The Accutane timeline: How long does isotretinoin take to work?

Table of Content:
The Accutane (isotretinoin) timeline | How can I ensure my Accutane treatment is successful? | Things to avoid during Accutane treatment

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Dr. Amit Om, board-certified dermatologist, says Accutane (isotretinoin) can be a life-changing treatment for individuals with severe or scarring acne (nodular or cystic acne) that has not responded to other acne medications.

Unlike most acne treatments that just manage acne symptoms, Accutane tackles acne at its source. It shrinks oil glands, cuts down sebum production, and helps keep pores clear. It also has strong anti-inflammatory effects, which not only help heal current breakouts but also lower the risk of future scarring.

According to Dr. Om, many of his patients find Accutane to be absolutely worth it—often turning to it as a last resort after years of trying other treatments without success. The emotional impact of acne can be significant, affecting self-esteem and mental health, and for those who respond well, Accutane can be truly life-changing. A single course often leads to long-term or even permanent improvement, making it one of the most powerful options for treating severe acne.

For people dealing with stubborn or painful acne, Accutane offers the possibility of clear skin, less scarring, and a renewed sense of confidence and comfort in their own skin.

How long does it take for Accutane to work?

Dr. Om says Accutane is a strong medication and it comes with significant effects—both positive and potentially negative ones. Here is a timeline of the changes that happen in the body while taking this medication.

Can you get an Accutane prescription via Miiskin?

Yes, absolutely. You can now request Accutane treatment via Miiskin with a board-certified dermatologist for only $59 per month.

The Accutane timeline

Dr. Om walks you through the Accutane timeline so you know what you can expect during your Accutane journey.

Accutane journey: Weeks 1–2

Dr. Om explains that during this time your skin goes through an adjustment phase. Acne might temporarily worsen often called the “initial purge”). You’ll probably notice dryness on your skin and lips, so daily moisturizing and lip balm are important. You might also feel some mild irritation or increased sensitivity.

Accutane journey: Weeks 3–6

Dr. Om that the peak of the Accutane purge should happen during this time, new pimples will appear, together with more redness and inflammation. Dryness becomes more pronounced—especially on your lips, inside your nose, and around your eyes. Some people may also feel mild joint aches or headaches.

Accutane journey: Weeks 7–12

New breakouts start to slow down, and inflammation begins to ease according to Dr. Om. Your skin texture becomes smoother, and oiliness is minimal. Post-acne marks may begin to fade, though some redness might stick around. Many people feel their skin is finally starting to clear.

Accutane journey: Months 4–5

Dr. Om says that by now, your acne is usually significantly reduced or nearly gone. New pimples should be rare, and any that show up tend to be smaller and heal fast. Scarring and dark spots continue to fade, and your skin tone starts looking more even. Dryness is still present but can be controlled with the right skincare.

Accutane journey: Month 6 and beyond

Dr. Om says that most people see clear skin with little or no active acne. Any lingering marks or redness may take a bit longer to fade. Oil production stays low, helping prevent future breakouts. If acne is still present, treatment may continue past six months.

Accutane journey: Long-term outlook

Many patients enjoy long-term or permanent acne relief. Skin often stays less oily even after stopping treatment. To keep your skin healthy and prevent relapse, stick to a gentle skincare routine with moisturizer, sunscreen, and any recommended topical treatments. dermatologist will determine if Accutane is right for you and will guide you through the step by step process.

How can I ensure my Accutane treatment is successful?

According to Dr. Om, following a few key steps can help you get the best results from Accutane.

Be consistent with your treatment

Take Accutane exactly as prescribed. Avoid skipping doses to ensure positive, long-term results. Take your Accutane with a meal that contains fat to help your body absorb it better. If you are taking any other medications, you should mention this to your dermatologist as Accutane interacts with many medications and over the counter skincare products.

Handle side effects with gentle skincare

Use a mild cleanser and a non-comedogenic moisturizer to keep your skin hydrated. Keep your lips protected with constant use of lip balm like Vaseline or Aquaphor. Skip any other acne treatments, exfoliants, or retinoids that could irritate your skin. To help prevent nosebleeds, apply a small amount of petroleum jelly inside your nostrils. Moisturize your entire body twice a day using a thick, fragrance-free cream like CeraVe, Eucerin, or Vanicream. A cool or warm mist humidifier in your room—especially overnight—can also ease dryness. Just be sure to clean it regularly (every 2–3 days and deep clean once a week).

Protect your skin from sun damage

Accutane makes your skin more sensitive to sunlight, so wear SPF 50+ sunscreen daily, and use sun-protective clothing like hats, sunglasses, and long sleeves when you’re outside.

Stay hydrated and eat well

Drink plenty of water to fight dryness and support skin health. Eating a balanced, high-fiber diet also helps your body while you’re on the medication.

Watch for changes in your mood or health

Be mindful of any mood changes, especially if you’ve had mental health concerns before starting Accutane. Let your doctor know if anything changes. And don’t forget to stay on schedule with blood tests to keep an eye on liver function and cholesterol.

Things to avoid while taking Accutane

Dr. Om emphasizes that the most critical precautions with Accutane is avoiding pregnancy if you’re a woman, or preventing pregnancy with your partner if you’re a man. Isotretinoin is highly teratogenic, meaning it can cause severe birth defects.

• Pregnancy – Accutane is extremely harmful during pregnancy. That’s why strict birth control and participation in the iPLEDGE program are required. You’ll need to provide a negative pregnancy test one month before starting and one month after stopping treatment.
  
• Donating blood – You shouldn’t donate blood while taking Accutane and for at least one month after stopping, in case the recipient is pregnant or could become pregnant.
  
• Too much vitamin A – Be cautious with foods high in vitamin A (like liver, egg yolks, full-fat dairy, and certain fish). Avoid supplements like multivitamins for skin, cod liver oil, or fish oil capsules, as combining these with Accutane can lead to dangerously high vitamin A levels.
  
• Alcohol – Since Accutane puts extra strain on your liver, drinking alcohol can increase the risk of liver issues and raise cholesterol levels.
  
• Waxing or laser treatments – Your skin becomes more delicate and sensitive during treatment, so procedures like waxing or laser hair removal can lead to burns, scarring, or damage.
  
• Harsh skincare products – Avoid retinoids, exfoliants, strong acne treatments, and acids like glycolic or salicylic acid, as these can make dryness and irritation worse.
  
• Picking or popping pimples – Your skin is more fragile and prone to scarring. Let breakouts heal on their own.
  
• Sun exposure – Accutane increases your skin’s sensitivity to UV rays, so you’re more likely to burn or develop dark spots. Always use sunscreen with SPF 50 and wear protective clothing.

Article References:
¹ https://pubmed.ncbi.nlm.nih.gov/31535587/
² https://www.ncbi.nlm.nih.gov/books/NBK525949/
³ https://pmc.ncbi.nlm.nih.gov/articles/PMC3602257/
⁴ https://pmc.ncbi.nlm.nih.gov/articles/PMC8014951/
⁵ https://ipledgeprogram.com/#Main
⁶ https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects
⁷ https://apps.medsch.ucla.edu/posters/files/pdfs/[email protected]

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