Accutane 101: Who It’s For, What to Expect
By Sarina Rubin
June 02, 2025
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For some, breakouts are an occasional inconvenience. For others, they’re a daily struggle—painful, persistent, and resistant to everything they’ve tried. If you’re in the second group, you may have heard about Accutane and wondered if it’s your next step.
Let’s break down the basics of Accutane: what it is, who it’s for, and what to expect if you’re considering it as a treatment option.
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What Is Accutane?
Accutane is the brand name for isotretinoin, a powerful drug that’s only available by prescription. It’s used to treat severe or treatment-resistant acne vulgaris, including nodular acne. It's a form of vitamin A that reduces oil production, unclogs pores, and decreases inflammation at a deeper level than topical treatments can reach.
Though “Accutane” is no longer available under that brand name in the U.S., the term is still commonly used to refer to generic isotretinoin capsules.
Who Is Accutane For?
Accutane is typically reserved for:
- Severe nodular or cystic acne
- Acne that hasn’t responded to topical or oral treatments (like antibiotics or retinoids).
- Recurrent acne that impacts quality of life and may lead to increased risk of scarring.
- A chronic skin condition that hasn’t improved after multiple treatment attempts.
Good to Know: Accutane is not usually a first step—but it can be a powerful and effective option when other therapies haven’t worked.
How Accutane Works
Accutane targets acne from several angles:
- Reduces sebum production (oil) from the sebaceous glands
- Shrinks oil glands to help prevent future breakouts
- Prevents clogged pores by promoting normal skin cell turnover
- Decreases inflammation at the source
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Kills acne-causing bacteria indirectly by changing the skin environment
What to Expect If You Start Accutane
Taking Accutane is a commitment, and knowing what to expect can make the process more manageable.
You’ll Need a Prescription and Close Monitoring
Accutane is only available through a dermatologist and requires monthly check-ins. This includes:
- Regular blood tests to monitor liver function and lipid levels
- Signing up for the iPLEDGE program (required for female patients to prevent serious birth defects)
- Monthly pregnancy tests and documentation of two negative pregnancy tests before starting the medication
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Signed consent forms and agreement to use birth control methods like birth control pills
It’s Usually a Multi-Month Course
Most courses of Accutane last about 4-6 months, though some may go longer or shorter depending on your response or the use of lower doses/higher doses.
Side Effects Are Common (But Manageable)
The most common side effects include:
- Dry skin and dry lips (hydrating products, like lip balm, are essential)
- Increased sun sensitivity (wear SPF daily)
- Flare-ups in the first month (this is temporary and expected)
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Mood changes, including rare suicidal ideation (discuss any history of mental health concerns with your healthcare provider)
Rare but serious side effects include Stevens-Johnson syndrome, toxic epidermal necrolysis, or inflammatory bowel disease. Other side effects may include nosebleeds, joint pain, or temporary increases in cholesterol or liver enzymes—hence the monthly labs. You may also experience dry eyes or changes in night vision.
Tip: You’ll want to build your routine around gentle, hydrating, acne-safe skincare while on Accutane.
Can Accutane Permanently Cure Acne?
Accutane is often the most effective acne treatment available for those with severe acne. For many people, the oral medication can lead to long-term remission, or, in some instances, a permanent cure. Although some people may need a second treatment process or touch-up treatments later in life, most see a significant improvement that lasts well beyond the treatment window.
Skincare Tips While on Accutane
Support your skin from the outside while Accutane does the internal work:
- Use a non-stripping cleanser.
- Apply a rich, non-comedogenic moisturizer daily (and reapply as needed).
- Always wear broad-spectrum SPF—your skin will be more reactive to the sun.
- Avoid harsh actives, such as AHAs, BHAs (salicylic acid), and retinoids unless directed by your derm.
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Be patient; progress is often slow and steady.
The Takeaway: Accutane Isn’t for Everyone—But It Can Be Life-Changing
Accutane isn’t a decision to take lightly. But for people with severe or stubborn acne, it can be the turning point in a long, frustrating skincare journey.
If you’ve tried everything else and nothing has worked, you may want to consider it as one of your treatment options. However, it’s important to discuss Accutane with a board-certified dermatologist and weigh all of its potential side effects to decide whether it’s the best treatment option for you.
Overall, knowing what to expect empowers you to move through this process with more confidence and clarity.