Four years ago I got to the point where I couldn’t stand the appearance of painful cystic pimples that left scars on my face. After trying everything else, my dermatologist and I decided it was time to call the big guys, and she wrote me a prescription for Isotretinoin (formerly known as Accutane).
Isotretinoin is an oral retinoid, a derivative of vitamin A, and it is the most effective FDA approved treatment for severe lumpy acne. There are other very effective retinoids out there, but isotretinoin is still considered the most effective we have. However, due to the potential side effects (which include birth defects), it is usually reserved for more severe acne cases or after failure of other retinoids.
What side effects exactly? Well, in addition to birth defects, isotretinoin most often causes joint pain, nosebleeds, and skin changes including extreme dryness, peeling, redness, and irritation.
âIf you’re not dry, you either don’t take the drug or your body doesn’t metabolize it,â Shari Marchbein, MD, New York-certified dermatologist and assistant professor of clinical dermatology at the NYU School of Medicine, says SOI. This is because isotretinoin works by speeding up the process of skin cell renewal, which can cause that characteristic dryness, flaking, and irritation.
But after treating severe cystic acne for five years, my dermatologist and I decided it was the best option. I was delighted when my skin cleared up completely in about three weeks. Fast forward four years later, and I still have almost no acne (although I still have occasional whiteheads or hormonal pimples). So the good news is, this stuff really worked for me. Butâ¦ my whole body was so dry I felt like the physical embodiment of the Saltine challenge.
In fact, while taking isotretinoin, I had to replace my arsenal of skin care products with a whole slew of new, gentler moisturizers. Thankfully, the searing side effects faded for me within weeks of completing my last dose – I can finally leave home without a tube of Aquaphor – but the scorched earth skin fight was real.
So, if you are considering starting isotretinoin or a topical retinoid like tretinoin, I strongly suggest that you prepare yourself (and your skin care regimen) for the dryness that will ensue. Here are the products that got me through the driest times and Dr. Marchbein’s pro advice on why these products actually work for skin that is struggling with isotretinoin.
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