Oral Retinoid
Reviews
3.9
2786 Reviews
Oral Retinoid
Efficacy
87%
Based on All Available Studies
Strength of Evidence
1
2
3
4
5
Note: Use with EXTREME CAUTION: Causes severe birth defects and fetal death.
Oral Retinoid
Side Effects
High
Oral Retinoid
Acne.org’s Real World Take
The nuclear option. It works reliably and provides long-term remission of acne, and even severe acne, in about ⅔ of people who properly take an adequate dosage. However, it permanently and irreversibly changes the skin and the body forever and users may experience long-term side effects for the rest of their lives. It’ll nuke it, but there is no going back.
Oral Retinoid
How to Get It
Have a dermatologist? Make an appointment to get this medication. Don't have a dermatologist? See The American Academy of Dermatology Physician Database to find one.
Read All About Isotretinoin (Accutane®)
Compare To Other Treatments
5
37.1%
4
33.4%
3
15.5%
2
7.3%
1
6.6%

Used Isotretinoin (Accutane®)? Rate It:

Choose from 1 to 5 stars
April 6, 2018
My Isotretinoin journey
Hi, I wanted to leave a review after finishing isotretinoin over a 8 month period. I read so many reviews that helped so want to do my bit... So...a bit about me: I'm a 28 year old female who had suffered from mild acne since my teens. My acne really wasn't that bad, hence most people wouldn't have defined it as acne. More or less, I had 2-3 active pimples at any given time, which meant I thought it could be easily treated with over the counter treatments. These never worked. My frustration grew. When I was 27 I went to a doctor in London (where I had moved one year prior from Australia). I explained to the doc that I still broke out and given my age, it was becoming a problem because it should have cleared up. I had been on various birth control pills, had an ultrasound for polycystic ovaries, but none of that had worked. I was referred to a dermatologist on the NHS. When I met with the derm she suggested accutane. I was very hesitant because I'd heard so many bad things about the side effects. I have had depression and wasn't keen to start medication that might affect my mood. She explained that if I went on anti-biotics, the chances were that the acne would return once I got off, so accutane was my best bet and I could start on a very low dose to reduce symptoms of side effects. After doing a lot of research I decided to give it a shot. I am 6ft tall and weighed 8-kg, so I was going to need more than your average girl. I still only started on 20mg per day. After 2 weeks or so I started getting dry lips, but they weren't too bad. I continued on the 20mg for a couple of months (no real improvement in my skin, and in fact it was getting worse). I upped to 40mg, but still no improvement and again...it was getting worse. I was obviously very upset, but the derm said I should still persevere and we upped it to 60mg, coupled with some steroids to combat the inflammation. It was at that point where I saw massive improvements. I stopped breaking out and was able to see the light at the end of the tunnel. I stayed on 60mg for a few months before going up to 80mg as I wanted the course to finish as soon as possible. My lips were dry, but I didn't get the skin peeling or other major side effects. What I did notice though was that my hair became very VERY dry. I have long hair and was losing more hair than I usually did. Fortunately, my mood was OK and if I was down, it was probably due to my living/work situation. After 8.5 months I finished the course and after a week or so my lips got better. It's now been 3 months since taking it and I haven't had a single pimple or break out. My scalp has started to produce oil again, which I hope will fix my hair, but I have just started taking hair loss/strengthening supplements called Nourkrin and I hope that will help improve the health of my scalp and hair. In a nutshell: It was disappointing at the beginning, but I am so glad I stuck with it as I now get compliments on my skin (this had literally never happened ever in my life). I still have faint red marks on my skin from the old scars (my skin is very sensitive so when I used to get pimples they'd leave marks which lasted for very long periods of time). I may consider laser treatment to deal with these residual marks, but I suspect they will fade with more time. Hoping the supplements improve the condition of my hair which has been the worst casualty of isotretinoin.
October 25, 2018
Hello! Has your hair returned to its natural oil state? I have quite dry wavy/curly hair and am really worried about making it even drier and frizzier! Thank you
March 2, 2018
Accutane
what are side effects if taking cold medicines or drinking alcohol ocassionally?
April 29, 2018
From what I have read, cold medicines and alcohol are metabolized in your liver and so is Accutane. So you're just making it work harder. Many people have also said they get drunk faster and on less alcohol while on Accutane. I honestly would say it's ill-advised to drink while on Accutane but you do you. I personally decided not to drink while on Accutane. I also figure most drugs have some metabolic process in the kidneys too and I want my liver to work with my kidneys as much as possible. My liver and I have this loving relationship because I want it to stick around and it has more documented medical functions than the human brain.
January 14, 2018
Side effects were manageable for me
180lb male age 23 duration: 214 days (~7months) dose: 40mg for 2 months, 60mg for 1 month then 80mg for the remaining months, respectively. I paid about $20 a month after bcbs insurance covered most of it. before isotretinoin: applied chapstick 2-3 times daily applied lotions only to elbows and feet during the winter eyes almost never dry easily complete an hour weight lifting workout with energy to spare during isotretinoin: -apply lip moisturizer up to 10 times a day, and even waking up in the middle of the night to do so -apply lotion at least once a day or get rashes -dry eyes in the evening sometimes made it difficult to read -nose was very dry, almost never had any moisture -my face flaked dead skin -any minor cut seemed to be redder than normal and take longer to heal -lifting weights became a little more difficult due to some joint pain, and feeling fatigued more easily; cut workouts to 30-40 min -**i got probably 50% more acne than i originally had during the first 4 months of my treatment** When it finally got into the summer time all the dryness related side effects reduced and made me significantly more comfortable I never got any sunburn, but only because i put on LOADS of sunscreen and avoided the sun whenever possible. i stopped treatment 8 months ago and i've had maybe a dozen pimples since. i still have some light acne scarring but i am treating it successfully with hydroquinone. all the side effects are back to normal. Thankfully nothing has been permanent. Overall I'd say it was worth it
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April 6, 2018
This med works! I use low dose.
December 14, 2017
Accutane Will Change Your Life!!
I'm going to write a very detailed review, but I'll summarize quickly: Accutane worked for me, but there were lasting side effects. I would encourage anyone considering the medication to do their research and really weigh out whether their acne is bad enough that risking long term side effects would be worth it. For me, I was 32 and my cystic acne had been ruining my confidence for over a decade. It was so worth it. The first month or so on Accutane, I experienced "flushing," i.e. redness and heat of my face, and a rough texture. Everything started to get dry, especially my lips. My acne began to clear almost immediately, which is NOT typical, and in fact I've read that some people don't see results until well AFTER they've completed their treatment! The second month, these side effects continued, as well as new ones: I'm really active in strength training and mountain biking, and I noticed a lot of pain in my lower body joints, especially my right hip. My hips were popping a lot. This was really discouraging, I didn't want to stop working out, but I really had to tone it down. When I had minor crashes on my mountain bike, they HURT and I bruised badly. My lips peeled constantly, I sweat more than usual and had hot flashes. Third month, I had blood with a bowel movement. Bright red, horrifying blood. I saw a doctor immediately, as is indicated by the warnings on this medication, because intestinal diseases are a potential side effect. Luckily, it turned out to be an internal hemorrhoid, and the tissue thinning that happens with Accutane just exacerbated the condition, so I was able to continue my course safely with no recurrence after I finished my course. I finished about five and a half months of the treatment, and here's the end result: I rarely break out, and when I do it's nothing compared to my old acne. My skin and hair are less oily. It's wonderful. The downside is that the flushing I experienced early in my treatment turned out to be a long term effect of Accutane; I now have mild rosacea that needs to be treated with a topical to keep my skin clear and smooth. No big deal. The worst of my lasting problems is my hip: Both hips still pop frequently and I think I caused a chronic hip injury by continuing to stay active through the discomfort while I was on the drug, though it's not anything that keeps me from physical activity. BUT it's important to note that I have had issues with my lower body joints for years, so I do not believe this would have happened if I weren't prone to such problems to begin with. I have read lots of reviews from people blaming Accutane for conditions as severe as fibromyalgia, and I'm not buying it; based on my personal experience, I believe that Accutane can exacerbate pre-existing conditions, but I don't think it's likely to cause new ones. Most of the complaints about Accutane "causing" new conditions that I have read are from people who began Accutane as a teenager, so I think it just seemed like the drug "caused" their condition, but in reality they were probably just asymptomatic at that time because of their age. Which brings me to my second disclaimer: I would personally not recommend this drug for anyone who isn't fully grown. I'm frankly shocked that a drug with such severe potential side effects is prescribed to kids who may very well grow out of their acne in a few years! So again: I urge you to find a doctor who isn't willing to used Accutane until you've exhausted all other options, and who seems knowledgeable about potential side effects. Even then, do your own research and decide if it's worth the risk. If you do start Accutane, STICK WITH IT even if you don't see immediate results! It was worth every miserable second for me to be rid of my embarrassing acne for good.
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November 21, 2017
Pros and cons
I went on a 4-6 month course of moderate strength roaccutane 3 years ago for moderate to severe acne. My acne was totally clear within a couple months of starting the course and at the time of taking it just had the side effects of dry skin and eyes, regular mild nose bleeds and cracked lips that would often bleed at the corners. They couldn't increase my dose because my cholesterol kept going high despite the fact I'm a young healthy 24 year old at the time. My skin stayed clear for probably 6 months post treatment then I started getting small spots again. It was mild for probably 12-18 months and then worsened more. I'm not at the point where I'm considering another treatment because it's now moderate. I never get cystic acne now but just a lot of spots again. Before treatment I'd say my acne was 7/10, with 10 being the worse ever and 1 being very mild acne. I'd say it's 4/10 now but still enough to bother me. I've tried creams and contraceptive pill that help a bit but my dermatologist says it's just keeping it at bay and will never be a long term fix. I'm worried about when I get older and want a family and I can't use anything for my skin, what will it be like then!? Downsides also to the drug I had severe hair loss which I think started 1 year or so after. I lost about half my hair thickness and my hair became dry and broke very easily. It's taken 3 years for it to almost grow back but it's probably 70% as thick as it used to be. Thankfully I have naturally very thick hair. I also get very lethargic and short of breathe easily and I think this started after the roaccutane. Doctors can't find a cause for this. So really in two minds about going back on it!
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January 23, 2018
Seems accutain was still in your gut.
October 20, 2017
pretty good.
this medicine works miracles for your skin but now that i'm off of it, i'm starting to have a relapse again. my forehead is starting to get little bumps and so is my chin.
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August 28, 2017
So far so good
This is a partial review because I am only on this medication for two and a half months. So far, so good. I am 37 years old. Quick history of my acne: Severe case when I was 20 (it seemed it was an overnight flare out of the blue) - 2 years later I had it under control by using topical stuff but lots of damage had been done to my skin. Over the years I've done microdermabrasion, facials, fraxel and pixel to reduce scarring. I was also using ProActiv just to keep the flare-up at bay for almost 10 years. Fraxel made a huge difference in the appearance of the scarring. In January of 2017, I decided to go full natural products on my face as ProActiv was causing wrinkles around my eye area, that backfired on me (Lesson learned: Never do cold turkey on your skin). 3months into using natural products (March)I had full blown flare up with huge cystic acne even on my neck area and face became extremely oily. By April, I tried to return to ProActiv but it made my acne red and irritated so I discontinue it. At this point I was so down and thought there is no hope. I was depressed and hardly go out anymore. Going to work everyday was a dread. Finally went to dermatologist in May and right away she prescribed me with Accutane with brand name Claravis. I started the meds in June. Two and a half months later I can say that I was back to my old self. I am now able to go out, confidence is back and life is beginning to come back to normal. I still have acne here and there but definitely so much better than before. Just the fact that the oiliness has went away made a huge difference in the appearance of my skin. I had a purge in the first 2 weeks but slowly faded away. My derm said I should see full clearance around 4th or 5th month, I believe it since 2 and a half months so far made a huge difference. Side effects: Besides dry lips, virtually none. I keep up with a good moisturizer and lip balm, I'm good. Will update again once my full treatment is complete.
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August 22, 2017
Isotretinoin 6 months course - fears before and an honest review
I suffered with bad skin since about 14 which is coming up 7 years. After going on 4 different pills and trying everything I was referred to a dermatologist for Isotretinoin. I made the mistake of googling all the side effects and totally freaking myself out with all the horror stories that fill the internet but after A LOT of careful consideration I decided to proceed with the treatment. Honestly, it has been the best thing for me and I am so glad I have done it. I have 1-2 months left of my course and am now on the highest dose I can be on (they usually use your body weight as a guide for dosage.) It hasn't been a super quick process but I've been patient and have slowly seen the results. When I compare my skin to old photos now it's simply amazing!! There are side effects with every drug and I do recommend carefully considering going on this treatment. I have only really experience dryness, particularly of the lips but nothing a good lip balm can't sort out, and I also get quite dry eyes so often need to apply some basic eye drops. Very occasionally I feel very stiff after the gym but that is rare. Obviously one of my main concerns was the supposed links with mental health and taking Isotretinoin (roaccutane). Whilst I have never been severely depressed, I certainly had a few months of poor mental health where I just felt very flat and anxious due to life not going so great as is sometimes the way! I expressed my concerns to my dermatologist and he advised me to just be aware of how I'm feeling and also let people close to you know that you are going on it so they can monitor you also. In the 5 months I have been on it i can honestly say I've experienced no issues with mood at all. With that said, that is my personal experience so I still think that, although the risk is small, it is important you give it careful consideration and just check in with yourself every now and then if you do decide to go on it. I'm excited to finish the course of treatment and FINALLY have clear skin, I already have so much more confidence and would advise anyone wanting to take isotretinoin to just really consider it but also not to worry about the vast amount of information thats on the web, just trust your doctor!
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July 18, 2017
Accutane cycle from July 10th 2016-February 2017. Clear
I went on Accutane for 5 months. I stopped a month before my expected time because my skin was completely clear. I had moderate acne my whole life, however at the of my sophomore year of college it began to get severe... which is when I decided Accutane was my last option. Long story short, your acne will most likely get worse before it gets better once you start your cycle. My skin didn't start to clear up fully until month 4. The biggest side effect I faced was dryness, not even so much my skin, but more so my lips. The sides of them would crack and bleed when I would smile or laugh... this was painful but aquaphor was a life saver. Now, my skin has been pretty clear ever since, I will occasionally get a random zit... THIS IS NORMAL. EVERYONE gets zits sometimes. Accutane does work, however it doesn't make your skin completely immune to dirt and grease after you finish! The one bit of advice I will give is DO NOT PICK. I picked so badly while I was on Accutane because I found my face absolutely disgusting and wanted more than anything for my skin to be clear. Doing this gave me horrible scarring. The hyperpigmentation lightens eventually... but not without expensive scrubs and exfoliators. My scars are just starting to disappear and I've been off Accutane for 5 months now. I can finally go out without makeup and still feel beautiful :)
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May 11, 2017
Just finished my 2nd course of Accutane, currently clear
Like the title says. I will return to this post and edit it to give 5 stars only if the clear skin is permanent this time. After my first course of accutane, which was a low dose of 20 and then 30, I was clear for about two months or three months before I got acne back again, concentrated on my chin and jaw area. Originally, I had pretty severe acne, maybe moderately severe to severe. I started getting acne when I was 11 and I am nearly 21 now. My acne worsened when I was on lithium medication for my mood-- I'm not on lithium now. Accutane does work, and I would recommend it. During my first course of accutane, I was blissfully clear skinned. I did not have an initial breakout. And I did not have side effects other than slightly chapped lips. Maybe it was because my dosage was kind of low, because I'm a lightweight person. So I just did my second course, and that went blissfully well, too. No initial breakout, no side effects. My skin got a bit dry near the end of the course. This time, my second time, I started with 40 and took 40 all the way through. I hope that this time, the acne won't return.
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.