If you’ve streamlined your skincare routine and tried every topical product under the sun in an effort to improve your chronic acne, but found little to no success, it might be time to talk about Accutane, also known as isotretinoin, with your doctor. For a crash course in the famous acne treatment, we enlisted a handful of top dermatologists to create a unique guide to Accutane.
From the benefits the oral medication has to offer (goodbye, pimples) to potential side effects like incredibly dry lips (you’ll need Aquaphor on hold), our expert panel breaks down everything you’ll want to keep in mind. mind before committing to the treatment of several months.
“It’s the best drug overall in terms of long-term effectiveness, but it can have significant side effects and is a commitment,” says Dr. Morgan Rabach, board-certified dermatologist and founder of LM Medical NYC.
To learn more about isotretinoin and whether it’s right for you, keep reading. With details on everything from the blood work schedule you’ll need to stick to, to the skincare swaps you need to make, Marie Claire describes every detail in our guide to Accutane, below.
What is Accutane?
Accutane is the brand name for a drug called isotretinoin, which is a high-dose vitamin A treatment in pill form. “Isotretinoin is the strongest drug we have for treating acne,” says Dr. Joshua Zeichner, board-certified dermatologist and director of clinical and cosmetic research in dermatology at Mount Sinai Hospital. “Unlike other drugs, it is associated with long-term remissions.”
Curious to know how it actually improves acne? Over the course of a few months, the treatment will permanently shrink your sebaceous glands, according to Dr. Rabach. In turn, this will lead to less oil production, fewer clogged pores, and most importantly, fewer breakouts.
Am I a candidate for Accutane?
Isotretinoin is approved for anyone over 12 years old. Although this is the baseline, deciding who should take Accutane is a more nuanced process for dermatologists. Most won’t recommend Accutane until other options have been exhausted. “A candidate for isotretinoin is anyone who has failed other oral medications (like antibiotics, spironolactone, or birth control) and has scarring,” says Dr. Rabach.
Dr. Sapna Palep, a board-certified dermatologist and founder of Spring Street Dermatology, adds that she finds the drug to be particularly helpful for those who cannot control hormonal acne. While it’s certainly common among teenage girls, she explains that she sees a lot of women in their 20s, 30s and 40s, as well as postmenopausal women, with chronic acne. In reality, a study found that 15.3% of women over 50 suffered from acne.
It is also important that anyone taking Accutane is not pregnant or trying to get pregnant, as the drug can cause birth defects and affect future fertility. Every woman on Accutane must enroll in the IPledge program and commit to taking two forms of birth control.
What are the benefits of Accutane?
While there are certainly side effects to consider (more on that later), Dr. Zeichner points out that unlike other antibiotics or creams, isotretinoin provides long-term remission for patients suffering from severe acne. “We can’t promise that skin will be clear forever, but it will certainly never be the way it was before you took it,” he says. Plus, it targets acne regardless of its location, whether it’s buttocks, chest, or face acne.
Dr. Palep also likes the treatment because patients can see active acne reduction in as little as two weeks. With that in mind, she will do her best to lighten the patient’s complexion with as many other topicals and antibiotics as possible beforehand to avoid extreme purging. “Think about it: if Accutane shrinks the sebaceous gland, it pushes out all the debris. If you’re clogged up and got all the pussy pimples [when you start Isotretinoin]it might look bad,” she said.
What are the side effects of Accutane?
Perhaps the most common side effect is very dry skin on the eyes, lips, and nose, says Dr. Rabach. This will be noticeable a few days after taking the drug. While diligent moisturizing will do the trick for some, others will need a prescription steroid cream to manage the flaking.
“In addition to dryness, the drug is associated with the development of muscle and joint pain, increased cholesterol levels and, rarely, blurred vision,” says Dr. Zeichner. Dr. Rabach adds that because isotretinoin is metabolized by the liver, it can cause stress on the organ. Therefore, it is important to reduce alcohol consumption.
There are also conflicting studies citing a relationship between Accutane and depression; however, no definitive link has been found. For a complete list of potential side effects, consult your dermatologist and visit the American Academy of Dermatology website.
How often should I see my doctor?
Considering the side effects that can accompany Accutane, monthly appointments with your doctor, as well as monthly blood tests, are non-negotiable to ensure all levels are up to snuff. Dr. Palep will also run labs a week after his patients take their last Accutane pill. “It shows me that everything looks good for them to come out. But, let’s say their cholesterol is a little high, I’ll take blood again at a three-month check-up to make sure everything is back to normal,” she says.
Will I get sunburned with Accutane?
You should never skip sunscreen (SPF 50, please), but it’s even more important to remember to lather and reapply when taking isotretinoin. “The drug can make you extremely sensitive to the sun, so it’s extremely important to protect yourself from the sun, especially if you’re taking it in the summer,” says Dr. Zeichner.
How long should I take Accutane?
Treatment usually lasts about four to seven months, but the exact timing will be decided by your dermatologist. While one cycle of Accutane will gradually improve acne, some patients will require a second cycle of isotretinoin.
It’s also possible that patients may have acne remission for years, but need to restart Accutane down the line, according to Dr. Palep.
Should I change my skin care routine on Accutane?
Dr. Rabach tells his patients to avoid any product that makes the skin more sensitive. Think benzoyl peroxide face washes, acid-type serums, retinol, and all topical acne creams. As for the products to use? Dr. Palep recommends sticking to “really simple things.” She suggests avoiding oils and serums, while looking for deeply hydrating oil-free moisturizers and gentle face cleansers.