To say adult acne is not fun is an understatement. When I went to my dermatologist for help, I was prescribed an intense medication called Accutane or Isotretinoin. I have been taking it the past 7 months and my last pill will be taken tomorrow (yay!) The end result has been amazing but I did experience a lot of ups and downs over the course of the time I have been on the medication. So today, I am sharing my experience with Accutane for adult acne in case it helps someone else who may be dealing with something similar or trying to decide if Accutane is the way to go.
Before we dive in, let me emphasize that I am NOT a medical doctor. I cannot tell you whether Accutane is right, wrong or safe for you. That is a discussion between you and your doctor/dermatologist. This post is only meant to describe the experiences that I personally had while taking Accutane for adult acne.
A Little Background
I have always enjoyed relatively clear skin. A blemish here a blemish there but nothing too crazy and nothing that wasn’t gone in a few days. Fast forward to turning 35 and deciding I no longer wanted to use birth control. I had been on it for over 10 years and it was just time. I was ready to be rid of all that so I stopped using it in January of 2017. All was good for about six months. After that, I started breaking out a little more often than usual. A little annoyance but nothing major. Then things started to escalate pretty quickly.
It got progressively worse until my face and jaw line were covered in painful cystic acne. I was 35 years old! This stuff was supposed to be done with wasn’t it? I couldn’t understand what was happening and I was beyond frustrated with the state of my skin. It got to the point where I was so embarrassed and felt like I couldn’t leave the house without makeup. It was all over and angry and so visible that it started to effect my self-esteem. And before you cue the sad violin, I am well aware that my situation may not compare to someone else struggling with adult acne. This is just an account of MY personal experience and MY feelings on what I was dealing with.
I started to get a little panicked. It was just something so uncharacteristic for me and I wasn’t quite sure how to deal with it. I started by switching to more natural skin care products and getting regular facials. No change. I switched up some of my favorite beauty products just to see. Nada. I even tried just forgoing makeup for a while to see if I was only clogging my pores more by trying to cover it up. I tried coconut oil washes because I had read about it online and coconut oil cures all right? Nope. I even completed a round of Whole30 during that time. I focused on only eating wholesome clean food and got rid of all sugar and dairy and still nothing. After about a year of struggle, I met a dermatologist for an acne consult.
Getting Started With Accutane for Adult Acne
After chatting with the dermatologist and going over all the things I had previously tried, I was prescribed a topical treatment called Epi-Duo and a medication called Spiranolactone. Spiranolactone is typically used as a blood pressure medication but they found it also helped adult acne in women. I figured it was worth a shot and at this point I was pretty desperate. I was told to use both for three months and then come back for a follow-up. After 3 months I was left with no change except some flaky skin due to the drying effects of the Epi-Duo.
When I went in for my follow-up, they discussed options with me and I was prescribed Accutane. I had heard of it and knew what it was because my husband had taken it as a teenager. I knew it was a strong medication with some significant side effects. As a male, my husband's time taking Accutane was a little easier.
As a female, I had to come in to get monthly pregnancy tests in addition to the routine blood tests. If you are a woman, you are required to “Pledge” that you will use two forms of birth control while on Accutane because of the significant risk of birth defects. You also have to answer comprehension questions in the form of on online quiz about this rule every visit. Just something to be aware of if you are considering Accutane.
After all is said and done, I will have taken Accutane for 7 months. Everyone's dosage is different based on your weight and recommended cumulative dosage. As I experienced some of the side effects, I was often asked if I wanted to go down to 1 pill a day instead of 2. Since the prescribed dosage is cumulative, that would just mean I would be on the medication even longer. So when I was experiencing those side effects, I decided to stick with the two pills a day in order to be done as soon as possible.
Speaking of side effects….
The Side Effects of Accutane for Adult Acne
Dry Skin/Skin Sensitivity
This one was expected as it is the number one most common side effect of Accutane. You will be DRY. All. The. Time. Your face and your body. I changed my skincare to something more moisturizing and that definitely helped with some of the dryness. I did at times feel a little itchy all over so I made sure to have lotion around to help with that. The only thing I didn't have to change up was my face wash. I was able to use my tried and true Philosophy Purity Made Simple face wash which has been one of my skin care staples for YEARS. Here are some of the other products that I did switch up to really help me combat the dryness.
Just FYI, this stuff is AMAZING! I feel that it really helped me with my skin's overall texture as well as scarring.
The area I feel the most dry is my mouth/lips. And this has actually gotten even worse the last two weeks for some reason. My lips and the corners of my mouth are often dry and recently the skin there has been flaking off no matter how much moisturizer I use. I know, gross. Luckily I am almost done but it was kind of odd that I had not experienced the intensity like this up until now. To help with my lips, I keep chapstick within an arms reach of wherever I am. In my purse, in my car, at work, in my nightstand, in the bathroom, in the living room- you get the idea. There are lots of special balms on the market but really what worked best for me was Kopari Lip Glossy (linked above) and plain old regular chapstick. Nothin’ fancy.
The other side effect of using Accutane for adult acne is the overall sensitivity of your skin. I could wear SPF 70 and get a sunburn walking from my car in the parking lot to the store on really sunny days. I had to make sure I had SPF with me at all times and I covered up when I was going to be outside. My summer was spent indoors instead of lounging by the pool. Nothing I couldn’t live with.
It is also important to know, that you cannot get waxes (not even bikini waxes), facials or do anything exfoliating while on Accutane. My friend told me about how she got her eyebrows waxed while on Accutane as a teenager and it pulled the skin right off. The horror! I switched to threading for the duration of my Accutane and that seemed to be just fine. I did however, use a brightening peel off mask that ended up burning a little piece of skin on my cheek. Lesson learned. You also cannot do things like get tattoo's because you can end up with severe scarring. And with Accutane, you scar SO easily for the smallest things. Sometimes even when I just absent-mindedly scratched my arm, I would end up with an actual scratch that would last a couple weeks. Because of the susceptibility to scarring and irritation, I would find that I bled more easily. Simple scratches turned into scabs that would bleed. This happened especially around my ears which was odd. Not glamorous but its real life.
Some people noted some significant hair loss with Accutane. I only experienced this on a mild level (thank goodness). It started about 3 months in and it was just a little more shedding in the shower than usual. I think maybe my daily collagen peptides (PS code BEAUTY10 saves you $$ on their website!) helped out to minimize this in my case. I highly recommend them even if you're not taking Accutane! Other people commented their scalp got very dry or itchy which I did experience. My hair has always been a little more oily at the root so if anything, Accutane actually helped the texture of my hair. Go figure.
Update May 2020
Things seem back to normal on the hair front. My hair stylist noticed a lot of baby hairs coming in in the 6 months post Accutane. So luckily what I lost seems to have come back! Now my hair is currently recovering slightly from my 2 year stint with hair extensions.
This side effect was by far the worst for me. The pain in my back and hips started small and progressively got worse the longer I was on the medication. So now, being that I am only a week from finishing, it’s probably the worst it’s been. Everything hurts. All the time. As someone with a pretty active workout routine, this has been the most frustrating thing to deal with. I was getting to the point where I no longer enjoyed my workouts and I dreaded them because I knew it would cause some flare ups. Recently I switched to doing more cycling instead of running or weight bearing exercises to help. I also started seeing a chiropractor. According to my dermatologist these symptoms should dissipate after a couple weeks of being off the medication so I am definitely looking forward of that! Collagen peptides also came to the rescue with side effect to as it helps with joint pain so I can't even imagine what it would have been like if I hadn't been using that daily.
Update May 2020
Thank the Lord baby Jesus that this side effect was gone about a month post Accutane. It was my biggest struggle and I was worried it would continue but I am happy to report that I haven't experienced anything similar to what I felt on Accutane. The normal aches and pains sure, but thats about it. My workouts are back to being enjoyable and something I enjoy.
This was a hard one for me for the few months that I experienced it. I knew ahead of time that one side effect of Accutane is depression symptoms but a couple months in when it started happening to me, I didn’t even think about it being related to the medication. I felt like I was going crazy. I was sad for no reason and always on the verge of tears. I’d have a couple days of feeling like myself and then it would come back. I experienced this for about a month before I realized that it was probably due to the medication. It lasted for about 6 weeks and since then, I haven’t noticed any more symptoms. It definitely made me more sensitive to those who have to endure long-term struggles with depression.
I do wonder though how much of my weight gain over this year (about 15-20 pounds) is attributed to Accutane. Weight gain in itself is not a direct known side effect however, given my history with food and being overweight, whenever I felt sad or angry, I turned to food. This happened often while I was on the medication. And the weight gain only made me more frustrated so it was just a vicious cycle for a while.
Increased Cholesterol/Triglyceride Levels
Accutane can also affect your triglyceride and cholesterol levels which is another reason why the monthly blood tests are required. I did see an increase in those levels the first month or so but after my last test result, my doctor assured me I was still in the normal range so I tried not to worry too much. After a few months of “normal” blood test results, I only had to come in monthly for the pregnancy tests. The pictures below show the progression of both my cholesterol and my triglyceride levels. I plan on getting new tests done after I have been off the medication for a few months just to follow up. If your levels are already high to begin with, it's something to keep in mind and monitor.
In terms of results I am definitely 100% satisfied with the condition of my skin now. Accutane for adult acne totally worked for me. My skin is better than it has ever been in my life. I have not had a breakout in months and when I did, it was a small blemish that was gone in about a day. I am very lucky with scarring as well considering how much I went to town on my face armed with an extractor and a magnifying mirror (don’t judge me. You know you’ve done it). Side note: DO NOT pick at your skin while on Accutane. Because your skin is so sensitive you are much more likely to scar. I learned this lesson when I tried to pick at my face the first few weeks. If I left things alone, blemishes would disappear in about a day or two. When I tried to pick at it, I would end up with a week long scab for the tiniest blemish.
Accutane improved the overall texture and appearance of my skin in addition to clearing up my acne. It truly was a miracle medication for me when it comes to results.
The pictures below are both without filters and without makeup.
Accutane is no joke when it comes to side effects. The ones I did experience are enough to make me hesitate should I ever need to take it again. I don't anticipate having to ever go through it again but they do warn you that some people have to do multiple cycles. Another thing to be aware of.
And to wrap things up, this post is not meant to be pro or against Accutane. Every person experiences side effects differently and you really need to research thoroughly before deciding if it’s something you want to take on. I just want to share my real life experiences with Accutane for adult acne. Both the good and the bad. One of the first things I did when I was prescribed Accutane was google all about other people's experiences. Hopefully this was helpful if you are exploring your options!
Update May 2020
It's officially been 2 years since I took my last pill and I am still so happy with my results. I haven't experienced anything beyond the regular hormonal breakout when my period comes around. I have heard stories of people needing to go on multiple rounds of Accutane so I am very glad that hasn't been the case. Accutane was truly a skin saver for me.
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