Oral Retinoid
2786 Reviews
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®)
Compare To Other Treatments

Used Isotretinoin (Accutane®)? Rate It:

Choose from 1 to 5 stars
September 9, 2021

I'm 17 I'm a BOY and started Accutane when I was about 15 This medicine is very effective in a positive way it helped clear my face full of acne in about 4 months but I did not get to finish the whole 6 months because insurance canceled while I was on Accutane MYORISAN brand 20mg I had no bad side affects accept for chapped lips which is very common and that was it.

        One year later I'm going back on Accutane to finish up and clear up my face completely I still have a good amount of acne. Now this brand of Accutane I'm taking is called AMNEAL 20 mg the first day I start taking it I feel normal, The second day I have a little chest pain for a couple minutes but feel normal, The third day I wake up around 4:30am I then took the pill about 5:00am Then left to work at 5:20am while I was on the road My vision started to blur and I thought it was because I was just tired and it felt like if you were to look into a light bulb and then look away that's what I was seeing I didn't want to believe it was the medicine THEN MY HEAD felt like there was a tight band around it but I just thought it was my Bennie but no it wasn't. I'm finally at work at 6:20 I get out of my truck and walk around I feel a bad headache and then feel like throwing up and then eventually throw up stomach acid so I'm thinking it was because I didn't eat anything with my Accutane so I then go to Panera Bread on my way there at a intersection I just had to get out of my truck and start throwing up nothing except water and coffee and the pain started to continue luckily none was there finally get to Panera bread order a breakfast sandwich and left to go in the back of the building parking lot to throw up rolling on the floor and just waiting to die I didn't want to go to the hospital because I didn't think they could do much finally I feel a little better so then I go back in to Panera and eat my breakfast sandwich and felt a little bit better and then a couple hours latter I feel like I'm going back to normal so I am not sure whether its the reason I didn't eat or an allergic reaction I'm going to take another pill with food and see what happens. 

February 4, 2021
Excellent, but only if you take it short-term

Accutane was the only thing that ever gave me clear skin, and that feeling was just great. My lifestyle and diet could be a mess and it kept my skin clear. If nothing works, I'd say just go for it.

However, I recommend everyone to only go on it short term, which is the usual duration recommended by your skin doctor, I would presume a year max is probably still ok, but only based on my own experience

Otherwise, unless you are that special few (of whom i'm so envious of), you will start to see all the side effects appear.

Accutane past a few months started messing with my stomach and bowel movements. Still nothing that is crazy so I stayed on it.  Then I started getting back pains. Still, nah clear skin is sooooooo much more important. A year passed and I find myself losing hair. Ok, that got me worried but no way was I going off accutane. By then I was already taking a dosage that is lesser, because  without a completely valid reason, no sane doctor will allow you to take the full dosage for past a certain duration, which can range from 4-8 months depending on the doctor and how much you can take per day.

Sad to say, the lesser dosage did not keep me clear, but still, I chose to continue taking it even for that 80% clear skin. That's just how persistent I was.

By 1.5 years, the hairloss was quite a concern I had to start on minoxidil. Minoxidil did great until I realized I landed myself in deeper shit because once you stop minoxidil, the hair that grew back will very likely go as well. So I had no choice but to stay on minoxidil. But that is another story altogether.

Even with all that, I continued on accutane as I continue getting more stomach problems.

One fine day, I decided I have had enough and I stopped. And though that was the start of a lot of the side effects lessening in intensity (they never go away completely), a while later I got hit with an autoimmune disorder which destroyed my life and when I did a search, I realized that accutane has a possibility of causing auto immune problems. Oh, if only I knew about it earlier...btw an autoimmune illness is medically incurable. And though I can't say for sure accutane is the cause for it, I can't say for sure it isn't.

Therefore, now. I always tell people, it is ok to take accutane, as a matter of fact, please do take it if you really want to and need to. But never take it long term (and past the recommended cumulative dosage), you will wreck your body in horrifying ways. We all want clear skin, but never do it at the loss of the healthy functioning of another body part.

January 20, 2020
The only thing that every worked; but it came at a price!

I have always had terrible cystic acne growing up that started when I was around 9-10 years old. Over the years I tried every damn treatment you could think of but nothing would get rid of it, or even get it under control. The products I tried would all just clear it up a little bit, but not enough to really notice much of a difference. I had an extreme morning and evening regimen of vigorously washing my face and putting acne creams on. If I ever once forgot to wash my face or put the creams on, I would wake up with the worst breakouts of my life the next day. I absolutely could not forget or skip a day, ever. I took birth control for my acne, but it only helped a small amount. I always thought once I got out of highschool the acne would just go away eventually, but it never did. Finally at age 23 with a face full of zits, I thought, ?This is it. This acne is never going away.? And I started looking into more drastic treatments. This is where the accutane came in. Let me tell you this was no walk in the park. I went through the hardest 6 months of my life while taking this stuff. It made my lips and skin soo unbearably dry. Describing it as uncomfortable would be an understatement. If I ever left my house without vasoline, I was absolutely screwed. My lips would get so dry that they would stick together and I couldn?t even get my mouth open. One time when they got stuck together, I forced them apart, and the skin from my bottom lip got pulled off and was stuck to my upper lip. It was bad, and nasty to be quite honest. I felt sooo tired all the time. I would sleep for 12 hours and wake up still feeling exhausted. I felt so fatigued. I am a full time college student, and school got extremely difficult while I was on this stuff. I just could not for the life me concentrate, and was always falling asleep in class. I couldn?t find time to get homework done and study because I was always so exhausted. I ended up failing TWO classes while I was taking this stuff. And I had never failed a class before in my life! I was also experiencing memory loss, which honestly freaked me out a bit. I was constantly forgetting things, leaving things at people?s houses, forgetting to do things, which is very unlike me. It also caused me to gain a ton of weight! Which was terribleeee. The weight gain was probably the worst part for me. I would literally go days without eating and STILL gain weight. I was always starving, but was always afraid to eat because I was blowing up like a balloon. I probably gained over 30 pounds during the 6 months I took this stuff. And then as soon as I stopped taking it, the weight fell off without me even having to try. 

However, despite all the terrible side effects, I still have to say I feel it was worth it. My acne was controlling my life, and I finally feel free now. I think what I like most is not having to do a full face of make up every time I leave the house. It feels like a true gift, because I always hated wearing make up. I no longer have to wash my face or put acne products on at all. It?s been about six months now since I stopped taking accutane, and all the side effects are gone. I?m back at my normal weight, and my skin is still completely clear. As others have mentioned, please be very aware of the side effects. If you can, try to take it during a time when you don?t have too much going on in your life. Also, you can pretty much expect to have no dating life whatsoever while taking this stuff, so be prepared to spend some time alone. 





This Was Helpful

1 user(s) found this helpful

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.
August 14, 2018
Holy grail if u can deal with the side effects
I started getting acne when i was 18, having never suffered from bad skin at all in my early teens. I tried everything, from changing my diet, drinking a shit tonne of water, different teas, antibiotics, topicals, different birth control etc. I was told that my acne was hormonal and probably caused by progestin from my bc pill. I'm going into my 4th month of accutane and omg my skin is clear and glowing, it's the first time in years I've felt confident enough to go out without makeup and I'm getting compliments as well! I will say I've had some side effects, sore heads for the first month or so, extremely sensitive and dry lips, dry skin everywhere, dry eyes, i get scratches and bleed easier and terrible joint pain if i exert myself in the slightest. My face also flares up and goes bright red out of the blue. But in my opinion, it's all manageable, just very inconvenient. I just hope that my skin stays clear when i come off the medication as I've heard that hormonal acne has a tendency to come back when u stop ur regular doses.
This Was Helpful

2 user(s) found this helpful

July 23, 2018
would recommend but not for the faint at heart
Accutane did everything I thought I would. At first it seemed to make my acne worse. for month 2-4 I was taking 80mg of isotretinoin and still getting huge breakouts- worse than before i started. However once month 5 came along, suddenly all the breakouts stopped. I did 6 months of Accutane and now 2 months later i have yet to get a single zit since month 5. 3 month of no zits? I'm crying tears of joy; It made the side effects worth it. I haven't had skin this clear since before puberty. The worst side effects for me were horrible cracking/peeling lips and constant bloody/scabbing nose. I literally could not leave my house without a tube of vasaline. I had situations where I would have to leave work or school to go back to my house to get my Vasaline bc my lips were bleeding so bad from being dry. I also experienced rashes on my hands and arms, a messed up menstrual cycle, constipation, dry scalp (which was actually nice because i have oily hair), and sore joints. The pregnancy tests and blood draws were terribly annoying but understandable considering the birth defect risk. overall- worth it (as long as I never have to do it again). However, prepare yourself for the side effects.
July 6, 2018
Extremely effective but be aware of the side effects.
Ive been battling severe acne since 2013. I'm now 19 years old and have been on accurane since January 2017. I wish I could post my before and after. Its amazing. I had cystic acne that destroyed the texture of my skin. I ALWAYS had at least a couple big painful cysts on my face surrounded by various smaller bumps. I was on Tetracycline which failed to make any difference whatsoever. I took the leap to Accutane and my acne was completely cleared in a matter of 3-4 months on it. After time, my acne scars have significantly faded as well and my skins texture is smooth and my skin is actually glowing! This however is an extremely powerful drug that effects more than just the skin. Some minor side effects ive personally noticed is increased hair loss, dry skin for the first few weeks and extremely dry, unrepairable lips. I cannot repair my lips no matter what i try or how much i spend. I assume as long as im taking accutane this problem will be persistent. The major side effects occur mentally. I would honestly probably look for another method of clearing acne if you have any prior mental health issues. I never considered myself depressed before accutane. Probably about 3-4 months in I was diagnosed with depression and put on anto depressants. They failed to work and at about the 6 month mark on accutane i grew extremely suicidal. This past christmas I attempted suicide. And i still live with perpetual suicidal thoughts. Since May 2018, ive been having panic attacks. This has brought on a whole new list of side effects such as having no energy, inability to sleep and at times extreme, overwhelming thoughts of suicide. I find myself uncontrollably crying every single day. This is not necessarily the cure for self-esteem issues caused by acne. Please consider ALL the possible side effects before starting this drug. Because you will most likely be on it for years and the cons can start to definitely outweigh the pros. I have decided against discontining my use of accutane simply because i think if I stopped my acne would come back further damaging my self esteem. I really don't understand why this is prescribed so easily to teens. Teenage acne is normal. Accutane should only be prescribed as a last resort. While It 100% has worked for my teenage acne, the side effects will be taken through my adult years.
June 24, 2018
It worked for a while my acne was back!
I was on accutane when I graduated high school (2015). I had bad hormonal acne, back acne and chest acne. I decided to go see a dermatologist because I decided I try with one since all my life I've treated my acne with home remedies, over the counter products and creams(it helped temporarily). I walked into the dermatologist explaining my situation I remember telling her "I'm tired of not having clear skin like my friends" I got to a point where seeing my skin full of acne/white heads was normal and I never really knew how bad it was until I tried ACCUTANE. Long story short the dermatologist looked at my face my back and my chest and right away told me about accutane she explained to me allllll the dryness it caused and side effects. I was put on birth control while i was on it. After the 2 month I saw AMAZING improvements my pores were smaller my skin was glowing!!! I had so much confidence in myself like never before! After finishing my 6 months on a 40mg... (20mg was my starting point) I was so happy i was going to be off of it!! 4 months passed and my acne came back only on my right side (that was always my acne problem) for some dumb ass reason I tried birth control again and it was such a horrible mistake!!! I now have acne all over my chin and jaw my cheeks as well it wont go away... I would hate to go back to accutane :(
April 29, 2018
We'll see how this goes
I haven't been on Claravis long but I'm on 40mg. I'm 27 and I have had mild-moderate acne on only my face for my entire adult life, it's very much hormonal and my face/hair has always been oily. Multiple doctors tried to sell me on accutane and I refused for years, I finally gave up. I have tried everything you can think of, I'm currently on spironolactone, hormonal birth control pills, and use aczone. . . I was using all 3 prior to accutane and my skin looks the best it has in years. I also moved from Florida to the PNW and this helped my skin because I spend less time in the sun, sweaty and hot. I mostly am just tired of having elaborate facial routines and ruining my clothes/towels/sheets with acne products/bleaching. My doctor reduced my dose of spironolactone while on accutane. I gave up drinking altogether but I have never been much of a drinker, I also have a medical background and value my liver too much to mix medications and alcohol. I did a TON of research prior to starting accutane and ordered: chapstick, lotion, aquaphor, eye drops, hydrating shampoo, thicker moisturizer, new sunscreen. . . and came prepared for battle with dry skin. I also take my accutane with fish oil pills and some version of fatty food. I have always drank lots of water, exercise every day, eat pretty good and wear sunscreen every day (I'm incredibly fair skinned). 5 days in and thus far, my only side effect has been dry lips (I managed them with aquaphor and chapstick with sunscreen),and a pressure headache which improved with Tylenol. Here is to hoping this jazz works, I hate messing with my hormones, I just want my face to not have new spots, old spots, and scars. . . all those chemical peels and microneedling only work for removing scars if you can prevent new break outs.
April 6, 2018
My Isotretinoin journey
Hi, I wanted to leave a review after finishing isotretinoin over a 8 month period. I read so many reviews that helped so want to do my bit... So...a bit about me: I'm a 28 year old female who had suffered from mild acne since my teens. My acne really wasn't that bad, hence most people wouldn't have defined it as acne. More or less, I had 2-3 active pimples at any given time, which meant I thought it could be easily treated with over the counter treatments. These never worked. My frustration grew. When I was 27 I went to a doctor in London (where I had moved one year prior from Australia). I explained to the doc that I still broke out and given my age, it was becoming a problem because it should have cleared up. I had been on various birth control pills, had an ultrasound for polycystic ovaries, but none of that had worked. I was referred to a dermatologist on the NHS. When I met with the derm she suggested accutane. I was very hesitant because I'd heard so many bad things about the side effects. I have had depression and wasn't keen to start medication that might affect my mood. She explained that if I went on anti-biotics, the chances were that the acne would return once I got off, so accutane was my best bet and I could start on a very low dose to reduce symptoms of side effects. After doing a lot of research I decided to give it a shot. I am 6ft tall and weighed 8-kg, so I was going to need more than your average girl. I still only started on 20mg per day. After 2 weeks or so I started getting dry lips, but they weren't too bad. I continued on the 20mg for a couple of months (no real improvement in my skin, and in fact it was getting worse). I upped to 40mg, but still no improvement and again...it was getting worse. I was obviously very upset, but the derm said I should still persevere and we upped it to 60mg, coupled with some steroids to combat the inflammation. It was at that point where I saw massive improvements. I stopped breaking out and was able to see the light at the end of the tunnel. I stayed on 60mg for a few months before going up to 80mg as I wanted the course to finish as soon as possible. My lips were dry, but I didn't get the skin peeling or other major side effects. What I did notice though was that my hair became very VERY dry. I have long hair and was losing more hair than I usually did. Fortunately, my mood was OK and if I was down, it was probably due to my living/work situation. After 8.5 months I finished the course and after a week or so my lips got better. It's now been 3 months since taking it and I haven't had a single pimple or break out. My scalp has started to produce oil again, which I hope will fix my hair, but I have just started taking hair loss/strengthening supplements called Nourkrin and I hope that will help improve the health of my scalp and hair. In a nutshell: It was disappointing at the beginning, but I am so glad I stuck with it as I now get compliments on my skin (this had literally never happened ever in my life). I still have faint red marks on my skin from the old scars (my skin is very sensitive so when I used to get pimples they'd leave marks which lasted for very long periods of time). I may consider laser treatment to deal with these residual marks, but I suspect they will fade with more time. Hoping the supplements improve the condition of my hair which has been the worst casualty of isotretinoin.
October 25, 2018
Hello! Has your hair returned to its natural oil state? I have quite dry wavy/curly hair and am really worried about making it even drier and frizzier! Thank you

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.