My 8-month Accutane journey with side effects and results

  • Accutane is the closest there is to a cure for acne, but it comes with a lot of side effects.
  • The side effects include extreme dryness, body soreness, sweating, and tiredness.
  • Insider producer Celia Skvaril was on Accutane for eight months and it helped clear her cyctic acne.
  • Visit Insider’s homepage for more stories.

Following is transcript of the video.

Celia: As many of you know, I’ve been struggling with a really bad hormonal acne breakout for a year and a half. In recent videos, I let you know that I was on Accutane, and I actually was on it for eight months. And now I have been off for a little bit over a month. In November of 2019, my skin got really bad, and I could not figure out why. It was the worst it had ever been, so I eventually decided to go on Accutane. It was hormonal, so there were deep, painful cysts on the sides of my cheeks. It hurt to wash my face, to put on makeup, and it was really taking a toll on my mental health.

My Accutane experience started in October of 2020. I found a dermatologist in my area that I knew prescribed it. What makes me a good candidate for Accutane?

Holly Dimura: So the fact that you have moderate to severe cystics, the fact that you’re getting cysts. I don’t jump to Accutane when someone comes in with just a few little pimples here and there. So we have more cystic acne right here. Those are going to be the harder ones to clear because there’s more contents in there. These little pustules here will probably clear up first. And then even the comedones, which are these, they’re a little white. And if you look at it close, you can see they have like little black dots in them as well. Those are open and closed pores. And those take, I would say, a little bit longer as well, because they really have to dry those oil glands up.

Celia: Something to note about being on Accutane is that you need to get a blood test every month. If you are a person with a uterus, it’s really important that you don’t get pregnant while on it. So you also need to get a pregnancy test every month and be on two forms of birth control. It’s time to take the first pill. Directions for opening. Child-resistant package. There we go. I felt like I started seeing a difference in my skin within a month or two of starting. Obviously it wasn’t drastic like the difference I see now, but I could definitely tell that some of my cysts were starting to heal.

While on Accutane, I used a very simple skincare routine, which was recommended by my dermatologist. I used Cetaphil gentle cleanser and Cerave moisturizer. I would say my worst side effects were dryness, sweating, and body soreness. I got eczema for the first time. I had dry itchy patches all over my body. I actually had to be prescribed a cream for it. I got terrible sores on the sides of my lips that hurt when I ate or opened my mouth at all. I always said to have ChapStick on me, and it had to be Aquaphor or Vaseline, or it didn’t work. I had multiple nosebleeds a month because my nose was so dry. I would groan getting up from a chair or a couch. I had constant lower back pain and it was really hard for me to work out. One of the most terrible symptoms that I had never heard of before was sweating. I swear I have never sweat more than I did on Accutane in my entire life. My upper lip sweat, my eyebrows sweat. Even though I was having all of these symptoms, I was seeing results. So that made it worth it for me. I actually haven’t had a pimple in about three months. My skin is doing great. I was just so happy. Like, if you’ve had acne before, you know that it really is a struggle, and it definitely takes a huge toll on your mental health. So I’m just really happy that I saw a difference with something. And I feel, I just feel really good. Since I still do have scarring and redness, I’m going to talk to Dr. Fatima Fahs about my results and what I can do to help reduce them.

Dr. Fatima Fahs: Well, first of all, congrats on being done with Accutane. It is a journey, and I always tell my patients like, Accutane is no joke. But clearly your results speak for themselves. So it looks like in your after photos, I can see that your acne has definitely cleared up significant. I do see a combination of different types of scarring, both post-inflammatory hyperpigmentation, which is just the surface dark marks on top of the skin, as well as the combination of those rolling scars along your cheeks, and a few little tiny ice pick scars towards the inner part of your cheek. So the very first thing, especially when you’re fresh off Accutane and you’re like, “OK, let me think about my routine and what am I going to get into place?” I always tell my patients that you must, must, must have a sunscreen on board that you love. And probably the No. 1 after sunscreen would be using a topical retinoid. So in terms of in-office treatments, one would be in-office microneedling, which is an amazing treatment. I love lasers or microneedling for this type of rolling scarring that we’re talking about. For the little ice pick scarring, there’s a procedure we do in the office oftentimes called TCA Cross. This is a specific type of chemical peel where we drop a very high percentage of an acid directly into those tiny little ice pick scars. And it, again, helps to slough that layer off and almost fill it in over time. So isotretinoin, or Accutane, is pretty much the closest thing we have to a cure for acne. But it’s really not a one-size-fits-all treatment. And a lot of patients do end up needing topical, or sometimes even oral acne treatment after they’ve completed their course.