accutane journey week by week

My 8-month Accutane journey with side effects and results

Following is transcript of the video.

Celia: As many of you know, I've been struggling with a really bad hormonal acne breakout for a year and a half. In recent videos, I let you know that I was on Accutane, and I actually was on it for eight months. And now I have been off for a little bit over a month. In November of 2019, my skin got really bad, and I could not figure out why. It was the worst it had ever been, so I eventually decided to go on Accutane. It was hormonal, so there were deep, painful cysts on the sides of my cheeks. It hurt to wash my face, to put on makeup, and it was really taking a toll on my mental health.

My Accutane experience started in October of 2020. I found a dermatologist in my area that I knew prescribed it. What makes me a good candidate for Accutane?

Holly Dimura: So the fact that you have moderate to severe cystics, the fact that you're getting cysts. I don't jump to Accutane when someone comes in with just a few little pimples here and there. So we have more cystic acne right here. Those are going to be the harder ones to clear because there's more contents in there. These little pustules here will probably clear up first. And then even the comedones, which are these, they're a little white. And if you look at it close, you can see they have like little black dots in them as well. Those are open and closed pores. And those take, I would say, a little bit longer as well, because they really have to dry those oil glands up.

Celia: Something to note about being on Accutane is that you need to get a blood test every month. If you are a person with a uterus, it's really important that you don't get pregnant while on it. So you also need to get a pregnancy test every month and be on two forms of birth control. It's time to take the first pill. Directions for opening. Child-resistant package. There we go. I felt like I started seeing a difference in my skin within a month or two of starting. Obviously it wasn't drastic like the difference I see now, but I could definitely tell that some of my cysts were starting to heal.

While on Accutane, I used a very simple skincare routine, which was recommended by my dermatologist. I used Cetaphil gentle cleanser and Cerave moisturizer. I would say my worst side effects were dryness, sweating, and body soreness. I got eczema for the first time. I had dry itchy patches all over my body. I actually had to be prescribed a cream for it. I got terrible sores on the sides of my lips that hurt when I ate or opened my mouth at all. I always said to have ChapStick on me, and it had to be Aquaphor or Vaseline, or it didn't work. I had multiple nosebleeds a month because my nose was so dry. I would groan getting up from a chair or a couch. I had constant lower back pain and it was really hard for me to work out. One of the most terrible symptoms that I had never heard of before was sweating. I swear I have never sweat more than I did on Accutane in my entire life. My upper lip sweat, my eyebrows sweat. Even though I was having all of these symptoms, I was seeing results. So that made it worth it for me. I actually haven't had a pimple in about three months. My skin is doing great. I was just so happy. Like, if you've had acne before, you know that it really is a struggle, and it definitely takes a huge toll on your mental health. So I'm just really happy that I saw a difference with something. And I feel, I just feel really good. Since I still do have scarring and redness, I'm going to talk to Dr. Fatima Fahs about my results and what I can do to help reduce them.

Dr. Fatima Fahs: Well, first of all, congrats on being done with Accutane. It is a journey, and I always tell my patients like, Accutane is no joke. But clearly your results speak for themselves. So it looks like in your after photos, I can see that your acne has definitely cleared up significant. I do see a combination of different types of scarring, both post-inflammatory hyperpigmentation, which is just the surface dark marks on top of the skin, as well as the combination of those rolling scars along your cheeks, and a few little tiny ice pick scars towards the inner part of your cheek. So the very first thing, especially when you're fresh off Accutane and you're like, "OK, let me think about my routine and what am I going to get into place?" I always tell my patients that you must, must, must have a sunscreen on board that you love. And probably the No. 1 after sunscreen would be using a topical retinoid. So in terms of in-office treatments, one would be in-office microneedling, which is an amazing treatment. I love lasers or microneedling for this type of rolling scarring that we're talking about. For the little ice pick scarring, there's a procedure we do in the office oftentimes called TCA Cross. This is a specific type of chemical peel where we drop a very high percentage of an acid directly into those tiny little ice pick scars. And it, again, helps to slough that layer off and almost fill it in over time. So isotretinoin, or Accutane, is pretty much the closest thing we have to a cure for acne. But it's really not a one-size-fits-all treatment. And a lot of patients do end up needing topical, or sometimes even oral acne treatment after they've completed their course.

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My Accutane journey and experience with isotretinoin

I’ve been super open during my accutane/roaccutane treatment in early 2020 on my Instagram and wanted to share more details here too.

A few comments before I share my journey, please talk to your derm or specialist if you think you are eligible for isotretinoin/roaccutane. I can only speak for myself and share my personal experience.

Roaccutane is a VERY powerful drug. It makes your skin dry, your joints painful, dries out your pores/sebum, can create teratogenesis (defects in embryos) and can mess with your mental health, if you have a mental health history (I do). It’s not something to be taken lightly. Any form of Vitamin A should NOT be taken when trying to conceive, or while pregnant/breastfeeding and you shouldn’t get pregnant while on the medication. So monthly blood tests (to check your liver is working well) and pregnancy tests are essential. These are normally administered by your doctor depending on where you get this prescribed.

I got it prescribed in Greece but then had to do my blood tests, so my GP in London referred me to a dermatologist via the NHS, which is normally a very long process. While I’m incredibly grateful to get a referral so easily (for some people it takes months), I really hated going to the doctor. It felt impersonal and he didn’t take my mental health seriously. He even said “if you’re not suicidal it’s fine”, which is INCREDIBLY insensitive. Thankfully I have the support to take these comments lightly. As I mentioned in one of my monthly updates (below), my mental health was seriously affected. I have a history of depression and anxiety, which might be the reason why, but please don’t treat your mental health lightly when on the medication. It’s hard to know how much it’s really affected you, but it’s better to be careful and take note than not.

If you need support please speak to someone. If I can help, message me. Now let’s get on the monthly overviews, I started on 40mg.

Essentials while on roaccutane

SPF50 DAILY

Loads of hydrating products

Gentle cleansers

Lip balm! The only thing that ended up working for me was nipple cream (pure lanolin). Check you’re not allergic first! I didn’t really wear lipsticks, occasionally tinted lip balms.

I mention a lot of Cerave, because they are gentle, non-irritating and get the job done! If you shop via Look Fantastic, remember I have an (affiliate) discount on many brands, use LFTFFANI here . Check out my full routine and dermatologist’s recommendations on the piece I wrote for PopSugar HERE .

A good thing to remember: spots get worse before they get better. That’s normal! Don’t freak out, please! Believe me I know it’s hard and it can take a toll on your mental health.

Month 1 on isotretinoin

A bit of peeling and itching started after 7 days. I somehow thought it would be a good idea to fake tan! Patchy skin hello. With some extra layers of my face cream the peeling was under control.

By week 2, I was itchy all over my arms, legs, and thinking it might be connected to the medicine. I ensure I use body cream nightly to combat this. I have also started to get dry eyes, which can also happen. I’ve been using sparingly an eye gel that’s very potent and apparently the only one that works in such a situation.

Within week 3 and 4, breakouts were going down, no new spots, not too much dryness. I had my first appointment with a dermatologist who discussed upping my dose next month. As dosage depends on weight, you can go up as long as a doctor suggests so.

Comparing my starting point with the end of month 1: my skin might not look clearer, but it certainly is. The reason for that the medication will bring *every*single*spot* to the surface, before the skin clears up.⁣ The thing is, I don’t mind this part of the treatment, maybe because I knew it was coming. The first time I went on this medication (in 2011) I wasn’t expecting it and it really affected my mood, psychology and mental health.⁣ ⁣ I’ve had my first blood test now, and seeing the doctor end of the month. After that the blood tests need to be done every 3 months, or sooner if the dose is increased. The reason for that is the liver processes the medication and it needs to be monitored to ensure everything works well. ⁣

A quick mention on the cost of accutane/roaccutane. Via the NHS each prescription cost me around £9, these were normally monthly prescriptions. If you are in the UK and don’t pay for prescriptions, you won’t have to pay for this one either. As a comparison, in Greece, each pack of 30 tablets costs €9+ depending on the pharmacy.

Month 2 on isotretinoin

Month 2, I developed acute dermatitis (itchy rash) on the side of my arm. I reluctantly removed all jewellery (there was loads) and reminded myself to ACTUALLY moisturise my whole body every day. The cold in London does not help the situation here! Every sebum gland will dry up so taking care of your body is essential.

This month I’ve really noticed the drying, but not of the skin, lips mainly and the cold doesn’t help. But also my nostrils are so dry I almost get nose bleeds – I’ve got a moisturising nose spray that helps. My eyes have felt watery for weeks and I put drops a couple of times during the day. I’m not wearing lenses which would make it worse but they feel really dry as it is.

On month 2, I’ve been really thinking about the mental health aspect of roaccutane. I had a great chat with  @raquelsmx  on the subject who suggested I keep track of how I’m feeling each day particularly the “low” days. Not gonna lie, it feels like they’ve been loads this month but can’t be sure it’s down to the medication or a combination that includes the weather, work, etc. If you’ve felt the same please message me! It’s simply not discussed enough!⁣

This month I saw the derm who upped my dosage to 50mg. The higher the dose, the worse the effects – so a little more drying than before etc. But you also finish the course quicker.

Month 3 on isotretinoin

Apart from two spots on my right cheek not much has changed and last month’s breakouts are healing.

No major issues with the 50mg dose. BUT – My lips have been drier than before but I haven’t been as good with applying lipbalm through the day and I’ve also been picking the dry bits when I was feeling stressed which isn’t the best! Nostrils and eyes are good. I still apply eye drops but not as religiously as last month (4 times a day). ⁣

Mood wise I’m not in the best space of mind but let’s be honest, the whole corona situation isn’t the best for anyone’s mood so I wouldn’t be able to say if this has anything to do with the medication. ⁣

My muscles and joints (especially around my ankles) are still sore every day, constantly, but I feel it the most the moment I wake up and take the first steps. After that I get used to it and I think I’m more use to the general soreness. ⁣I free like a grandma!! I randomly found out my collagen protein helped me with my muscle pains!

Month 4 on isotretinoin

A full month of quarantine (hey corona) and in mid-April I was told I can’t get another prescription. I know there are more important medications that people need and prescriptions that are life saving – BUT – I didn’t feel it was fair to cut my roaccutane course in the middle, with NO warning. The dermatologist told me that since the 27th of March they’ve stopped roaccutane prescriptions, they don’t know for how long. I know he probably has hundreds of patients, but I feel like I should have been informed at the end of March and not mid-April, a week before my current prescription finished. He said private derms can still give prescriptions, otherwise I should split up my medicine and make it last longer. So instead of 50mg a day, I should do 40mg. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⁣ He also said my GP would prescribe me a cream – adapalene (a retinoid, which I’m very familiar with) to use topically. Obviously it’s not the same thing. I’d then have to go back to 20mg and slowly increase and my treatment would take longer, instead of being done in June. ⁣ ⠀⠀⠀⠀⠀⠀⠀⠀⠀⁣ He didn’t tell me why they can’t give prescriptions. After a lot of stress I managed to receive some from my mum from Greece. While waiting I had to split up the pills I had, so for about a week I was taking 20mg and the last few days 10mg a day.⁣

Joint pain remains and it’s a little worse. It could be because I’m exercising a bit more than usual. My nose has been unbearably dry!! Some days it was so painful and dry that it was bleeding. I think it’s due to hay fever and blowing my nose. Applying cream every night helped. ⁣My pigmentation is better this month, but the focus is of course on spots first, then pigmentation!

Month 5 on isotretinoin

Because of the prescription issues last month, I was on 20mg for a few days before going back on 50mg. Going back on 50mg made my joints and muscles more sore for a few days. Now I’m back to the “normal” level of joint pain, which I feel mostly around my ankles when I stand up after sitting down for a long time.

I’ve changed derms though not sure how, my initial doctor ghosted me. He never showed up for my monthly appointment (done over the phone) but in the meantime I had an appointment with a different doctor at another hospital. She asked me to come in the hospital as I had to sign 3 different forms to ensure I understood that I shouldn’t get pregnant etc etc, to have a blood and pregnancy tests and get my prescription.

She said I got 2 full months to go, I thought it would be less, but essentially I’ll be done in mid-July. Hay fever isn’t helping my nose dryness but some days are better than others!

Month 6 on isotretinoin

In theory I’m done this month, completing my full dose towards the end of July (on the 22nd). ⁣I didn’t think my lips could *be* any drier (in Chandler’s voice) and as much as I LOVE the sea, it doesn’t help one bit! ⁣

I now have to apply lip balm even more often and you might be able to see my lips have bled. Fun times. ⁣

Other than that I haven’t noticed any changes this month. I can’t wait to finish as I’m pretty certain it’s negatively affecting my mood and thoughts and overall mental health. ⁣

Also I got only one new spot, which I was quite surprised by, as I wasn’t meant to be getting new ones now. I’m thinking the sea/salt/spf combo is to blame but who knows 🤷🏻‍♀️

Since I’m back home, I’ve planned to see my dermatologist (the one who initially prescribed the medication) and I’m hoping she agrees I’m almost done. I also have a phone appointment with my London dermatologist towards the end of the month, though I’m not sure how she’ll be able to decide if I need to stop or not, without seeing me.

Final month on isotretinoin

Happier, glowier, a new spot has popped up the day I was finishing my medication but thankfully my doctor said it’s fine and no need to take any more!

As I said last month, my lips were suffering!! You can see the blood on the left photo (From July). The only thing that helped was pure lanolin from the pharmacy which is often used for sore nipples!!! Well it worked a treat.

Nostrils also super dry. I don’t wish this upon anyone! So uncomfortable. ⁣

I had someone ask me about my joints and I think they are much better, not as sore and painful as in the past few months. They still hurt a bit (especially my ankles) when I stand up after a long period of sitting. ⁣

My mood is certainly better but I know for a fact it’s because I’m back home in Greece that I’m overall happier. Try it! 100% money back guaranteed ⁣

As you can see in the close-ups my pigmentation around my mouth is getting better. That stupid mark next to my nose is SO slow to fade, but otherwise, it’s all good.

• accutane , accutane before and after , accutane experience , accutane for mild acne , accutane journey , accutane on mild acne , accutane results , accutane review , accutane side effects , accutane tablets , accutane uk , acne treatment , isotretinoin , isotretinoin experience , isotretinoin side effects , isotretinoina , roaccutane , ukbeautyblogger , ισοτρετινοΐνη , ισοτρετινοινη

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BHSkin Dermatology

Dermatologist – Glendale | Encino-Tarzana

The Complete Accutane Before and After Guide: How to Get the Most Out of Your Acne Treatment

You may have heard of Accutane —an oral isotretinoin formulation prescribed for pimple treatment—both from gushing celebrity advocates and media naysayers. And now, you’re probably wondering if you should give it a try after a string of failed acne regimens.

Does Accutane really work, or is it just another overhyped showbiz fad? More importantly, is this medication safe for you?

In this article, I shall explain the benefits and risks of Accutane treatment and what you can expect during therapy. But before you can judge whether or not the drug works, you need to understand a few things about acne formation.

How Does Acne Develop?

Acne is the inflammation of the pilosebaceous unit—the part of your skin made up of the hair follicle and oil (sebaceous) gland. Its most common triggers include stress, hormonal changes, medications, poor hygiene, bad food choices and many others. When any of them is present, the following chain of events may occur:

Follicular Overgrowth

Factors that can cause cellular overgrowth inside the hair follicle include:

• Hyperactivity of androgens or testosterone-like hormones
• Reduced body levels of linoleic acid, a fatty acid people can only obtain from the diet
• Immunologic changes

The excess cells do not only grow fast, but they are also unusually sticky. The hair follicle has limited room, so cellular overgrowth can easily clog your pores and make them swell from debris and oil buildup.

Excess Sebum Production

Sebum is the skin’s oily secretion. It minimizes moisture loss from the skin and protects it from microbes and oxidative stress. Excess sebum production is often due to hormonally induced sebaceous gland dysfunction.

Increased Bacterial Activity

Sebum contains a type of lipid called “triglycerides.” Triglycerides are food for Propionibacterium acnes , a normally harmless skin inhabitant. P. acnes bacteria multiply fast when it’s raining triglycerides. The microbes and their waste products irritate the skin.

Inflammation

All of the above changes lead to pressure buildup inside the hair follicle and subsequent inflammation. The lesion can grow and rupture, causing acne.

Hormonal changes make teenagers acne-prone, but the condition can afflict people of any age, including babies.

How Do BHSkin Dermatology Specialists Get Rid of Acne?

At BHSkin Dermatology, we have a vast anti-acne arsenal , which includes the following:

Medicated Cleansers

Cleansing the skin twice daily minimizes impurities and oil buildup. Antibacterial cleansers inhibit bacterial growth. Cleansing is the gentlest approach to acne.

Topical Drugs

Topical medications like benzoyl peroxide, erythromycin and clindamycin have antimicrobial action. Some, like azelaic acid, can clear up your pores while getting rid of bacteria.

Systemic Antibiotics

We may prescribe oral antibiotics if patients don’t respond to topical treatments. Minocycline and clindamycin—two of the most commonly prescribed acne-busting antibiotics—also prevent oil accumulation in the skin.

Hormonal Therapy

Some individuals are prone to hormonal acne or breakouts caused by androgen fluctuations. These patients may benefit from anti-androgenic medications.

Diet Modification

Chocolate, milk, sweets, and fatty meals have all been implicated in breakouts, although the link between acne and food is not entirely clear. Still, adequate hydration and a healthy diet never hurt the skin, so we encourage our patients to make better food choices consistently.

Acne Surgery

This procedure removes blackheads and whiteheads to prevent severe acne. 

Intralesional Glucocorticoids

Steroids injected into the skin curb inflammation in big, nodular acne.

Phototherapy and Lasers

UV radiation targets P. acnes and reduces skin inflammation. Laser treatment and photodynamic therapy get rid of abnormal sebaceous glands.

Systemic and Topical Retinoid Formulations

Retinoids are vitamin-A-like molecules that can work wonders on the skin. Topical retinoids include tretinoin and adapalene. Isotretinoin can be used topically or orally. Accutane is one of several oral isotretinoin brands.

The above acne treatments work in different ways, so their efficacy and safety also vary. Your dermatologist may recommend the mildest therapies first but will consider aggressive ones if you fail to respond.

How Does Accutane Work?

Accutane is a brand name of oral isotretinoin. It works at the genetic level to:

• Normalize cell growth and function in the hair follicles and oil glands.
• Prevent clogged pores.
• Modulate your skin’s immune response.

Moreover, isotretinoin has antimicrobial action against P. acnes , which is vital if the strain has become resistant to conventional antibiotics. We recommend this medication for various acne types because it thwarts all the stages involved in acne formation. In contrast, other pimple treatments inhibit only one or two stages.

As previously mentioned, isotretinoin is also available in topical form. In our practice, we sometimes combine both oral and topical treatments to reduce the patients’ systemic exposure and risk of developing unwanted side effects.

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What should you expect when taking accutane.

Oral isotretinoin treatment is highly effective against acne and a myriad of other skin problems. However, many find the experience uncomfortable or too restrictive. Here is a list of the things you can expect when taking this medication.

Timeline of Effects and the Chance of Accutane Purge

In the first 2 weeks, your skin will start to feel less oily. Before your first month of treatment ends, you may experience a paradoxical acne flare, termed colloquially as “Accutane purge.” Skin purging looks like acne exacerbation. That is why you hear some Accutane patients saying, “It gets worse before it gets better.” 

The cause of the Accutane purge is unknown. Patients with deep lesions or those with a size greater than 1 mm are especially susceptible . However, it may be related to skin hypersensitivity to dead bacterial debris released during the early stages of oral isotretinoin therapy. Another possible reason for its occurrence is the drug’s action itself, as it induces the pilosebaceous units to shed abnormal cells and replace them with better ones.

At our clinic, our options for treating these flare-ups include careful dose adjustment, gentle cleansing, oral steroids, antibiotics and photodynamic therapy . 

After 1-3 months, you should see your skin becoming clearer. From 4 months onwards, isotretinoin will continue to block acne formation. The usual duration of therapy is 4-8 months.

Isotretinoin continues to work for up to 2 months after your last intake. At our clinic, we may stop the prescription without waiting for the patient’s skin to clear up totally to ensure they avoid unwanted side effects.

Potential Side Effects

The most frequent adverse effects of Accutane treatment are skin tightness, redness and peeling. With the purging of oil glands, you may also observe dryness of the skin, eyes and other mucosal surfaces. Photosensitivity and hair and nail changes are also common.

Systemic side effects are likewise linked to oral isotretinoin therapy, but they are either rare, preventable or manageable. They include:

• Severe birth defects, because the drug crosses the placenta and also acts on the baby’s genes
• Increased vulnerability to Staphylococcal infections due to lower sebum production
• Muscle, bone or joint pain
• Pseudotumor cerebri, a benign condition where the pressure inside the skull rises. Symptoms include blurry vision, nausea and headache. It can develop if one takes Accutane with a tetracycline antibiotic like minocycline or doxycycline.
• Pancreatitis and fatty skin growths (xanthelasma) due to elevated blood triglycerides
• Exacerbation of inflammatory bowel disease, particularly ulcerative colitis
• Elevation of liver enzymes due to inflammation
• Clotting problems that can increase the risk of spontaneous bleeding

Some may think that the drug causes suicidal thoughts, but there is no strong evidence connecting psychiatric illness to Accutane intake. Meanwhile, acne itself can affect people socially and psychologically, so many patients are prone to depression and other mental health issues.

As a medical practitioner, I believe that awareness of a treatment’s potential risks protects patients. Hence, the inclusion of oral isotretinoin’s side effects in this discussion. However, that doesn’t mean you should avoid this medication if it’s what you need to treat recurrent acne. If you’re seeing a licensed medical professional for oral isotretinoin therapy, you’re also protecting yourself from the drug’s potential risks.

Accutane Before and After: How BHSkin Dermatology Providers Manage Oral Isotretinoin’s Risks

After a thorough evaluation, we walk our patients through various aspects of the treatment. We explain the proper intake of isotretinoin capsules and what they need to do to optimize their benefits and minimize risks.

Besides patient education, we also ensure the patients are rendered the following services during therapy:

• Patient screening—oral isotretinoin is very effective, but it’s not for everybody. We typically recommend another form of acne therapy to prevent aggravating a pre-existing medical condition.
• Pregnancy testing and birth control—female patients will have regular pregnancy tests before, during and after the treatment. They are also required to use two forms of contraception. Birth control pills are safe to take alongside Accutane. Male patients must also use contraception during therapy because a small amount of isotretinoin ends up in the semen.
• Recommend emollients for flaky or dry skin, lip balm for chapped lips, and artificial tears for eye dryness
• Prescribe antibiotics for superficial infections
• Adjust isotretinoin’s dose
• Blood testing as needed
• Avoid prescribing medications known to have unpleasant interactions with isotretinoin
• Discontinue the treatment, if necessary
• Work with other specialists, if necessary
• Assessing the cosmetic results—we monitor the patient’s progress to know when to stop therapy.

Importantly, we remind our patients to stay on top of their follow-up appointments during Accutane therapy.

What Should You Do to Ensure the Success of Your Accutane Treatment?

One thing to prioritize before starting oral isotretinoin therapy is registering for the iPledge program. This is a web-based pregnancy risk management program for individuals on Accutane or those planning to take it.

The iPledge website has a list of requirements for both male and female patients. In a gist, they all involve strict protocols for preventing pregnancy during Accutane treatment and vice versa.

An Accutane prescription is good for only a month. Patients need to satisfy iPledge requirements—a negative pregnancy test and declaring two birth control forms—before they are given another.

Aside from iPledge participation, patients must also do the following:

• Take Accutane pills as instructed by their physician.
• Wear sunscreen when going outdoors.
• Take the necessary blood tests.
• Schedule regular consults with their healthcare provider.
• Inform their physician of any problems.

Severe complications and unexpected pregnancy can set patients back from their treatment goals, but these recommendations help ensure better outcomes.

What Should You Not Do While on Accutane?

It’s best to avoid the following during the treatment course to prevent complications:

• Smoking—the combination of isotretinoin and cigarette consumption increases lung cancer risk . Also, smoking releases chemicals that are bad for the skin.
• Drinking—alcohol augments the drug’s liver toxicity. The same goes for liver-damaging medications like methotrexate.
• Blood donation—isotretinoin stays mostly in the blood, and no one would want it accidentally transfused to a pregnant woman.
• Phototherapy, lasers and harsh chemical treatments—isotretinoin sensitizes the skin to the effects of these therapies.
• Taking Accutane without medical supervision—as previously mentioned, we physicians make sure that your treatment works and remains safe. You can buy the drug online, but taking it without medical supervision can lead to dire consequences.

When I take my patients’ medical history, I make sure to ask if they have other health concerns. There’s a long list of drugs that do not work well with Accutane, and one of my roles as a physician is to help them determine which ones to avoid.

The Accutane treatment experience has its ups and downs. However, patients can reduce these hassles by working closely with a medical specialist.

Will Your Acne Come Back After Accutane Treatment?

Acne disappears completely after one treatment course in about 85% of patients. The rest need a second course. The period of remission takes years for most.

Does Accutane Make You Gain Weight?

Accutane changes your body’s lipid composition, but there is no clear link between weight gain and intake of this drug.

Should You Take Isotretinoin for Mild Acne?

Some cases of mild acne may be treated right away with this medication. You may discuss this option with your dermatologist. In my practice, a low daily dose or alternate-day dosing regimen works well for patients with mild acne and in whom oral isotretinoin is not contraindicated.

Does Isotretinoin Cause Cancer?

What is known today is that isotretinoin does not increase the risk of skin cancer in humans. In fact, retinoids can protect you from this condition. They stimulate the formation of skin cancer protectants and modulate the immune system. Moreover, isotretinoin has been used to boost the effects of cancer drugs against other tumor types.

What Do BHSkin Dermatology’s Patients Say About Our Acne Treatments?

Here are some of the things patients say about our clinic’s acne treatments:

“I can’t say enough good things about Dr. Don Mehrabi and the entire BHSkin Dermatology staff. The products they prescribed have worked some incredible wonders, and I have had a very long, severe case of acne. I highly, 100% recommend this clinic.” 〜 Jared H.

“ I took my son to see Dr. Mehrabi for his acne. Dr. Mehrabi took his time and examined my son, and he is extremely knowledgeable. We have been to other dermatologists, but Dr. Mehrabi earned our confidence easily. He looks very young, but he knows what he is talking about.” 〜 Jacklin J.

“I went to Dr. Mehrabi for his laser and acne service. My face was full of little brown spots since I was born, and he removed them all without leaving any scars. Also, for years, my face was full of white heads that would not disappear. They never came back after I started using the skincare regimen he prescribed. Now, all my family goes to him for any skin problem, and I refer him to all my friends.” 〜 Parisa N.

The Case for Oral Isotretinoin Is Strong

An ounce of prevention is worth a pound of cure. And when it comes to preventing acne scars, nothing beats Accutane treatment. Just remember that you have to take it with caution and work closely with a licensed medical professional during therapy.

And as always, the best partner you can have on your Accutane journey or any skin health need is a board-certified dermatologist .

Having Clear Skin Doesn’t Have to Be Convoluted Guesswork

You can have acne at any age, but you don’t have to put up with the scars. Accutane treatment can help. For head-turning, pimple-free skin, choose only LA’s most trusted dermatologists at BHSkin Dermatology. Visit us at our Encino or Glendale clinic or use our virtual portal for a remote consultation.

Book your appointment today!

• Chien, A. L. (2019). Chapter 185: Retinoids. Fitzpatrick’s Dermatology (9th ed). McGraw Hill Education. https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210442555
• Goh, C. et al. (2019). Chapter 78: Acne Vulgaris. Fitzpatrick’s Dermatology (9th ed). McGraw Hill Education. https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210419885
• Hunsu, V. O. et al. (2021, July 20). Retinoids as Chemo-Preventive and Molecular-Targeted Anti-Cancer Therapies. International Journal of Molecular Sciences. 22. https://doi.org/10.3390/ijms22147731
• iPLEDGE. Safety Notice. Retrieved October 4, 2023, from https://ipledgeprogram.com/#Main
• Layton, A. (May-June 2009). The use of isotretinoin in acne. Dermatoendocrinology. 1(3). 162-169. https://doi.org/10.4161%2Fderm.1.3.9364
• Lee, J. J. et al. (2010). Mortality in the Randomized, Controlled Lung Intergroup Trial of Isotretinoin. Cancer Prevention Research. 3(6). 738-744. https://doi.org/10.1158/1940-6207.CAPR-09-0124
• Liu, J. et al. (September 2022). Acute acne flare following isotretinoin administration successfully treated by 5-aminolevulinic acid photodynamic therapy. Photodiagnosis and Photodynamic Therapy. 39. https://doi.org/10.1016/j.pdpdt.2022.102893
• U.S. Food and Drug Administration. (2002, June 20). Accutane. Retrieved October 4, 2023, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2002/18662s051lbl.pdf
• U.S. Food and Drug Administration. (2021, October 12). Isotretinoin Capsule Information. Retrieved October 4, 2023, from https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/isotretinoin-capsule-information

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online

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My Accutane Journey: Week 2 | Dizzy spells, redness and dry lips

Week two on Accutane brought about a few stronger side effects. It’s easy to forget just how powerful this drug is when you think it’s just two small pills that you’re taking daily. I want to give a really honest account of the side effects that I feel along the way, but I think it’s important to point out that so far, nothing has been unbearable at all. In fact, I’d go as far to say that the side effects so far have just been mildly inconvenient and extremely easy to manage. With that in mind, let’s get into the weekly breakdown…

Day 8 I woke up on day 8 of Accutane with horrible knee pain and of course, dry lips too. The joint point was that horrible that it actually made me feel a little sickly right at the back of my throat. You know, that kind of sickly feeling you get when you stub your toe? It was that kind of sickly. I’m glad to say that it wasn’t constant so getting on with my day wasn’t a problem at all. I’ve also noticed that I keep having weird dizzy spells still and getting quite breathless with heart flutters. They last around ten minutes or so and make me feel quite panicky. I’ve had them before – way before Accutane, so who know what the real cause is.

Day 9 Day 9 was much easier with the joint pain. I started taking a couple of Ibuprofen and Codeine together (Nurofen Plus) which helped massively. I started to get a really bad headache today, but honestly, I get headaches as it is so I can’t pin that to the Accutane.

My Accutane Journey: Week 2 | Dizzy spells, redness and dry lips | Rachael Divers

Day 10 Had the mother of bad headaches today, Sickly, sensitive to light and completely dizzy! I took to wearing my Migracap which offers a massive relief and taking my Nurofen Plus. Again, I can’t pin this to  Accutane because I get bad heads quite often as it is.

Day 11  On day 11, the only side effect I really still felt was dry lips which I’m sure will be present throughout. I find that I can’t be without my lip balm for less than a minute (I’m not even joking!) without my lips feeling dried out and uncomfortable. They’re not actually dried out in the usual sense as in cracking or rough, but they feel like there’s a layer over them constantly that’s going to peel away. Imagine you’ve put one of those peel off face masks on your lips and that’s exactly how it feels but without being able to see or actually peel it. It’s very bizarre but I can definitely deal with it. And on the plus side, I can still wear my lipsticks as long as I pair them with some balm or a gloss.

Day 12 Nothing new on day 12, simply dry lips which I can certainly deal with.

Sometimes my skin can feel painful and inflamed, especially after cleansing | My Accutane Journey: Week 2 | Dizzy spells, redness and dry lips | Rachael Divers

Day 13 I’ve noticed for a few days now that my face looks a little red but I simply put it down to not feeling so well and having a hot flush. After noticing it even more throughout today and doing a little reading, I’ve noticed it’s actually a side effect of Accutane! I’m not sure why it happens, but it’s very bizarre as it’s just around my face and nowhere else at all (you’ll be able to see the red tinge to my face in the photograph). Very strange but nothing a little makeup can’t fix. Additionally, my skin around my chin and mouth has started to peel a little today but nothing major at all.

Day 14 Nothing new to report today, just the standard dry lips and flushed skin. Although Accutane is an extremely serious and powerful drug, I’m happy to say that I’ve been able to adjust to the side effects so far. I know I’m in for a very long journey yet, but I think listening to your body and taking things slowly is key – along with moisturising lots and really taking care of your skin along the way.

I’m documenting my Accutane journey monthly over on my YouTube channel which you can find by clicking here . Hit the subscribe button so you don’t miss any videos if you’d like to keep up with my journey.

© This post is copyright of Rachael Divers 2017.

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What I've Learned From Taking Accutane—For the Second Time

In This Article

I am just about to finish my sixth month of Accutane, medically referred to as Isotretinoin, for the second time. You read that correctly, this is not my first time going through the motions with the drug often referred to by dermatologists as the “ closest thing we have to a cure for acne .” Like many others, this initial appeal is what drew me in at first. It sounded like something that was too good to be true, and in a way, it was.

My First Experience

My first go-around with Accutane began around two years ago in July 2018. At the time, I was still in college, about to begin my senior year, and eager to finally have somewhat clear skin. My dermatologist started me off at the lowest dosage, in order to get my body acclimated with the medication during the first month.

I went into this process having only heard personal stories from friends, some of them even having to take it twice (yikes, I thought). Prior to actually getting my prescription, I had gone through extensive preparation and education through my doctor.

Basically, when you go to your dermatologist and say you want to go on Accutane, a few things happen. First, you’re only allowed to even begin the process after having tried several other forms of acne treatment. In the years prior, I had been on minocycline, doxycycline, birth control, and other topical treatments to no avail.

Then, once they formally determine you are indeed an eligible candidate, you have to take a blood test, which you’ll continue to do every month. Next, they’ll get you set up in their iPledge system, which creates an online profile to answer any questions after your monthly dermatologist appointment. These questions cover the basics, ensuring you’re using two methods of birth control (due to the severe birth defects Accutane can cause), confirming your knowledge of the process (you have to pick up your prescription in a matter of five days), etc. This also has to be done every month.

During your monthly appointment, your doctor will evaluate your progress and ask if you’ve experienced any side effects. These include but are not limited to dry skin, headaches, joint pain, vision problems, moodiness, and depression. It’s not a fun time. From there, they’ll determine whether to keep you on the same dosage, increase it, or decrease it upon evaluating the condition of your skin. Once this is decided, they’ll call your script over to your pharmacy and your pharmacy will fill it once you’ve completed your online questionnaire.

I traveled back and forth once a month on the bus for the entire school year. I dealt with having my bloodwork done at a lab in New York and sent back to Rochester, coordinating to make sure everything fell within the proper five-day time frame, the financial issues related to these visits—the works.

Throughout this entire journey, I ran into several problems—not even just with the medication itself. I was going to school in New York City, but I lived upstate in Rochester, which is six-hour drive away. During the time I was completing my first dosage, the rules pertaining to the monthly doctor’s appointments had changed. The new rules required in-person visits and no longer allowed for virtual options, presenting me with a huge problem.  

I considered my options: I could either go home once every month to do what was medically required of me, or try to find a dermatologist. I did some research, and unfortunately found my insurance did not cover out-of-region specialists. So, I had to go home. I traveled back and forth once a month on the bus for the entire school year. I dealt with having my bloodwork done at a lab in New York and sent back to Rochester, coordinating to make sure everything fell within the proper five-day time frame, the financial issues related to these visits—the works.

There were times that I would even skip class because I was simply too embarrassed to show my face in front of my peers, who all seemed to have missed this stage in life, or at least weren’t dealing with it like I was.

On the physical side, I was a wreck. The second month was hands-down the worst of them all. My skin decided to purge everything all at once. I had the worst breakout I ever experienced. My entire face hurt, I was constantly in pain, nauseous, the corners of my mouth were bleeding, and so was the inside of my nose. Not only that, I was embarrassed to show my face in public. There were times that I would even skip class because I was simply too embarrassed to show my face in front of my peers, who all seemed to have missed this stage in life, or at least weren’t dealing with it like I was.

What I Learned

I had to come to a few realizations, the first being that life waits for nobody. I refused to let my acne and insecurities take control of my plans, my education, and my self-confidence. I did not want to miss dinners with my friends, or class because my acne was bothering me. It helped to talk about all of this out loud with people I was close with, it made my struggle seem easier to handle. I shared my frustrations with them and even if they couldn’t directly relate, their sympathy did make me feel better. I was grateful to hear them verbalize their support, it was invaluable to me.

Then, I realized I need to start looking within to find my confidence. This was an absolutely necessary part of this process. My own perceived self-worth started to grow, mostly because I had no choice but to move forward. I began to embrace my flaws and accept perfection is not realistic. Interning at a PR company with beauty clients had me constantly exposed to the societal ideals of what skin “should” look like. At first, I still actively made an effort to cover up, clear my blemishes, and experience a type of self-shame that nobody should have to go through. Then I realized I was okay the way I was, and I got through it.

It helps to compartmentalize the bad moments and recognize them for what they are: moments. I won’t feel like this forever.

I finished my first round of Accutane in February 2019. I didn’t see major results until mid-January, which was a relief after months of constant stress and exhaustion with the entire process. Although I ended up with acne scars, my flare-ups were completely gone. I was in a state of disbelief. I didn’t have more than a tiny zit or two, total, over the next seven months.

The Second Coming of Isotretinoin

It wasn’t until October 2019 when I noticed my acne had returned with a vengeance. I started to get a few breakouts here and there, and as the months passed, they continued to get progressively worse. I wanted to give it some time and try some other methods before considering going back on Accutane, knowing the toll it would take on my mind and body. I tried a few chemical peels, microneedling, and a hefty amount of new (expensive) skincare products. Alas, nothing seemed to help. In fact, my acne continued to worsen. 

I decided in February of 2020 to go back on Accutane. I had my initial appointment with my dermatologist, and they agreed to prescribe me this supposed miracle solution for the second time. I had to appreciate the irony in the whole situation. 

I have been dealing with the same frustrations, the same disappointments, the same moments of self-criticism I experienced during the first round. The difference this time, though, is I understand how to work through it.

Although I was happy to begin my journey to clear-ish skin again, I also knew what I was in for this time around. I stocked up on Aquaphor and had a full bottle of water on me at all times. The side effects the second time around have been pretty similar, mainly the dryness and thirstiness. However, I have noticed that my joints have been bothering me a lot more. Mind you, this is the same exact brand of Isotretinoin I took the first time. 

I have been dealing with the same frustrations, the same disappointments, the same moments of self-criticism I experienced during the first round. The difference this time, though, is I understand how to work through it. Yes, my skin purged and I didn’t want to leave the house at times—but it’s all forced me to look beyond what I see in the mirror. It might sound cliché, but I have learned to build a strong support system within myself. While relying on my close friends and family definitely helps, it is far more valuable to my self-esteem to be able to affirm that I am worthy of experiencing the same joys in life as everyone else. Acne or no acne.

While relying on my close friends and family definitely helps, it is far more valuable to my self-esteem to be able to affirm that I am worthy of experiencing the same joys in life as everyone else. Acne or no acne.

The Bottom Line

This time around, I have been able to have more time to reflect on how I can see myself as beautiful. Even if I'm having an off-day and not feeling great about my skin, I can find other things to be grateful about—whether it’s how good my hair looks, something I accomplished at work, or simply making a friend or family member smile. It helps to compartmentalize the bad moments and recognize them for what they are: moments. I won’t feel like this forever. This is something passing in time, and it’s far more important to look beyond this issue.

Overall, my experience with Accutane has taught me to feel comfortable being my most authentic self, whether that is complaining about my acne or embracing it. Achieving "perfect" skin isn’t even a real thing. Everybody has pores and texture and scars of some kind. At the end of the day, it’s important for everyone to understand that unrealistic societal beauty standards exist, but that doesn't make them real. 

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