Odds are if you know acne, you know Accutane. Medically termed isotretinoin, the hotly debated treatment is what dermatologists call “the closest thing we have to a cure for acne.” Dr. Hadley King, a dermatologist at Skinney Medspa, says, “Accutane can be a life-changing medication for people who suffer from severe acne.” It works when all other acne treatments fail, including benzoyl peroxide, salicylic acid, retinoids, Aczone gel, oral antibiotics, hormonal treatments, chemical peels, and more.
“For severe recalcitrant acne, isotretinoin is an excellent option,” King says.
All this considered, dermatologists acknowledge that Accutane has the potential for severe side effects. Dry skin, lips, and eyes; blurred vision; and mental and emotional side effects are all on the table. “It is critical that patients are screened appropriately and followed closely while taking it,” King says.
Of course, it’s one thing to hear dermatologists’ perspectives on Accutane. But it’s another to hear from real women who’ve taken it. Because of its potential for major side effects, the drug has a controversial reputation among potential patients and skincare enthusiasts. But don’t waste your time getting lost in a WebMD black hole. Instead, read what the following Accutane users have to say.
If you’ve ever been on Accutane, considered it, or know someone who’s taken it, you’ll find the following stories fascinating.
“I had terrible skin growing up—we’re talking giant spots on my face along with copious amounts of back and chest acne. It started around the sixth or seventh grade. … I remember having such bad bacne that I was too embarrassed to wear my hair up because you could see all the blemishes. As you can imagine, that seriously effed up my self-esteem.
“Through a stringent course of antibiotics, topical creams, and the pill, my acne slowly started to go away, but never completely, and I couldn’t escape those bad flare-ups. It was my senior year of high school when my dermatologist recommended Accutane to kick my ‘moderate yet persistent’ acne. A magic pill that would finally give me clear skin? I was all over that. Dry skin and the other side effects seemed like a small price to pay.
“Accutane gets a pretty bad rap, but I had a relatively benign experience with the drug. You had to commit to two forms of birth control, and I distinctly remember deciding on birth control pills and abstinence as my two forms. Maybe it was because my mom was sitting there; maybe it was because my school had posters that read ‘Abstinence Makes the Heart Grow Fonder’ hanging up in the locker rooms, and I had approximately one hour of abstinence-only sex ed. Oh, small towns.
“I went on the drug for six months and committed to the monthly check-ins, pregnancy tests, and quizzes making sure I was taking the prescription seriously and wasn’t experiencing any mental side effects. I did notice that my skin got chapped, which I battled with tubs of Aquaphor ($13). And since I was/am so pale, wearing the highest SPF out there was something I already did. The weirdest side effect I noticed was that I could go four days without washing my hair, and it wouldn’t look greasy at all.
“My skin started to clear up—like, really clear up—and it stayed clear. That was seven years ago, and while I still get the occasional pimple around my period, my skin is basically blemish-free. Now I get compliments on my skin; in fact, it’s become one of the (physical) things I’m most confident about. I go out without any face makeup on frequently, and recently I was even on camera (HD, no less) without a stitch of foundation or concealer. But I don’t rely on the everlasting effects of Accutane; once my skin cleared up, I started to make a point to take extra good care of my skin.
I know that Accutane isn’t for everyone, but it was for me.”
— Allie, 24 (on Accutane at 18)
“I’m currently on my second round of Accutane. The first time I went on the medicine was nine years ago, when I was 15. I had horrible cystic acne that no amount of antibiotics or Retin-A topical treatments would help. I had really bad physical side effects the first time I went on Accutane. On top of the unbearable dryness and chapped lips, I remember losing clumps of my hair in the shower, even months after I was off the medication. My eyes were also always bloodshot, and people thought I was high 24/7 (I never was).
The bloodshot eyes and vision problems would also cause me to get really bad headaches.
“Accutane helped my skin stay blemish-free and absolutely clear for about a year and half. But by the time I got to college, I started breaking out again and was prescribed Spironolactone. This helped, and I was on this medicine for a few years. Unfortunately, a year and a half ago, at 23, my skin started breaking out again. For the better part of a year, I tried different treatments from estheticians who had worked in the past, but this time to no avail. Remembering the side effects I had on Accutane, I was doing everything I could not to have to go on the medication again.
But after I began avoiding social situations because I was so self-conscious of what I looked like, I had to turn to my last resort.
“I’m currently at the end of my third month of Accutane, round two. Since day one, my lips have been more chapped than ever, and no amount of ChapStick, lip balm, or ointment helps at all. I see people stare at my lips, and feel so embarrassed. It also just hurts—they’re so chapped that they crack and bleed on a daily basis.
“Since you have to be on two forms of birth control to take the medicine, I also had to start taking birth control, and that led to the worst side effect so far. The first month, I was constantly irritable and moody, would start crying for no reason, and also gained so much weight that half of my pants don’t fit anymore. It literally happened where one day, I went to put on my jeans and they wouldn’t fit over my thighs. Now, not only am I self-conscious about my skin, but I’m self-conscious about my body too.
I look at myself in the mirror and don’t even recognize the person I see.
“Since my dosage was upped this month too (I started at 40 mg per day and am now at 60 mg per day), I’ve also noticed that I’m having problems with my eyesight. Writing on my computer screen or the TV is often blurry, and no matter how hard I try, I can’t get it in focus.
“My skin has cleared up significantly this month, as it’s supposed to, though it’s by no means blemish-free yet. I have another three months to go, if everything goes all right, and I pray that it does. However, I constantly wonder, even if this does help clear up my skin, how long will it last? When I did the treatment almost a decade ago, I was told that about 30% of people have to do it twice. When I started it this time, I was told some people even have to do it three times. This terrifies me because this drug is so potent, and I don’t know the long-term side effects it could have on my body.”
— Natalie, 24 (on Accutane at 15 and 24)
“After having scarring acne almost all my life, I started freshman year of high school, and I was sick of it. I had heard good things from a friend who tried Accutane. My mom didn’t like the sound of me taking it in high school, and our family doctor at the time insisted mine wasn’t bad enough to warrant a prescription, but she is one of the few doctors who rarely prescribes anything and was being very cautious.
“Years later, after college, I finally had my own health insurance and decided to see a dermatologist about taking Accutane. I blame most of what happened on the inexperienced dermatologist who consulted me. Not only was her communication lacking, but she neglected to tell me that the drug loses its potency when you stretch it out over time. I was concerned about the negative side effects like peeling skin because I work in face-to-face sales. She assured me that if I took it over the course of a year and not six months [the standard duration], I wouldn’t experience the extreme of those effects.
So I stretched the medication out, and as soon as I stopped taking it, my acne came back! And it was with a vengeance this time.
“It wasn’t until two years later when I saw a more experienced dermatologist that he confirmed I should have taken the dose in six months if I wanted the most effective results. So my story is one of caution, and I would urge anyone interested in Accutane to pick an experienced dermatologist, start sooner rather than later, and take it all in under a year for best results.”
— Jessica, 27 (on Accutane at 22)
“I loved Accutane. I tried everything—Retin-A, tetracycline—and nothing worked. It did make my face red and peeling, but it was better than an acne face. It was such a life-changing experience after trying so many other medications. I don’t have scarring. I’m happy with my complexion today. I have four kids and would have any of them try it if needed.”
— Kelley, 38 (on Accutane at 21)
“When I decided to try Accutane, my mother warned me to be careful; she told me that it had made her ‘feel crazy’ when she used it and that she had to discontinue it. I didn’t care. My acne had progressively gotten worse after I had my son at 18. Now I was 21 and in cosmetology school and felt that having clear skin was a must.
“I had a positive experience with the medication itself—none of the ‘craziness’ my mother experienced, no dryness, no issues with my hair, and my blood work was always fine. The worst part was getting on Accutane. Between getting on birth control, having blood work done, and the Accutane waiting period, it was about three months before I could even begin.”
— Marissa, 27 (on Accutane at 21)
“Accutane is scary. I have no idea if they still do this, but you get giant packs of pills that have a picture of a baby with the circle and a line through it on the back of every single pill. They are serious about the fact that you cannot get pregnant on Accutane. You also go on birth control immediately and have to get a full-on blood test to make sure you aren’t pregnant every single month. … It was no joke. You also aren’t supposed to drink on Accutane, but since I was 18, that lasted all of about two days.
“Overall, Accutane was an amazing drug. It cleared my skin up, and it did it fast. It just made me stop producing oil. I could go a week without washing my hair, which was never possible for me before. It was such a confidence booster. I remember looking in the mirror and thinking, Wow, my skin looks good. It became addictive in a sense. I wanted to be on Accutane forever when I started out.
“With all the good, there are obviously side effects. Accutane messed with my emotions. … It also ruined my stomach. I became so sensitive to certain foods that I actually ended up in the emergency room one night. At the time, nobody knew what was wrong with me. … I finally saw a gastroenterologist, and they said I developed a gluten sensitivity. My body has a hard time breaking down gluten now because it has been stripped of all my good bacteria.
“Do I regret being on Accutane? I honestly have no idea. I go back and forth. I can’t say for certain if anything else could have cleared my painful cystic acne like that drug did. Let’s be honest—it hasn’t been smooth sailing since then. I have since gone to maintain by sticking to daily Aczone gel and prescription benzoyl peroxide for breakouts. But it did the dirty work to get my skin to a great place. For those who suffer from acne, I do think it is life changing. I just really wish I could eat a bagel.”
— Teona, 31 (on Accutane at 18 and 24)
Do you have a personal experience with Accutane? Tell us about it in the comments below!