Accutane is an effective acne treatment for many, but it is not a one-size-fits-all solution.
And despite having an excellent success rate when treating severe acne on the face and body, Accutane can still be ineffective for some people.
This ineffectiveness can sometimes manifest as acne not improving while taking Accutane or returning after finishing an Accutane course.
However, there might be several reasons why Accutane doesn’t work for everyone, and while some can be improved by paying attention to how you take this medication and what you combine it with, others may require a complete change of treatment.
Therefore, in this article, we will take a closer look at the possible causes of why Accutane doesn’t work for everyone and what to do about it.
Not Enough Time Has Passed
Accutane might be the nuclear weapon for treating acne; however, it isn’t an overnight miracle drug, and this treatment also needs some time to work before showing some results.
While most users should start to notice positive skin changes by the end of month two on Accutane, it’s not unheard of for people not to see any changes in their skin up to the sixth or seventh month on Accutane.
In fact, while doing the research for this article, I was checking forums like Reddit and Quora, and most of the users who complained Accutane didn’t do anything for them by month four of taking it ended up eventually reporting that their skin did start to improve after the sixth or seventh month of Accutane treatment.
Therefore, while you cannot always predict how long it will take for Accutane to show some results, checking in with your health provider regularly and discussing your concerns and progress might be the best way to decide whether you should continue taking Accutane or try an alternative treatment.
Incorrect Accutane Dose
Accutane comes in various doses, and each person has prescribed a unique dose based on factors such as the severity of their acne, health, lifestyle, and weight.
Due to concerns about Accutane’s side effects, doctors will prescribe low doses of the medication.
In practice, this looks like just 0.1 to 0.2 mg of the medication per day per kilo of body weight instead of the 1 to 2 mg per day per kilo of body weight.
However, it’s not uncommon for Accutane users to have their doses bumped up after a few months of using it and not experiencing satisfactory results.
Therefore, if you are taking a low dose of Accutane and it’s not working for you, discuss with your doctor whether increasing the dose might be worth considering.
Incorrect Accutane Use
Another factor that may lead to unsatisfactory results while taking Accutane is the incorrect use of the medication.
For example, Accutane is advised to be taken with food, especially a meal containing some fat such as fatty fish, nuts, avocado, or a spoonful of peanut butter.
This is because Accutane might not be well absorbed through the digestive tract if taken on an empty stomach, which can result in the body not getting enough of the active ingredient, which means that you won’t be benefitting from it as much as you should.
Additionally, those with digestive problems such as irritable bowel syndrome (IBS) may also experience digestive issues when taking Accutane, which means the drug won’t be correctly absorbed, resulting in less effective results.
Therefore, if you have been taking Accutane correctly, but it does not seem to work, checking for an underlying digestive issue might be a good idea.
Accutane is an ultra-concentrated dose of vitamin A, and this component works by purging the clogs in your pores, which often results in a lot of breakouts initially.
Therefore, if you are noticing more pimples than normal while on Accutane, you may be going through the purging stage, which is when an active ingredient pushes the clogs that would’ve become pimples at different points in time all at once toward the skin surface where they can heal.
This purging phase can last anywhere from four to twelve weeks, which is when your skin will likely be at its worst before it starts to get better.
It’s worth noting that all vitamin A derivatives are capable of causing this, and while not everyone experiences the purging stage, it’s important to understand that this is a normal part of using vitamin A, whether orally or topically, and shouldn’t be seen as the drug not working for you.
Having an inflammatory diet consisting of foods that can cause inflammation in the body, such as sugar, refined grains, and processed foods, can also be a reason why Accutane isn’t working for you or a reason why acne comes back after clearing for a little while thanks to Accutane but then quickly returning after some time of stopping the medication.
This is because inflammation in the body triggers a complex chain of reactions that can lead to hormonal imbalances and the overstimulation of the oil glands, which can result in more acne breakouts.
Therefore, if you are experiencing any of these issues while on Accutane or your acne comes back after finishing your course of medication, it might be time to look into your diet.
Additionally, intolerances to certain components in foods like dairy and gluten can also cause inflammation, so if you’re still experiencing breakouts after looking into your diet, it might also be worth considering getting tested for such intolerances or sensitivities to certain foods.
Another factor that can contribute to Accutane not working for you is a hormonal imbalance.
Hormones work as messengers in your body and can affect biological processes such as inflammation, oil production, and the healing that happens in your skin.
Therefore, if certain hormones are out of balance due to various reasons such as stress, a nutrient deficiency, or an underlying health condition, this can mean that your body won’t respond to Accutane as well as it usually would and your acne might not be treated as effectively as it would with a balanced hormonal system.
Therefore, if you have been taking Accutane correctly but your skin is still not responding, it might be time to look into hormonal testing and assessment to see if there are any underlying issues that need to be addressed.
While doing the research for this article, I read about positive experiences. Accutane users have had after stopping the medication and switching to hormonal medications such as spironolactone, which can be an effective solution for treating acne caused by hormonal imbalances.
Some underlying health conditions like polycystic ovary syndrome (PCOS) in women can sometimes cause acne to come back after seemingly getting rid of this condition with the use of Accutane.
PCOS is a condition in which the ovaries produce an abnormal amount of androgens, which are the male sex hormones present in women in very small amounts. However, androgens are also the hormones that regulate the activity of the oil-producing glands, therefore, an overproduction of androgens can lead to an overproduction of oil, which will then get stuck inside the pores and lead to acne.
Additionally, Accutane itself has been observed to lead to thyroid dysfunction, which can also be a factor that contributes to acne as the thyroid is an important regulator of hormones and metabolism.
Therefore, if you have finished with your Accutane course and are still experiencing breakouts that range from moderate to severe in larger areas of the face and body, it might be worth getting tested for any underlying conditions like PCOS or thyroid dysfunction, as this could explain why Accutane isn’t working for you.
Potential Interference of Medications
It is generally advised to avoid taking some medications while on Accutane, as these can interfere with its function, leading to decreased efficacy and potential side effects and discomforts.
Some medications that are known to interact with Accutane include tetracyclines (doxycycline, minocycline, etc.), which are antibiotics commonly prescribed to treat acne; therefore, taking these while on Accutane can be counterproductive, and you must always let your doctor know if you’re taking or have recently taken these antibiotics before being prescribed Accutane.
Additionally, some other forms of vitamin A, such as acitretin and bexarotene, which are used to treat psoriasis and some forms of skin cancer, can also influence how Accutane works.
Finally, drugs that cause bone loss (for example, anti-seizure medications such as phenytoin and corticosteroids such as prednisone) can also cause Accutane to become less effective and could be a factor for why it isn’t working as expected.
Therefore, if you have recently taken any medications mentioned or are currently taking them, it’s essential to let your doctor know. Additionally, if you’re on a course of Accutane and are considering taking any of these medications, it’s important to consult with your doctor first.
Other Potential Interferences
A few other potential interferences that make Accutane less effective can include taking some herbal teas or supplements.
These can also lead to a variety of other complications, and side effects of herbal products are also described in various reports, including the potential to cause liver damage that can be dangerous while undergoing treatment with Accutane, which is processed in the liver.
It has already been found that some Accutane users who have been using herbal supplements while taking the medication have shown elevated liver enzymes detected in monthly blood tests, which can be an indication of potential liver damage.
Additionally, some herbals have been reported to interfere with the effectiveness of birth control pills, and this action can have serious consequences while on Accutane, which is a teratogenic medication with a high risk of causing birth defects if taken during pregnancy.
Therefore, it’s highly recommended to avoid taking any nonessential supplements and herbals while on Accutane and to always inform your doctor if you are currently taking or plan on taking any of these products, as this can potentially affect the efficacy of Accutane.
Clogging Ingredients in Cosmetic Products
One of the main reasons why acne comes back for many people after Accutane is the use of cosmetic products that contain clogging ingredients.
Clogging ingredients found in skincare and makeup products can either create a seal on the skin and prevent the natural oil flow or get stuck inside the pores and, similarly, prevent the natural flow of oil to the skin surface.
This will then result in a stiff plug that consists of skin oil, dead skin cells, and other types of cellular debris which some strains of bacteria, including the acne-causing bacteria, use to feed on and proliferate, causing pimples to form and with enough growth, can cause cysts and nodules.
Therefore, to prevent your acne from coming back after finishing an Accutane course, it’s essential to check the ingredients of the products you are using or are interested in trying for potentially clogging ingredients.
This includes, but is not limited to: some forms of silicones, stearates, emollients, occlusives, oils, etc.
My name is Simone and I am a certified skin specialist. I created this website to teach my readers how to take great care of their skin and I also like to occasionally share my honest opinions on skincare products I’ve tried. You can learn more about me here.
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