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Accutane Cleared Up My Cystic Acne When Nothing Else Worked — But The Experience Had Its Ups And Downs

It ended up being the best thing I've ever done for my skin — but it wasn't easy, to say the least.

Hi! I'm Inga, a 24-year-old woman who still battles the occasional pimple. But, let me tell you, it's thanks to Accutane that the battle isn't a full-blown war. Here's a makeup-free photo of me, a few years after my 6-month treatment.

For anyone who might not know, Accutane is a prescription drug used to treat and prevent moderate to severe acne.

It works by reducing the amount of oil released by glands in your skin. Because it’s quite powerful and can come with significant side effects, it’s typically only prescribed if your acne hasn’t responded to other treatments.

My acne started in early high school. It was never classified as severe — but it did inhibit my confidence. I never left the house without some sort of concealer to try and mask the embarrassing red bumps. Here's a photo from 2018, about six months before I started Accutane.

Photo from 2018, 6 months before the author started Accutane
Inga Parkel

No matter how many different facial cleansers I tried — including brands like Cetaphil, Proactiv, and St. Ives — I was unsuccessful in my attempts to beat the consistent cystic acne and whiteheads that were most common on my nose and chin. 

When I turned 21, I decided it was finally time to see a professional. I booked an appointment with a dermatologist to figure out if there was anything else that could be done.

A doctor writing a prescription
Peopleimages / Getty Images

On my initial visit, I talked to my dermatologist about ways I could try and treat my acne. I explained that my skin was consistently oily and that I suffered from cystic pimples and the occasional whitehead. Her initial recommendation was to try a topical treatment facial wash that was supposed to be stronger than drugstore face washes, along with a prescription for Veltin gel, which is used to spot treat acne.

After a few months of no improvement, my dermatologist said the last option we could try was Accutane.

Rows of Accutane pills
Miragec / Getty Images

While the Veltin gel did help with spot treatment by excessively drying out active pimples, the topical face wash wasn't doing much to actually prevent new acne. So, I figured Accutane would be my final attempt.

In order to understand what exactly Accutane does to prevent acne, I asked Dr. Y. Claire Chang, a board-certified cosmetic dermatologist, to explain.

Because Accutane works by reducing oil secretion, one of the most common side effects of taking it is very dry skin and lips. I dealt with both over the course of my treatment.

Dani Souza / Via tenor.com

Prior to Accutane, I used to be terrified of lotioning my face for fear that I would make my skin even more oily. But, my six months on Accutane was the first time facial lotion became my absolute saving grace. So was chapstick. 

About a month into treatment, my skin went from extremely oily to extremely dry. The flakiness was nearly as embarrassing as rampant acne, and unfortunately lasted the entire course of the treatment. No matter how much Cetaphil face lotion I slathered on, it never felt like my skin was fully soothed. 

The first few months, I was worried because I wasn't seeing any improvement. I still had my regular acne plus extremely flaky, dry skin — so there was no way I could cover up my pimples without looking like cracked leather. About four months in, though, I started to see some positive first signs.

It's also worth noting that I had to change my skincare routine during my course of treatment. Pre-Accutane, I used face cleansers meant for oily skin, but once Accutane reduced my oil production, I shifted to Cetaphil's gentle skin cleanser and have used it ever since. 

Once the four-month mark hit, my skincare routine shortened to daily face cleansing and moisturizing. I no longer spent excessive time using concealer to cover up pimples, and my face's oil secretion finally leveled out so it wasn't so dry. 

One unexpected pro of lowered oil secretion was that it made my hair less greasy. Typically, I have to wash my hair every day if I don't want to look like a total grease ball. However, on Accutane, I would go 3–4 days without having to wash my hair 😬. And let me tell you, that was a luxury! Sadly, now, I'm back to washing my hair every day.

CBC TELEVISION / Via hellogiggles.com

According to Dr. Chang, other common side effects can include conjunctivitis, itching, facial redness, sun sensitivity, dryness of the nose, nosebleeds, and joint and muscle pains. Less common side effects include hair loss, changes in vision, headaches, mood changes, and elevation in triglyceride levels. However, I was lucky to have only experienced facial dryness. 

The preparation for Accutane is quite extensive. It required ongoing blood tests, pregnancy tests, and an online questionnaire.

A gloved hand holding blood vials
Andrew Brookes / Getty Images/Image Source

Accutane is a drug that can cause severe birth defects, miscarriage, and stillbirths if you get pregnant while taking it, hence the monthly pregnancy tests and monthly checkups with a dermatologist. 

"Female patients must be on two forms of contraception and get monthly pregnancy tests while on the medication," said Dr. Chang. "Females should wait at least 1 month after stopping isotretinoin before getting pregnant."

As mentioned, I took Accutane every day for 6 months, as prescribed by my dermatologist. Since I have insurance, my out-of-pocket cost was only $30 each month.

Some other key takeaways nearly four years after my time on Accutane:

The author smiling
Inga Parkel

It does NOT treat existing acne scars. I still have some scars on my nose from cystic acne, but those have become less noticeable over time, but not as a result of Accutane. As of right now, I don't use anything to treat my acne scars, I've just let them fade with time. 

It doesn't mean you'll never get another pimple again.  I do get the occasional pimple here and there near my period, but that's a result of hormones rather than overactive oil glands.

• You're still responsible for skin maintenance. I still have to wash my face daily. But at the same time, my face's oil production is much more manageable and regulated. (And I don't have to wear concealer anymore.)

All in all? Thanks to Accutane, my confidence has been restored. I would definitely recommend anyone who's tried everything under the sun and still can't find relief to talk with their dermatologist and consider it.

Similarly, Dr. Chang recommends having a comprehensive discussion with your dermatologist to see if you are a candidate as well.

And if you are, weigh the pros and cons. As she explains: "While isotretinoin is highly effective at treating acne, it may not be the best treatment for everyone." 

If you have experience with Accutane or a similar acne treatment, I'd love to hear about it in the comments!