My Skin Story
What is Accutane?
My Experience with Isotretinoin
Round 2: Trying Isotretinoin Again
Product Recommendations For Acne Prone Skin

My Skin Story

Last month, I finished my second round of Accutane (isotretinoin) and it was way more intense physically and mentally than I expected compared to my first experience. As someone who had tried every acne medication in the book, Accutane was the only thing that “cured” my acne and gave me the clear skin I always dreamed of… until about 3 years later when my acne returned. 

My acne journey began when I was around 14 years old, a bit later than my peers. For years, I tried various topical and oral medications for acne and finally went on birth control pills. This helped with my acne, while I would still get breakouts, they were manageable. 

When I was 21 years old I was misdiagnosed (long story for another blog) and had to go off of birth control pills and onto an IUD. Soon after getting off of birth control pills, I slowly started to develop severe cystic acne (only on my face) like never before. It worsened between 2015 and 2017. 

I tried EVERYTHING, well, almost. I tried topical solutions, changing diet, medication, facials, everything short of Accutane. Some things did nothing, others helped a bit, but nothing did enough. Besides the physical aspects of living with acne, this took a toll on me, mentally. While dealing with all my medical problems, having to deal with acne as an adult for the first time was confusing and embarrassing. I’m a bit impulsive and couldn’t help but pick at and mess with my acne causing it to become worse and lead to scarring. 

I know we are our own worst critics and this couldn’t have been more true for me during this time. I had moved from the U.S. to Spain in 2017 and for my first year abroad I wouldn’t go outside without full coverup and makeup. The acne messed with my confidence and increased my social anxiety. 

Finally, in Spain, I decided I couldn’t live my life in the shadows any longer. I hated rejecting plans if they were too last minute, outdoorsy or sporty (my favorite kind of activities) if I wasn’t feeling free to go out without makeup. Although when I confided to people about problems with acne, they were surprised and would say that it wasn’t “that bad” because I became a pro at covering my acne and “flaws” with loads of makeup that looked somewhat natural. Don’t get me wrong, I love makeup for fun and art, but it was becoming a chore and lost its appeal. 

I was willing to do anything at that point. So, I decided to give Accutane a try. 

What is Accutane?

Accutane is a medication with the active ingredient, isotretinoin. So, I actually didn’t take Accutane, but I took a medication called Dercutane in Spain. Dercutane has the same active ingredient as Accutane, isotretinoin. (Like how Advil and Motrin are both ibuprofen)

Technically speaking, “Isotretinoin is an oral prescription medication that affects sebaceous glands and is used to treat severe acne. The drug was approved by the US Food and Drug Administration (FDA) in 1982 to treat severe, resistant, nodular acne that is unresponsive to conventional therapy, including systemic antibiotics.” “Isotretinoin is an orally administered systemic retinoid.” “While the exact mechanism of action is unknown, isotretinoin inhibits sebaceous gland function and keratinization at pharmacologic doses. The drug has been observed to reduce both the sebaceous gland size and sebum production.” https://www.ncbi.nlm.nih.gov/books/NBK525949/

My Experience with Isotretinoin

I remember as a teenager, accutane has such a bad rap. I heard horror stories about this super intense medication (and after doing two round of it, many of the warnings now seem justified). This is my experience, and why I decided to do it again. My first round of medication was many years ago but I this is how I remember it. 

After doing my own research I noticed there were two main routes people take with this medication. One way is to take a higher dosage for a shorter period of time, or take a smaller dosage for a longer period of time. I was advised to take a smaller dosage for a longer period to lessen possible side effects. I am very glad I chose that route, as I ended up being affected with many side effects anyway. 

For first round of isotretinoin, I was placed on 20 mg a day and took it for almost a year to reach a sufficient cumulative dose for my body weight. Before starting medication and every month or so during treatment, I had to take a blood test to ensure the medication wasn’t causing problems in my body. Along with the blood test, I also had to take a pregnancy test because you must not be pregnant while on this medication as it will cause birth defects. 

I went through my private health insurance in Spain which covered the cost of the doctors visits and the blood tests, however I had to pay out of pocket for the medication. (I think if you go through public health care in Spain the cost of the medication is reduced.) Dercutane cost me about 42 euro/ box of 50 pills. It was expensive but compared to other products and facials I’ve tried, it was a small price to pay for the promise of a lifetime of clear skin. During my second round of Isotretinoin I used a generic brand and the cost was a bit less, around 34 euro/box of 50 pills. 

During the first course, my side effects included dry lips, dry skin, dry eyes, bruising/ cutting easily, sensitive skin, weak muscles/joints, and alcohol flush (although you SHOULD NOT drink any alcohol while on this medication). The worst side effect for me was dry eyes. My eyes began to hurt so much and were so sensitive to light that I had to go to the doctor and start eye treatment. I stopped wearing contacts for almost the entirety of the rest of my treatment and would only wear contacts at night for special occasions.

I also had to change my whole skin care routine while I was on the medication because my skin was so sensitive for example, no retinoids or  (I’ll link some of my essential products for during/ post treatment below). I was not allowed to do any hair removal (waxing/ laser/ threading/ electrolysis) besides shaving, so keep this in mind. Also, I had to stay out of the sun and wear as much sun protection as possible when I couldn’t stay out of the sun. For this reason I recommend starting Accutane after the summer. 

I started to see results about 1.5 months into treatment. At first, my skin seemed to get worse because I developed real pimples (the kind with white heads) but the cystic acne was decreasing bit by bit. Finally it seemed to clear up entirely and despite my acne scars I had the perfect skin than it had ever been in my life (before high school). I lived in bliss of perfect skin and mostly no makeup for years, until last summer. 

ROUND 2: Trying Isotretinoin Again

My skin stayed clear for the next 3 years. I’m not sure if it was caused by a change in hormones when I had to replace my IUD, or if it was just because I was in the unlucky percentage of people that has an acne relapse. But, I noticed that I was slowly starting to develop cystic acne again and wanted to get back on treatment before it got worse. 

I thought I knew what to expect from my first round of accurate, but I was mistaken. Although my second round of isotretinoin was shorter than the first, it was way more difficult and filled with intensified side effects. My second round of Isotretinoin started with 10 mg/day for a month and then upped to 20 mg/day. 

My skin reacted similarly as it did the first time, with the skin purging and breaking out with white heads for about a month (unlike the cysts that I was trying to get rid of). However, I had horrible stomach aches, muscle/ joint aches, bloating, insomnia and depression that I didn’t experience the first time. I also got menstrual cramps like I haven’t had in years. The pain was so bad I had to go to the doctor who told me this was normal during the first month on the medication. 

The major bloating subsided within a few months, but my appetite increased and I gained weight. Along with the dry and sensitive skin, lips, and eyes that I experienced the first time, it took a serious toll on my body and sleep. I had insomnia so bad that I eventually started taking melatonin. 

By far the worst thing that happened during my second round of Isotretinoin was when I fell and injured my hip. I think that my muscles/joints were more prone to injury (a side effect of the medication). I ended up being couch bound for a few weeks and unable to walk normally for a few months. As an exercise/ running enthusiast, it was difficult for me to accept that I needed to adjust my workout routine. 

Due to the bloating, increased appetite and injury, I ultimately gained about 10 pounds. But, I was determined to get through this treatment. I wanted to be done with isotretinoin forever (fingers crossed). 

Today, after being off of the medication for a month, my skin is very clear. With the bloating gone, my appetite back to normal, and the resumption of exercise, I’m starting to shed the extra weight.

While the second round of treatment was very difficult mentally and physically, I do believe it was worth it for me and I still believe in the possibility of forever clear skin. I love being able to go out without makeup, feeling free and confident, and I am working on feeling that way regardless of my skin. 

My Top 3 Product Recommendations For Acne Prone Skin

Disclosure: These are my honest opinions and I may be compensated when the affiliate links below are used.

1. Acne Scar Cream: My favorite product for acne scars is Mederma PM. After years of using this product I can say it worked great for me. After a few weeks of using it there was a noticeable improvement in my scars. Also, it helped to manage breakouts during treatment as it is a gentle formula. I used it as my nightly moisturizer before, during and after treatment. 

Note: This product comes in a bigger size tub which seems like a better deal, however I was advised that the big tub means that the product is more exposed to oxygen and other things in the air that can degenerate the active ingredients. I was advised that the tube products in general last longer and are more effective than when they are stored in a tub. 

2. Pimple Patches

One of the biggest challenges with my acne was to just LEAVE IT ALONE. I would always pop and pick at my skin. I would just slap the pimple patches on and not touch my face. They also facilitated healing. I used to use the COSRX Acne Pimple Patches when I lived in the U.S., and used MEDca Acne Patches when I lived in Spain.

3. Gentle Cleanser: When I first started the medication, I had to switch to gentle products (i.e. without salicylic acid and retinol).CeraVe Hydrating Cleanser was This cleaner was perfect for my newly dry and sensitive skin. Alone, it was almost strong enough to remove all my makeup without using my makeup remover. It’s a strong yet gentle formula perfect for sensitive skin.

After stopping the medication, I switched to a cleanser that was for normal to oily skin, CeraVe Foaming Cleanser. I am still currently using this cleanser and I love it. It does an incredible job of removing left over makeup, doesn’t irritate my sensitive skin, and was more affordable than all of the face products that I was using before starting the medication.

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Disclaimer: I am not a medical professional, I am simply sharing my experience. Please consult with a medical professional regarding all advice and information presented here.