
Acne can be stubborn and difficult to treat, particularly in cases where standard topical treatments and over-the-counter solutions have failed. For those with moderate to severe acne, isotretinoin (previously known as Accutane) is often prescribed as a highly effective treatment option.
Derived from vitamin A, isotretinoin tackles the underlying causes of acne, leading to long-lasting improvements. In this article, we’ll guide you through the isotretinoin treatment journey and discuss what to expect along the way.
What is isotretinoin?
Isotretinoin is an oral medication used to treat severe forms of acne that don’t respond to other treatments. It works by significantly reducing the production of oil (sebum) in the skin, preventing clogged pores that lead to acne. Isotretinoin also promotes skin renewal and has anti-inflammatory effects, making it highly effective in achieving clearer skin over time.
Before starting isotretinoin: Important steps
Initial consultation with your dermatologist
Before you can begin isotretinoin, you’ll need a consultation with a dermatologist to assess your skin and health history. Because isotretinoin has potential side effects, it’s important to share any pre-existing health conditions and medications you are currently taking.
Blood tests: A blood test is often required to monitor liver function and cholesterol levels, as isotretinoin may impact both. Regular blood tests will continue throughout the treatment.
Pregnancy precautions: Isotretinoin can cause severe birth defects, making it essential for female patients to follow strict contraceptive measures during treatment and for two months after stopping the medication. Monthly pregnancy tests and ongoing contraceptive use are necessary during this time.
Setting expectations
Isotretinoin works wonders for many, but it’s not an immediate solution. The results take time to appear, often requiring several months before significant improvements can be seen. The treatment process requires patience and consistency.
Stages of the isotretinoin treatment journey
Weeks 1-4: Getting started
During the initial phase of isotretinoin treatment, your body adjusts to the medication. Most dermatologists begin with a low dose to minimise side effects.
Initial breakout: It’s common for acne to worsen temporarily, known as the “purging phase,” as the medication accelerates skin cell turnover.
Dryness: One of the first side effects is skin dryness, particularly on the lips, eyes, and face, as the skin’s natural oil production decreases.
Key tips: Stay hydrated, use a gentle cleanser, and apply fragrance-free moisturisers and lip balms to combat dryness. Avoid harsh exfoliants.
Weeks 5-16: Middle phase
At this stage, your body is more accustomed to isotretinoin, and visible improvements may begin. Many people experience fewer breakouts and a smoother skin texture.
Ongoing dryness: Dry skin and lips will likely persist, and some may experience joint stiffness or muscle aches. In rare cases, mood changes can occur.
Flare-ups: While acne improves for most, some occasional flare-ups might still occur. Staying consistent with the prescribed regimen is key.
Key tips: Continue using moisturisers and protect your skin from the sun with broad-spectrum sunscreen, as isotretinoin increases sun sensitivity. Attend all follow-up appointments to adjust dosages if needed.
Weeks 16-52: Final phase
The length of isotretinoin treatment varies depending on individual factors like body weight, dosage tolerance, and acne severity. A typical course lasts between 5 to 8 months, though some treatments can extend to 12 months to ensure optimal results.
By this stage, most patients will see a substantial reduction in acne. With the completion of the treatment, many experience clear or nearly clear skin.
Reduced oil production: Your skin will produce much less oil, leading to fewer breakouts and improved overall skin condition.
Fading scars: While isotretinoin reduces acne, existing scars may still remain. Treatments like laser therapy or microneedling can be considered post-treatment for further scar reduction.
Key tips: Continue gentle skincare and consistent sun protection to avoid worsening scars or pigmentation.
After completing isotretinoin treatment
After the isotretinoin course is finished, most people experience lasting relief from acne. Approximately 80% of patients will see long-term acne remission. However, post-treatment care is important to maintain results and manage any lingering side effects.
- Skincare post-treatment|
Even after acne clears, your skin may remain sensitive for several months. Stick to mild, non-irritating products and avoid aggressive treatments as your skin heals.
- Relapse and retreatment
Although many achieve long-term results, a small percentage of patients may experience a relapse of acne. In such cases, a shorter course of isotretinoin or other treatments may be recommended by your dermatologist.
- Monitoring side effects
Side effects such as dry skin often subside after treatment, but your dermatologist will continue to monitor your progress. If you’re female and of childbearing age, contraception needs to be maintained for at least one month after stopping isotretinoin.
Common side effects of isotretinoin
Isotretinoin is a strong medication, and side effects vary from person to person. The most common include:
- Dry skin and lips
- Nosebleeds due to dry nasal passages
- Joint or muscle aches
- Mood changes (rare)
- Increased sensitivity to the sun
Is isotretinoin right for you?
Isotretinoin is often a game-changer for individuals with persistent acne, offering long-term relief. While the treatment requires patience and side effects must be carefully managed, many patients find the results well worth the effort. Clearer skin is within reach for those who follow through with the treatment plan.
If you’re considering isotretinoin, or if you’re currently on the medication, maintaining open communication with your dermatologist is key. Regular check-ups, proper skincare, and close monitoring will help you achieve the best possible outcome.
Start your acne treatment journey with Dermo Direct
At Dermo Direct, we specialise in managing a variety of acne conditions, including those requiring isotretinoin. Our expert dermatologists provide personalised consultations online, allowing you to access professional acne care from anywhere in Australia. Begin your journey towards clear, healthy skin by booking a consultation with us today!