Help! I have tried EVERYTHING to get rid of my acne, but nothing ever worked for me! Am I going to stay like this forever?
If you have ever had acne in your life, chances are that you’ve considered or at least heard of the infamous Accutane, a drug that seems to have some magical powers when it comes to clearing acne.
But as soon as you convince yourself that this may do the trick for you, you start reading about something even stranger. Side effects, and oh dear, these can be scary alright.
However, there are many misconceptions when it comes to taking Accutane and I want to address all of these as well as give you an insight into all the things you need to know about the drug.
Therefore, I created this article to help you gather all the necessary information you need to know before you start taking the drug as well as provide you with the best skincare routine when on Accutane.
What is Accutane?
Accutane is the drug name.
It can also be found by different brand names such as Roaccutane, Amnesteem, Claravis, Sotret, etc.
The active ingredient that makes the drug work is isotretinoin which is the most powerful form of vitamin A.
Accutane is the weapon of last resort.
The one you use when nothing else works for your acne.
That is why Accutane is usually given after other acne medicines, antibiotics, or topical treatments have failed to give you results.
Basically, you resort to Accutane when all else fails.
This is why you can’t buy Accutane in the pharmacy or in the shops. It is a prescription-only drug, and if you are considering it, you need to see a dermatologist to get a prescription.
A dermatologist will be asking some relevant questions regarding any history of medical conditions as well as require a blood test to check for hormonal imbalances and liver function.
Some things you may need to answer before safely starting Accutane are:
- history of heart disease, high cholesterol or triglycerides;
- osteoporosis or other bone disorders;
- an intestinal disorder, such as inflammatory bowel disease, ulcers, or Crohn’s disease;
- eating disorders such as anorexia nervosa; or
- liver disease
The dosage is based on your medical condition, weight, and response to treatment, but a dermatologist will typically prescribe you a low dose (usually from 0.5mg to 2mg) for 15-20 weeks. However, this may be prolonged and can last up to 10 months.
Yep, even “nuclear weapons” like Accutane take their time to work and give results.
What is Accutane Made of?
Isotretinoin was first developed in the 1950s but it only started being used in the mid-1970s.
The original brand names were Accutane® and Roaccutane® but there are now many generic versions on the market, depending on the drug’s potency.
Isotretinoin (13-cis retinoic acid) is a vitamin A derivative which describes it as a retinoid.
The liver naturally makes small quantities of isotretinoin from vitamin A, but the drug that is prescribed to tackle certain skin conditions such as severe acne is made synthetically.
What Does Accutane Do?
Accutane is used to treat severe cystic or nodular acne that has not responded to previous topical treatments such as benzoyl peroxide or clindamycin or other orally taken treatments such as tetracycline or minocycline.
It works by targeting the overproduction of oil by the sebaceous glands and reducing it by up to 80%.
Your sebaceous glands are responsible for producing sebum which serves as a natural lubricant and moisturizer for your skin.
That is why normal skin is naturally soft and smooth.
But if you suffer from severe acne, this means that your sebaceous glands are thrown into overdrive and produce massive amounts of sebum that can’t flow out of your pores normally anymore and remains trapped inside.
Here, the sebum mixes with dead skin cells and clogs your pores while creating an airless environment for the acne-causing bacteria to thrive.
P. Acnes, the bacteria that causes acne, feeds on the excess sebum.
But here’s when Accutane comes in to save the day by significantly reducing sebum production and quite literally starving the acne bacteria to death after some time.
What Are The Side Effects of Accutane?
There is a reason Accutane is the nuclear weapon of last resort.
Yes, it will effectively eliminate your acne and most probably for good, but not without wrecking some damage on your skin first.
I understand that by now you are probably freaking out because you have read all the scary side effects and someone may even tell you that Accutane may cause severe bowel inflammation and this and that.
Look, I am not going to discard these claims as total bulls*it because we are all different and Accutane is a tailored treatment to each individual rather than one size fits all.
This means you may experience different side effects while your body is getting used to the drug or none at all whatsoever.
As long as you make sure you go to a good dermatologist that will have the common sense of giving you the dose you need, chances are that you will get away with minor side effects that usually take time getting used to and you are good after the initial discomfort.
So here are some side effects you can expect in the short term:
- Dryness (dry skin, dry or chapped lips, dry mouth, dry scalp)
- Photosensitivity (your skin will become increasingly sensitive to the sun which means skipping sunscreen is a total no-no)
- Purging (yes, your skin can potentially become worse before it gets better and this is because the active ingredient isotretinoin promotes cellular turnover, which means that the gunk you already have inside your pores will come out sooner and this will result in acne breakouts that will subside after some time)
While this can understandably take a huge toll on your confidence and self-esteem, it is important to remember that it is only temporary and once you’re past it, your skin will look better than ever.
However, there are some long term side-effects that, in my opinion, shouldn’t be overlooked, but due to the extremely small percentage of people that have experienced some of these, they shouldn’t really scare you at all.
Here are some of them:
- Abnormal bone growth
- Birth defects (which is why women must take birth control alongside Accutane while having the treatment)
- Depression and mood swings (due to the moderate to severe headaches the drug may give you while your body is in its early stage of getting used to it)
- Dry eyes (due to the drying effect it has, which makes it unsuitable for contact lens wearers and it is advisable to switch to wearing glasses while receiving Accutane treatment to avoid discomfort)
- Joint pain (again due to the drying effect it has)
- Inflammatory bowel disease (which has been documented while the drug was in its earliest stage of production but it has been thoroughly researched since then and precautions to prevent such condition have been taken)
While this may sound scary as hell, it has been documented to appear in less than 10% of patients in millions of people receiving the treatment.
Chances are you won’t ever experience them, however, if you feel like you cannot take the drug because it gives you unbearable side effects, you can always stop the treatment and opt for something milder instead.
Can Accutane Damage Your Liver?
While Accutane can’t damage your liver long term if you have never had issues with liver functions before, it may still cause liver enzymes and lipids to become slightly elevated.
However, while isotretinoin appeared to have a greater effect on lipids than liver enzymes according to a study conducted in 2014, this was not statistically significant and it does not indicate that dermatologists should avoid prescribing isotretinoin use for appropriate indications.
While regular follow-ups with your derm are extremely important and the drug should be used cautiously, Accutane can’t permanently damage your liver.
Is Accutane Worth It?
While Accutane shouldn’t be the first treatment of choice, it is an option worth trying if nothing you’ve tried before has successfully treated your acne.
It is definitely worth the temporary pain as statistics show that it has been successful in treating cystic or nodular acne in 95% of patients and the results are often permanent.
Accutane doesn’t just clear up your skin. It gives you the confidence and self-esteem boost you’ve most desperately needed while dealing with painful and obnoxious acne.
Once it’s all done, you will not have to deal with it anymore and this will contribute to making you feel comfortable in your own skin.
So, Accutane is hardly the devil drug we should all fear after all, don’t you think?
The Best Skincare To Use While On Accutane.
Expect your skin to become super sensitive on Accutane.
This is not something that should make you worried, but you do need to become responsible for the products you apply while your skin is in this delicate state.
To minimize the risk of irritation and unwanted effects, it is best to keep your skincare routine as simple as possible. Stick to the basics and use the mildest products you can get your hands on.
In the morning it is important to cleanse, moisturize, and slather on that sunscreen to protect your skin from burning.
In the evening, cleanse and moisturize and you are good to go.
Here are some recommendations from my side to help you maintain your skin in perfect condition while going through this rather intense treatment.
My Top Cleansers to Use While on Accutane.
Cleansing your face is the most important part of your skincare routine as this allows you to remove the buildup of dirt and pollution that’s been accumulating on your skin throughout the day.
However, choosing the right cleanser for you while you’re receiving Accutane treatment can be challenging as you always need to remember to opt for one that is mild, non-medicated, and does not contain any alcohol, fragrances or exfoliating agents.
To make life easier, I have combined a list of my most trusted cleansers to aid you on your healing journey. Here are my favorites:
#1 Avène – Extremely Gentle Cleanser
The Extremely Gentle Cleanser from Avène has been specifically developed for fair, thin, and sensitive skin that has become irritated due to climatic conditions, dermatological treatments, and extreme dryness.
It effectively removes dirt, makeup, pollution, and impurities; this refreshing cleanser will soothe your skin and leave it with long-lasting comfort and hydration.
It is free from fragrance, parabens, artificial colors, and alcohol.
#2 CeraVe – Hydrating Cleanser
The CeraVe Hydrating Cleanser is the classic when it comes to effective cleansing and deeply hydrating your dried-out skin.
It gently sweeps away dirt, pollution, and impurities without stripping away moisture and it is enriched with hyaluronic acid to strengthen and restore the natural barrier function for long-lasting hydration.
It is specifically formulated for dry skin types and is free from soaps and fragrances. It is also hypoallergenic which means it is suitable for most sensitive skin types and it is non-comedogenic, which means it won’t clog your pores and cause a buildup of dirt and bacteria.
#3 Elemis – Rehydrating Rosepetal Cleanser
Elemis is a brand that is in my pricey, guilty pleasures bucket so whenever I feel like spending a little extra on a high-quality formulated product, this is the brand I inevitably go back to.
This gentle cleanser contains healing rose petal extracts, lethicin, and it is rich in vitamin E and it aims to replenish the moisture in your skin and gently purify it.
It preserves a protective and nourishing film on dry skin and it has a light texture that is gentle enough to be used as an eye cleanser.
#4 The Ordinary – Squalane Cleanser
Another trusted product from The Ordinary I absolutely recommend for skin that has been dried out due to dermatological treatments.
The Ordinary’s Squalane Cleanser is carefully formulated to cleanse and soothe dry skins while simultaneously moisturizing with a combination of hydrating squalane and other lipophilic esters.
Simone’s Top Moisturizers to Use While on Accutane.
Moisturizing while on Accutane treatment is of utmost importance as your skin is probably going to become super dry and sensitive so you need to keep it hydrated.
It is also important to choose the right one while your skin is in a delicate state.
Opt for one that contains a minimum of chemicals as well as no alcohol and fragrance.
Here are my favorites:
#1 Avène – Extremely Rich Compensating Cream
The Extremely Rich Compensating Cream as the name says is a specialist when it comes to nourishing gentle and sensitive skin.
It boasts a rich and creamy texture that will maintain the moisture in your skin and keep it soft, smooth, and supple.
It is hypoallergenic and specially formulated for sensitive skin with paraben-free and non-comedogenic formula.
#2 CeraVe – Facial Moisturizing Lotion
Another classic for extremely dry skin is the CeraVe Moisturizing Lotion that offers a lightweight and silky texture that provides all-day hydration.
It is efficient in helping to strengthen and restore the natural skin barrier to prevent moisture evaporation and provide the ultimate comfort for your skin.
#3 Elemis – Hydra Boost Day Cream
Another great product from Elemis is the Hydra Boost Day Cream for Dry Skin that will banish areas of dryness and leave your skin feeling smooth and soft.
Enriched with a powerful blend of hyaluronic acid, marsh samphire extract, and starflower oil to strengthen your skin’s natural moisture barrier and addition of vitamin E to protect your skin against free radical damage.
It produces an instant moisturizing effect that will treat your skin when in need of a boost of hydration.
My Top Sunscreens to Use While on Accutane.
Consider this to be the most important part of your morning skincare routine while on Accutane.
Isotretinoin is a powerful ingredient that will increase your skin’s sensitivity to the sun and besides the very uncomfortable burning sensation you may experience, there is also the added risk of acquiring some dreadful pigmentation.
You should, therefore, avoid direct sun exposure whilst taking Accutane and consider slathering on that sunscreen for added protection, just in case.
Here are my top recommended sunscreens while on Accutane:
#1 REN – Clean Skin Mineral SPF30 Mattifying Broad Spectrum Sunscreen
This daily gentle physical sunscreen is specifically formulated for even the most sensitive skin types and it is my personal favorite and something I recommend to everyone when it comes to sunscreens.
Infused by naturally sourced zinc oxide, the cream forms a protective shield as soon as you apply it to your skin and forms a non-comedogenic barrier that intercepts the sun’s harmful rays and environmental pollutants.
#2 Ultrasun Face Anti-Aging Lotion SPF 30
This gentle and protective formula is something that remains to sit in my handbag ever since I moved to my sunny little island a few years ago.
This was about the time I discovered Ultrasun and I have been loving their products ever since as they offer full-day protection that works super compatible with my sensitive skin.
It absorbs quickly into the skin and the high protection formula contains a blend of anti-aging and safeguarding ingredients to prevent premature photo-aging as well as a powerful antioxidant complex that helps protect your skin against oxidative stress and free-radical formation.
#3 Paula’s Choice Resist Youth-Extending Daily Hydrating Fluid SPF50
Paula’s Choice is a brand everyone should consider taking a look at as they use no artificial fragrances and colors, are cruelty-free, and most importantly clinically proven to be non-irritating.
Their Daily Hydrating Fluid SPF 50 is fortified with a potent blend of antioxidants and it is fast-absorbing with the perfect broad-spectrum sun protection.
Trust me, you are going to love it as much as I do.
My Top Lip Balms to Use While on Accutane.
This is the softest and most delicate part of your face right after the eyes is and unfortunately the most affected area by the intense drug.
So many people are suffering dry, peeling lips as a result of their prescription medication and having a lip balm in each pocket of your jeans is something you should seriously consider if you are planning on starting Accutane.
Okay, maybe not to that extent. But, still.
Lip balms are a must when Accutane steps its foot on the dancefloor and here are some of my most trusted suggestions:
#1 NUXE – Baume Levres Reve De Miel Honey Lip Balm
The NUXE Lip Balm is a repairing and ultra-nourishing treatment for your lips that just glides onto your lips like a dream and makes them feel instantly soothed and moisturized.
Perfect for before-bed lip care while you’re on Accutane.
#2 Ultrasun – Ultralip SPF 30
Ultrasun Ultralip SPF 30 is a high-quality lip balm designed specifically to protect your delicate pout from the sun and its aggressive UV rays.
Think of it like this – if you are ready to protect your entire face, neck, and body from burning, why shouldn’t you do that with the most sensitive area on your face?
We often neglect our lip care and this is not something you should overlook especially while on Accutane.
The only downside I used to have with this balm is the kind of sunscreen-ish smell it has, but I soon got used to it as the most important thing for me is protection before everything else.
If it does the job – it is worth it.
What You Shouldn’t Do While on Accutane…
There are a few things people constantly seem to get confused about, and I will happily point out a few things that you should stay away from doing while on Accutane.
Exfoliating Your Skin.
First and most important.
Do not exfoliate your skin while you are on Accutane.
Because isotretinoin promoted cellular turnover, which means that extra exfoliation is not needed. Besides this, it can be harmful to your sensitive skin because it can irritate it and make it sore.
Stay Away From Waxing.
Waxing or laser hair removal is an absolute no-no during Accutane.
This is because your skin is going to become thinner and more sensitive while you’re taking the medication and waxing will pull on your skin and may potentially cause a wound.
Lasers, on the other hand, can burn your skin and may leave some unwanted spots or even areas of pigmentation.
Do Not Pick Your Nose.
While not picking your nose is generally to be avoided unless you want to raise some eyebrows around you, it is exceptionally important not to do this while you are on Accutane.
Your skin will be super dry and sensitive and picking your nose may cause irritation and nosebleeds. Apply a gentle ointment like Vaseline instead or something without a fragrance or any scent so it doesn’t bug you.
PS: We all do it, but no one ever talks about it.
So there’s that.
Don’t forget all this is temporary & it will all go away once you stop treatment.
While Accutane should always be considered as a last-resort treatment, many people have found it to be extremely helpful in clearing acne.
If you are considering starting this medication to treat your acne, please remember that it can sometimes be tough and your skin will be extra needy during this temporary process.
It is important to take care of your skin and have the best skincare routine when on Accutane to help it heal and become flawless.
Accutane isn’t pleasant, but the results are well worth the temporary side effects.
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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