DermTV – About Accutane – When to Use It [ Epi #433]

When Accutane first came out 30 years ago, the specific indications for its use according
to its FDA approval was for “severe, scarring, cystic acne unresponsive to multiple different antibiotics”. While
those are still the “official” criteria for Accutane’s
use, let me tell you my interpretation and my recommendations. In my opinion, it’s time to use Accutane
when inflammatory acne, meaning pimples, pus pimples and cystic acne… when they don’t respond to topical or internal
treatments after a few months. Internal treatments means
either antibiotics, or birth control pills for females, or even a combination of the two. So if you’ve been on one or two antibiotics, each for a month or more, and they haven’t
helped, or if you’ve tried one or two of the birth
control pills that are usually helpful for acne and despite
that you still have inflammatory acne… then in my opinion, it’s time to use Accutane. In terms of the original criteria of scarring
acne, I think scarring can be not only physical
but emotional as well. The emotional impact of acne… the lowered self-esteem, the anxiety, depression and the resulting impaired quality of life
accompanying acne… I believe can all have a long lasting impact and in fact is the emotional counterpart to
scarring. So whether or not your acne leaves physical
scars on your skin, if it’s persistence constitutes a meaningful compromise of your emotional
well being, then in my opinion that’s a quality of life
issue justifying consulting a dermatologist regarding the use of Accutane. Accutane cures acne. Period.

Comments 42

  • I 100% agree, Accutane saved my face! 🙂

  • I heard that Accutane can be used as well to help improving mature women skin (45+) such as, wrinkles, facial expression lines and aging spots! How about birth control pills and their different multi-results effects? I know few girls take different birth control pills and each one is experiencing different results in her body and skin! Such as, gaining /losing weight, increasing breast size, improving hair condition, PMS irregularity..etc , and what is the best Birth C. to take ?

  • I used accutane for 18 months under the directions of my dermatologist. Worst 18 months of my life (cracking painful skin etc). I had incredible skin for 6-9 months after I finished my treatment and soon after my skin gradually returned to its original state (scaring cystic acne). The only lasting difference I had is that my acne on my back and chest is no where near as sever.

    I would definitely consider all the alternatives before being convinced by this supposed cure-all 🙂

  • Wasn't accurate taken off the market in 2009 because it was dangerous? It's super toxic and you cant donate blood because of it and it causes severe birth defects if you become pregnant.

  • I'm on 40-60mg yet after two months. and and the and I only experience the side effect so far.
    My face is just better but my back is around the same.
    I strongly agree with Dr. Schultz that this medicine makes the biggest improvment on self-esteem. But everyone should know that by the begining of the treatment it is hard be emotionally balanced, especially for people who have some form of depression. So take care!

  • Going on accutane was one of the best decisions my doctor and I made about my skin.. We tried to sort out the acne through topical and internal methods but when neither worked after 4 months, I was put on accutane. I'm stil dealing with the scarring I have, as my purging period was pretty bad, but despite that, I can't suggest accutane enough!

  • I used Accutane and my acne healed. One year later it came back but less severe. Is it advisable to go back on Accutane?

  • I used it and it cured by cystic chest and upper back acne. It was amazing. im 17.

  • i thought accutane is now banned in the U S ???

  • Yeah me too I had it whn I ws 14

  • My doctor had prescribed me when I was 14 for the first time for acne.After that I never ever had had acne breakouts,maybe once in 2 years due to infection.But later when I ws 15 I went again to my doctor cause I have super oily skin & again he prescribed Accutret( In My Country Its Called That).I still have it maybe 30 tablets for a month & half during summer & rain.But in winter I take 15 tablets & take a break.Doctor Neil is my regime good for me…? Please reply.Take Care.


  • You need moisturize your skin very nicely at that time. Do you have dry skin… ?

  • Yeah cause it has isotretinoin in it…

  • now I'm 19 by the way & I have taking it since 15…

  • During pregnancy you are not allowed to take it. Or like even if you are planning on being pregnant.

  • How is your liver after those years?

  • I used Accutane (Roaccutane here in Australia) for 9 months when I was 20. It made my skin amazing. I had been on birth control for acne since I was 14. I had to go off that BC at 28 because of lack of access and all my acne came back.

  • thats terrible, i started using accutane and birth control at 17 for 9 months, i forgot the strength i was using, but it cleared up my face completely. my doctor told me its rare for the skin to return to its previous state after the treatment. of course i do get the occasional pimple, who doesn't? I hope you find a cure for your condition.

  • I took accutane about ten years ago. It worked for me but I still have some mild acne now. Sometimes I want to take it again but I know my acne probably is not severe enough to take it again. It worked for me and I didn't experience any permanent side effects, just dry skin. It doesn't cure acne forever, but I believe it cures severe acne FOR SURE!

  • I took accutane and I donated blood!

  • Do you mean you have to get your blood taken while on accutane to monitor your liver?

  • Agreed! People act like this medication is so horrible but realize that MANY medications out there have risks as bad, if not worse than this one. It is a life changer and worth the risks for many people! As long as you monitor your health while on it, it is relatively safe. It just bothers my that accutane gets a bad rap while so many other meds that have risks are not paid attention to.

  • Its good… why ? 🙂 I take 20mg so mayb dats y nothing hs hppnd. I go on & off with accutret. I dn't consume it everyday.

  • It's … GOOD GIRL GINA!

  • My doctor put me on a high dosage and I had very server side effects. It cleared my skin but he wouldn't put me on a lower dosage so I stopped taking it and my acne came back with avenges.

  • Yeah I was using dermatologist recommended moisturisers and lip conditioners, it was a tough time: I had to eat everything on a teaspoon because my lips would crack if I tried to use a soup spoon! It changed the nature of my skin and I now have very dry flakey skin 6 years later. A boy who went to my school attempted suicide due to the emotional/psychological side effects. I'm sure it works well for some but I would recommend doing careful research and not assuming its a miracle!

  • I think that acknowledging that other drugs on the market have serious and sever side effects does not diminish the fact that accutane can cause some people real problems. I think that its up to each individual to weigh up their own personal pros and cons and make the decision that is right for them, with full access to and understanding of the facts about the drug 🙂


  • I went on Accutane for 8 months when I was 16 as I had severe cystic acne, it worked & the only side affects I had experienced were: dry skin,aches & pains in my joints & nose bleeds. Although after 4 months of being off accutane, I relapsed & my acne came back, less severe but it's still bad around my jaw line. I am looking into going back on to accutane as I am now turning 21 & its still bad, which has a huge affect on my self confidence. Good to read others stories; makes me feel less alone

  • accutane is sooo bad for you though. I know it clears it up, but in the long run you'll have a lot of health problems.

  • Accutane include the risk of serious side effects, However, the emotional pains left by severe acne can drive some to suicide or have an inward personality. Therefore, for some the risks are worth it.

  • I never had acne till I was 22. It was wild,and doctor prescribed accutane. My skin is clear since then, I'm 36 now.I have dry skin now, put nothing a good cream can't help with.And yes,you need to have blood tests while you are on it to watch your liver.

  • hi! A few years ago I have co many acnes, now I have awful acne scars. What I have to do, I want beautuful face again without acne scars. I thinking about Fraxel metody. Please help

  • It's not only for severe or cystic acne.. If you fail the other antibiotics the only choice is accutane. I get like 4-5 pimples and nothing else helped so I got it without having severe acne.

  • Dr. Schultz. I am a 26 year old who has struggled with t-zone acne, some chin cystic acne, and oily skin since I was a teenager. I have tried everything from Benzoyl Peroxide, to Glycolic Acid (yours is awesome as you know I have commented many times), and even reducing and changing my regimen to try to find the right balance. I have seen a dermatologist in my area a few times but nothing has worked permanently. How should I approach this with my dermatologist if I really want to try this?

  • I have also been on Ortho Tri Cyclen and Ortho Tri Cyclen Lo for years… with no change in my acne.

  • Accutane is a miracle drug. I had hereditary cystic acne, like all my fathers family. Prior generations were disfigured by scars. My dad & uncle even got skin cancer from UV radiation treatments derms used in their teens. But those of us in my generation have beautiful skin & no scars, bc we're fortunate to have taken Accutane

  • Consult a Dermatologist as he stated in the video. I'm no Dr. Schultz, but I am a patient on Accutane and I can verify that everything he said is true. Accutane does work and it does cure your acne. Go see a dermatologist, tell them your story, and maybe he or she will prescribe it to you. Some people find it hard to be prescribed, but it was easy for me. good luck.

  • Accurate worked a miracle with my severe acne, BUT I have mild to moderate acne again 🙁

  • accutane doesn't cure acne for all users

  • I'm on acutane and I'm loving the results I had it very severe and I litterally hated my self and hater my life until I started using acutane every other pill / cream dident do shit for me

  • How do u use accutane .the cream i was prescripted with (chloramphenicol +Tretinoinum ) is very thick and doesnt dry or anything like that .so when i use it my skin is very oily and shiny .and i know i have to use twice a day but it just feels wierd .Please help me !!!

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