What Happens if You Stop Taking Accutane Then Start Again
If you're here right now, I'yard willing to bet you lot've already spent a few dozen hours contemplating/deep-dive-Googling Accutane and everything virtually information technology: the potential side effects, the before-and-subsequently photos, the real-life stories, and the first-person experiences. And I know this because not only have I lived through acne—I'm talkin' a constant rotation of blackheads, whiteheads, and cysts on my face at all times—merely I've besides taken isotretinoin, aka the generic drug name for Accutane (which, FYI, isn't on the market anymore, but anybody still refers to isotretinoin as Accutane anyway).
And because I've been down the research pigsty myself, I also know just how important it is to have first-person stories about isotretinoin that are real—ahem, not simply the horror stories you see on sketch websites—and accurately describe all aspects of isotretinoin. Considering despite what you've heard, dermatologists agree that Accutane isn't actually as scary as it's made out to be (muuuch more on that beneath), and that the vast majority of patients who take isotretinoin are, after their course, totally fine.
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But, hey, I become it—you want details. Which is why I chatted with nine women nigh their before-and-subsequently experiences with isotretinoin, from a few who finished their doses merely a year ago, to some who finished theirs a decade agone, along with expert commentary from dermatologists. Keep reading to find out everything you lot've, well, already been Googling for hours/days/years, starting with…
What is Accutane?
Isotretinoin, commonly referred to as Accutane (note: Accutane was a make proper name for isotretinoin and is no longer manufactured), is a vitamin-A derivative that, when taken orally, minimizes the oil production in your skin. "Accutane permanently shrinks your oil glands so they can't be stimulated every bit easily anymore," Mona Gohara, Md, dermatologist and associate clinical professor at Yale School of Medicine, has told Cosmo . Basically, isotretinoin slowly shuts down the political party in your pores, so acne has a hard time setting upwardly store on your confront.
How long does it take to see results on Accutane?
Unremarkably, you'll offset to see some results from Accutane later a few weeks, with bigger results effectually three months, and best results afterwards six months. But—simply!—your results are almost guaranteed to vary, because when it comes to isotretinoin, there's no universal dose or timeline; it all depends on your weight, your dosing, the severity of your acne, how well your body tolerates the medication, and your dermatologist's guidance.
That being said, many patients tend to take xl-60mg of Accutane a twenty-four hour period for six months—though, again, how many milligrams you take each day and for how long is based on your weight and health. For people with developed female acne (AFA), i.east., women over the age of 25 with stubborn, persistent, hormonal acne, some dermatologists will prescribe a lower dose of Accutane over a longer period (think: 7 to nine months) to minimize the run a risk of relapse. Over again, it all super depends.
Does Accutane piece of work forever?
Ideally, yes, Accutane is a permanent set up to major acne breakouts. Only in reality, even the best-adhering patients can still get the occasional tiny zit (because we're all human, and humans sometimes accidentally sleep in their makeup, or stress out too much, or partake in a bit as well many cocktails), though they'll rarely experience acne as severely every bit before.
"I would say only v percent of my patients go on isotretinoin a second time, either because their acne came back in full, or because they're getting some breakouts that they don't want to deal with once more," says Dr. Gohara. "Some other five percent become a lilliputian bit of acne once more that clears up with retinoids or antibiotics, and the other ninety percent never see a pimple once more."
Is Accutane bad for you?
Near dermatologists hail Accutane as the closest thing to an acne cure that exists, but that's not to say Accutane isn't a serious drug with serious potential side effects—information technology is, and everyone can answer differently to the medication. But does isotretinoin deserve the scary reputation you see on the internet? Definitely non (except, of course, when nosotros talk most its known adventure of causing birth defects, which is why regular blood tests, pregnancy tests, and nascence control is required while taking the drug).
But in terms of the other out-there side effects you hear near, I once polled a scattering of dermatologists who, collectively, had written more than 2,200 isotretinoin prescriptions in their careers. They said out of all their patients, fewer than xv of them had serious problems while taking Accutane—the furnishings of which were resolved with a lower dose or stopping treatment altogether. Again, as with any medication, anybody'due south trunk responds differently, which is why your doctor will be your BFF during your Accutane journey.
Now, ready to get into those before-and-after photos and first-person stories? Idea so. Let's get into it:
✨ Nine months post-Accutane ✨
A few months before I decided to start isotretinoin, I adult a very rare, very astringent type of acne called acne conglobata, which left my face covered in deep, itchy, leaky, and incredibly painful cysts. Information technology afflicted every aspect of my life, and I honestly felt similar a victim to my ain skin. I concluded upwardly going on isotretinoin for a trivial over eight months, and for the majority of that fourth dimension, I was on 30mg: a lower dose than the usual 40-60mg, but the perfect dose for me.
I had pretty much all the side effects that you hear almost with Accutane: I was tired all the time, no matter how much sleep I got; my skin dried out to the point of getting little flakes everywhere; I couldn't exercise without getting a headache; if I stood upwardly likewise long my back would anguish. The worst side effect for me was the dry out eyes, and I practise think it affected my mental health a bit—I just felt more broken-hearted and didn't have any motivation. But, that's besides why my dose was lower: to keep my mental health and the side furnishings in check.
Thankfully, all of my side furnishings started to subside a month after I finished Accutane, and I noticed my energy levels rising after about 2 weeks. I still have dry eyes nine months after, and I still break out before my period. But by "break out," I mean a few tiny spots on my face—nothing like earlier. Nonetheless, all of the side effects were so worth it to me, because isotretinoin saved my skin—it genuinely changed my life.
A dermatologist's take:
"Accutane, aka isotretinoin, shrinks the glands in your peel that produce oils," says dermatologist Mona Gohara, Dr., associate clinical professor at Yale School of Medicine. "When you shrink those glands, your organs—including your eyes—will be drier, but this side effect unremarkably goes away after y'all finish your dose."
Equally for Mariah'south lower energy levels? Another common, however annoying side event. "Some reports suggest that fatigue is dose-dependent, meaning the higher your dose of isotretinoin, the more than probable you are to experience information technology," says Marisa Garshick, MD, of Medical Dermatology & Cosmetic Surgery in New York City. "In general, though, most people find this side effect to exist temporary."
✨ Ix months postal service-Accutane ✨
Before isotretinoin, my skin was so oily that fifty-fifty setting powder couldn't take away the polish, and my face was covered in inflamed breakouts. My dermatologist ended up starting my Accutane dosage at 20mg the outset month, then bumped me up to 40mg for three months, then had me on 60mg for the last two months.
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Throughout my course, I dealt with pretty bad eczema on my arms and a dry scalp toward the end, and I also dealt with continuous headaches (though they were persistent enough that I stopped noticing them afterwards a while, so information technology actually wasn't the end of the world). The simply remaining side result I have 9 months after stopping Accutane is the eczema. It's still on my arms, and I've besides noticed it becoming credible around my scalp, but information technology isn't nigh as bad as it was when I was on Accutane.
As for my acne, I do get the occasional cyst or whitehead now, though nowhere about as severely as before. It actually took me a few years to finally get through with isotretinoin because of how scary it'southward made out to be, but for me, the whole thing was generally fine. I do feel really proud of myself for going on it despite my fears, though, and if I needed to, I would probably do it all again.
A dermatologist's take:
"Dryness is far and away the most common side issue of isotretinoin" says Dr. Gohara. "Most patients can expect some caste of dry lips, dry skin, dry optics, and lord's day sensitivity while they're taking it." Though eczema certainly isn't the norm, it also isn't uncommon: "Eczema comes along considering the drug is substantially sucking the oils out of your skin, which is good for your acne, only not great in terms of skin moisture," she says. "I tell my clients to bandy harsh soaps and washes for gentle, hydrating cleansers, then moisturize with heavier creams equally opposed to lighter lotions."
Taking isotretinoin? Fight dryness with these 4 products:
✨ 11 months post-Accutane ✨
I got my offset breakout when I was 12 years erstwhile, and for the next five years, I was in a constant battle with my pare. I tried everything nether the sun to treat it: antibiotics, topical creams, chemical peels, veganism, hormonal pills, spironolactone, cortisone shots, lasers—everything. I was somewhen diagnosed with polycystic ovary syndrome, or PCOS, a hormonal disorder that can crusade—among other things—persistent acne. I knew then that I had to take the leap and effort isotretinoin.
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I was on it for eight months total: For the kickoff iii months, I took 40mg, so 60mg for the last five months. I had dry everything—face, lips, optics, scalp, trunk—and my hair started shedding a scrap, too. I'm prone to headaches, but Accutane actually exacerbated the symptoms, and my caput would often experience like it was crushing in on itself. It was all an emotional roller coaster for me. I'1000 not certain if it was the medicine or my personal life or both, but I definitely remember I was more emotionally delicate while I was on it.
About two months after I finished Accutane, I saw the severity of my migraines, dry optics, and dry scalp decrease. After four months, my emotional health evened out and I felt dorsum to my old self. As for my skin, I'thou now experiencing breakouts all along the lower half of my face up and around my hairline. Thankfully, they're much more minor than before—merely small whiteheads and blackheads—and truthfully, they could also only be a side effect of going off nascency command a few months ago.
It sounds weird, but I really think I was meant to go severe acne. My journey taught me and then much near myself: to love myself and be confident, no matter the condition of my skin. Yes, it was so hard, but I wouldn't modify a affair. And I would 100 percent consider going dorsum on isotretinoin again if I needed to.
A dermatologist'southward accept:
If the thought of potentially losing your hair on Accutane freaks you out, take deep breaths: "If whatever hair loss occurs, information technology's generally temporary," says Dr. Garshick. " One written report showed that isotretinoin doesn't bear on hair loss if the dose is low enough."
Dr. Gohara agrees, stating that "less than 10 percent" of her patients encounter this side effect, and if they do, "it'southward unremarkably because the hair is drier and more fragile from the medication, and nine times out of ten, it slowly grows back totally normal," she says. "Once the Accutane's out of your system, pilus and nails are always laggy in terms of regenerating themselves."
✨ One year mail service-Accutane ✨
I suffered with severe acne for three years before deciding to effort isotretinoin. My breakouts were super oily, sore, and ruddy no matter what I put on them, and kids at school would call me Braille face. I didn't take Accutane just that one fourth dimension, though—I ended up taking it three times over the next few years.
The beginning two times, my acne slowly got worse over six months, and so came back equally bad as before. My dermatologist even switched upwards the dosing each time: My showtime course, I slowly reached 60mg a day; my second course, we took the approach of 10mg a day for a longer period of time; and my third course, I slowly reached 60mg once again.
But after my tertiary round, my pare was still incredibly oily and broken out. I remember sitting in my dermatologist'southward office as he explained that Accutane hadn't worked how it should have. He apologized and said there was nothing else he could offer me. I cried the whole way home. But then, strangely, my skin began to clear up a few months subsequently, about like a delayed event. Now, my skin is totally articulate, and I don't have whatever active acne.
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Fifty-fifty though Accutane eventually worked for me, it wasn't an easy journey. I honestly had most every side effect in the book: dryness, eczema, rashes, body soreness, fatigue, blurred vision, headaches, nosebleeds, breadbasket issues, pilus loss, irritability, and brain fog. Even my vision was withal a little blurry until this by summertime. But recently, I went to an ophthalmologist who reassured me that my vision is officially dorsum to xx/20.
If you lot practice make up one's mind to go on isotretinoin, I have ii words of advice: one) Take progress pictures! I promise you will not notice how much your skin has inverse without them, and they'll really help you lot stay positive; and 2) Listen to your body. It's then important to rest when you lot need it, and say no to going out if your body needs information technology. I tried to push myself over and over again, and I ended up worse off in the end.
A dermatologist's take:
"In that location are certainly people who take longer to reply to Accutane," says Rachel Nazarian, Medico, a dermatologist with Schweiger Dermatology in New York Metropolis. "This may exist due to their own natural resistance, or due to their doctor's dosing regimen, just it's important to retrieve that even when you cease taking the pills, the medication continues to stay in your organisation for weeks. So some people may actually start to show comeback effectually this 'tail cease' of treatment."
FYI: These will help go along yous clear even subsequently Accutane
✨ one.5 years postal service-Accutane ✨
Before Accutane, I used to take astringent acne—generally concentrated on my cheeks and forehead, but also forth my neck, breast, and back. I took 50mg for the majority of my isotretinoin treatment, and luckily, my side effects didn't bear upon my day-to-day life that much: My optics, lips, face, and unabridged body were dry; I had the odd headache here and there; and toward the end of treatment, I got some joint and back hurting.
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For the first month of handling, my skin also went through the initial purging period, meaning my acne got significantly worse (like, it doubled in severity) before it started to at-home downwards once again. Those first few months were 100 percent the hardest to endure, but I await back at it all with gratitude. Even though my acne did come back 6 months after finishing Accutane, it'due south nowhere near as severe—I'd say my skin is 60-70 percentage meliorate than information technology was before.
Overall, I'm actually lucky to have had such a positive experience, with very minor and manageable side effects. When my acne was at its summit severity, my mental wellness truly suffered in all means imaginable. So if my skin ever came to affect me the fashion it did prior to isotretinoin, I would probably go on it again.
A dermatologist'due south have:
"In terms of purging, I'd say a third of my patients see their acne get worse in those first few months of taking Accutane, while a third meet nada happen at all, and the last third say, 'This is the all-time thing that's e'er happened,'" says Dr. Gohara. "For most people, after month three, their improvement takes off like wildfire."
✨ 2.five years post-Accutane ✨
Earlier isotretinoin, I had severe cystic acne on my face, chest, artillery, and back. Every fourth dimension my skin bumped against something, it felt like somebody had poked the most sensitive blister. My acne would then form keloid scars, which I still have all over my shoulders and back.
I decided to go on Accutane in the fall of 2017. I started with a depression dosage twice a day, then was upped to a stronger dose in one case a 24-hour interval later a few months. The strongest side upshot I had was dry skin: My scalp and nose were e'er dry and itchy, and my lips were constantly cracked. The second side issue was a lower booze tolerance. I think going out with friends early in my Accutane journeying, drinking just a few drinks, and getting a terrible hangover and headache that lasted way longer than my usual hangovers. Thankfully, these were my only two big side effects, and they went away on their own within two months subsequently treatment.
Considering my body tolerated Accutane and then well and the results were so excellent, I finished after six months rather than the predictable ix. I'1000 so happy I did it, and I wish I hadn't been so scared in the first place. The best part is that my skin isn't constantly inflamed anymore—I tin vesture makeup, bras, and whatever apparel I want without being in constant pain. And now, whenever I do become the occasional pimple, I'm not worried that I'one thousand about to face clusters of inflammation for months.
A dermatologist'southward accept:
"In general, it's recommended that people avoid alcohol while on isotretinoin," says Dr. Garshick. Not only does Accutane already put a bunch of stress on your liver (which is the aforementioned organ responsible for processing all those White Claws you drink), but it also dries your body out. Basically, you're setting yourself up to have a major hangover the next mean solar day.
✨ Four years post-Accutane ✨
I used to have patches of painful cysts and nodules underneath my skin that didn't respond to regular acne treatments. I grew upwardly in a beach boondocks and would article of clothing a full confront of makeup to the beach, or beg not to go to school because I was having a specially bad skin day.
I ended up doing two rounds of isotretinoin about four years apart. The first time, it worked perfectly, and I didn't accept a single pimple for three years. Over time, though, my acne came dorsum even worse and more painful than before, so I concluded up doing a 2d circular of treatment. It's been about four years since I finished, and while I still get an occasional pimple, my acne hasn't come dorsum at all. I have no residual effects from the medication, and all of my deep acne scars have gone away, too.
For me, the biggest side effects I dealt with were an extremely dry nose and lips, and I had large patches of cracked and scaly skin. Simply all of it started to get away inside a few weeks after I finished the medication. I honestly wouldn't hesitate to get back on isotretinoin if my acne came back, though. The five or half-dozen months of uncomfortable side effects didn't outweigh the great benefits for me.
A dermatologist's take:
As Dr. Gohara said, very few (v percentage, if she had to judge) of her patients proceed Accutane a 2d time, while the vast majority never meet a major breakout again. Again, your results will vary, simply remainder bodacious well-nigh patients see life-changing improvements with a grade of isotretinoin.
✨ Five years post-Accutane ✨
Before isotretinoin, I had astringent cystic nodular acne, more often than not on the lower half of my face, that wouldn't respond to typical acne treatments. The bumps under my skin were so large and sore that I ended up going on 60mg of Accutane in 2015. Throughout my half-dozen-month dose, everything was dry—my eyes, the insides of my nose (to the point of occasional nosebleeds)—and my joints were super strong and achy, especially in the morning and at night. Even angle downwards and picking something upwards was harder on Accutane; I had to move slower because of how stiff I felt.
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Thankfully, all of my side furnishings ended quickly, but a few weeks later I stopped taking the pill, simply my acne started to come back six months afterwards. In the end, I decided non to proceed another dose of Accutane, though, since my acne is and so hormonally driven that I feel like information technology wouldn't have helped. I nonetheless have acne five years after, just I've found more natural ways to care for it over the years, and it's nowhere as severe as it was earlier.
Even though information technology didn't work for me, I'thou still actually grateful I took isotretinoin. Without it, I wouldn't accept started my Instagram business relationship @myfacestory and wouldn't take connected with all the people I've had the opportunity to meet online and in person. The fact that Accutane didn't work for me ended upwardly being my gateway to skin positivity; information technology helped me have and love my skin no matter what it looks like.
A dermatologist's have:
Ask a dozen dermatologists for their thoughts on isotretinoin and hormonal acne, and you lot'll probably become a 50/fifty separate in opinions. Some dermatologists believe isotretinoin isn't super constructive for hormonal acne in women, but Dr. Gohara (and many others) disagrees.
"We know that acne is caused by a hormonal surge that triggers your oil glands to produce oil, allowing bacteria to settle in and create inflammation," says Dr. Gohara, "so it simply doesn't make sense to me that this process wouldn't reply well to isotretinoin. I recall that in the cases where a patient's skin isn't responsive to Accutane, it's because that person's torso only isn't responsive to Accutane—which can happen in some people."
✨ Eight years postal service-Accutane ✨
The all-time way I could describe my skin prior to isotretinoin is...painful. There was a catamenia of at least five years where I don't retrieve waking up without my face hurting. I really got fired from a job at a dazzler counter in higher because the manager thought I made a bad impression on customers because of how my skin looked.
Accutane ended upwards working really rapidly and really successfully on my acne, but I also had nearly every side outcome—the almost annoying of which was the dry skin. I needed to apply balm to my face, hands, and body all the time, and I dealt with horrible joint pain, particularly in my hips. Because isotretinoin dries up a lot of your trunk'south natural moisture and lubrication, fifty-fifty my anus (yup) was dry, which meant taking a sh*t was one of the about painful experiences of my life.
I also experienced suicidal thoughts and ideations toward the finish of my treatment, but I didn't want my derm to pull me off the meds—at that point in my life, I idea my skin was more important than my mental health, but I should have been upfront with my dermatologist (I absolutely don't recommend this dangerous behavior, FYI).
Within six months, my acne cleared up, and my dermatologist decided I no longer needed to take isotretinoin. All of my side furnishings disappeared within a month, except for the depression. To be fair, I've always had depression in some class, merely I had never had suicidal ideations until I was on isotretinoin. Notwithstanding, as awful as some of my side furnishings were, I don't regret a second of information technology. I was so self conscious most my skin that I used to hide in the bathroom and cry. I truly believe that Accutane was the just feasible handling for my cystic acne.
A dermatologist's take:
According to Dr. Nazarian, less than one percent of her patients feel mental health symptoms while on isotretinoin. As for Dr. Gohara, "scientifically, in that location's no correlation between isotretinoin and depression or anxiety, merely anecdotally, I run into it in 10 percent or less of patients," she says. "If somebody has a pre-existing mental health condition or is seeing a mental healthcare provider, I make sure that provider is on board with Accutane before I even start information technology, and that nosotros are in really close contact so we can rapidly lower the patient's dose or come off of the medication ASAP if need be."
If you or someone you know is considering suicide, telephone call the National Suicide Prevention Lifeline at 800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.
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