Accutane Acne Adult

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Lindsey Metrus is the associate general manager at and has been with the brand since 2015. Her work also appears in BuzzFeed, StyleCaster, and Yahoo.

Onyeka Obioha, MD is an LA-based board certified dermatologist and fellow of the American Academy of Dermatology, as well as a member of the Skin of Color Society.

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A pimple can easily feel like the end of the world, especially if it’s big, painful, red, and you get the picture. For those of us with the occasional breakouts or smatterings of blemishes across our faces and bodies, topical acne products, antibiotics, or birth control usually do the trick to clear them. But for people with excessive amounts of pimples, visible redness, and deep-rooted cysts, dermatologists may suggest isotretinoin, popularly known by the now-discontinued brand name Accutane.

The name alone may raise eyebrows: Isotretinoin can cause serious congenital disabilities and has been associated with an increased risk of suicide and depression. So we asked three top dermatologists our burning questions: How does Accutane work? Who should take it? And how much should you worry about the side effects?

Isotretinoin is an oral prescription medication derived from vitamin A that's used to treat moderate-to-severe acne. Formerly known as Accutane, you may also know isotretinoin by the brand names Amnesteem, Sotret, Claravis, Absorica, Myorisa, and Zenatane.

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Isotretinoin is the closest thing to a “cure” for acne. Although it's not unheard of for acne patients to need multiple courses of isotretinoin, about half of patients who take just one course of the med never need acne treatment again. The American Osteopathic College of Dermatology says of isotretinoin, “There is nothing else in the world that comes close to being this effective for severe acne.”

It’s the gold standard for treating severe nodulocystic acne, Obioha adds. I use it a lot [on my patients] because it’s the best medication for cystic acne.

There are plenty of other prescription medications for treating pimples—like topical medications and oral antibiotics—but they don't work as well as isotretinoin does against severe cystic acne, Obioha insists.

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For deep cystic lesions, topicals aren’t able to penetrate as deep down into the oil glands to be effective, she advises. Oral antibiotics can be effective for this type of acne but are not a good long-term treatment option due to the concern for antibiotic resistance.

Spironolactone is a great option for treating hormonal acne in women, she says—but not all cystic acne is hormonal, and it's a no-go for guys. (Spironolactone causes breast growth in men).

When other acne medications fail to deliver for acne patients, derms often look to isotretinoin, Obioha explains. I also commonly use isotretinoin for patients who don’t have severe cystic acne but have moderate acne that has not responded to topical or other oral medications.

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“One of the main effects acne has on the body is in the sebaceous glands of the skin, Tanzi explains. People with deep, inflamed acne may have excess sebum in their skin, a symptom that isotretinoin targets. [Isotretinoin] reduces sebum production and makes the pores less ‘sticky’ so they don’t get clogged, she says.

When pores aren't clogged with sebum, they're less likely to be colonized by the acne-causing bacteria Propionibacterium acnes, Obioha adds. By depriving this bacteria of a moist, comfy place to grow, isotretinoin prevents new blemishes from forming and calms active zits, too.

Isotretinoin is usually taken daily for about four to six months, but it's a gift that keeps on giving long after you stop taking it. Isotretinoin not only reduces sebum production while you're on the medication, it curbs your sebum output

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. [It] changes your oil glands for the long term, making you less likely to break out in the future when you’re off of the medication, Obioha explains.

If that's music to your ears, Obioha agrees. She calls isotretinoin magical, especially for patients at risk of scarring. If cystic acne goes untreated, it can leave lifelong scarring even after the acne breakouts stop, which is very difficult and expensive to treat, she says. Thus, for my new patients who present with severe cystic acne, I initiate the discussion about starting isotretinoin at the first consult.

Dry skin and chapped lips are practically a given since isotretinoin stops your skin's oil production. The most common side effect is dryness—dry skin and chapped lips, Obioha explains. The dryness is actually how we as dermatologists know the medication is being absorbed.

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One study showed that a whopping 100 percent of isotretinoin patients experienced cheilitis (inflamed, cracked lips), and roughly 66 percent complained of dry skin. Isotretinoin also makes skin more sensitive to sun exposure, so sunscreen is an absolute must.

Other common side effects include elevations in blood lipid levels, she adds. Crappy news for needle-phobes: People taking isotretinoin need regular blood testing to monitor their blood lipid levels and liver function. That's because people taking isotretinoin often show liver test abnormalities, although lasting damage to the liver is very, very rare.

Common complaints from isotretinoin users are dermatitis, facial redness, nose bleeds, dry eyes, and mucositis, which involves swelling, pain, and sores in the mouth and digestive tract. Joint pain and muscle aches affect about 15% of isotretinoin patients. Some rarer side effects include night blindness, rashes, headaches, hair loss, and worsening asthma symptoms in people who are already asthmatic.

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Whether isotretinoin causes inflammatory bowel disease has been debated. Still, research suggests IBD is either a very unusual side effect of isotretinoin use or somehow linked to having severe acne.

The potential isotretinoin side effects that have grabbed the most headlines are psychiatric. Isotretinoin's link to suicide and depression has sounded major alarm bells in the medical community, yet no one can say for sure that the med causes people to become depressed or suicidal.

Severe acne makes you more likely to become depressed and suicidal, she points out. The potential relation is something to be aware of and counsel patients about.

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Having a history of depression doesn't mean you're uninvited to the isotretinoin party, Obioha says. But if you want to take the medication, be sure to seek support for your mental health.

In a patient with a history of depression, it’s important that the patient has a multidisciplinary team monitoring the patient’s mood, she says. This team should consist of the patient’s dermatologist, family members, psychiatrist and/or therapist, and primary care physician.

If you want a prescription for isotretinoin and are physically capable of getting pregnant, your derm is bound to bring up the iPledge program.

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iPledge is a risk management program for isotretinoin, Obioha explains. It is designed to prevent pregnancy and other potential adverse effects while taking the medication, since isotretinoin can cause devastating congenital disabilities.

Patients, providers, and pharmacists all enroll in the iPledge registry in order to take, prescribe, and dispense isotretinoin, respectively. iPledge requires isotretinoin patients of childbearing potential to use two—yes,

—forms of contraception while taking their meds. If you're sexually inactive, that's considered a form of birth control under the iPledge program; nevertheless, you're still required to use a second contraceptive method even if you swear up and down you're celibate.

After Struggling With Acne, My Dermatologist Prescribed Me Accutane

Also, patients in the iPledge program have to repeatedly prove they're not pregnant to get their prescriptions. They have to submit two negative pregnancy tests to their doctors one month apart before even

If you have moderate-to-severe acne that isn't chilling out with OTC treatments and other prescription meds, isotretinoin may have the potential to transform your skin for good. Schedule a thorough chat with a dermatologist to learn more about the side effects and find out if this med is a good fit for you.

If you're experiencing thoughts of suicide, please reach out for help to the National Suicide Prevention Lifeline, available 24/7 by phone at 800-273-8255 or live chat.

Accutane For Adult Acne: My Experience

Takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.To say adult acne is not fun is an understatement. When I went to my dermatologist for help, I was prescribed an intense medication called Accutane or Isotretinoin. I have been taking it the past 7 months and my last pill will be taken tomorrow (yay!) The end result has been amazing but I did experience a lot of ups and downs over the course of the time I have been on the medication. So today, I am sharing my experience with Accutane