First, what is acne?
The cause of acne is pretty simple: dead skin cells, sebum, and bacteria all goop together and clog your pores, causing an infection in the skin. Sebum is your naturally produced skin oil that naturally expresses from your pores to keep your face hydrated and protected, but unfortunately, sometimes it produces excess.
The History of Treating Acne
Greek physicians Aristotle and Hippocrates used the Greek words ionthoi and varus to describe acne as a condition that is strongly associated with puberty (Grant, 1951). In the Ebers Papyrus (Fig. 2), ancient Egyptians used the term aku-t, which means boils, blains, sore, pustules, or any inflamed swelling (Grant, 1951).
Given its phonetic resemblance to the term we use today, this likely represents the root word of acne. The term acne vulgaris (vulgaris means common) was first used by Fuchs in 1840 and has persisted to the present day (Grant, 1951). It was not until the invention of microscopes that skin glands were identified which allowed for advancements in dermatology. Read more about the history of acne here!
When was Accutane first developed?
Accutane, a severe acne medication, was first developed in 1982. While the intended use of Accutane was to clear the skin of severe acne, and [in many cases] has been proven to do so, its past is deeply scarred by reports, medical studies, and lawsuits citing links to serious side effects including death. While Accutane itself has gone off the market (as of 2009), there are currently generics with the same active ingredient — Isotretinoin — available. Tracking and prevention of side effects is much improved, but severe issues abound! Here is a brief history of Accutane, from the time it was approved in 1982 to the present day.
What exactly is Accutane? (Isotretinoin)
Accutane is the brand name for the generic medication Isotretinoin. It is in the retinoid class of medications (retinoids come from vitamin A) and was approved for severe treatment-resistance (like antibiotics) acne in 1982 by the U.S. Food and Drug Administration (FDA). Unlike other retinoids, which are topical (like tretinoin; see Important Safety Information), Accutane is an oral medication. It’s an effective therapy that helps with several of the main factors contributing to acne, like oil production, clogged pores, inflammation, and more (Pile, 2021).
Like many medications, Accutane also has several “off-label” uses—these are conditions that isotretinoin is not FDA-approved to treat. Still, sometimes providers may choose to prescribe it for these purposes if they see fit. Examples of off-label uses include (Pile, 2021; Landis, 2020):
- Severe cystic acne
- Acne that is causing scarring
- Moderate acne
- Cutaneous T-cell lymphomas
- Prevention of squamous cell carcinoma (a type of skin cancer) in high-risk patients
- Rosacea (*)
Note: For those who have found this article through the wish to learn more about Accutane, we are going to continue to use the term throughout this article, even though it has been discontinued since 2009 and Isotretinoin is the main title for similar treatment in the present day.
How does Accutane work?
Accutane helps treat acne by shrinking the oil glands (sebaceous glands), preventing clogged pores, decreasing the growth of skin bacteria, and anti-inflammatory effects. During treatment, Accutane also reduces oil (sebum) production (see below “Is Accutane Safe” for more about why this is a serious issue). Most people continue treatment until their acne clears; however, some people have acne relapses and need to pursue a second course of Accutane (Fallah, 2021).
It can take several weeks or more for Accutane to have its full effect, and it can make acne get worse at the beginning of treatment. Most people who take Accutane have a course of treatment that lasts for 15–20 weeks (Pile, 2021). (*)
Is Accutane Safe?
As we mentioned above, Accutane reduces oil production in the whole body. This is a very serious and potentially tragic process, as our bodies naturally produce oil for a reason. It’s needed for brain health and gut health, thus causing both mild and severe side effects like the below, specifically depression and IBD, which can be imminently serious.
What are the main side effects of Accutane?
Some of the most common side effects of Accutane include (Pile, 2021):
- Chapped or dry lips (cheilitis) occur in approximately 90% of users
- Dry skin
- Itchy skin
- Dry eyes
- Dry nose
- Joint and muscle pains
- Temporary hair thinning
- Intestinal symptoms
- Urinary symptoms
- Increased sensitivity to sun
- Decreased night vision
- Accutane may increase the level of blood fats, sometimes to risky levels. This reverts to normal when the drug is stopped. Occasionally it may affect the liver.
- Thoughts of suicide
* Because there is not enough evidence to tell whether this medicine can cause depression and other mental health conditions, dermatologists look for warning signs of depression and other mental health conditions. Dermatologists also recommend taking precautions. If a person taking Isotretinoin has any symptoms of depression or another mental health condition, the person must stop taking isotretinoin right away
Even Higher Risks of Accutane
One extremely serious complication of Accutane is its potential to cause severe pregnancy and birth problems. You should not take Accutane if you are pregnant or may become pregnant because there is a high risk that it can result in loss of the pregnancy or harm to the baby.
This potential compilation is so significant that the FDA has issued a black box warning (its most serious warning). The FDA classifies this drug as Pregnancy Category X, meaning that it has been shown to cause harm to the developing fetus and is contraindicated in people who are pregnant or who may become pregnant. Please note that in these cases it is mandatory to use 2 forms of birth control!
Also, if a patient develops any of the following signs or symptoms of IBD (Inflammatory Bowel Disease) the patient must stop taking isotretinoin and see a doctor:
- Severe stomach or bowel (intestines) pain
- Bleeding from rectum
- Yellowing of skin or eyes
- Dark urine
Will acne return after Accutane?
Hormonal acne is more likely to come back after a course of Roaccutane (Accutane) has successfully cleared it. [In] severe cases antibiotics may be necessary.
"You should try and find the right combination of topical treatments instead."
Topical treatments will address the cause of acne in the long term and also prevent it from returning. Treating topically may require more patience and take longer, but in the long run, will be more beneficial for your skin and overall health. (*)
Does accutane help with scars?
One such side effect that must always be taken into consideration is the potential for Accutane to cause the skin to become more sensitive to the sun. This is an important limitation as many patients who are candidates for Accutane treatment are in their teenage years and are often active in various outdoor sporting activities and receive significant sun exposure. Therefore, dermatologists must exercise caution when prescribing Accutane in this context. (*)
- Read real people reviews about Accutane Sunburn on Quora
- Click here if you’d like to see an example of an Accutane sunburn
(But beware as it’s a bit graphic)
We get it, sebum production can lead to acne, and that is a big concern! But the risks can simply outweigh the benefits, and in a big way. Our products at Averr Aglow work to balance that sebum production, without risk, with topical treatments that are all-natural, calming, soothing, and have long-lasting effects.
Accutane Alternatives: Averr Aglow Natural Combo!
Instead of just trying to clear the acne you can see, you have to go after the breakouts that are brewing below the surface of your skin, waiting to erupt. Breakouts start in those deep layers when sebum and dead skin cells clog your pores and lead to bacteria growth, just like we talked about above. To prevent and tackle breakouts, you need to balance your sebum levels, buff off the dead skin before it can clog your pores, and preemptively fight off bacteria.
Here's the piece of the puzzle other brands don’t address: skin health. Skin with acne needs a boost of nourishment, so it has a fighting chance against aggressors. Good news! Averr Aglow's products are formulated to get rid of existing breakouts, correct the issues that cause new ones, and replenish your skin with nutrients so you can have a strong, healthy complexion for years to come.
Read here about how our Clear Skin products will absorb nutrients with a clean, fresh spritz from our Clarifying Hydration Dew, balance your oil production, and exfoliate with our Radiant Cleansing Nectar and/or Luminous Complexion Toner, then draw out impurities overnight with our Clear Skin Elixir with its natural French Pink Clay.
Hear our Averr Aglow founder, Cami, talk directly about her experience with Accutane and why and how she created Averr Aglow, by “curating a specific blend of plant-based ingredients that’s unique to your body and similar to your sebum.” Check out her video below!
We have also written many more articles about Acne and how we treat it with gentle natural, cruelty-free ingredients, food and nutrient supplements, and more! Check them out here, and worry no more about harsh side effects!