Let’s talk about Accutane - Does it really work? (Part 1)

 For the past 25 years I have had hundreds of clients with light to moderate acne come in to receive treatment. About 70% of them were successfully cured of their acne by me, but sometimes just a simple change to skin care routine would do. While sometimes a combination of products like prescription tretinoin and Spironolactone would do the trick for some clients, a synergetic combination of acids like BHA and AHA plus retinol works for others. Every once in a while, none of the above treatments work and after a few months of deceiving results and acne that would return with vengeance, I’d then know it’s time to bring Accutane into conversation. 

Some clients would be immediately open to the idea and book their appointment with a recommended dermatologist right on the spot, while others would be a little more apprehensive. Those more likely to take skincare advice from prepubescent Tik Tok influencers would come up with all sorts of unrelated excuses, claiming “it’s gluten!” “It’s dairy!” “Maybe if I just become vegan…” “Ok, maybe Keto!” “Maybe I need to sleep more, or go on a detoxifying diet, and change the water I drink.” “I won’t eat chocolate or any sugar and it will get better.” “I can just check my hormones” (we will get back to the subject of hormonal acne in a different post). Yes, some of my clients did it all with just marginal improvement. While I am a huge advocate of healthy living, and implementing most of the points above in everyday life, none of that has ever cured stubborn acne. In short, nothing works for severe acne except accutane.

For the sake of disclosure, I have no interest, hold any stock, nor am I being paid by any pharmaceutical company for this post. I am speaking on this with 25 years of hands-on experience treating all kinds of faces, and all kinds of acne. If you tend to rely on influencers for the latest in beauty and skincare, my advice would be to first look at their skin type and see if it aligns with yours. If it doesn’t, almost all of their advice can be thrown into the trash as they are not formally educated in skin care and likely don’t know what is best for you. It can be frustrating and isolating to see people with seemingly perfect skin discredit a product that could very easily solve all your current skin concerns, just know you’re not alone and millions of people have turned to Accutane to care for their acne. 

So what is Accutane? Accutane is the fancy brand name for a drug called isotretinoin. Derived from vitamin A, accutane is taken orally and is prescribed by your dermatologist. If you’re familiar with behind-the-counter skin treating drugs, It’s in the same family as tretinoin and Retin-A. It’s best used to treat severe cystic and nodular acne. The most common cause of cystic acne is excessive oil production. Accutane not only reduces oil production and cell shedding to unclog pores, it also kills the bacteria in your pores that causes inflammation. One thing we know for sure, Accutane has over 90% success rate in curing severe acne when used according to dosage instructions and working closely with your dermatologist. While an acne relapse is uncommon, it mostly occurs when the user becomes a little impatient and doesn’t keep up with the recommended use timeline. Most of my clients who used Accutane have cured their acne permanently. Rare Hormonal acne aside, this drug has a remarkable success rate and that is why I feel comfortable recommending it to clients when we’ve exhausted all other options in curing their acne. This treatment must be done and supervised by a licensed Dermatologist only! Don’t try to order it on Aliexpress or whatever else people pick up their counterfeits, this is a potent product and you should treat it as such!  

So Why is this drug so controversial? Well, It can cause some unwelcome side effects like:

- Super dry, rashy skin

- Chapped lips and inner corner of the nose

- Back and joint pain

- Dry eyes

Serious side effects like:

- Depression

- Ulcerative Colitis

- Crohn's disease

Can occur, and it’s important that you clearly communicate your symptoms to your dermatologist. 

You should never use Accutane while pregnant or while trying to become pregnant. In fact, you should be using two forms of birth control when treating your skin with Accutane because serious birth defects can occur. 

I have seen hundreds of clients on Accutane and thankfully, the worst side effect that I have come across is joint pain that was easily resolved within a few weeks. The rest of the side effects are tolerable and easily treatable with a highly moisturizing skincare routine. 

A few of my clients quit Accutane before their treatment was over because of this common little thing called the Accutane purge. Just like retinol, there is a period within your Accutane use that your skin will get worse before getting better. For the first 60 days, you will experience much more acne, blackheads and nodules coming to the surface of your skin. However unlike before, instead of staying on your skin for weeks and causing scarring, the acne and nodules will clear way faster and you should be out of the purge period by the third month. You will feel like all the impurities that have been living under your skin are literally being expelled through your pores as they’ve been hit with an eviction notice once and for all.