Isotretinoin (Accutane®)
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Side Effects

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

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

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

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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.

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karenhanson
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. 

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Coffee_sipper15
March 5, 2019

Look beautiful!! So happy to hear good reviews!

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kennah
November 8, 2019

What month did you see clearing?

 

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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

 

Alcohol:

- 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

 

Pro's

- 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

 

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January 15, 2019
AMAZING

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. 

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January 2, 2019
HAPPY WITH MY SKIN!!!

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!!!

 

KEEP IN MIND IF YOU GET A CVS REWARDS CARD YOU GET LIKE 40% OFF A WEEK ON A PRODUCT IN STORE- THIS IS WHEN YOU CAN GET CERVA TO YOUR ADVANTAGE SINCE ITS ALREADY A BIT PRICEY!  *just make sure you set up your email and get the app to get those good deals!*

 

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

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Coffee_sipper15
March 5, 2019

Amazing!! 

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December 29, 2018
best decision I EVER made

I know many of the side effects and the reviews can be intimidating but I promise you it was the BEST decision I ever made. I didn't realize how much of my confidence my acne had eaten away at and gaining that back was worth it to me. My acne was lots of little and medium-sized pimples all over my face, neck and chest. I occasionally got a deep cystic one that was painful. I have EXTREMELY dry and sensitive skin and even I had honestly no side effects. Yes, my lips were dryer and cracked easily but nothing a few coats of vaseline a day couldn't fix. I made sure to lather it up at night and I was basically fine. My hair stopped getting greasy completely which was actually a total WIN. I washed it maybe once a week. My skin was DEFINITELY more sensitive to the sun, it got reader quicker and when I forget and went tanning (even with sunscreen) I burned and had very dry skin for a bit after. If I wore a hat and tried to stay fairly covered most the time it was no issue. After the first 2-3 weeks I could see my acne shrinking, almost becoming flatter and after about 1 month I noticed the redness of the acne leaving. After 6 weeks my acne was gone and I had a bit of hyperpigmentation and some blackheads which weren't even bad at all. After about 3 months my acne, blackheads and most of the hyperpigmentation was completely gone. I got an occasional little red bump but otherwise, it was basically done. My skin was glowing and so smooth by the end of the treatment. I'm sure I could have stopped taking the pills after about 4 months but I figured it's better to finish fully and I stuck with it for 6 months. I cannot encourage you enough, if you are desperate enough to be reading the reviews just get the prescription already! It is at least worth a shot. 

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Coffee_sipper15
March 5, 2019

Awesome review!! If you don’t mind me asking... how old are you? I’m in my early 40s. And wondering if it has different outcome based on age, hormones etc. 

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November 19, 2018
Amazing - although 7 years after treatment my severe acne has returned
I was put on Roaccutane when I was 14 and had tried every topical/oral antibiotic/contraceptive pill treatment from my GP and nothing worked. I immediately saw results, although did get very dry skin. I had no side effects such as depression. I would recommend this to anyone struggling with severe acne, my only wish was that my GP put me on it sooner and did not make me go through the torture of all the topical and oral antibiotic treatments. The reason I have scored 4/5 stars, is that now at age 21 my skin has flared up again - 7 years later and its come back as worse than ever. I am currently having to go down the topical cream routes again with my GP, which I am hoping works this time. If this does not cure it, I am hoping to go back on Roaccutane.
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November 17, 2018
Does acne Return after Accutane?
I took Accutane for 1 full year going up to a dosage of 60 mg. Side effects were tough although I was very pleased with my end results and it was completely worth it. My biggest nightmare was the acne coming back. I have been off for 8 months now. The first 6 months my skin was perfect, not even tiny breakouts. However the last two months it has slowly been creeping back. It is not nearly as bad as before Accutane however I am starting to get worried it will slowly get back to that. I keep getting small breakouts all over my face. I was my face morning and night and still it is coming. I also use a tropical cream given by my dermo when I got off however it does not seem to be doing much.I am very stressed out and considering going back on it because I am worried it will spread further. Overall very much worth going on the pill however in some cases like mine breakouts and large pimples can still return.
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November 12, 2018
I Am My Own Skin Goals
Hello! (side note i may refer to accutane and roaccutane, I'm not sure if theres a difference) I wanted to share my experience of acne and how I've struggled with it for the last 8 years. I started getting acne around 11 years old. Between then and 16 i made several trips to my GP where i tried multiple different treatments like a range of topical creams, antibiotics and going on the contraceptive pill. None provided me with the results i wanted. 2016-2017 was probably the worse years of my acne, all across my face, chest and back. I had had a couple of friends in a similar situation to me and they were put in roaccutane. I had done my research and knew that this was something i definately wanted to try. The side effects didn't put me off. If it meant getting the skin id dreamt of, it was worth it. In the middle of 2017 i started my course of accutane and started filming little clips of skin every few weeks or so and storing them on the 'my eyes only' bit of snapchat. (i will include pics if i can). I was discharged from the hospital december that year but at that point had had clear skin for a good 2 months. I do have to admit i did get cocky with it towards the end and wasn't taking the meds daily for those last two months and it may have come back to bite me on the arse, as nov/dec 2018 this year i am starting my second course of accutane. Going back to the doctor after almost a year after being discharged she did inform me that 20% do find acne to come back so it may have also just been i am a part of that 20%. I am so excited to start my second course again and have the best skin again, and go back to confidently not wear skin makeup. Side effect management: - Dry Lips: my dermo nurse on my first course of accutane recommended a 'nipple cream' that breastfeeding mothers use to heal broken skin on the old nips. Its very thick so id apply morning and night and then use trusty carmen during the day - Dry Skin: (on the face i mean) actually after my course i found garnier moisturising sheet masks to work a dream as well as daily cetaphil, I get the big tubs off amazon and they last a good 6months. I also continue to use gentle cetaphil face cleanser. I did get the occasional nose bleed but keeping the nose moist as well with the cetaphil and a Q-Tip helped. Also get the occasional headache, mainly when increasing the dosage but they passed. Bumped to start accutane again :))
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September 21, 2018
Wish We Had Started Earlier
My son had struggled with cystic acne since junior high. He tried a variety of different OTC and Rx products with limited success. We had resisted using Accutane due to worries about side effects, especially those which might be permanent. He had had some gastro issues, so we needed clearance from a gastroenterologist. This doctor said she did not believe there was any connection between Accutane and gastro problems such as colitis or Crohn's disease. He is a long distance runner, so he was also worried about joint/bone issues. Finally, in the summer leading into his senior year of high school (2017) he started taking isotretinoin. Within a month he saw improvement. After five months he was essentially getting no new acne. Now he is at college and is essentially acne free. The side effects were quite minor--the typical dry lips and a couple of nose bleeds. We wish we had started with Accutane a couple of years earlier. The reviews on this site were very helpful in convincing us to proceed. I hope this helps others with their decision.
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Remy2022
October 29, 2018
Thankyou for your information. My son is going to start next week. He is a freshman in college and nothing has worked up to this point. I am worried about these initial breakouts I'm reading about. His face is so broken out now I cant imagine it getting any worse. I'm hoping for an experience simliar to your sons. How did he handle the nose bleeds?
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Remy2022
October 29, 2018
Thankyou for your information. My son is going to start next week. He is a freshman in college and nothing has worked up to this point. I am worried about these initial breakouts I'm reading about. His face is so broken out now I cant imagine it getting any worse. I'm hoping for an experience simliar to your sons. How did he handle the nose bleeds?
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Noellis
November 1, 2018
My son is about the same age and I was so worried about the initial break out for the same reason as you. I feared accutane so much for many reasons. We got to the point where we feared acne more and what it was doing to him. We did have an initial break out for the first 2 and 1/2 months. We started him low and are still on a low dose because we don’t want to risk more breaking out and are just on a 9 month plan instead of 5. He’s doing great now and is clear now at 5 1/2 months. Still has pih and scarring to fade and fill in. Nosebleeds are minimal.
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September 2, 2018
My miracle
I never suffered with acne as a teen, I guess I was lucky. My skin wasn't perfect, but it was blemish free. When I hit 20, everything went downhill. My hormones went crazy. Suddenly, it was as if my face was as out of control and there way nothing I could do to maintain it. I tried various products, microdermabrasion, light therapy, Tetracycline and a number of intense and EXPENSIVE chemical peels. For about 3 months, the tetracycline worked, then my acne came back with a vengeance. It was the worse I had ever seen it and suddenly I couldn't look at myself. I couldn't look at other people, I became anxious, shy, sad - I felt ugly. I began facial peels. I must of had at least 10-12 checmial peels( which did help). Slowly my acne began to improve, but it was still there, only not as aggressive and at a cost of £90+ a peel I couldn't continue using them. I learnt about accutane from the sk:n clinic where I was having my chemical peels; by which point my acne was graded as modular pustular acne - not nice, I know. Anyways, I continued having chemical peels for about 5 months,having at least 2 a month, before I demanded to be referred through my doctors to a dermatologist (only registered dermatologists can proscribe accutane in the uk and i just could not afford to fund it privately) I was rejected at first. I went back ofcourse, kicked up a fuss and told them how depressed I was. I finally got to see a dermatologist and straight away was given accutane. My first appointment, they preached about not getting pregnant, checked I wasn't already, checked my weight and just wrote me a prescription. I though it would be more difficult, but once I got to that stage it was fairly easy. I was told that I would need monthly appointments, needed to go on at least two forms of contraception (although I didn't because I can't have synthetic hormones for medical reasons), would need to keep an eye on my mental health and come back every four weeks for an up-dated prescription. I started on 20mg a day for 4 weeks- no problems, no difference. I increased to 30mg for 4 weeks then 40mg. I started to notice I was no longer breaking out, like at all. I had no side effects at first. My dose increased to 50mg a day. The skin on the back of my hands began to dry, like scales. My lips split, like they reallllyyy split. My eyes became so dry and gooey and I was going through at least one bottle of eye drops a week. They're not exaggerating when they tell you to moisturise ( personal preference, cetaphill - it's a life saver and can be used on your face and body) I started to get backache, really badly. I became nauseas. All my blood test came back fine and within 6 months I was off accutane and spot-free. I'm the happiest I've been with my skin in over 24 months. The only side effect I'm still suffering with currently is backache but I've only been off accutane for 6 weeks. Despite the side effects , I would go back on it tomorrow. Roaccutane changed my life, for the better. It's a life saver and I don't regret going on it.
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.
Find a Doctor Using The American Acacemy of Dermatology Website

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.
Find a Doctor Using the American Society of Plastic Surgeons Website