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June 24, 2019 4:54 pm
Is Accutane Actually Dangerous? The Miracle Cure Everyone's Afraid Of
Why this controversial medicine isn't as dangerous as you've been led to believe.
hen I was a teenager, I had 50 pimples scattered across my face at any given time. Yes, literally 5-0. I counted. I tried every over-the-counter and prescription fix available, and while a few of them worked—pretty well, for a couple of years at a time—the clusters of cysts and whiteheadsalways came back. Finally, my mom asked my dermatologist to prescribe me isotretinoin, what used to be called—and is still commonly known as—Accutane.
I took the pill every day for five months and my acne...disappeared. My skin basically did a complete 180, to the point where I’d do actual double takes in the mirror. My friend Maggie, 26, also credits isotretinoin for resetting her skin. “I would not be the same person today without it. It was essential for me,” she texts when I ask about her experience. Like me, she has no regrets.
But the thing is, some people do—or at least, they have questions. Many questions. Google “Accutane” and you’ll see what I mean. “Why is Accutane dangerous?” “Is it safe to use Accutane for acne?” and “What are the risks of taking Accutane?” immediately pop up and link to articles about truly scary potential side effects. (If I had already developed my millennial habit of Googling every Rx I’m prescribed, teenage me might have been too terrified to take my first dose.)
Much of the panic started when a former U.S. representative’s 17-year-old son died by suicide in 2000. He’d been on Accutane for six months before his death (a typical course of treatment lasts four to six months), and his dad blamed the drug, igniting years of contentious debate.
But the thing is, some people do—or at least, they have questions. Many questions. Google “Accutane” and you’ll see what I mean. “Why is Accutane dangerous?” “Is it safe to use Accutane for acne?” and “What are the risks of taking Accutane?” immediately pop up and link to articles about truly scary potential side effects. (If I had already developed my millennial habit of Googling every Rx I’m prescribed, teenage me might have been too terrified to take my first dose.)
Much of the panic started when a former U.S. representative’s 17-year-old son died by suicide in 2000. He’d been on Accutane for six months before his death (a typical course of treatment lasts four to six months), and his dad blamed the drug, igniting years of contentious debate.
Spurred in part by this tragedy and others like it, scientists have looked for clear links between isotretinoin and depression and suicide. Some patients have claimed that taking the medication caused their depression, but so far, there is no conclusive evidence that Accutane directly leads to mental health issues.
Multiple large, controlled studies don’t support that hypothesis,” explains dermatologist and psychiatrist Amy Wechsler, MD. “Actually, we often see an increase in self-esteem and mood during treatment because clearing the skin can promote confidence.” (In the early 2000s, spokespeople for the maker of Accutane argued that since it’s common for teens to have both acne and depression, the two diseases might overlap but treating one has not been proven to lead to the other.)
The five dermatologists I interviewed for this story still stand by Accutane as an over-all safe, effective—the most effective, actually—treatment for acne, especially the stubborn kind that doesn’t respond to anything else. “We’re still learning more about how exactly it works,” admits Rachel Nazarian, MD, “but we know that it shrinks oil glands and makes cell turnover more efficient. And just in the past few months, we’ve learned that it also alters the skin’s microbiome, the collection of good and bad bacteria, to mimic that of someone who doesn’t have inflammatory acne. We know enough for me to feel very comfortable prescribing it to my patients.”
Still, the drug isn’t 100 percent side-effect-free, and one serious warning would give anyone pause: Women should never, ever get pregnant while on Accutane because it can cause serious birth defects. Before taking your first dose, you need to clear two blood or urine pregnancy tests, at least 30 days apart, and literally pledge (via an online FDA program) to use not one but two forms of birth control for one month before, during, and one month after being on the drug. You also need to get monthly follow-up tests to rule out pregnancy, and many doctors will monitor your blood along the way to watch for liver or other complications.
I know that sounds intense. But it’s worth noting that a lot of this stems from strict U.S. regulations.“We’re the only country in the world that monitors isotretinoin to this level,” says dermatologist Dendy Engelman, MD. “You could essentially walk into a pharmacy in South America, ask for it, and get it that day.”
Here’s some more perspective: The derms I talked to have collectively written more than 2,200 isotretinoin prescriptions, and of those, fewer than 15 patients have had serious problems (any of their issues were resolved with a lower dose or a hard stop). “The most common side effects are skin dryness and sun sensitivity,” says Dr. Wechsler. “These are usually managed just fine with lip balm, moisturizer, and SPF.”
Hayden, 26, another friend who’s taken Accutane, says it definitely dehydrated her skin and triggered joint pain. And she’s still dealing with straw-like hair (the drug reduces the size of oil gland sand suppresses oil production everywhere, including on your scalp). But despite these problems, she says, “I have no regrets about taking Accutane. Acne can be paralyzing, and it helped free me of the worst breakouts.”
As for me, the only annoying issues I had while on the drug were the frequent blood tests, flaky lips, and having to figure out how to conceal my pimples while waiting for it to kick in. Actually, I’m considering round two, because after years of no acne (results can last from a year to forever, depending on the patient and dose), I do get the occasional breakout. And now that I’m armed with the latest research and all these derms okays, I am ready to get my yes-I-1000-percent-woke-up-like-this skin back.
Topic starter
June 24, 2019 5:04 pm
As with all drugs there are side effects and they are not to be taken lightly. When I see clients that have tried all kinds of prescription drugs, prescription topical creams, and home over the counter products and still nothing is helping it is sad. Many are teens and do not understand why their acne does not get better. It effects self esteem also.
For some Accutane is a wonder drug and it is the last resort of prescription meds to try. When the acne goes away the people I have seen are so thankful
June 25, 2019 1:54 pm
I have struggled with acne since I was about 13. Even today it still heavily effects my self-esteem. I have been prescribed Rentin-A which worked for a long time and now I'm prescribed Clyndamycin which only seems to help pustules. I have thought about taking Accutane but I have also heard it has a lot of bad side effects. I think it all depends on the person and if the risk is worth it. But of course now that I'm older I know my acne is nowhere near bad enough to need to take it.
June 25, 2019 1:58 pm
I feel like it depends on the person who takes it, you never know how it could affect someone which is why it should be monitored by a doctor but I think in general for people who have acne 3 and 4 that it is a good thing because if nothing else is working to clear up the inflammation and also they're only taking the drug for a couple months until it clears up and that's it then I think it is beneficial in those cases because it's not like they're taking it for a long period of time and it's something that can increase their self esteem and reduce the infection.
June 25, 2019 2:58 pm
All medications have side effects both common and rare. Accutane has been available with a doctor's prescription since the 80s and it's side effects are known and monitored by doctors. The danger is that that now the original patent on the drug has expired it is more available and can even be found on the internet without a prescription and presumably without the warning labels. It may have been overprescribed when it became first available and many of the law suites against the original manufacturer of the drug that awarded money to people harmed by the drug have been overturned. All medications have the potential for side effects. The birth control pill can cause strokes is some women, it is well known and documented but millions of women take the pill and hope they are not the rare case. Accutane should be taken as a last resort for cystic acne but the results are remarkable and will greatly improve quality of life for the person suffering from it. Nothing is without it's risks.
June 25, 2019 9:33 pm
If I had to relive my teenage years again I would go on this drug in a heartbeat, After years of antibiotics and irritating topical creams I was more than ready to just take a pill. This medication came on the market in the 80s and it was at the very end of the worst of my breakouts. When I heard about it I only wished it had been available sooner. After a decade of being an esthetician i have seen several people who have been on this medication and I'm always impressed with what I see. The acne is gone and for some who are very young there is very little discoloration and scarring. This period of my life affected my self esteem and confidence and it took years to get over it. Most meds come with side affects. I think its worse to live with acne and in the long term all the scarring it causes then to take accutane. Plus today patients are momitored monthly to make sure they are not experiencing any negative side affects from this powerful medication.
June 26, 2019 10:14 pm
Like all medications available today it is up to the patient to do significant research. Unfortunately, doctors, these days tend to only have a couple of minutes with each person under their care. There are strict suggested protocols that should be followed before prescribing this medication. A complete health history with questions regarding mental health; prior suicide idealization/attempt, mania, or other disorders need to be disclosed. For females, two consecutive negative pregnancy tests should be done prior to the first dose.
Often times those who suffer from severe acne have a profound sense of loss of control. By educating them and making them part of the care they are empowered.
I feel that if someone is a good candidate this medication should be an option. Often time those who deal with severe acne are young people. These developmental years are important and not fitting in, self-isolation, and sense of helplessness hamper psycho-social development.
Topic starter
June 27, 2019 7:27 pm
Yes too many times drugs are sold by counterfit websites. Accutane is a very strong drug that can be used with acne grade 4. Many times it is the last thing a person will try. People should go to a Dr and be monitered when using it
June 29, 2019 6:50 pm
I think if acne has been resistant for years and not responded well to other remedies it's best to consider going to talk to a doctor and be evaluated for Accutene. Every medications in commerce have side effects and can impact a person negatively if not taken with cognition. Accutene has worked successfully for many of my clients suffering from severe acne the only complaints i have heard was about very dry skin, extra sensitivity to the sun and not being able to wax while taking it. Otherwise i think its best taking a chance with Accutene rather then keeping severe inflamed acne on the skin and risk of scarring.
October 4, 2021 4:04 pm
Prescribing someone accutane takes longer then most people would think. Accutane is a heavy duty prescription that dries your skin beyond means. If your acne is extremely bad and unmanageable, I would recommend going to see a dermatologist for accutane but sometimes its not the best thing to just go straight after just for the benefit of clear skin. As stated before accutane is heavy duty, dermatologists require a pregnancy test before they can even prescribe you the accutane just because again its a harsh drug.
November 22, 2021 1:10 pm
My boyfriend almost went on Accutane and I remember he brought a booklet that had so many warnings and things for him to go over and sign. It was an intense looking booklet and they definitely don't want people drinking alcohol while on it. Needless to say he never started it because he didn't wanna completely give up alcohol yet...
November 22, 2021 1:10 pm
@sydneymissaleiectskin-com yeah it also causes serious birth defects if you get pregnant while taking it!
February 5, 2022 5:09 pm
I have never heard of accutane until I started watching tik tok. Accutane can do wonders for someones skin the has severe acne, but it comes with a lot of side effects like dry skin, vision issues, chapped lips, and joint pains.
February 10, 2022 5:45 pm
I have never had severe enough acne to be prescribed accutane , however i know several people who were on it growing up. It did wonders for their skin but from everyone who has had it, it is more of a last resort kind of thing. It isnt a medication that should be taken lightly. A lot of research should be put into it before deciding to take it. As someone said above, doctors only have a limited time with the patient so often times theyre ready to just prescribe something and see the next person. so with that being said the research is soley dependent on the client.
February 13, 2022 2:43 pm
@keyonnaectskin-com
It is used as after all other treatments have failed. Many people have been helped with this drug as it certainly works. There are many side effects that are bothersome. There are severe side effects such as birth defects.
February 13, 2022 2:45 pm
I would hope that Doctors are cautious when prescribing this medication. It is not the first drug to choose as there are many others that do not have the severe side effects Accutane does
February 14, 2022 2:41 pm
BIG reason why I didn't start it. I was talking to my doctor about while in college and I figured it wasn't going to be a good option haha.
February 14, 2022 2:48 pm
I talked to my doctor about going on Accutane while dealing with adult acne in college. She was very hesitant about starting me on it because of the side effects. She thought my skin would benefit from it. But she did inquire heavily about my mental health at the time.. which I thought was interesting.
This article is interesting because I do agree with what it says about how damaging acne can be to one's self esteem. But what I do not agree with is (and have talked to many friends who have been on Accutane and have verified), that while the Accutane did eventually clear up their acne, it did get worse before it got better. Also, a lot of my friends said that they had extremely dry flaky skin and lips. So I feel like saying that people's self esteem got better while on Accutane may only be for a small handful of people. For the people I know who have been on it and if I were to be on it as well, they were very self conscious while taking it. It wasn't until they were close to being done where their self esteem really improved.
May 5, 2022 12:40 pm
Working in a dermatology office we have prescribed many patients accutane. It isn't for everyone. Girls have to come in once a month for pregnancy tests, be on two forms of birth control (BC and use condoms, condoms and have tubes tied ect.) They also have to answer questions in order to pick up their prescription and we also have to evaluate them for any changes in mental health. Guys just have to come in once a month, we evaluate them and then they have to answer questions to pick up their medication. Women are also not instructed to not get pregnant for a couple months after they stop taking the medication because it could cause birth defects but it doesn't effect your ability to have children.
May 5, 2022 12:42 pm
@marlimartiniectskin-com The patients that we have prescribed Accutane to had terrible cystic acne. They eventually got clear but the most common side effect is dryness, and they can get terribly dry.
May 5, 2022 12:47 pm
@sydneymissaleiectskin-com At our office we give a pregnancy test when they want to start then they have to come back a month later to have another pregnancy test before we prescribe the medication. We also have them take a pregnancy test once a month at their visit. For both males and females we draw blood to get their lab values before we prescribe the medication as well. After females stop they have to come back an additional visit to get another negative pregnancy test.
May 6, 2022 2:29 pm
I do think Accutane is a good drug when all other treatments have been tried. It comes with harsh side effects and birth defects may happen of you get pregnant. As you said you test for that so that is the responsible test to perform
May 6, 2022 2:31 pm
Accutane dehydrates the skin. And with most treatments the acne gets worse before it starts to get better. It is the natural way the skin would react. Things have to work their way up to the top of the skin to get out.
June 19, 2022 8:42 pm
MY friend went on accutane and cleared her skin completley in the 6 months. It does have some side effects like they were saying. She lost alot of hair and her lips were always flakey.
June 19, 2022 8:44 pm
@paigebrickhouseiectskin-com Thats alot for the women. I would be terified to get pregnant. The outcome could really effect your child.
June 19, 2022 8:47 pm
@keyonnastarksiectskin-com I have never heard about the vision changes. Thats strange.
June 21, 2022 9:55 am
Since the drug has many side effects its good to have all the checks and balances you mentioned. Severe birth defects cna happen to women when pregnant
July 26, 2023 1:53 am
Taylor Wynn one of my favorite social media influencers documented her entire accutane experience, she went from having oily, cystic acne, to clear skin. But her skin type changed from oily, to dry skin.
The article states it can dehydrate your skin which in this case happened to her. But her skin has never looked better it totally transformed her life and confidence, but it's definitely not for everyone.
July 26, 2023 2:00 am
@virginiaduffiectskin-com I totally agree that all medications have side effects both common and rare, accutane is not for everybody. I have a friend who has oily cystic acne & her dermatologist recommended accutane, afterward she suffered long term mental health problems and struggled with depression.
However, all things work differently for different people.
July 26, 2023 2:08 am
@marlimartiniectskin-com I would recommend this as a last resort to people based on the fact that accutane has really bad side effects..
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