Isotretinoin (aka Accutane) has often been called a “miracle drug”: it promises to permanently cure you of acne in just a few months, and—for most people—it delivers. Obviously, as someone who has struggled with acne for almost half my life, I was intrigued. Last year, I finally decided to take the plunge and ask my doctor about getting a prescription. Here are five things I wish I knew before I began my isotretinoin journey:
- It can take a while to get a prescription
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Although isotretinoin totally gets rid of acne for most people, it’s only used as a last resort because of all the potential negative effects. So when I went to see my primary care physician about starting on isotretinoin, she informed me that I needed to try a few other prescription drugs that target acne first; my insurance would only cover the cost of isotretinoin if those treatments didn’t work.
After a few months of taking various pills—with no long-term improvement in my acne—I was able to move forward in the process of getting an isotretinoin prescription. It took a visit with my doctor, two negative pregnancy tests, blood tests, a quiz and a month of waiting, but I finally began taking isotretinoin in August of 2021 (about six months after I had initially asked my doctor for a prescription).
- You have to commit to monthly tests and check-ins with your doctor
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Your isotretinoin prescription won’t be automatically renewed each month. To get the next month’s supply, you’ll need to take a pregnancy test to prove that you’re not pregnant and have a meeting with your doctor to discuss any side effects you’re experiencing. Then you have to pass a short online quiz on the iPledge website (iPledge is a government safety program that’s meant to minimize the risk of taking isotretinoin). And any time you increase your daily dose, you need to get your blood drawn for testing. After you’ve completed all these steps, you can finally pick up the next month’s supply of isotretinoin.
- You’ll need to invest in some really good lip balm
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Before I started on isotretinoin, I was a bit worried about some of the possible side effects—I really didn’t want to spend the next few months dealing with body aches or vision problems. Luckily, I never developed any of the more serious side effects, but I did have to deal with the most common condition that isotretinoin users experience: dryness. My face and lips were so dry all the time. The dryness on my face wasn’t too hard to manage: I just applied a thick layer of moisturizer twice a day to stop the skin from peeling. But my lips were perpetually chapped, no matter how much Aquaphor I put on (and I put on a lot). It was annoying, but not too bad in the grand scheme of things. And it was definitely all worth it in the end.
- There’s a max cumulative dose that your doctor can prescribe
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I was a little shocked when my doctor told me that I would hit my maximum cumulative dose after five months of taking isotretinoin. The max cumulative dose is different for each person since it’s based on your height and weight, and your doctor can’t prescribe more than that amount. And the length of your treatment depends on how many milligrams you take per day—taking a higher daily dose means that you’ll reach your maximum (and therefore the end of your treatment) quicker.
- You might need to go on a second round
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Sometimes the first round of isotretinoin doesn’t work perfectly, so you’ll need to go on a second round to fully clear your skin. And even if the first treatment works perfectly, you’re probably not going to have flawless skin right away. Even though I’m not breaking out anymore, I still have to deal with red marks and scars on my face—evidence of the years that I spent dealing with acne. But getting rid of my acne was the first step to improving my skin, and I’m so grateful that I was able to do so with isotretinoin.
Starting on isotretinoin was the best thing I ever did for myself. The drug entails a lot of inconveniences, but they’re a small price to pay for the confidence boost that it has given me. If you’re struggling with acne, I would highly recommend talking to your doctor about isotretinoin—it can change your life.