Life Later Accutane: 9 Women on What *Really* Happens When the Dosing Stops

If yous're here correct now, I'grand willing to bet yous've already spent a few dozen hours contemplating/deep-dive Googling Accutane and everything nigh information technology: the potential side effects, the before-and-after photos, the real-life stories, and first-person experiences. And I know this because not only have I lived through acne—I'm talkin' a constant rotation of blackheads, whiteheads, and cysts on my face up at all times—but I've also taken isotretinoin, aka the generic drug proper noun for Accutane (which, FYI, isn't on the market anymore, but anybody nonetheless refers to isotretinoin as Accutane anyway).

And because I've been down the research hole myself, I also know merely how important it is to have kickoff-person stories about isotretinoin that are real­—ahem, not just the horror stories y'all see on sketch websites—and accurately depict all aspects of isotretinoin. Considering despite what yous've heard, dermatologists agree that Accutane isn't actually every bit scary every bit information technology's made out to exist (muuuch more on that below), and that the vast majority of patients who take isotretinoin are, afterwards their course, totally fine.

But, hey, I go it—you want details. Which is why I chatted with nine women about their before-and-subsequently experiences with isotretinoin, from a few who finished their doses merely a year ago, to some who finished theirs a decade ago, along with expert commentary from dermatologists. Keep reading to detect out everything yous've, well, already been Googling for hours/days/years, starting with…

What is Accutane?

Isotretinoin, usually referred to every bit Accutane (note: Accutane was a brand name for isotretinoin and is no longer manufactured), is a vitamin-A derivative that, when taken orally, minimizes the oil product in your skin. "Accutane permanently shrinks your oil glands so they can't be stimulated as easily anymore," Mona Gohara, MD, dermatologist and acquaintance clinical professor at Yale School of Medicine, has told Cosmo . Basically, isotretinoin slowly shuts down the party in your pores, and so acne has a hard time setting upwardly shop on your face.

How long does it have to encounter results on Accutane?

Usually, you'll kickoff to meet some results from Accutane subsequently a few weeks, with bigger results around three months, and best results later six months. Just—only!­—your results are almost guaranteed to vary, because when information technology comes to isotretinoin, there's no universal dose or timeline; it all depends on your weight, your dosing, the severity of your acne, how well your torso tolerates the medication, and your dermatologist's guidance.

That beingness said, many patients tend to accept 40-60mg of Accutane a day for six months—though, again, how many milligrams y'all have each day and for how long is based on your weight and health. For people with developed female acne (AFA), i.due east., women over the age of 25 with stubborn, persistent, hormonal acne, some dermatologists will prescribe a lower dose of Accutane over a longer menstruation (think: 7 to ix months) to minimize the take chances of relapse. Once again, it all super depends.

Does Accutane work forever?

Ideally, yes, Accutane is a permanent fix to major acne breakouts. Simply in reality, fifty-fifty the best-adhering patients tin can still become the occasional tiny zit (because we're all human being, and humans sometimes accidentally sleep in their makeup, or stress out too much, or partake in a chip too many cocktails), though they'll rarely feel acne every bit severely equally before.

"I would say only five pct of my patients proceed isotretinoin a 2d time, either considering their acne came dorsum in full, or because they're getting some breakouts that they don't desire to bargain with again," says Dr. Gohara. "Some other five pct get a footling bit of acne again that clears up with retinoids or antibiotics, and the other 90 percent never see a pimple again."

Is Accutane bad for you?

Nigh dermatologists hail Accutane as the closest affair to an acne cure that exists, only that'southward not to say Accutane isn't a serious drug with serious potential side furnishings—it is, and everyone can reply differently to the medication. But does isotretinoin deserve the scary reputation you see on the cyberspace? Definitely non (except, of course, when we talk virtually its known risk of causing birth defects, which is why regular blood tests, pregnancy tests, and birth control is required while taking the drug).

But in terms of the other out-at that place side effects you hear about, I once polled a handful of dermatologists who, collectively, had written more than 2,200 isotretinoin prescriptions in their careers. They said out of all their patients, fewer than fifteen of them had serious bug while taking Accutane—the effects of which were resolved with a lower dose or stopping treatment altogether. Again, as with any medication, everyone'due south body responds differently, which is why your md volition be your BFF during your Accutane journey.

Now, fix to get into those earlier-and-after photos and commencement-person stories? Idea so. Permit's get into it:

✨ 9 months post-Accutane ✨

A few months before I decided to start isotretinoin, I adult a very rare, very severe blazon of acne called acne conglobata, which left my confront covered in deep, itchy, leaky, and incredibly painful cysts. It affected every aspect of my life, and I honestly felt similar a victim to my own skin. I ended up going on isotretinoin for a little over eight months, and for the majority of that fourth dimension, I was on 30mg: a lower dose than the usual forty-60mg, only the perfect dose for me.

Photo credit: Courtesy Image
Photo credit: Courtesy Epitome

I had pretty much all the side effects that you hear about with Accutane: I was tired all the fourth dimension, no matter how much sleep I got; my skin dried out to the point of getting piffling flakes everywhere; I couldn't exercise without getting a headache; if I stood up also long my dorsum would ache. The worst side effect for me was the dry optics, and I do think it affected my mental health a fleck—I just felt more anxious and didn't have any motivation. Just, that's also why my dose was lower: to keep my mental wellness and the side furnishings in cheque.

Thankfully, all of my side effects started to subside a month subsequently I finished Accutane, and I noticed my energy levels rising afterwards most two weeks. I still have dry eyes 9 months afterward, and I all the same interruption out before my menstruation. But by "break out," I mean a few tiny spots on my face—cipher like before. Still, all of the side effects were so worth information technology to me, because isotretinoin saved my peel—it genuinely changed my life.

A dermatologist'southward take:

"Accutane, aka isotretinoin, shrinks the glands in your pare that produce oils," says dermatologist Mona Gohara, Doc, associate clinical professor at Yale Schoolhouse of Medicine. "When yous shrink those glands, your organs—including your eyes—will be drier, just this side effect unremarkably goes abroad afterward y'all finish your dose."

As for Mariah'southward lower energy levels? Some other common, all the same abrasive side result. "Some reports suggest that fatigue is dose-dependent, meaning the college your dose of isotretinoin, the more probable you lot are to feel it," says Marisa Garshick, MD, of Medical Dermatology & Cosmetic Surgery in New York City. "In full general, though, virtually people find this side issue to exist temporary."

✨ Ix months post-Accutane ✨

Before isotretinoin, my skin was so oily that fifty-fifty setting pulverisation couldn't take away the shine, and my face was covered in inflamed breakouts. My dermatologist concluded up starting my Accutane dosage at 20mg the first month, then bumped me upward to 40mg for 3 months, then had me on 60mg for the terminal two months.

Throughout my form, I dealt with pretty bad eczema on my arms and a dry out scalp toward the terminate, and I also dealt with continuous headaches (though they were persistent plenty that I stopped noticing them afterward a while, and so information technology actually wasn't the finish of the globe). The but remaining side effect I have 9 months afterward stopping Accutane is the eczema. It's nonetheless on my arms, and I've also noticed it condign apparent around my scalp, but information technology isn't nearly every bit bad as it was when I was on Accutane.

Every bit for my acne, I practise become the occasional cyst or whitehead now, though nowhere near as severely as earlier. It actually took me a few years to finally go through with isotretinoin because of how scary information technology's made out to be, simply for me, the whole thing was generally fine. I do experience really proud of myself for going on it despite my fears, though, and if I needed to, I would probably do it all over again.

A dermatologist'due south accept:

"Dryness is far and away the virtually common side event of isotretinoin" says Dr. Gohara. "Most patients can expect some degree of dry lips, dry skin, dry out eyes, and sunday sensitivity while they're taking it." Though eczema certainly isn't the norm, it also isn't uncommon: "Eczema comes along because the drug is essentially sucking the oils out of your skin, which is proficient for your acne, but not not bad in terms of peel moisture," she says. "I tell my clients to swap harsh soaps and washes for gentle, hydrating cleansers, then moisturize with heavier creams as opposed to lighter lotions."

✨ 11 months post-Accutane ✨

I got my first breakout when I was 12 years old, and for the next five years, I was in a constant boxing with my skin. I tried everything under the sun to treat it: antibiotics, topical creams, chemical peels, veganism, hormonal pills, spironolactone, cortisone shots, lasers—everything. I was eventually diagnosed with polycystic ovary syndrome, or PCOS, a hormonal disorder that tin can cause—amidst other things—persistent acne. I knew and then that I had to take the spring and endeavor isotretinoin.

I was on information technology for 8 months total: For the showtime three months, I took 40mg, so 60mg for the last v months. I had dry everything—face, lips, eyes, scalp, torso—and my hair started shedding a bit, besides. I'm prone to headaches, but Accutane actually exacerbated the symptoms, and my head would often experience like information technology was burdensome in on itself. It was all an emotional roller coaster for me. I'm non sure if it was the medicine or my personal life or both, merely I definitely call back I was more emotionally delicate while I was on it.

Most two months after I finished Accutane, I saw the severity of my migraines, dry out eyes, and dry scalp decrease. After four months, my emotional health evened out and I felt back to my old self. Every bit for my skin, I'chiliad now experiencing breakouts all along the lower half of my face and around my hairline. Thankfully, they're much more small than before—simply small whiteheads and blackheads—and truthfully, they could besides just be a side effect of going off nativity control a few months ago.

Information technology sounds weird, merely I really call up I was meant to go astringent acne. My journey taught me so much about myself: to love myself and be confident, no matter the status of my peel. Yes, it was so hard, but I wouldn't alter a thing. And I would 100 percent consider going back on isotretinoin again if I needed to.

A dermatologist's take:

If the idea of potentially losing your hair on Accutane freaks you out, take deep breaths: "If whatsoever pilus loss occurs, it's generally temporary," says Dr. Garshick. " One written report showed that isotretinoin doesn't impact hair loss if the dose is low enough."

Dr. Gohara agrees, stating that "less than 10 percentage" of her patients come across this side outcome, and if they do, "it'southward usually considering the hair is drier and more fragile from the medication, and ix times out of x, it slowly grows back totally normal," she says. "In one case the Accutane'south out of your system, hair and nails are always laggy in terms of regenerating themselves."

✨ 1 year mail service-Accutane ✨

I suffered with astringent acne for 3 years before deciding to try isotretinoin. My breakouts were super oily, sore, and red no thing what I put on them, and kids at school would call me Braille face. I didn't take Accutane but that ane time, though—I ended upward taking it iii times over the next few years.

The first two times, my acne slowly got worse over six months, then came back as bad as before. My dermatologist even switched upwardly the dosing each fourth dimension: My first course, I slowly reached 60mg a day; my second course, we took the approach of 10mg a day for a longer period of time; and my third class, I slowly reached 60mg again.

Only afterwards my third round, my skin was notwithstanding incredibly oily and broken out. I remember sitting in my dermatologist's office as he explained that Accutane hadn't worked how information technology should have. He apologized and said there was aught else he could offer me. I cried the whole way home. Just so, strangely, my skin began to clear upwards a few months later, nigh like a delayed effect. Now, my skin is totally articulate, and I don't have any active acne.

Even though Accutane eventually worked for me, it wasn't an easy journey. I honestly had virtually every side effect in the volume: dryness, eczema, rashes, body soreness, fatigue, blurred vision, headaches, nosebleeds, stomach problems, hair loss, irritability, and brain fog. Even my vision was yet a fiddling blurry until this past summertime. Simply recently, I went to an ophthalmologist who reassured me that my vision is officially back to 20/xx.

If y'all do decide to go on isotretinoin, I have ii words of advice: 1) Take progress pictures! I promise you will not discover how much your skin has changed without them, and they'll really assistance yous stay positive; and 2) Listen to your body. It's and so important to remainder when yous need it, and say no to going out if your torso needs it. I tried to push myself over and over again, and I ended up worse off in the terminate.

A dermatologist's accept:

"At that place are certainly people who take longer to respond to Accutane," says Rachel Nazarian, Medico, a dermatologist with Schweiger Dermatology in New York City. "This may be due to their own natural resistance, or due to their doctor's dosing regimen, only it's important to retrieve that even when you stop taking the pills, the medication continues to stay in your organization for weeks. So some people may actually outset to show improvement effectually this 'tail end' of handling."

✨ 1.v years post-Accutane ✨

Before Accutane, I used to accept severe acne—generally concentrated on my cheeks and brow, but also along my neck, chest, and dorsum. I took 50mg for the majority of my isotretinoin handling, and luckily, my side effects didn't bear upon my twenty-four hour period-to-day life that much: My eyes, lips, face, and entire trunk were dry out; I had the odd headache hither and there; and toward the end of treatment, I got some joint and back pain.

For the outset month of treatment, my skin as well went through the initial purging period, significant my acne got significantly worse (like, it doubled in severity) before information technology started to calm downwardly again. Those first few months were 100 percent the hardest to endure, just I look back at it all with gratitude. Even though my acne did come back six months afterwards finishing Accutane, it's nowhere near equally astringent—I'd say my pare is 60-lxx percent better than it was before.

Overall, I'm really lucky to have had such a positive experience, with very minor and manageable side effects. When my acne was at its acme severity, my mental wellness truly suffered in all means imaginable. So if my pare ever came to affect me the way it did prior to isotretinoin, I would probably go on it again.

A dermatologist's take:

"In terms of purging, I'd say a third of my patients come across their acne go worse in those first few months of taking Accutane, while a tertiary see nothing happen at all, and the last third say, 'This is the all-time thing that's ever happened,'" says Dr. Gohara. "For most people, after month three, their improvement takes off like wildfire."

✨ two.5 years post-Accutane ✨

Before isotretinoin, I had astringent cystic acne on my face up, breast, arms, and back. Every time my skin bumped against something, information technology felt like somebody had poked the well-nigh sensitive blister. My acne would and then course keloid scars, which I still take all over my shoulders and back.

I decided to go on Accutane in the fall of 2017. I started with a depression dosage twice a solar day, and so was upped to a stronger dose once a 24-hour interval later a few months. The strongest side consequence I had was dry skin: My scalp and nose were always dry and itchy, and my lips were constantly cracked. The 2nd side effect was a lower alcohol tolerance. I think going out with friends early on in my Accutane journey, drinking only a few drinks, and getting a terrible hangover and headache that lasted style longer than my usual hangovers. Thankfully, these were my only two large side effects, and they went away on their ain inside two months afterwards treatment.

Because my body tolerated Accutane so well and the results were then excellent, I finished afterwards six months rather than the anticipated nine. I'm and then happy I did information technology, and I wish I hadn't been so scared in the first place. The all-time part is that my skin isn't constantly inflamed anymore—I can wear makeup, bras, and any clothes I want without being in constant hurting. And at present, whenever I exercise go the occasional pimple, I'm not worried that I'1000 virtually to face clusters of inflammation for months.

A dermatologist'due south accept:

"In full general, it'due south recommended that people avert booze while on isotretinoin," says Dr. Garshick. Not only does Accutane already put a bunch of stress on your liver (which is the same organ responsible for processing all those White Claws y'all potable), but it also dries your body out. Basically, you're setting yourself upwards to have a major hangover the side by side 24-hour interval.

✨ Four years post-Accutane ✨

I used to have patches of painful cysts and nodules underneath my skin that didn't respond to regular acne treatments. I grew upwards in a embankment town and would clothing a full face of makeup to the embankment, or beg not to go to school because I was having a especially bad skin day.

I ended upwardly doing two rounds of isotretinoin nearly iv years apart. The get-go fourth dimension, it worked perfectly, and I didn't have a unmarried pimple for three years. Over time, though, my acne came back even worse and more painful than earlier, so I ended upward doing a second round of treatment. It's been virtually four years since I finished, and while I still get an occasional pimple, my acne hasn't come back at all. I have no residual effects from the medication, and all of my deep acne scars have gone away, too.

For me, the biggest side furnishings I dealt with were an extremely dry olfactory organ and lips, and I had large patches of cracked and scaly pare. Simply all of information technology started to become away within a few weeks subsequently I finished the medication. I honestly wouldn't hesitate to go back on isotretinoin if my acne came back, though. The five or six months of uncomfortable side effects didn't outweigh the nifty benefits for me.

A dermatologist's take:

As Dr. Gohara said, very few (v percentage, if she had to guess) of her patients proceed Accutane a second time, while the vast bulk never see a major breakout again. Again, your results will vary, but rest assured nearly patients run into life-irresolute improvements with a class of isotretinoin.

✨ Five years postal service-Accutane ✨

Before isotretinoin, I had astringent cystic nodular acne, generally on the lower half of my confront, that wouldn't answer to typical acne treatments. The bumps under my skin were and then large and sore that I ended up going on 60mg of Accutane in 2015. Throughout my vi-month dose, everything was dry—my eyes, the insides of my nose (to the point of occasional nosebleeds)—and my joints were super stiff and achy, especially in the morning and at night. Even bending down and picking something up was harder on Accutane; I had to move slower because of how stiff I felt.

Thankfully, all of my side effects ended quickly, just a few weeks after I stopped taking the pill, but my acne started to come dorsum vi months later. In the end, I decided not to go on another dose of Accutane, though, since my acne is so hormonally driven that I experience like information technology wouldn't have helped. I nonetheless have acne five years later on, but I've found more natural ways to care for information technology over the years, and it's nowhere as severe as it was before.

Even though it didn't work for me, I'm withal really grateful I took isotretinoin. Without it, I wouldn't take started my Instagram business relationship @myfacestory and wouldn't have continued with all the people I've had the opportunity to meet online and in person. The fact that Accutane didn't work for me ended up being my gateway to pare positivity; it helped me accept and beloved my skin no matter what information technology looks like.

A dermatologist's have:

Ask a dozen dermatologists for their thoughts on isotretinoin and hormonal acne, and yous'll probably get a fifty/50 split in opinions. Some dermatologists believe isotretinoin isn't super effective for hormonal acne in women, but Dr. Gohara (and many others) disagrees.

"We know that acne is caused past a hormonal surge that triggers your oil glands to produce oil, allowing leaner to settle in and create inflammation," says Dr. Gohara, "then information technology but doesn't make sense to me that this process wouldn't answer well to isotretinoin. I think that in the cases where a patient's skin isn't responsive to Accutane, it'southward because that person's body merely isn't responsive to Accutane—which tin can happen in some people."

✨ Eight years post-Accutane ✨

The best way I could depict my peel prior to isotretinoin is...painful. There was a period of at least five years where I don't think waking up without my confront hurting. I really got fired from a job at a dazzler counter in college considering the director thought I made a bad impression on customers because of how my skin looked.

Accutane ended upwardly working really quickly and really successfully on my acne, but I also had nearly every side effect—the virtually annoying of which was the dry out skin. I needed to apply lotion to my face, hands, and body all the time, and I dealt with horrible joint pain, especially in my hips. Considering isotretinoin dries up a lot of your torso's natural moisture and lubrication, even my anus (yup) was dry, which meant taking a sh*t was ane of the most painful experiences of my life.

I also experienced suicidal thoughts and ideations toward the cease of my treatment, simply I didn't want my derm to pull me off the meds—at that point in my life, I thought my skin was more important than my mental health, but I should accept been upfront with my dermatologist (I absolutely don't recommend this dangerous behavior, FYI).

Within six months, my acne cleared up, and my dermatologist decided I no longer needed to take isotretinoin. All of my side effects disappeared inside a month, except for the depression. To be fair, I've ever had depression in some form, but I had never had suicidal ideations until I was on isotretinoin. Still, as awful as some of my side effects were, I don't regret a 2d of it. I was so self conscious about my skin that I used to hide in the bathroom and weep. I truly believe that Accutane was the only feasible treatment for my cystic acne.

A dermatologist's take:

According to Dr. Nazarian, less than ane per centum of her patients feel mental health symptoms while on isotretinoin. As for Dr. Gohara, "scientifically, there'southward no correlation between isotretinoin and low or feet, only anecdotally, I see it in x percent or less of patients," she says. "If somebody has a pre-existing mental health condition or is seeing a mental healthcare provider, I make sure that provider is on lath with Accutane before I fifty-fifty start information technology, and that we are in really shut contact so we can quickly lower the patient'southward dose or come up off of the medication ASAP if need be."

If you or someone you lot know is considering suicide, call the National Suicide Prevention Lifeline at 800-273-8255 or contact the Crunch Text Line past texting Dwelling to 741-741.

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