RealSelf Q&A with Dr. Buka

Q:  I am on Accutane. What can I expect?

A:  Expect great results with mild side effects.

Isotretinoin (Accutane) is perhaps the most powerful medication we have in our armamentarium against acne. Not only does it greatly decrease active acne lesions, it has a remarkable durability, usually resulting in clearance for years after the end of a therapeutic course. Your medication course is typically weight-based and can last 4-6 months depending upon how many milligrams you take each day. Side effects are dose-dependent, meaning the more Accutane, the more side effects. Dryness is far-and-away the most common side effect we notice in patients receiving Accutane. It’s not a good or bad sign and won’t affect the overall length of your course; it’s just one of the common side effects experienced on this medication. Very severe acne sufferers may notice a temporary worsening of their acne prior to overall improvement, but usually it’s a steady improvement from Day 1. In my experience, the most notable results are seen during months #2-3.

Acne scarring is unfortunately a separate topic altogether. Accutane may make scars appear redder, but typically won’t improve them. It just works on active acne lesions. But don’t despair! There are presently amazing treatments for acne scarring, with laser and chemical peels being the most routinely used among them.