accutane side effects

5 Women on What It’s Really Like Taking Accutane

Magic pill or nightmare waiting to happen?

Voices are power. This series offers an empowering space for women to share their stories on taboo-busting topics.

For those struggling with acne, Accutane can seem like the Holy Grail, a miraculous solution to a deeply frustrating and painful problem. But as with most things that sound too good to be true, it’s unfortunately not that simple. Here, five women open up about their experience taking oral Isotretinoin and dealing with its sometimes devastating side effects (including itchy skin, dry lips, mood swings and depression). So, is Accutane worth it?

“I noticed severe depressive episodes while on Accutane.”

“I used Accutane when I was around 19 and then again at around 24. I never had the really bad acne you might typically associate with using Accutane. (Sidenote: My brother did, though, and he saw incredible benefits from Accutane.) But I did have what my dermatologist and I considered pretty severe hormonal and cystic acne from grade seven onward. I remember a girl on the bus telling me I should really use foundation—clearly that comment stuck as I still remember it to this day. Thanks a lot, Kira! It weighed on my confidence. I thought I would grow out of it, and Accutane seemed so drastic, but when I was facing going into second-year university with the same childhood acne, I decided drastic measures were necessary. So I tried it. The first time, it worked initially, but it didn’t last. The second time, it worked! I will still get the odd blemish around my period, but for the most part my skin is clear and I feel confident leaving the house with no makeup on. The side effects the first time weren’t terrible. Dry, sensitive and irritated skin was definitely prominent though. The second time, I noticed the mental side effects much more. Depression is something I live with now, but at the age of 24 it was not something I had struggled with yet. I noticed severe depressive episodes while on the medication. I considered going off the drugs early because of this, but decided to stick it out, knowing I wasn’t having suicidal thoughts and there was an end in sight. I would say the results are worth it. When I do get the odd blemish, I’m reminded of how self-conscious I was. You think it’s all anyone notices at any time, and no matter what else you do externally or internally, it’s really hard to feel beautiful when you have acne. I know that sounds vain and superficial. It’s not how I would ever want anyone suffering from acne to feel about themselves, but it’s the reality of how I felt. When you’re on Accutane, it’s mandatory that you check in with your doctor and have blood tests for your liver every month. In my experience, they would ask me about my mental health, but they never suggested I see someone or offered much advice or support on those aspects, which I think was a misstep. Maybe that has changed over the past five years, but I think mental health support should be mandatory for Accutane.” —Kendra, 30

“After a few weeks, they started to clear, but my whole body was extremely dry.”

“I started taking Accutane when I was 19. I had had acne since my early teens. It was mostly small pimples but they were all over my forehead, chin, neck, shoulders and back. I was really shy about it and never wore tank tops. I’d get uncomfortable when I felt like people were looking at my skin. I tried what felt like a million products, including prescription creams, but nothing seemed to work, so my dermatologist suggested I try Accutane for nine months. He warned me about the most common side effects, like dry skin and mood swings, but I didn’t think anything of it. I was taking the minimal dosage and figured it wouldn’t really affect me. When I first started taking it, I noticed my skin was red and swollen, and it seemed like I had even more pimples than before. After a few weeks, they started to clear, which I was happy about, but my whole body was extremely dry. It hurt a lot. My lips were peeling off, my hair started to break and my skin was so itchy it felt like it was on fire. A few months in, I could see major improvements, but unfortunately, I had to stop taking it for a while because, and this is a bit embarrassing to say, but, I developed anal fissures. It was horrible and insanely painful. I couldn’t even go to the bathroom at one point. I stopped for a couple of weeks and started back again, determined to clear my acne for good. I had to stop two more times because of the same problem, but I finally finished the treatment. I was completely pimple-free. I couldn’t believe it. Had I known what would happen to me prior to taking Accutane, I think I still would have done it, because now, nearly 10 years later, my skin is perfect and I don’t have to worry about pimples anymore. It truly gave me my confidence back.” —Florence*, 28

“For years I barely needed to wash my face.”

“My unremarkable teen acne started at puberty. I was lucky enough not to have cystic acne like my brother, but in combination with frizzy hair, braces and glasses, that regular acne obliterated my self-confidence. After 10 years of prescription washes, refrigerated creams, pills and spot treatments, I had had enough. Going to job interviews after university with a flare-up was a humbling experience. I would wear my hair long to hide behind it, turn my face or avoid eye contact, speak or smile very little to avoid drawing attention to my mouth and acne. This was viewed by potential employers as anything from lack of ambition to lack of confidence in my abilities, costing me a few jobs that I know I was qualified for. Tired of being seen as an adolescent in my mid 20s, I finally broke down in my dermatologist’s office. He said that my acne itself was not an extreme case, but that he could see the effect it was having on me psychologically and thus talked to me about Accutane. He told me that it could be very hard on people who are prone to depression so asked if I had ever suffered from it (I lied, but figured it was only fair since I was blaming my acne for it in the first place). The whole process was over in three months. The first two weeks were the hardest.  Your acne gets worse as your body clears out every single pore you have, and your mood totally crashes, which is a bad combination. You just have to hang in there and hope. And when it works, it’s the most insane experience. Everything literally falls out of your pores and then they close up, giving you what I liked to call my “shiny new skin.” When my face cleared up, as cliché as it sounds, I got a job, started dating, and really started to feel like myself (before I would do anything not to be noticed). For years I barely needed to wash my face. Seven years later, my skin is still very clear. I probably get one blemish a month and only wear light concealer to even out my skin tone and cover some scaring.  If someone told me my acne would come back tomorrow, my PTSD would kick in. I would be the first in line for my next Accutane prescription. I am never going back to being a wallflower.”—Catherine, 33

“I was crying every other day for no reason.”

“I used to have lots of acne on the sides of my face. It bothered me a lot and it itched—a lot. My doctor sent me to a dermatologist who gave me a six-month Accutane prescription. Over three months, it went away completely. I was like, ‘Damn, now I love my skin.’ It was flawless like the skin of an actress. The pills aren’t covered by OHIP, so the money was coming out of my own pocket. They are quite expensive, but I had to do what I had to do. In the second month, I started feeling nauseous and some level of depression. I had never dealt with depression before, so I didn’t know why I was feeling that way. I realized a bit later on that it was the Accutane. I had major mood swings; I didn’t want to talk to people. I was crying every other day for no reason. My mother used to be like, ‘What happened? Something is bothering you,’ and I was like, ‘No it’s just the pills.’ They were starting to affect my work life as well because of the mood swings. I didn’t want to work—all I wanted to do was sleep. After I went off the pill it took me about a month and half to go back to my normal. I went back on Accutane again right before my wedding. My skin had been acting up and—well who doesn’t want their wedding pictures to look good?—so I went back to the doctor and he agreed to give me a one-month Accutane prescription. So, I took it again in November of last year and it helped my skin clear out for my big day in February. I didn’t have side effects that time. Now I still get acne but it’s mostly hormonal and because of the heat.” —Bhairvi, 27

“After the four-month course was over, my skin was super clear.”

“The first time I used Accutane I was 19 years old.  I had cystic acne throughout my teen years and I had tried a few different things, from various topical creams to antibiotics, but nothing really seemed to work. Being incredibly self-conscious and insecure about my skin (which in retrospect, was probably not as bad as I thought!) I thought I would give it a try. The dermatologist did indicate that there were many short-term side effects. My lips would get so dry that I would have to apply lip balm almost every hour; and I felt tired most of the time. The other effect was that my skin got worse before it got better. By the second month, my skin just erupted with all this acne, far worse than what I had before. Even though the doctor had warned me, it was so disheartening to see my face. But by the end of the third month, my skin began to clear and I started to finally see the results. I did it again when I was in my late 20s, when my cystic acne came back. I think it was less problematic than when I had it my teens, but I was upset that the results had not continued. So my dermatologist said I could take it again and that there was a time limit on its effectiveness, that by 10 years most of the results would be gone. I did another four-month course, and the side effects were somewhat similar. After the four-month course was over, my skin was once again super clear, so at the time I was happy with the results. But a few years later, when I got to my late 30s, my skin became super sensitive and I developed rosacea and eczema, which I still struggle with. The truth is, I am not sure these are some of direct effects of taking Accutane twice, but I think there is some correlation based on my own understanding and research. I don’t necessarily regret taking Accutane because I did get great results; however, in hindsight, I would have certainly done much more research about side effects; perhaps I would have also looked into something more natural or healthy; or maybe I could have been less obsessed with having perfect skin.  This is probably the reason why so many girls and women turn to options like Accutane, because of the obsession with a female’s appearance, that our self-worth is inherently tied to our physical appearance. That’s why I’m so glad there are many movements today that are working against this constant focus on the physical, including the more recent Pimple Positive Movement. Hopefully then, when my own daughter is 18 or 19, she won’t be focusing on getting ‘perfect skin’ but rather she’ll be secure and comfortable in her own.”—Andrea*, 46 

*some names have been changed for anonymity

Photography by Oana Cazan

 

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