So, about a month ago, I started Accutane. If you’re not familiar, it’s one way to tackle acne problems. It’s practically a last resort for treatment, because there are some serious side effects.
As a teenager, I started the medication and was on it for about eight months. That was in 1995, when the medicine did not come in a generic form (and was thus expensive), and some of the risks were not taken as seriously by the patients. Since then, I think the medicine faced some risks of being taken off the market. Teenagers were committing suicide while on the medication, and I’d guess some people didn’t take the risk of birth defects as seriously. While these should not be taken lightly, the drug really is a miracle drug for people who have found nothing else works for them.
As I’ve experienced things being on the medicine, I’ve tried to look up info on the effects other people had – their progress. In doing so, I found that until you go to the dermatologist, there is really a lack of information you may want before you start. Most people who have questions really just want to know if it’s successful, and don’t really ask about what it takes to be on the drugs. So here’s some info for all of you (I know – not in line with weight loss, but still).
So, I don’t know what they tell the guys, but here is the least you need to know if you’re a woman thinking about taking Accutane:
- You’ll be on it for at least four months, and it is in your system for one month after you stop taking it.
- Your skin will be DRY, particularly your lips, the inside of your nose, and possibly your v-jay.
- The effects last several years (which is why I’m starting on the meds again after 17 years).
- If you’re a woman, you are required to be on two forms of birth control at all times. Pretty sure this is true even if you’ve had a hysterectomy, tubes tied, or have been deemed otherwise sterile (I guess some of these procedures don’t “take”). Your two forms have to come from two separate lists – primary forms and secondary forms (see below).
- You will have two pregnancy tests BEFORE you’re even allowed to start on the medication. One at the doctor appointment where you decide to start on Accutane, and one after 30 days from the first, but while on your period (for me, this took a total of seven weeks).
- Your birth control methods (that is the two forms) start one month before you start taking the medication (and last for one month after you stop).
- You have to have a pregnancy test EVERY month.
- You have to pledge to use the two forms and you will be tested EVERY month on your knowledge of the two forms of BC you identified with your doctor (for example, a question might be “True or False: If you miss two birth control pills, you can continue to have sex as long as you use a condom). Incidentally, the answer is False – you have to not have sex the rest of your pill pack.
Here are the birth control methods:
Primary Forms:
-Tubal sterilization (tying of your tubes)
-Partner’s vasectomy
-Intrauterine device (IUD)
-Hormonal (combination birth control pills, skin patches, shots, under-the-skin implants or vaginal ring)
Secondary Forms:
-Barrier forms (always used with spermicide): Diaphragm or Cervical Cap
-Barrier form (used with or without spermicide): Male latex condom
-Others: Vaginal sponge (contains spermicide)
So, some of you might think I don’t have it that bad when it comes to skin. This is true – I don’t have it THAT bad. Here is my before picture:

So that’s the WORST in the last 2 years. Pretty sure this is the day I decided to start seeing the dermatologist again.

This is an average day before I started on Accutane. Not that bad, right? Zits – all small – mostly around my lips and chin, with small ones on my cheeks and forehead. Honestly, this wouldn’t be bad if I wasn’t throwing every kind of preventative prescription cream on my face, and my derm agreed, which is how we landed on the plan to move forward with Accutane.
I would like to point out that my doc and I had lengthy conversations about my plans to have kids, whether I’d had kids, whether I was seeing anyone, planned to, etc. etc. There was another medicine she had in mind that was not as intense, but required constant usage (and you must also avoid pregnancy), where as Accutane is something you take for a short while and it has longer lasting effects. As I plan to have kids one day, and had previous experience with Accutane, this is the path I chose.

This is today – five weeks into treatment. My camera softens it a little, but i have several recent break outs around my mouth (two under my lips, one on my chin, one at the corner of my mouth). I seem to get breakouts right around my “lady time” each month and they suck. Other people ask me why the medicine isn’t working. Unfortunately, like a lot of acne medications, it gets worse before it gets better. My thought on this: a zit takes on a life cycle which lasts about 6 weeks. So, when you start the meds, you’re speeding up anything that was already started. But, with these period-induced break outs, I’m not so sure.
So when does it end? Well, I have to have two consistent months of no more break outs. As I broke out like a week ago… sigh. You may or may not be able to tell from the above picture though, my nose black heads are GONE. Gone. They were all pebbly about two to three weeks into the medicine. I couple of pore strips (Walgreen’s brand – what what), and I yanked out what the Accutane was pushing out (kind of like baby teeth!). What’s left though are some very big pores which I’ll have to ask my derm about on my next visit (if they don’t shrink by then).
I’ll write another post soon about the worst symptoms (for me) and how I tackle them, and let you in on the best little gift Accutane unexpectedly gave me
By the way, none of my statements have been reviewed by a doctor or by the pharmaceutical company, so take it as one gal’s opinion and talk to your doctor.