Throughout high school and into university, I always had pretty bad, cystic and hormonal acne. My acne was always a huge insecurity of mine, and it really took a toll on my confidence. Growing up with unlimited access to social media did not help either, as I was constantly consuming content featuring women with perfectly smooth, professionally photoshopped and edited skin. Being an anxious teenager, I was constantly comparing myself to people online.
I remember my mom showing me a video once of a slice of pizza being transformed into a model through Photoshop, and although it was shocking, I guess the message never stuck with me. The truth is, and I know it’s oversaid, but social media is everyone’s highlight reel. Everyone’s posts are photoshopped, and their skin is smoothed and blurred, and everyone is using filters. Looking back, I understand that I have always been very concerned with my appearance, and that it has affected every area of my life. I think it’s important to recognize the unrealistic beauty standards young women are constantly facing, especially today, with the rising use of GLP-1s for extreme weight loss and other appearance-altering medications and procedures.
With that in mind, there were many different reasons that I decided to start Accutane. It was a mix of supporting my mental health, dealing with the constant pain from cystic acne and for my own self-confidence related to my appearance. I just want to make sure that all of this is taken into account as you read my story.
The battle with acne
I remember being extremely nervous for my first day of grade 9. I was thirteen and had just started getting pretty bad hormonal acne around my mouth. Acne was totally new to me, and it is safe to say I was struggling with it. I constantly felt like people were staring at it, and it made me insanely insecure. They would take a quick glance at the lower half of my face, and I would notice them struggle to keep eye contact with me; it felt like they were so tempted to get another look at the bright red pimples on my chin. I remember coating my skin with drugstore concealer that felt so chalky and rough, and it only seemed to irritate my skin more.
By the eleventh grade, the pimples and whiteheads had spread to my cheeks, my forehead and all over my back. I tried my best to feel more confident despite the red blotches covering me. My acne was all I could think about; I worried about it day and night. Winter was always the worst. Canadian winters are already rough, but my acne got especially bad when I couldn’t get any sun. I only wore long sleeves and hoodies to school to cover the acne on my back, and I did my best to cover what was on my face with concealers, powders and colour correctors.
I expected the acne to clear up once I got to University, because for some reason I believed there was a time limit on my breakouts. It only seemed to spread, and the sides of my face had been encrusted with deep acne scars from my constant picking and popping. And worst of all, the pimples were painful. I would get huge clusters that seemed like mountains of different pimples stacked on top of each other; they were extremely irritating. They pulled and burned my skin; sometimes, my breakouts were so bad that it hurt to move my face. Many of my pimples were recurring, and once I would pop them and thought I had finally gotten rid of them, they would just come back, a brighter red, more tender and much angrier.
My acne always fluctuated in times of stress or during PMS, and this just became an awful cycle I felt like I could never escape. During these times, when I already felt extra sensitive and overstimulated, when I was already spiralling, I resorted to picking at my skin, because it always felt like one more thing that I couldn’t control. I would rip apart my face in front of my bathroom mirror, hoping that all of the red and white spots would magically disappear the next day. But it only ever made it worse, it gave me huge purple scars and large pores. Acne had become such a huge deal to me, it felt like I wasn’t myself.
I tried absolutely EVERYTHING to get rid of it. I have tried just about every face wash available, personalized skin care products, medicated creams and even antibiotics, which only ended up hurting my skin more. Especially medicated creams, they only ever burnt my skin and made it more sensitive, and never really attacked the pimples. I have spent so much money on pimple patches, nose strips, peel-off masks, acne spot treatments, serums, scrubs, and I even got facials. I would burn my face on purpose under the sun in hopes that it would sizzle off my acne and lift the deep scars.
I would complain to my doctor, dermatologist, and naturopath, and they truly helped me try everything to get rid of it. Until one day, I finally asked my doctor if I could try Accutane. I had asked her before, and she always said I needed to try other options and that Accutane should be a last resort. By this point, I had tried just about everything. So, she referred me to an online dermatologist for an assessment.
The side effects
I knew the side effects of Accutane were intense, but during my first online appointment, they sounded even worse: extreme dryness, sensitive skin, muscle and joint pain, headaches, dry eyes, hair thinning, and more extreme ones like birth defects, psychological effects, liver damage, digestion problems, and so much more. I took lots of time to really consider these side effects, and if you are thinking about starting Accutane, I encourage you to do the same. But, in the end, I decided to go ahead and start.
It was the right decision for me at the time. My acne controlled my life, as someone who already struggles with my self-image, it just really chipped away at my confidence. This was almost two years ago, and I can say now that I’m very happy I did it then, but I’m not so sure I would do it again. Here are the ups and downs of my 9 months on Accutane, the simple tips, and the products I would recommend if you are planning to start it, too.
I started Accutane in September of 2024, right before my second year of university. My dermatologist started me on a low dose, but very quickly moved me to the highest dose since my acne seemed to be pretty stubborn and needed some heavy-duty treatment.
Okay, so first of all, the dryness, and yes, I was very, very dry. As someone who had only ever had very oily skin and hair, this was sort of a relief. I didn’t have to wash my hair every day, and my skin didn’t look drenched in oil for the first few months, which was nice. But then winter came, and my skin got flaky, my hair started to feel coarse, and it was super gross. My lips were extremely dry; they peeled every single day and would crack and split anytime I moved my mouth. I often woke up with pretty bad nosebleeds because the inside of my nose was so dry; it was horrible. I combatted this dryness with a few key products, starting with Aquaphor. I know everyone loves Aquaphor already, but it really saved me during this time. I would put Aquaphor all over my face before I went to bed and on my lips, making sure to reapply often. I would even put some very gently on the inside of my nose if it were that bad.
When my skin got really flaky, I would often wash my face with warm water and CeraVe and very gently exfoliate my entire face with a washcloth. If my lips were really bad that day, I would use a little extra pressure and really scrub off all the dead skin. The most important part of this routine is that I made sure to moisturize immediately after, or else my skin would just be disgustingly dry all over again. For moisturizers, I avoided anything with harsh exfoliating acids, like salicylic and glycolic acids. So, I stopped using my CeraVe moisturizer and started using La Roche Posay Cicaplast Baume B5. This moisturizer is a little more expensive than others, but it absolutely saved my skin, and now, even after Accutane, I still use it in the winter or whenever my skin is extra dry. It is gentle yet thick, restoring a smoothness to your skin that other moisturizers just don’t offer. Despite my efforts, my skin was always pretty dry, and I think that is inevitable at such a high dose. But keeping up with moisturizing is so important to help you stay comfortable and avoid further skin damage. It’s definitely a lot of work to stay on top of, but if you already have a skincare routine, this should be easy.
My roommate, who is also on Accutane, found that using Lanolin (yes, nipple cream) as lip balm works amazingly! So I also used that quite a bit. It’s a little thicker than Aquaphor, but it’s great for extra dry days.
(All of these products are usually available at any drug store and you don’t need to buy them from Amazon).
I have noticed my hair is much thinner than before I started. I used to have very thick, heavy hair. While I was on the pill, I would lose clumps of my hair in the shower, and lots of it would fall out when I brushed. This was really gross and very upsetting at the time, and I now have a lot thinner hair than before Accutane. I’m hoping that my hair grows back thicker soon, but it has been quite a while since I stopped, and I’m not sure it ever will. I still have a good head of hair, but it’s definitely different than before.
During the 9 months I was on Accutane, I lived in a very old, very dry apartment in Montreal. I already had issues with how dry my room was at night, I would wake up with a very dry throat, and I was always coughing and sneezing. I combatted this by getting a humidifier, which helped so much. I really noticed a difference when I had it on, and I think it actually really helped with how dry my nose was. My nose bleeds were less frequent, and I felt like I could breathe. I would recommend getting one even if you aren’t super dry. It just made my environment a little more comfortable, especially in the dry winter months.
I purposely planned to start Accutane in the fall and was done before the next summer. I never got a sunburn while on Accutane because I wasn’t in the sun much, and when I was, it was very low UV. So, I can’t confidently state what its effects would have been on my skin. Sun protection is extremely important, and if you do plan to be on Accutane in the summer months, make sure you limit sun exposure and get a good sunscreen, 50 SPF atleast. Or even finding a moisturizer with SPF is great. Try to stay out of direct sunlight during peak UV hours, and please protect your lips with an SPF lip balm. Accutane makes you burn a lot quicker and increases the risk of skin damage, so make sure to protect yourself.
I have never really been a serious athlete, and when I was taking Accutane, I was not very active. I tried my best to go to the gym and get outside as much as possible. I have always loved walking, though. I walked almost every day, about 25 minutes to and from school, even in the winter. I think Accutane made my legs extra sore, and these pains were bad, I can’t lie. I felt it especially when I would lie down after a long day. My back has always felt very stiff (which could be unrelated), but I have noticed a lot less pain after being off Accutane for over 6 months. I have got back into going to the gym, and I do lots of yoga. My sister is a competitive rugby and volleyball player, and she is currently taking Accutane. She says that since starting Accutane, she has noticed more pain in her lower back and legs, specifically in her hip area. She has had many injuries over her career as an athlete, but has noticed a lot more discomfort in her ankles while on the pill.
My overall experience
According to my doctor, you are only allowed to be on Accutane for 9 months at a time. Some people need much shorter lengths, and others need longer lengths and will go back to it after taking a break. Similar to the dose, I was on the highest available dose, but my roommate is currently on a much lower dose and will probably not need to be on it as long as I was. Everyone is different, everyone will experience the side effects differently, and results will be different too. I was on it for exactly 9 months. For the first 4-5 months, I noticed no changes in my skin. I only really noticed the side effects, which sucked. And my acne did get much worse before it got better; the “purge” is indeed real. After the 6th month, I really saw a change in my skin, and it felt amazing. I no longer had any painful breakouts, and my pores were basically invisible. It felt so great, and I felt totally free from my acne. My confidence definitely changed. I wasn’t worried about people staring at my pimples, and I actually felt pretty, for the first time in a long time. My nose also looked much smaller, which I had heard was one of the weird side effects (nose is normal size again BTW).
By that summer, I was completely done with Accutane, and I felt so confident. My skin was always glowing, and I finally had a non-oily skin type.
Almost a year after getting off the pill, I feel great. I never ever experience breakouts, and if I do, it is usually only one, very small, very manageable whitehead or pimple that can be cured with a pimple patch. My body feels much better, and the muscle and joint pain has not lasted. For me, this was a fair trade for clear, pain-free skin.
I do have acne scars on the sides of my face and around my mouth. They are not very visible, but of course, I notice them.
For me, Accutane was the right decision. I feel so much better not having to worry that something will give me a breakout, or that people are staring at my breakouts, and I feel very free. It was a huge insecurity that weighed on me pretty hard, and it’s very upsetting to think about how much control this insecurity had on me when I was younger. The only regret I have is not starting Accutane earlier, during those extra-awkward teen years. Although if I hadn’t done it then and had known more about the severity of some side effects, I don’t know if I would do it again today. So, hopefully my acne journey has finally come to an end, and I am very grateful for Accutane.