The first time I really noticed my acne, I was in the seventh grade at a sleepover with friends, and we were playing with makeup. I had just swept on baby blue eyeshadow and a hideous frosted lipstick. It was very Lizzie McGuire, and it was everything. But while checking out my masterpiece in the mirror, I noticed a small eruption of red pimples on my forehead and cheeks. I suddenly went from loving my makeup to wanting to bury my head under my pillow. Still, it wasn’t the worst; I was comforted to notice that my friends had breakouts, just like me. I figured it was a rite of passage—like bleeding through my pad or an awkward first kiss.
When high school began, my acne hadn’t gotten any better, and it wore down my already low self-esteem. I felt so self-conscious that I would wake up first at sleepovers so I could cover my pimples with concealer. I turned down after-school plans when I didn’t have makeup in my bag to touch up, and applied another layer of foundation before heading to my dance classes (which, looking back, probably contributed to the problem). After raiding the drugstore for over-the-counter treatments with little success, my mom finally took me to a dermatologist at the start of my junior year.
At first, I went on a series of topical medications (not effective enough) before moving on to an oral antibiotic, which didn’t stop my acne completely, but made enough of a difference for me to start to feel good about myself. My remaining breakouts were generally limited to my chin, but they were cystic, painful, and most irritatingly, constant. I always had at least two deep red pimples that would inevitably scar.
By the time I got to college my acne was no longer just an insecurity, but a huge factor in my worsening mental health. I felt trapped in my own skin, to the point where I refused to go out on weekends. I was constantly comparing myself to other women and feeling increasingly worthless. I had always placed value on my appearance and was preparing to enter the beauty industry. It weighed on me.
After a brief experiment with spironolactone, a blood pressure medication used to fight hormonal acne, that hit a wall, my dermatologist finally suggested I go on isotretinoin—commonly referred to as Accutane, a now discontinued brand. At the time, I was about to graduate and desperate to try anything that could clear up my skin.
Now, it’s been a year after I finished my treatment. And ultimately, I’m so glad I did it. I wouldn’t go so far as to call it life-changing, but it absolutely had an effect on my outlook and how I feel about myself. My skin today isn’t perfect, but it’s leaps and bounds better. It wasn’t an easy process, though. Going on isotretinoin is a serious undertaking that involves pregnancy tests and flaky skin. The decision to go on this medication shouldn’t be taken lightly. Read on for the nine things I wish I knew before going on isotretinoin and what you need to know about Accutane side effects.
It works like a topical, but stronger.
Isotretinoin is an oral retinoid, so it behaves in a similar way a topical retinoid would, just at a much higher strength. It regulates the way dead skin cells are shed, so there’s less build up and pore clogging. It also reduces oil gland size and production by up to 90%, which is why dry skin is such a common side effect.
You’ll need to avoid alcohol.
Most doctors recommend avoiding alcohol during treatment, which is something to consider before committing to the medication. However, the level of strictness varies; some doctors suggest not drinking at all, while others are a little more lenient depending on your family history and other factors.
