Accutane: What you need to know

September 11, 2017 6 min read 0 Comments

Accutane: What you need to know

By Kali Kushner

accutane before after

What would you say if I told you that you could take a miracle pill for 4-6 months that would cure your acne for LIFE? Bring it on, right? Well if you're a severe cystic acne sufferer like me who has literally tried everything from antibiotics to light therapy and grudgingly failed, you'd probably say "where do I sign up??" and "why haven't I heard about this before?!" At least that was my initial reaction when I first heard about Accutane.

What is Accutane?

Accutane, also known as Isotretinoin or Roaccutane, is a form of vitamin A that has been on the market since 1982 to treat severe nodular cystic acne. Although the original brand of Accutane by Roche Pharmaceuticals no longer exists (confusing, right?), there are still generic options like Claravis, Zenatane, Absorica, and Myorisan that all contain the same active ingredient- Isotretinoin. This drug works by shrinking your oil glands, reducing acne bacteria and inflammation, and preventing clogged pores. Sounds amazing, AMIRITE?

Since its debut, Accutane remains to be the most effective acne medication on the market, period. Although I can't find any actual statistically data supporting this, my dermatologist once told me that Accutane clears about 85%-90% of acne in all patients, and that only 15% need a second course. What I have come to realize over the past few years is that the figure she provided me is wildly incorrect. Relapse rates are all over the board and although Isotretinoin holds promises of clear skin for life, that isn't always the case.

Can You Relapse After Accutane?

Isotretinoin is a heavy subject for acne sufferers all around because it clears some people's acne for life, others have to do multiple courses, and there are a handful of those straight up against it. It can be dream shattering to go through a course of Accutane, be completely acne free and then one day have all your spots magically return. If this has happened to you, know that you aren't alone! It is actually quite common to relapse within your first few years of being off of Accutane.

From what I have personally experienced and observed within the Instagram acne community over the past two years is this: Accutane DOES work but it usually isn't 100% permanent. What I mean by this is that your acne may return, but typically in a much lesser amount. Let's say you had severe cystic acne that covered your entire face, once your course is completed you may still get a cystic spot once a month or even once every two months. Most people wouldn't consider that as relapsing- however if you were someone who only had a few cysts a month and those few cysts returned once your course was completed, you may think of it as a relapse. Statistically relapse rates fall anywhere between 10% and 60% because there are so many different variables that play into relapsing; most of which you cannot control. Some of the biggest factors that can increase your chances of relapsing are:

Severity of acne

Being of male gender

Hormonal Imbalance like PCOS; Polycystic Ovarian Syndrome in women

Not taking Accutane with enough bioavailable food

Not reaching a cumulative dose of 120 mg/kg

Side Effects of Accutane

For most the idea of being free of such a heavy, life impacting burden like severe cystic acne sounds like a dream come true. Trust me, as a fellow acne sufferer I know how debilitating severe acne can be and how tempting it can be to say screw it all, I'm going to jump right into this new life of blemish free skin! No more makeup? No more feeling self-conscious in public?! Gimme, gimme, gimme! But let's be clear about one thing- there are a wide range of side effects that can occur while taking the drug. If you choose to take this drug you WILL experience some side effects. The severity and longevity of those effects is what will vary from person to person. So, while I can't tell you exactly how your body will react, what I can say is this- when you take Accutane you are taking a gamble on your health. I'm not saying that to frighten you or discourage you from taking it; I just believe that anyone who is planning on taking Isotretinoin should be fully aware of the side effects that can happen while taking, or even after taking it. Here are just a few side effects that are typically short term, but can be long term as well :

Common side effects from Accutane:

Dry skin



Dry nose


Dry mouth

Dry lips

Cracks in corners of mouth

Dry eyes

Joint paint

Back pain




Hair loss

Rare side effects from Accutane:


Aggressive Behavior

Abnormal Liver tests

Decreased night vision


Fast heartbeat

Thoughts of suicide

Hearing loss

High blood sugar

Inflammatory Bowel Disease

Mood changes

Muscle Pain

Pink Eye



Sudden Blindness

Swollen Lymph nodes

Excessive Hairiness

Inability to have an erection

Sensitivity to light

Safety Procedures

Though side effects are common, there are important safety procedures in place to monitor the patient while taking Isotretinoin.

I pledge: Many people believe once you have taken Accutane you cannot get pregnant. This is simply NOT true. A few friends tried to tell me, "you can't take that! You'll never be able to have kids!" While it IS true that you shouldn't get pregnant while taking isotretinoin, once it is out of your system a few months later- you are in the clear to have a completely normal, healthy baby. If you are a woman who chooses to take Isotretinoin, you must answer Ipledge questions every month as well as have a monthly blood test to prove that you are not pregnant. You should avoid getting pregnant while on Accutane at all costs, because it has been proven to lead to extreme birth defects in children. Ipledge requires women to use two forms of birth control as well as answer about 10-20 questions a month on safe sex or abstinence before they're allowed to pick up their prescription for that month.

Blood work: It is required to have monthly blood tests done while on Accutane to monitor both your triglyceride levels and your cholesterol. Accutane has the ability to raise both of these which can lead to things like metabolic syndrome or heart disease.

Alcohol Consumption: You should not drink on Accutane. For some reason this is one safety procedure people seem to take lightly and I will never understand why. Anytime I see or hear of someone drinking on Accutane I'm like "oh no honey, what is you doinnn?" Drinking on Accutane can cause permanent, irreversible liver damage. Isotretinoin is metabolized through your liver, so once you begin to drink on top of that your liver starts working double overtime. Both alcohol and Accutane can increase the amount of triglycerides in your blood, which again, can be dangerous. I turned 21 during my course of Accutane so I had one drink during my entire 6-month course. Bad decision. The next day I felt like I was hit with a ton of bricks and I could barely move without feeling nauseated, it was hands down the worst hangover of my entire life. 10/10 would not recommend. 

Other Safety Procedures:

Do not donate blood

Do not tan either outside or indoors, minimize sun exposure

Do not wax, use laser, or microdermabrasion until 6 months post treatment

Do not get tattoos until 6 months post treatment

DO NOT BUY ACCUTANE ONLINE! It can only be prescribed by a health professional


With all things considered, Accutane remains the most powerful acne fighting drug on the market today. There may be extreme side effects and a chance for relapse BUT for some, yours truly included, it is worth the price of clear skin. If you're reading this article because you are trying to decide if you want to take Accutane or if it's worth the risk, my advice is talk to those who have taken it. Most people who have taken Accutane understand the way it works will have mostly positive things to say, while those who haven't taken it will have mostly negative things to say. I took Accutane in 2015 and even with all of the side effects and dreaded monthly tests, it has been completely life changing. I did relapse but, I don’t regret it. Not even one bit. 


Giveaway:  To kick off our new blog relaunch - We'll be hosting giveaways in each of our featured blog posts! Articles that were written by Brigid or Kali will be open for a giveaway to win a Banish Kit! To enter: Just comment below something that you learned from reading this post or what your thoughts were! We'll pick a winner at the end of the day! Spam comments will be disqualified.