Accutane: What to Know Before You Say Yes
2 June, 2025

by Jenna Curcio
If you’ve tried everything for severe acne — topicals, antibiotics, and every OTC spot treatment — and still feel stuck, Accutane might be the next step. But before you commit, it’s key to understand how it works, what the side effects are, and why a board-certified dermatologist is your go-to for guidance.
Here’s what to know so you can make an informed, empowered decision.
Accutane Basics: What It Is + Who It’s For
Accutane (aka isotretinoin) is a prescription oral medication made for treating severe acne — especially when other treatment options haven’t helped. It's often used for nodular or cystic acne that leaves marks and lingers despite a solid routine.
It works by shrinking oil glands, lowering sebum production, and changing how your skin renews itself. Translation? Fewer clogged pores and less inflammation over time.
Most importantly, Accutane should only be considered with support from a board-certified dermatologist, since it requires close monitoring and isn’t one-size-fits-all.
When to Consider It
Accutane isn’t usually your first stop, but it might be the right call if you’re dealing with:
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Severe or nodular acne that won’t quit
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Scarring or dark spots from recurring breakouts
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Acne that hasn’t responded to other treatment options (like oral antibiotics or retinoids)
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A skin journey that’s starting to affect your confidence
If that sounds familiar, your dermatologist can walk you through whether it’s time to give this a go.
Side Effects: What to Expect + How to Deal
Accutane comes with real side effects, which is why regular check-ins with your dermatologist are part of the deal. Common side effects include:
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Dry lips and dry skin (very dry, like constantly reaching for Aquaphor dry)
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Sun sensitivity — SPF isn’t optional
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An initial breakout in the first few weeks (even months in some cases)
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Mood shifts (always share your mental health history with your provider)
More rarely, it can affect your liver, cholesterol, or digestion — which is why monthly labs are standard.
You’ll also need to:
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Join the iPLEDGE program (if you could become pregnant)
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Take regular blood tests before and during treatment
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Use two forms of birth control
It’s a lot and a big commitment — but it’s also manageable with support.
Your Routine on Accutane: Keep It Gentle
While Accutane works from the inside, your skincare needs to support your barrier from the outside. That means:
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Cleanse gently with something like the Chamomile Jelly Cleanser—it’s non-stripping and ideal for dry, reactive skin.
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Moisturize daily with something rich but acne-safe.
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Skip harsh actives like AHAs, BHAs, and retinoids unless your derm says otherwise.
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Keep SPF in your rotation, every day.
How Long It Takes + What Results Look Like
Most Accutane courses last around 4–6 months, but it varies. You may start on a lower dose and work your way up depending on how your skin reacts and how you’re tolerating side effects.
Some people see results quickly. Others take longer. Either way, consistency and communication with your board-certified dermatologist make a difference.
And while a second round is sometimes needed, many people experience long-term clarity after just one course. It truly all depends.
Let’s Be Real
Accutane isn’t a quick fix — and it’s definitely not for everyone — but for people with severe acne, it can be a major breakthrough. If you’re considering it, ask questions, weigh your treatment options, and go in with your eyes wide open.
Talk to a board-certified dermatologist who understands your skin and your journey. Know your side effects, prep your skincare lineup, and don’t be afraid to advocate for what feels right for you.

Author
Jenna Curcio
Ciao, I’m Jenna :) I’m a writer and brand strategist with 6+ years of experience telling stories in the beauty world — both professionally and personally. After years of dealing with acne, I know how overwhelming and emotional the skincare journey can be. I’m here to make it feel a little less confusing and a lot more human.