The Truth About Accutane and Acne

Isotretinoin, more commonly known by the brand name Accutane - is an oral acne medication that was first approved for the treatment of severe cystic acne in 1982.  Anyone who has dealt with acne knows it as the Big Guns in acne treatment because it's typically reserved for the more severe, stubborn cases.

While there is an understandable draw to the medication for acne patients who are desperate to heal their skin - there are potentially serious and harmful side effects that must be carefully monitored by the prescribing provider.

The most common side effects associated with isotretinoin treatment are:

- Alopecia (hair loss),  headaches, dry skin, cheilitis (painful cracks at the sides of the mouth), abnormally dry eyes, skin and mouth, acne flare ups, light sensitivity, decreased appetite, headaches and a depressed mood.

The most serious side effects are:

- Teratogenic effects (birth defects), including facial clefts, intellectual disabilities, heart defects, and blindness

- Liver inflammation

- Stevens Johnson Syndrome (rare, but potentially deadly skin rash)

Although depression is often mentioned in anecdotal reports, a systematic review of the literature noted that depression was not actually increased by taking Isotretinoin.

In recent years more light has been shed on the psychological effects of acne and and the possible scarring that is associated with delayed treatment of acne. For this reason, there has been a movement to reduce restrictions and increase access for patients to Isotretinoin. 

With all of this risks surrounding Accutane - you might think that the rewards of clear skin would be a sure bet!

Not so fast though...The surprising truth about Accutane is that studies actually show an acne relapse rate of 50% by 6 months after treatment. Clinically I see even higher relapse rates a couple years down the road. 

As an acne specialist, I often see patients who are contemplating Accutane or have completed 1 or 2 rounds of treatment with Accutane. Now let's carefully discuss some of the alternative treatment options.

Is There a Holistic Alternative to Accutane?

Why do acne patients often relapse after treatment with such a strong medication? In my clinical experience - this is because the acne that you see on the skin surface is a symptom of internal imbalances. When medications are used to cover up symptoms without addressing the root causes, acne will always resurface.

The first steps of holistic acne healing is to understand the factors that cause acne and then overlay your personal health history to find YOUR specific root cause. Often seemingly unrelated symptoms such as anxiety, IBS, bloating and painful periods could actually be clues to your root cause of acne.

Acne is a complex of multi-factorial conditions meaning there any be many different causes depending on the individual.

  • Gut microbiome imbalances
  • Food intolerances
  • Sluggish liver
  • Nutrient deficiencies
  • Blood sugar imbalances
  • Hormonal imbalances
  • Unprocessed emotional trauma

For many acne patients - they become their own detective and apply a self-healing framework that systematically addresses these underlying causes and restores balance in the body.

The Clear Skin Code is my signature self-study program which walks you though each step of understanding your skin and reversing the underlying imbalances. The most important part of this course is that you will actually be empowered to be your own healer and work with your body to create optimal health.

Most patients will not require 1:1 treatment, but in cases of severe acne or resistance - hormone and gut testing may be needed really address the root causes.

The Bottom Line:

Accutane is a very strong medication which must be regarded with caution. I recommend that all holistic alternatives be carried out before considering Accutane as a treatment option for your acne. As you begin to explore the holistic approach, I invite you to join my signature self-study program or consider a 1:1 consultation. 

If you do decide to pursue treatment with Accutane, the risks associated with treatment must be weighed against the potential benefits.

If you want to learn more about the Clear Skin Code self-paced program - please click HERE!

If you're interested in working 1:1 with ME - please click HERE

P.S. As always, if you have any questions - please feel free to email me at [email protected] and I'll personally get back to you!  




1. Sadeghzadeh-Bazargan A, Ghassemi M, Goodarzi A, Roohaninasab M, Najar Nobari N, Behrangi E. Systematic review of low-dose isotretinoin for treatment of acne vulgaris: Focus on indication, dosage, regimen, efficacy, safety, satisfaction, and follow up, based on clinical studies. Dermatol Ther. 2021 Jan;34(1):e14438. doi: 10.1111/dth.14438. Epub 2020 Dec 6. PMID: 33085149.

2. Costa CS, Bagatin E, Martimbianco ALC, da Silva EM, Lúcio MM, Magin P, Riera R. Oral isotretinoin for acne. Cochrane Database Syst Rev. 2018 Nov 24;11(11):CD009435. doi: 10.1002/14651858.CD009435.pub2. PMID: 30484286; PMCID: PMC6383843.

3. Tan T, Hallett R, Yesudian, P. Efficacy and relapse rates of different Isotretinoin dosages in treating acne vulgaris: systemic review. 

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