Accutane: A powerful acne medication used to treat moderate to severe or persistent acne.
Side Effects: Dry skin, cracked lips, dry eyes, bloody noses, itchy scalp, joint pain, eczema, hair loss, and birth defects.
I’ve been on Accutane twice now.
Anyone who knows someone who has been on Accutane or who has experienced it themselves knows that this treatment is far from easy. However, I have found that many more people are on it than we are led to believe. I had really bad acne in high school. I had tried multiple different topical creams and oral antibiotics, but nothing seemed to work. My last resort was to go on Accutane, which is basically the final treatment option that many dermatologists wish to avoid. The decision to start Accutane is not easy. To consider starting the treatment means six months of taking two pills twice a day, bloodwork once a month for the duration, dermatologists visits after every blood work, iPledge forms to fill out, monthly prescriptions to pick up, monthly pregnancy tests to take, and so much more.
In non-medical terms, Accutane works by drying out the skin, so that no under-the-surface oils can develop into stubborn acne. The process is long and difficult, which is why dermatologists try to avoid it.
Hesitation and worry. That’s what I felt this past summer when my dermatologist gave me the approval to go on Accutane for the second time. We had been monitoring my skin since March 2021 and had seen no improvement, so it was decided that I would start the treatment in September, right after arriving back at school. The side effects were the easy part. Sure, I woke up with a few bloody noses (I got one this morning while writing this), my eyes were extra dry, and my skin was covered in patches of eczema, but at least I was getting a hold of this persistent acne.
The hard part was coming to terms with the fact that I had to do this all over again. I was so mad at my skin for not staying clear from my first round of Accutane back in my junior year of high school, and I was mad at the whole process that lay ahead of me for the majority of my junior year of college.
For those curious as to what the Accutane process looks like, let me run you through it. Once a month (and it has to be a month or later since my last dermatologist visit, not even a day sooner), I drive two hours home to see my dermatologist for all of 10 minutes, so she can look at my face and lab work and make sure that everything is in order. That’s the easy part. Beforehand (exactly two weeks before), I have to make sure I drop my lab slip off at UHS (University Health Services) so they can write my lab work out and send it into the lab. A week after this (and a week before my dermatologist appointment) I have to go get my bloodwork done at UHS. Usually the blood work requires me to fast, so I try to go earlier in the morning. The blood work MUST be taken a week before the appointment and no earlier. I get tested to check my Triglyceride levels, my Hepatic Function, and my hcG, which is a fancy word for a pregnancy test. After that, I head to my appointment a week later, get a new prescription for the month, and a new lab slip for when I drop it off at UHS yet again in just two weeks’ time. Before I can pick up my prescription, I have to make sure I fill out an iPledge form, which is essentially a website that makes you answer around 5-10 questions about pregnancy prevention and the effects of the medication.
The iPledge website is fairly new. When my mom went on Accutane in the early 90’s, all she had to do was sign a piece of paper acknowledging that she wouldn’t get pregnant while on the medication and for a month after stopping treatment. With our advanced technological systems and more information into birth defects caused by Accutane, I am now required to pee in a cup before every dermatologist visit so they can make sure I’m not pregnant, as well as provide my blood work labs with the same result. While some may acknowledge the surface level side effects, like dry skin and joint pain, as something to dampen the strength of this medication, let me enlighten you.
Getting pregnant on Accutane is a BIG no-no. That’s why the steps to ensure no pregnancy occurs are so extensive. The chances of a baby being born with congenital birth defects is 20% -35%. These can include malformations of the ears, face, and heart. If the child isn’t born with any physical defects, studies have shown that 30-36% will experience neurocognitive impairment. The back of my medication shows several diagrams of infants and the different defects they may be born with. The slots that hold my medication show a silhouette of a pregnant woman with a big red X through her, driving home the “DO NOT GET PREGNANT UNDER ANY CIRCUMSTANCE WHILE TAKING THIS DRUG!” point.
Accutane is draining. On one hand, I’m happy that it’s working, and although it takes six months, the acne that had so stubbornly stuck with me for so long is finally starting to go away. On the other hand, the side effects and the process of constant check ups is sometimes hard to manage on top of a busy college schedule. However, I feel like a pro considering this is my second go around.
I’m currently finishing up my fourth month of Accutane and have seen major improvements. My skin and lips still get pretty dry, and my joints still hurt sometimes, but I have close to zero breakouts and am happy that I’m approaching the end.
Accutane isn’t for everyone. I praise those who feel comfortable enough in their skin to not care about any blemishes or scars that others may be able to see. For me that’s not the case, and that’s also alright. At the end of the day, it all depends on how you feel in your own body. I wasn’t happy with my skin throughout middle and high school, and I wasn’t happy with my skin last year, either. I constantly wore layers of foundation and concealer to cover up the blemishes. It was frustrating starting the second time, because it meant I had failed at improving my skin back in high school. It made the six months back then appear to be completely worthless. I chose to take a difficult route for the second time, but I’m happy I did, because I’ve noticed considerable improvement in both my skin and my overall well-being.
Although Accutane is a pain in my ass, I do thank it for everything it’s given me over the past four years of my life.