Does Accutane Really Cure Severe Hormonal Acne?

I remember when my doctor first told me about Accutane after countless skin treatments and procedures failed to achieve any lasting results on my face. She explained to me what the drug did, how long the treatment would be, and that I could finally stop worrying because after treatment this time my acne would never return.

Obviously I was excited and I gladly did all the necessary blood tests, signed the paperwork, and paid each installment for my six months of treatment.

About seven years on, a new dermatologist, and a second course of Accutane treatment later, my acne came back with a vengeance. Despite those investments, I’ve since managed to get my acne under control on my own but I often wondered why my acne returned after this ‘acne cure’. Interestingly, I met someone else who shared a similar experience where her acne re-merged ten years after Accutane, and that made me realize that many other people may be going through this as well.

So the short answer is no, Accutane does not work permanently for everyone. Acne can come back for several reasons, and it can occur within a few months or years after completing treatment.

I think it’s important to understand why this can happen so I’ll delve a bit deeper into the factors that can cause acne relapse after Accutane, and what you can do if you’re considering this form of treatment or if you’ve already started and want to ensure that your acne stays in remission.

What does Accutane do?

Accutane belongs to a category of medications called retinoids, which are Vitamin A derivatives. So it is theorized that if you take Vitamin A in large doses then the effect would be the same as Accutane.

A little point of information here: Accutane is actually the trade name for the drug that was discontinued due to various reasons and that stirred up a lot of controversy surrounding the medication. But due to its popularity, many persons still stick with the name even though the actual drug is Isotretinoin.

This is now marketed by different brands and is typically prescribed for moderate to severe stubborn acne that does not respond to other treatments such as antibiotics or topical creams and ointments.

Like the Vitamin A supplement, which is oil soluble and can cause toxicity if taken in excess doses, Isotretinoin can cause a build-up of fat in the bloodstream and impact the liver. This is why close supervision by a doctor is essential during treatment, and patients are even warned not get pregnant as serious birth defects will occur.

Other side effects reported include dryness; whether of the skin, lips, and nose, joint and muscle pain, hair thinning, decreased night vision, even depression and thoughts of suicide though to a lesser extent.

That aside, Isotretinoin mainly works by reducing the size of your oil glands, which decreases the production of oil or sebum. It significantly minimizes the risk of clogged pores that leads to the formation of pimples, and helps with inflammation.

The medication is taken orally, typically between three to six months and it is so effective that on average acne clears up before the end of treatment.

When should you consider taking it?

As mentioned before, Isotretinoin is reserved for stubborn acne. That means you’ve exhausted other treatment options and nothing has worked. Or any positive results are short lived.

But unfortunately a factor that is often overlooked in considering this form of treatment, is the age of the patient.

The National Library of Medicine indicates that there is a higher rate of relapse of acne in patients that are preteens and young teenagers, specifically between 12 and 16 years old. And in a study conducted for that demographic, the time period of relapse was within one year.

This experience is shared by young adults as well. And one of the arguments is that there is a higher fluctuation in hormones among teenagers and women in their reproductive years that cause the acne.

But it doesn’t end there. Besides from age, there are other reasons that may be causing Isotretinoin to be ineffective for more people than you think.

Some specific factors that can cause acne to come back

• The underlying cause of acne is not fixed: Women that have adrenal or ovarian syndrome associated with elevated androgens such as Polycystic Ovarian Syndrome (PCOS) commonly relapse after isotretinoin therapy. This  can be associated with age as hormonal disorders such as PCOS mainly affect women of reproductive age so it is not surprising that after taking Isotretinoin, if the offending hormones are not managed, then acne will return.

• The severity of acne may have been misdiagnosed so the dosage and duration of treatment may not have been sufficient.

• You may have stopped treatment prematurely either because of impatience or not understanding the phases of recovery that can include purging when treatment begins to take effect.

There are some other factors that may contribute to acne recurring after Isotretinoin that may interest you, but essentially these boil down to how the medication is administered, proper supervision by a doctor, and other health concerns of the patient that Isotretinoin simply does not treat.

One thing for certain is that Isotretinoin is almost guaranteed to put acne into remission and give the relief that most people desire because it’s very effective in treating the symptoms. But as we will discover, the difference between short term and long term results from Isotretinoin depends a lot on you and I’ll explain this below.

So what you can do?

• Be proactive by taking steps to treat the underlying cause of your acne even while taking Isotretinoin. This just means making positive lifestyle changes such as exercising and focusing on nutrition to manage hormonal fluctuations, which is typically at the root of the problem. Since the drug is so powerful, it may still clear your acne even while suffering from hormonal imbalance, but if not managed, eventually acne will return.

• Follow the instructions of your doctor to the letter: Don’t take other medications before checking in with your doctor first, not even supplements while on treatment. While on this drug, it pays to be diligent and patient to complete the full course of treatment, and maintain your doctor appointments so that your progress can be monitored and any adjustment to your dosage can be made to help achieve optimum results.

• A good skincare routine is essential: We mentioned that dryness of the skin is the most common side effect of taking Isotretinoin.  So gentle and moisturizing products should be your focus, especially during treatment. It would also be best not to use any active ingredients at this time and always opt for broad spectrum, high SPF during the daytime.

Takeaway

Isotretinoin should not be viewed as the cure for acne despite how it has been marketed over the years. If you decide that the medication is right for you, be prepared to see amazing results but don’t think that you are in the clear forever solely because of it.

The reality is that your acne can come back after treatment with Isotretinoin but you can do something about it. Essentially, while it offers relief by putting acne into remission for a period of time, it’s an opportunity for you to focus more on your health and take targeted steps to treat the root cause of acne, which is normally related to hormones.

So like me if you didn’t know these things about Isotretinoin, that’s fine. We live and learn. You’re acne may have already returned or it may in the future but don’t get discouraged and definitely don’t think it means you need to go back on the medication.

I was able to clear my acne on my own years after it came back almost as bad as it was before, and others have been able to do the same. So trust me you can too.

Try some of the tips I’ve shared and you’ll be okay.