Can Accutane “shrink” your nose?

Table of Content:
Can Accutane shrink your nose? | How does Accutane affect your nose size? | How to get an Accutane prescription? | How do I know if Accutane may shrink my nose? | Can Accutane help shrink my nose if I have rosacea? | What research say about Accutane for rosacea nose | Limitations

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What is Accutane?

Accutane is the brand name for isotretinoin, a powerful prescription medication primarily used to treat severe nodular or cystic acne that hasn’t responded to other treatments like antibiotics or topical medications. Accutane works by significantly reducing the amount of oil (sebum) your skin produces, which helps prevent clogged pores, reduce bacteria and inflammation¹.

Why do users claim Accutane gave them a “nose job”?

Dr. Amit Om, board-certified dermatologist, says that several Accutane users have shared on social media personal experiences suggesting that the medication has given them a free nose job. While these accounts are anecdotal, they offer insight into how Accutane may influence facial appearance, particularly the nose.

Can Accutane really “shrink” your nose?

Dr. Om says that Accutane cannot “shrink” your nose’s bone or cartilage, so it won’t alter the actual structure of your nose. However, it can make your nose appear smaller in some cases due to the effects it has on the skin. He also added that you would only notice a big change in your nose if you had large, overactive sebaceous glands in the first place.

How can Accutane affect your nose then?

Dr. Om says that Accutane can affect the appearance of your nose by having these effects on the skin.

• Reducing oil production and sebaceous gland shrinkage: Accutane drastically reduces sebum (oil) production and shrinks the sebaceous glands, especially in oily areas like the T-zone (forehead, nose, and chin). If you have enlarged or clogged pores on your nose, the reduction in oil can make the skin appear smoother, less swollen, and less puffy, which gives the illusion of a smaller nose².
  
• Decreasing inflammation and swelling: If your nose was affected by acne or general inflammation (like it is in many cases of oily or acne-prone skin)³. Accutane can reduce this, making the contours of your nose appear more defined.
  
• Minimizing the size of your pores: As oil production decreases, pores may look smaller and tighter, especially on the nose, which can again lead to a sleeker appearance.

So, does Accutane “make your nose smaller” then?

Yes! Dr. Om says that Accutane can make your nose appear smaller, even though it doesn’t change your nose’s structure, it can still change how your nose looks, especially if oiliness or inflammation were exaggerating its size⁴.

How to get an Accutane prescription?

If you are affected by severe acne or concerned about the size and shape of your nose due to acne or rosacea and are wondering whether Accutane can help you with this, you can have an online consultation with a board-certified via Miiskin. 

You need to answer some questions, add some photos of your face (in this case your nose) and if the dermatologist considers that Accutane can be helpful for you, you will get a prescription. They can also recommend alternative treatments based on your personal circumstances. 

Is everyone’s nose affected by Accutane?

Dr. Om says that not everyone’s nose is noticeably affected by Accutane. The degree of change depends on how oily or inflamed your nose area was before treatment. If you have large sebaceous glands, visible pores, or swelling from acne or excess oil, you’re more likely to see your nose appear slimmer or more refined during treatment. However, if your nose wasn’t particularly oily to begin with, you might see little to no visible change.

So how do I know if Accutane will “make my nose smaller” or not?

Dr. Om says Accutane can make your nose appear slimmer if certain skin conditions are present before treatment. Whether you notice a visible change depends mostly on how oily or inflamed your nose area is to begin with. Here’s how to tell:

Signs that your nose may appear smaller on Accutane

• Very oily skin, especially in the T-zone (nose, forehead, chin)
• Visible, enlarged pores on the nose
• Frequent blackheads or breakouts centered around your nose
• Puffy or inflamed appearance in the nasal area due to acne
• A history of sebaceous hyperplasia (enlarged oil glands)

Signs you may not notice much change on your nose after taking Accutane

• Naturally dry or normal skin
• Minimal acne or oiliness around the nose
• Tight, smooth skin texture without visible pore issues

Can Accutane help if my nose is getting thick from rosacea?

Dr. Om says that Accutane can definitely help your nose appear slimmer if you have rhinophyma, a skin condition that causes the nose to become enlarged, red, and thickened, often with a bumpy or swollen appearance. It’s a severe form of rosacea, usually developing after years of untreated or poorly managed papulopustular rosacea⁵.

Key features of rhinophyma

• Thickened, oily skin on the nose
• Enlarged pores and visible oil glands
• Bulbous, irregular shape to the nose
• More common in men

Causes of rhinophyma

• It’s linked to chronic inflammation and overgrowth of sebaceous (oil) glands
• Not caused by alcohol (a common myth), though alcohol may worsen rosacea symptoms

Why may Accutane help with rhinophyma?

• It shrinks oil glands, which can reduce the thickness and oiliness of the nose
• It prevents further skin thickening caused by overgrowth of sebaceous tissue
• It can slow or stop early rhinophyma from progressing

Rhinophyma treatment options

• Early stage: Low-dose Accutane (isotretinoin) may reduce gland size and slow progression
• Advanced stage: Laser therapy, dermabrasion, or surgery may be needed to reshape the nose

What research says about using Accutane for rhinophyma

Studies suggest that isotretinoin (Accutane) plays a valuable role in managing nasal skin thickening related to rosacea and rhinophyma, either as a primary treatment or as an adjunct after surgery. 

Low-dose isotretinoin has shown to effectively reduce sebaceous gland activity, improve skin texture, and slow progression of rhinophyma, potentially delaying or avoiding surgical intervention. 

Additionally, in patients with thick nasal skin post-rhinoplasty, isotretinoin may enhance early cosmetic outcomes, although its long-term aesthetic benefits appear limited. Overall, these findings support the careful, targeted use of low-dose isotretinoin in both pre- and post-surgical settings for individuals with thickened or oily nasal skin due to rosacea-related conditions^{6 7 8} .

Limitations on the use of Accutane for rhinophyma

Dr. Om says that Accutane will not reverse advanced rhinophyma (permanent tissue overgrowth), but it can prevent or slow progression. If your nose is already severely thickened, you may need additional treatments like laser therapy, dermabrasion, or surgery.

In short, Dr. Om says that Accutane can be an effective tool to manage papulopustular rosacea on the nose and make it look more normal—especially if caught early and it should always be used guided by a dermatologist.

Article References:
https://www.ncbi.nlm.nih.gov/books/NBK525949/
https://pubmed.ncbi.nlm.nih.gov/6213204/
https://pubmed.ncbi.nlm.nih.gov/34820691/
https://www.ncbi.nlm.nih.gov/books/NBK544373/
https://pubmed.ncbi.nlm.nih.gov/38018283/
https://pubmed.ncbi.nlm.nih.gov/30288563/

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