Accutane is a highly effective, intense drug used to treat acne. It is a naturally occurring derivative of vitamin A which, if taken in high doses, cures acne.
The Dermatology Group of the Carolinas reports that Accutane reduces the sebaceous gland size and production, encourages skin shedding, prevents clogged pores, has anti-inflammatory properties and can reduce acne-causing bacteria.
Is Accutane worth it? Yes, as long as the individual in question is prepared for the side effects which, for most people, can be intense. It should never be taken lightly.
My acne began right around middle school and has persisted into college and like so many others, I have tried everything on the market to lessen it.
Dermatologists started me on various skincare regimens, which first progressed into prescriptions and now into Accutane. I even got several chemical peels which did nothing except irritate my skin further.
Though I am currently taking Accutane, it is not my first go-around, and initially, I absolutely refused it.
Before I got prescribed Accutane during my junior year of high school, I was of the belief that I should either try to naturally fix my acne with holistic creams and supplements or learn to deal with it.
Accutane’s reputation had preceded itself and I decided that the medication was too destructive and intense for me. How long did that belief last? About six months.
Eventually, my acne became painful and impossible to ignore, so I resorted to speaking with my dermatologist about starting Accutane. The process of getting approval to begin was long and tedious, but eventually I started taking Accutane.
For the first month or so of my prescription, I experienced the “purge” which means that my acne got significantly worse before it got better.
During this time, I also experienced the well-known side effects like dry skin and dehydration.
Around month three is when the more grisly side effects came into play such as anxiety, headaches and brain-fog. Since these issues were not prevalent in my life before Accutane, it was quite a shock to me and I almost quit my prescription altogether.
In 1999, the FDA placed a warning on Accutane prescriptions for possible increased suicidal thoughts, aggression, psychosis, depression and violence. For those who are predisposed to these symptoms, this warning should not be taken lightly.
Additionally, monthly blood work is typically required in order to track various levels in the body, and as someone who has an aversion to needles, this was a big deal.
However, I stuck with it in hopes that it would be worth it, and for a while, it was. I was on Accutane for roughly seven months in 2023 and by the end of those months, my skin was clear.
It was outstanding. Not only did my face appear to be acne-free, but it felt more physically comfortable to live in my skin. Because I had acne since I was 13 years old, being without it for the first time in years was tremendous.
Fast-forward to approximately one year later, I noticed some acne on my cheeks again. I attributed it to factors such as stress and diet, until it persisted.
A year and a half later, my acne was back in full swing and I decided to get back on Accutane.
I am, once again, on month three of the medication. Though I feel many of the same side-effects that I did the first time, because I knew what was coming, it has been far easier to manage.
The Accutane experience is vastly different for everyone and it is always best to speak with a medical professional about the different options for acne treatment before resorting to it.
Lisa Lopez is a dermatology nurse practitioner at the Fresno State Student Health and Counseling Center. She discussed her knowledge of Accutane and what exactly happens to a person while taking it.
“So Accutane actually remodels the skin from the inside out and helps prevent further damaging effects from things, [whether] that just be acne or the hormonal effects of the android hormones, such as testosterone, that cause acne,” Lopez said.
Lopez explained that not everyone is suitable for Accutane or should consider it. Namely, those who are pregnant or are trying to get pregnant, those with depression, and those with elevated liver enzymes or a liver condition.
I have seen people with mild acne try to get a prescription for Accutane and to me, it is senseless. The medication is no joke, and if it can be helped, those who do not experience severe, ceaseless acne should forget it.
With that being said, she also spoke about what a good candidate for Accutane looks like.
“[A good] candidate for Accutane would be someone who’s failed on many of the traditional treatments,” Lopez said. “We would do the topical treatments, some oral treatments, [and] if those are failed treatments, then we may consider someone for Accutane.”
As mentioned before, the side effects can be gnarly. Before beginning Accutane, in-depth research should be done concerning what might happen to that patient’s body. For me, research was everything.
“The main side effect, and most patients will experience this, is drying of the skin, the mucous membranes, the lips- those things can be mitigated along the way,” Lopez said. “The more severe effects could be lower moods or depression, or intolerability to the medication.”
Lopez explained that the success rate of Accutane is approximately 95% and there are certain things patients can do while taking the drug to ensure its effectiveness. This can get complicated, especially for those of us that live busy lives.
“Well, it is being taken orally, so making sure that you just do what you do any other time [that] you’re taking good care of yourself, [like] decreasing your stress, making sure that you’re eating healthy, drinking full glasses of water, avoid any excessive chocolate, sugar-intake; things like that,” she said.
Accutane, because it is so hard on the body, makes it difficult to keep up with what is “normal” for the body and mind. It is challenging to maintain healthy stress levels and drink plenty of water in general, but especially if, for example, I am a working student.
Ultimately, I do what I can. I live with the mindset that it is what it is, and as long as my acne clears, I will learn to deal with it.
The month-by-month upkeep for Accutane is quite high-maintenance, especially for women. If a woman were to get pregnant while on the medication, there is a very high likelihood for severe birth defects to develop.
However, male patients are also required to closely monitor their health.
“Every month a patient would be seen by the practitioner, whether that be the nurse practitioner, the doctor, or the dermatologist, just to check in to make sure that they’re not having the side effects, [and we] do a blood test to make sure that the female patient is not pregnant,” Lopez said.
Having acne can be debilitating and anyone who has experienced acne knows that. However, Accutane can also be debilitating. My belief is that each scenario is less than ideal, so I choose the one that will erase the other.
Thus, Accutane is worth all of the complications as long as one does their research and preparation. It should not be a decision made on the whim, but one as a final resort.
I asked, “Is it worth it?”
“Absolutely,” Lopez said.