Accutane, also known as isotretinoin, is the go-to for stubborn acne, but it’s neither a magic bullet nor a light commitment. This article breaks down what it’s really like to take Accutane, from the weird side effects to the surprising facts that most people never hear before starting. Dive in for a real-world take on timelines, tips, and what to expect so you can handle your treatment like a pro. If you’ve ever wondered about the myths, risks, or life on Accutane, this article lays it all out.
Isotretinoin: What to know before you start
Isotretinoin is the most effective oral option for severe, scarring or treatment-resistant acne. It shrinks oil glands, lowers bacteria and calms inflammation — and many people see long-term improvement after one course. But it’s also powerful and needs close follow-up.
Doctors usually dose isotretinoin by weight. A common start is 0.5 mg/kg/day, often raised toward 1 mg/kg/day if you tolerate it. Typical treatment runs 4–6 months with a target cumulative dose around 120–150 mg/kg. Higher total doses can reduce recurrence, but your dermatologist will pick the right plan for you.
How to take it and what to expect
Take isotretinoin with food that contains fat — that boosts absorption. Expect an early flare of pimples for the first few weeks before skin clears. Most people notice clear skin by month three or four, though full benefits may take longer. Use gentle, non-foaming cleansers, a basic moisturizer, and daily lip balm to combat dryness.
Safety, monitoring, and key warnings
Common side effects are dry lips, dry skin, nosebleeds, and dry eyes. Less common but important effects include raised triglycerides, elevated liver enzymes, hair thinning, and increased sensitivity to sun. Your provider will check blood lipids and liver tests before treatment and periodically during therapy.
Isotretinoin causes severe birth defects. If you can become pregnant, you must follow strict pregnancy prevention rules: use two reliable forms of contraception, get regular pregnancy tests, and follow your country’s safety program (for example, iPLEDGE in the U.S.). Avoid pregnancy for at least one month after stopping treatment; many programs require proof of negative tests before each refill.
Watch for mood changes. Some people report depression or thoughts of self-harm while on isotretinoin. Contact your doctor immediately if you notice new or worsening mood symptoms. Also avoid vitamin A supplements while on treatment — they can increase side effects.
Drug interactions matter. Don’t combine isotretinoin with tetracycline antibiotics (risk of intracranial hypertension). Tell your clinician about all meds and supplements. Limit alcohol while on treatment to reduce liver strain and lipid spikes.
Buying isotretinoin: it’s a prescription-only medicine in most places. Use licensed pharmacies and verified online pharmacies if ordering remotely. Avoid unverified sellers — counterfeit or wrong-dose pills are a real risk.
If isotretinoin isn’t right for you, options include topical retinoids, oral antibiotics, hormonal therapy (for people assigned female at birth), chemical peels, and light or laser treatments. Talk through benefits and risks with a dermatologist so you pick the safest, most effective route for your skin and life situation.
Have an open conversation with your prescriber about goals, side effects, contraception, and follow-up. With proper monitoring, many people complete one course and enjoy clearer skin long after stopping the drug.