Accutane (isotretinoin): what it is and why people use it
Accutane is the brand name many people use for isotretinoin — a strong oral medicine for severe, scarring, or treatment-resistant acne. It can shrink oil glands, cut inflammation, and often gives long-lasting results after a single course. Because it’s powerful, Accutane comes with strict rules and side effects you need to understand before starting.
Who should consider Accutane and how it’s given
Dermatologists usually recommend Accutane when topical creams, antibiotics, or other treatments haven’t helped, or when acne is causing deep cysts and scarring. Typical courses last about 4 to 6 months. Dosing is often based on body weight — many patients take roughly 0.5–1 mg per kg of body weight per day — and the doctor may adjust the dose to balance results and side effects. Some people need a second course, but many get lasting clearance from one round.
Risks, monitoring, and simple safety steps
The most serious risk is birth defects. Isotretinoin causes severe fetal harm, so people who can get pregnant must follow strict programs (like iPLEDGE in the U.S.): regular pregnancy tests, using two reliable forms of birth control, and confirming negative tests before and during treatment. Do not get pregnant while on Accutane and for at least one month after stopping the drug.
Other common effects include very dry skin, chapped lips, nosebleeds, and increased sun sensitivity. Less common but important risks are raised cholesterol or liver enzymes, and mood changes. Your doctor will usually check blood lipids and liver tests before starting and again during treatment. Report sudden mood changes, vision problems, severe stomach pain, or unexplained muscle weakness right away.
Practical tips to make treatment easier: use a thick moisturizer and lip balm daily, avoid harsh scrubs and waxing while skin is fragile, wear SPF 30+ every day, and skip vitamin A supplements (they add to risk). Don’t donate blood while on isotretinoin and for at least one month after you stop.
Talk openly with your dermatologist about goals and concerns. Ask how long you’ll need treatment, what dose they recommend, and what labs they’ll monitor. If mood changes or serious side effects appear, contact your provider immediately — early action matters.
If Accutane feels like too big a step, there are alternatives: topical retinoids, antibiotics, hormonal options (for people assigned female at birth), chemical peels, and laser treatments. A dermatologist can compare risks and benefits based on your skin type, acne severity, and personal plans like pregnancy.
Accutane can work when other options fail, but it demands respect and careful follow-up. Get clear instructions from your doctor, follow safety rules, and use simple daily skin care steps to reduce side effects while you treat your acne.
