Isotretinoin (Accutane®)
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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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April 11, 2024
Product used:
Dangerous and useless for hormonal acne
It helped somewhat while I was using it, but the acne never fully went away. Upon stopping the medication, the acne eventually came back full force.
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Francesca D
October 4, 2024
Gosh that’s good to know, thanks. My dermatologist discussed a medication to even out my androgen levels, pending a blood test. Apparently this is the hormone responsible for persistent acne. But she thought Isotretinoin would be effective, too.
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September 4, 2023
Product used: Absorica (Isotretinoin)
Really think before taking
It worked for 5 years. My skin looked amazing but then I had the worst outbreak. It was the dreaded pizza face. My acne was worse than before going on Accutane. And they don’t tell you that after Accutane, acne doesn’t heal smoothly. The acne left deep deep scars. Deep pits that no cream will ever take care of. And men be careful, my ex got erectile dysfunction after using Accutane in his 20s.
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Francesca D
October 4, 2024
I head no idea this could happen. So sorry this was your experience, but thank you for sharing. I’m also looking at a longer term medication that evens out androgen levels for hormonal acne.
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August 20, 2020
Hair loss

Destroyed my hair. Do not go on this poison 

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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.
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June 30, 2018
Don't take it unless you absolutely have to
Taking this medication was a horrible mistake. I took it for a year, and a year after being done with medication, I still experience awful side effects. Joint pain, tingling in body, dry mouth and DRY EYES. These are only some side effects I'm still experiencing after taking it. On top of all, my acne came back. This medication is NOT worth all the pain you will endure during and after taking it. If I could go back in time I'd never take Accutane.
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February 19, 2018
If I could give it zero stars, I would
Taking Accutane was a HUGE mistake! I took it because I had been battling acne for over a decade. I did not have cystic acne but my face was always full of pimples and some were quite painful. The entire month and a half I took it, I was severely sick to my stomach. I missed several days of work and could not keep any food down. I also developed the largest pustules I have ever had in my life. The only acne scars I have on my face are from the breakouts I had while on Accutane. It still upsets me, over a decade later, that i could have been scar free if I hadn't taken this drug. I also believe my immune system was severely compromised from taking Accutane. I got terrible colds the following 2 winters in a row that I had a terrible time fighting off. Prior to taking Accutane, I would only get minor colds in the winter. If you are a female with hormonal acne, I highly recommend trying Spironolactone first. 50mg 2x a day has kept my skin clear for 9 years now. Absolutely nothing else worked for me except Spironolactone. I know that some people with cystic acne do have success with Accutane. But it was a horrible nightmare for me. I recommend females try Spiro first before resorting to such a damaging drug as Accutane. Unfortunately, guys cannot take Spiro due to side effects in the male body.
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ExultantIndex
April 6, 2018
I’m doing great on low dose Accutane! It has cleared my skin with few side effects. It has also reduced my sebaceous hyperplasia. Maybe you were dosed too high...
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March 20, 2017
Scary side effects
I had been working with my dermatologist for nearly two years when she suggested I take Accutane to combat my persistent acne. I am a woman, (a young woman at the time) so I was given two large packets of warnings and agreements, contracts practically stating that I understood the risks I was going to be facing etc, etc (these contracts I had to sign). It was vital for my doctor to know that pregnancy while on this medication was absolutely unlikely and I was put on birth control and (would have been) required to take monthly urine and/or blood tests to prove that I was not pregnant (and that my liver was not failing me). I did more research, very in-depth research, a few weeks before I was due to start taking Accutane. I read that Accutane was originally introduced some years ago as a cancer drug but was a failed cause. Now, whether this is completely true or not.. it scared the life out of me. Reading the side effects listed in the packets given to me also made me feel as though risking my health was NOT worth it. So I decided not to go forth with the treatment. Luckily I found the Acne.org Regimen and my skin is completely blemish-free because of that. I strongly recommend exhausting all of your options before considering Accutane, especially if you are a (romantically active) girl or woman. In my personal opinion, a drug so harmful that it can cause absolutely horrific birth defects is a drug not taking a chance with. Be wise in your choices please and think about it thoroughly! Best wishes! :)
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slurpeedude
November 2, 2017
So you never actually tried it, but still giving a one-star review? Your not a researcher, and your discouraging other people from using Accutane because of the research that "may or may not be true." This is a review forum, not your opinion.
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January 11, 2017
mental and possible physical health effects
i felt a negative change in my mental state, mental fog difficulty speaking to other and some symptoms of depression after taking this drug for a couple of weeks and thus stopped after about 2 months. I would not recommend, as whether or not any of the long term physical effects are proven or not, anything that changes ur mental state when it is not meant to is scary....
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KristineClay
February 9, 2017
I currently have symptoms of depression but am starting accutane in a few days. Do you think Its best I abort mission? Ive suffered from acne for 10 years and nothing has worked so I wanted to give accutane a try. My current mental state is fragile though and reading your review makes me fearful.
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Solomon92
July 14, 2017
I feel like a lot of ppl are depressed bec of acne. And accutain usually gives you the that feeling of hope so in most cases no depression.
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January 7, 2017
awful
do NOT take this medication. It has ridiculous side effects and makes women infertile in most cases. Please save yourself the troubles.
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KristineClay
February 9, 2017
What side effects are you referring to besides what you mentioned about it making women infertile?
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Solomon92
July 14, 2017
I personally know a lot of women with kids that was on Accutane in the past. Only issue is not getting pregnant while on it.
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December 22, 2016
Estrogen levels
I took Accutane about 10 years ago. Since then I have been battling with my estrogen levels being too low. Causing long drawn out periods that come early and can last for 2-4 months without stopping. I also am at a lower chance of being able to get pregnant. This means I take artificial estrogen on top of birth control which is an increase to developing cancer. Wondering if anyone else has had these issues or similar after taking this med?
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WishClean
January 9, 2017
I have no experience with accutane, but I have experienced low estrogen levels due to PCOS & other hormonal imbalances. Do not take artificial estrogen, it's very risky. Instead, look into the DIM supplement or bioidentical estrogen.
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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