acne on your body as well
I had to shave less because my hair on my body wasn't growing as quickly Lol

Cons:

Extreme Extended Hair Loss in my case
Expensive, Cannot drink alcohol, dry skin, skin rashes, Must be very observant to your body, God awful possible side effects than can truely affect your life
Acne came back after 6 months , Really hard to get a Dermatologist to presrcribe it to you

I would most definitely recommend this to someone with SEVERE acne ONLY. To those who have mild acne I'm absolutely against them taking this and those with mildly severe-if you wish proceed with caution. Now before I started this medication I did an extended extreme amount of research, even though my acne was severe and I was deep in depression I still didn't just jump right into it. I read a ton of FORUMS about it and a ton of reviews. First off let me say that the first 2 months I combined Accutane at 20mg with Cephalexin which is completely safe, why you might ask, those two combined have been known to prevent that nasty IB of Accutane that I read all about. I never got an IB my acne stayed consistent without worsening and my face started to clear up within that month. Which was the ending of October last year. I wasn't completely clear till about 2 months or so. It is the least to say that it not only saved my face but it saved me. I was losing myself in a mask that I couldn't take off. It was a God sent. However by the beginning of month 5 I started to experience extreme hair loss. Clumps of hair in the drain and as the shower hit my head from the back when I would wash my hair I could feel it falling down my back. So I stopped the medication but the hair loss didn't. We are now in October obviously and my hair loss has just stopped suddenly and my hair is growing back like-pregnancy hair... it's crazy. I read a bunch of forums about those who suffered hair loss from Accutane and how it wouldn't stop. I read this one review about this lady who hadn't been on it for 3+ years and her hair would not stop thinning. That was one of the worse and almost had me in tears but others that had the same side effect like me, had similar experiences with the hair loss not stopping. I've lost about 50% of my hair in comparison to when I started Accutane. And my acne has returned but definitely is nowhere near the way it was when I started Accutane. Even with the hair loss, I don't regret taking Accutane one bit... I was in a bad place and Accutane was the only light that helped me get out of there. No topical or antibiotics could save me from the hell risen acne that I had at that time. Would I take Accutane again? Hell no. Ill do everything I can to rid my now mild acne by Dan's Regimen or at least keep it at bay but I won't ever go back on Accutane.
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October 13, 2013
My experience after TWO courses of accutane

Pros:

It works
Cleared my skin and gave me new self-confidence
Reduced Oil

Cons:

It only works temporarily - acne eventually returns
side effects especially hair thinning/loss
skin now slower healing

I have suffered with acne all of my life and tried EVERYTHING, topical creams, over the counter stuff, various anti-biotics, cutting out diary, diets, home-made remedies, etc. Went on accutane at 19 when I was at my wits end. Had (still have) mild to moderate acne around the sides of my mouth and lower cheeks. first course was for 2 and a half month but I stopped because I felt my hair falling out. Skin was clear for just over a year and then I broke out worse than before. Panicked and went back on roaccutane for 4 months, my long elbow length hair was a mess and I have had to cut it SHORT to get rid of the dead dried up ruined ends. Yes roaccutane will clear you up, yes it does work in that respect, but at a price, and only for a limited amount of time in my case.I have heard of miracle stories where people go on one course and TA DA thats that and years down the line thier skin still doesn't trouble them. However, I have also heard of many stories similar to my own, where skin only stays clear for an amount of months/years until you find yourself breaking out again. In my opinion, it is always worth giving roaccutane a try if you have tried everything else and if you want to discover if you are one of the lucky ones accutane offers permanent results to. If like me you are a female and find your acne typically hormonal then I wouldn't bother. It will always return eventually. There is no quick-fix for hormonal acne. You can follow my time through my second course of roaccutane and see a full list of my pros and cons here [link edited out] . P.S (price was - first course I did throguh NHS so meds were free, second course private so £60 per prescription. Plus extra money I spent combatting the side effects such as lip balm, eye spray, etc).
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October 11, 2013
My experience with Roaccutane, 2 days away from finishing treatment.

Pros:

It works
Side effects are durational

Cons:

Side Effects
Price

I'm a 20 y/o girl and I've dealt with severe acne since I was 12. Eight years of antibiotics, topical treatments, hormones, all got me nowhere. I did go on the pill for about 2 years (Dianette) which worked for the duration, but when I had to stop taking it due to stroke risk, the acne returned worse than ever. This is when I decided to go for roaccutane, as my dad suffered with acne until he was about 25, and I wasn't keen on another 5 years of hating the way I looked. I'm now at the end of my treatment (two days left) and I thought it would be a good time to post the diary of notes that I wrote up throughout my treatment to track my progression. I kept it so that I could keep an eye on how I was changing, and also as I thought it could help people who are looking into taking the drug, or those who are already on it and were wondering if their side effects are normal, etc. The 'diary' contains my progression as well as side effects and how I worked out dealing with them. Without further ado: PRE MEDICATION Very bad acne over all of back. Cystic acne over shoulders and across chest. Pimples and blackheads over all of chest and back. Bad blackheads on face. Depressed moods whenever I would look at my skin. Quite intense scarring from eight years of wounding. I also experience keloid scarring so a few of my scars from cystic spots have formed permanent raised scars. Because of all this my dermatologist has prescribed me isotreinoin (accutane/roaccutane). MONTH 1 (20mg daily) I started on 20mg. Throughout the month I did not experience much change. After a few days I did notice that my lips felt more dry, but nothing too uncomfortable. My spots started to get a little bit worse, mainly in the form of cystic acne. I also had a little trouble sleeping, which I had never experienced before but, after researching, found out to be one of the many side effects. This only happened once or twice during the first month and hardly at all after that. MONTH 2 (20mg daily) My dermatologist kept me on 20mg to make sure that I was still coping okay on the drug and not suffering too many side effects. This is the month where my spots became really awful. I was prepared for roaccutane to make my skin worse before it got better, but it was still unpleasant to experience. I found that the spots I was getting were like a new breed, cystic and incredibly painful to touch. If my bra strap pinged against one or I leant against the corner of something by accident, I would be close to tears with the pain. However, towards the end of the month I noticed that I no longer had any blackheads. I was so happy about this and saw it as a possible sneak preview of my future skin. My lips got really bad this month, particularly towards the end. The regular vaseline that I had been using no longer worked at all on my chapped lips, but I worked out a way to manage them with BLISTEX MEDI PLUS. Blistex Medi Plus saved my life, it repaired and rehydrated my lips, and I only had to apply it morning and night. Pre treatment I had quite greasy hair, normally needed washing every other day, with dry shampoo top ups. But at this point in the treatment, I found my hair not needing to be washed for about 4 days, which was handy. MONTH 3 (30mg daily) I had my dosage upped to 30mg. The cystic acne I experienced the previous month was starting to dwindle (or at least coming less frequently). My lips were becoming very dry, my top lip was now chapping too which was hadn't happened yet. My hair wouldn't get greasy for 5 days without washing it now. The inside of my nose would also become painfully dry and flaky, and would sometimes bleed. During this time I went on holiday to a very sunny place and didn't bother to stay out of the sun like it's advised you do on this medication, but didn't burn at all. You're supposed to burn and blister and all sorts on this medication if you go out in the sun but I didn't experience any of this. Month 4 (40mg daily) Dosage upped again. The dry lips became even worse in this month. I discovered that the environment had a big part to play in how painful they were. If it had been raining recently or if the air was more humid my lips would be fine, but if it was very dry out, or if I was in a closed off air conditioned area (such as a car), they would become unbearable. I also started to suffer from angular chelitis, which I found would heal if I put coconut oil on the cuts. If I used my beloved Blistex Medi Plus on them it would aggravate it, for some reason. Angular chelitis would flare up if I were in the dry environments without applying my lipbalm frequently enough. The dryness inside of my nose was also affected in the same sort of was I found. I began to notice that my eyes were drying up this month. When lying in bed before sleep my eyelids would almost glue together due to the lacking of their usual lubrication. I also swam underwater in a chlorinated swimming pool with my eyes open and the next day my eyes were bloodshot and stinging. It cleared up after a few days but was very uncomfortable whilst it lasted. DO NOT WAX YOUR SKIN ON ACCUTANE. I hadn't read that you weren't supposed to do this and waxed my eyebrows this month. Afterwards, I'd thought that they felt a little more raw than usual, and woke myself up in the night several times when I rolled over and the fabric of my pillow case touched the waxed area and stung so much. Over 24 hours later the skin was still bright red and looked a little wet. Turns out that without the usual protective oils in your skin, the top layer of skin comes right off when you wax on this medication. I could have had permanent scarring, thankfully I healed okay, but for about 10 days I had scabs on my eyebrows whilst the skin grew back, which wasn't too pretty. Month 5 (40mg) My Blistex Medi Plus stopped working for me this month, not sure why. My lips got drier and sorer than they ever have been. I tried using Vitamin E oil on my lips, as apparently it's the oil most similar to human sebum (what roaccutane dries you out of), which worked at first but then didn't really do anything after the first time. This is when I started using Blistex Moisture Max with Hydrating Pearls, and Palmers Cocoa Butter Lipbalm in conjunction with each other, which worked a treat if applied every hour or so. I found I was getting quite moody if I hadn't drank much water recently, but downing a pint of it when I noticed the feeling would sort me out straight away. Month 6 (50mg-60mg) During this final month I was upped to 50mg, and halfway through I upped it again to 60mg as I felt that I was handling the side effects okay and I wanted to be off it sooner rather than later. 60mg is the maximum dosage allowed for a female of my weight. Spots were very infrequent by this point. Hair doesn't get greasy at all, longest I'd gone without washing it was a week and even then it looked as fresh as if I'd washed it earlier that day. Currently, I have 120mg left to take, so 2 days! I have very dry lips, eyes, and hair, but I have no spots at all! My skin is so clear, other than scarring which will fade with time. I feel so much more comfortable and confident, and am in less pain. I didn't experience many of the major side effects that I thought I would, such as dry skin or depression. I think I owe the dry skin one to using Body Shop shea butter and cocoa butter shower washes. I did get slightly moody but I think that was due to dehydration which makes sense with the premise of the drug. My side effects will be different to yours but I thought it'd be useful to give my experience. Everyone reacts differently to this, and the list of side effects does look scary but you shouldn't be afraid, as you can treat them as they come. You will know if they are becoming too much for you, and if you feel you are no longer benefitting your body you can stop at any point. Best of luck to all of you!
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October 8, 2013
Only on the first month, nearly at second

Pros:

it clears acne quickly
keeps excess oil level.

Cons:

time consuming and need patience
dries skin out
gets bad before it gets better.

I started off with a few spots in year 8, in between my eyebrows. (this was when i was around 13) and then it gradually got worse. however, some products like OXY, did the trick for about a few weeks, then it got immune to the ingredients in the product of OXY, so got worse again. I tried everything, like the Dianette pill, creams, tablets, gels, and so on. I then found this website, (acne.org) and tried the regimen. now i only did about 3 months is of it, so didnt really give it chance. however it did do some improvement whilst on the 3 months. which boosted my confidence. but then i found the accutane drug, and so i researched about it, the side effects and such, and asked my mum to book a doctors appointment. so we did. i spoke to them and they said yeh, they are happy to give me it. so went to the dermatoligist.. blah blah blah. and then finally got it. now like any other person, when it comes to acne and the path to clearing it, youre inpatient right? yeh, i am too. im only on my first month, about to go on second.. (my mum keeps track, i have no idea). and i am getting a few pimples, but mum says it shows its working, as its taking all the bacteria out from under the skin and pushing it out. but it is upsetting me, and i just want it to hurry up and clear. but cant just wish for that. so then, to make myself feel better, i look at peoples pictures before and after, and give me that reassurance, that it will clear eventually in the next month ish.
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October 4, 2013
Horrific drug.

Pros:

Temporarily clear face

Cons:

Hairloss
Wrecked skin
Premature aging

I was prescribed claravis for very mild acne and it essentially wrecked my life. Thinned out my skin, I have wrinkles 3 years later at 20. Thinned hair, rosacea, pale skin, rectal bleeding, still dry years later . I was a normal person before accutane. Now my life will never be the same. I honestly can not emphasize how life altering (for the absolute worst) this drug was. It is possibly the most sad thing in the world to thing how different my life would have been had i just not gone to a dermatologist. Derms should be the absolute lowest paid doctors. Unless theyre performing surgery they are ignorant, ignorant people with little skill. IF YOU are reading this, just think for 2 seconds. Look at all the one stars you see. You dont see that with anything else. When you go to buy a tv if there were 30% 1 stars you would quickly look to another tv where there were only maybe 2 or 3. Just look at all the severe side effects that you could endure. Avoid it. Dont take this drug.
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September 6, 2013
Accutane for sebaceous hyperplasia

Pros:

Sebaceous hyperplasia resolves in 3 weeks
skin not oily while taking the medicine

Cons:

dry lips
dry nose
blood tests

I had multiple sebaceous hyperplasia (overgrowth of oil gland) on my face and chest. Very annoying and I felt so upset that I couldn't even look at others while I was talking to them. Because these bumps won't go away at all which is worse then acnes. I trying laser, and Tretinoin. Both failed. These bumps just keep coming back. Finally I heard about Accutane from one dermatologist. I decided to try it right away. The doctor started it with a very low dose as 20 mg/day. I thought it was too low comparing to other cases, but it actually worked great! all the bumps were gone in 3 weeks. I was really happy even though I still have old scars from acnes which I regret didn't do anything when I was younger and having the acne problem. So I took the Accutane for 7-8 months at low dose 20-40 mg. And the hyperplasia never came back. However I experienced dry lips, dry skin(which I feel good because I have very oily skin :(), dry eyes and some weight gain I not sure if that's caused by the drug. So 1 month ago I decided to stop taking the drug since I want to have the bumps on my nose removed in 6 months. Then I noticed that the hyperplasia lesions are coming back :(... Not sure what to do now.
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September 5, 2013
It's Complicated

Pros:

Clears acne
Controls oiliness
Smooths skin

Cons:

Dryness
Back pain
Low immune system

I am now 3 and a half months into my Accutane experience, and it's been a weird one. I started getting acne at about the age of 11; I am now 16 years old and in my junior year of high school. I should start by saying how strong this drug is, and how important it is to understand, discuss, and think about the drug before you start blindly. The drug was hard to obtain, but in the end my insurance ended up covering everything because my acne case was so severe, it was considered a medical issue. the monthly dermatology and blood work appointments honestly don't bother me. As far as my skin goes, it has been a very up-and-down-like process.Granted, my acne was horrible, and I had a very terrible habit of picking and squeezing my face, thinking that was the only way to get rid of the acne. DO NOT SQUEEZE OR PICK YOUR PIMPLES, BLACKHEADS, OR DRYING SKIN. IT WILL LEAVE SCARRING. My face only has about 3-5 pimples on it now (compared to the 30-50 pre-accutane). My face is so smooth, if I didn't have a mirror, I'd think it was perfect. HOWEVER, it is not perfect. I have an extremely red complexion, and my acne scars are so noticable that it's almost like I never got rid of my acne in the first place. My dermatologist told me that about a month after I finish the drug, the redness with go away and the scars will fade. As for the deepened scarring, I will have to wait a year to get them surgically removed. I must say, I am very nervous for my scarring. I have a hunch that using my salicylic acid facial scrub is not helping the dryness or scarring. My lips, skin, and hair has been very dry. Always moisturize, and keep a great chapstick with you at all times. My face and lips has also gotten very red, and swollen. I have NOT experienced any depression while on this medicine (I had terrible depression pre-accutane). My back pain has increased, I have nosebleeds often, and my immune system has been low. I don't see these side-effects impacting my decision on the drug. They don't bother me as much as they probably should. I'm hoping the next 2 and a half months go by quickly so I can finish my 6 month accutane experience, and see the final results. Overall, if you are looking for a basically permanent solution to your stubborn acne, accutaune will get rid of it. It is a miracle drug, and I am very happy I started it. I hope my story was helpful to anyone.
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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.