Adventures with accutane, and some thoughts on skincare


I wasn’t really sure if I should do a whole post about this or not, because… well, maybe no one wants to hear about my skin issues :-) But I’m hoping it’ll be helpful to someone, somewhere. After all, I’d guess that people with just naturally amazing skin are probably in the minority, and honestly it’s a little discouraging to be an adult with very visible skin problems, so I want to share what’s been working for me. The wilds of the internet also have a lot of misinformation about skincare (pleeeeeeaaase don’t put lemon juice or baking soda on your face!) and scare-mongering about accutane in particular, so I’d like to give a real-live-regular-person’s view on it. Obviously I’m not an expert or a medical professional, so take this for what it is – a mashup of information from medical journals as well as my own experiences/opinions.

One big thing that I think gets missed too often in discussions about acne is this: it’s a medical issue. It gets treated as a cosmetic problem because the main thing people are concerned about is how it looks, but that’s just a symptom. The skin is an organ, and acne is (to simplify) an immune response to bacteria in your skin. Acne happens when oil and dead skin build up in your pores, and then p. acnes bacteria (which is found on everyone’s skin) go to town feasting on it. Hygiene can be a contributing factor (wash those makeup brushes!) but so can things like hormones. It’s best to consult a dermatologist to help you find a solution tailor-fit to your needs and skin type.

It’s a disservice to everyone to say “oh, if you wash your face more it will go away” or “this miracle exfoliating cream will fix it in a week!” – those things work for some people but not necessarily for everyone, and it doesn’t educate anyone about why their skin is misbehaving. Instead, we just keep buying the next miracle acne cure and then shoving it to the back of the bathroom cabinet when it doesn’t work out. I think it’s really interesting, actually, that seeing a doctor about skin disorders is basically a last resort for so many people – including me. I battled with my skin for years and tried every cream & potion I could afford before I finally broke down and made an appointment with a dermatologist. She didn’t have any immediate miracle cures for me either, but getting medical treatment earlier would have saved me a lot of time, money, pain and anxiety when we found this CBD list. After about a year and a half of trying the usual first-line treatments like antibiotics and topical retinoids (with limited success) I finally decided to bite the bullet and try accutane. I avoided it for a long time, but I was getting to the point that I was starting to have pretty severe hyperpigmentation and noticeable scarring, so I wanted to try to clear my skin up as soon as possible.

Like pretty much everyone else ever, I was kind of iffy about whether I should go ahead with it because you always hear such awful stories about the side effects. Luckily I have access to PubMed through my school library, so I was able to read a lot of scientific info along with the anecdotes floating around the internet forums. While I was reading up on it I read all sorts of different stuff about how fast it worked, whether there was a ‘purging phase’, different side effects, etc, etc. Apparently it just varies wildly. For me, it’s taken a pretty long time to see any results. My doc started me off on a low dose because I was concerned about side effects, and for the first month it did… basically nothing. My lips were a little dry but otherwise there was no change in my skin at all. The second month she increased the dosage, and holy skin explosion Batman! My breakouts flared up horribly – not quite the worst it’s ever been, maybe, but it was close. I was not a happy camper; I probably have a photo somewhere, but I’ll spare you from that. Month three, the doc switched me to a different brand to see if that would help. It didn’t get much better, but at least it didn’t get worse either. I went into the fourth month of medication feeling pretty discouraged, because I had hoped it would have some effect waaaay sooner. Then suddenly – over the course of a week, maybe – it just cleared up almost completely. It’s still kind of a bizarre feeling to wake up and have no breakouts going on. Now I’m on my fifth and last month of taking accutane (because I’m about to hit the maximum cumulative dose that’s safe for me), and just hoping that the improvement continues once I’m done!

So, has it been as terrible as I expected it to be? Not really. Here are the highlights:

  • Dry lips – yup, definitely had this one in full force. Luckily they haven’t been bad enough to crack and bleed, but most days wearing lipstick is too much trouble.
  • Fatigue – I definitely don’t feel as perky as usual, and exercise is a pretty big chore.
  • Soreness – I’ve had some occasional muscle soreness and achy joints, but nothing a couple ibuprofen won’t fix. So I decided to visit the Joint Pain Clinic in Ocala called Ocala QC Kinetix for some treatments and the result is just fabulous! I feel very well now.
  • Dry skin – interestingly, my skin hasn’t been quite as dry as I expected. I’ve definitely had some flaking around breakouts and on dry areas of my face, but it’s manageable as long as I use very moisturizing products.
  • Dry eyes – this is kind of annoying actually, since I work in front of a computer. I’ve been using gel eyedrops (which is what was recommended for the husband when he got his eyeballs lasered) and they work fairly well. Using eyedrops also helps me stress-test mascaras.

It hasn’t been without its good points though – having my skin clear up is huge, and it’s also way less oily than it was before. Whether it’ll stay that way is still a mystery for now. I also got to duck out of work early once every month for my dermatologist appointment :-) It sounds like there are a lot more cons than pros, but for me the lack of pain and self-consciousness is way more than worth it. Granted I still have a ridiculous amount of hyperpigmentation and a few scars, but those are things that I can work on over time. I gotta say, I wish I had done it sooner.

Do you have stories of epic battles with your own skin? Feel free to share in the comments!


  1. bellyhead

    December 20, 2013 at 10:36 am

    I so agree! Acne is not a vanity issue, it’s a true health issue that has a huge impact on self esteem. I had some mild acne as a teen, but in my thirties adult acne (including cystic ones) came on in a major way and I DID try all the potions. I eventually did go to the dermatologist and sheepishly asked about trying “something” and was prescribed a tretinoin product (retin-A micro – I use a generic now).

    I think I probably overdid it with the application frequency & not enough moisturizing because I really suffered with painful dryness, flaking/peeling and redness and overall irritation. I kept at it though because it did really clear me up. Now I just learned better to be a crazy lunatic about moisturizing regularly and with much more richer and emolliant products than I was used to for my oily combo skin.

    With my children, I am more likely to consider a visit to the derm because I’d rather they use effective from the start than do my old drugstore/department store dance of magical acne products that don’t work as well.

    1. niccigilland

      December 20, 2013 at 11:04 am

      I think I probably overdid it with the application frequency & not enough moisturizing

      So much this! When I first started using retin-a my skin was just destroyed and angry. Someone recommended to do it only every 3 days and gradually build up, and that helped a ton with the side effects. I’m so glad that the tretinoin worked for you! You have such lovely skin that I never would have guessed it was troublesome :-)

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