Accutane Side Effects: 9 Things to Know About the Acne Treatment

According to Ciraldo, I was in the minority of cases. Some people do experience worsening if they have long-standing acne. This is usually due to purging, in which the isotretinoin pushes out dead skin cells and debris. Because your skin can become red and dry, the medication sometimes makes acne look more inflamed and obvious. My reaction was probably a combination of purging and irritation, but it eventually cleared up. I just had to push through.

Potential side effects include changes in mood and serious depression.

Case reports of severe depression occurring with isotretinoin have been documented by the FDA, especially in younger teens, however it is unclear if this is directly linked to the drug itself or a symptom of the acne. To be safe, the FDA recommends prescribers check with patients about their personal and family history of psychiatric disorders, and patients should be monitored for signs of depression, mood disturbance, and psychosis during monthly appointments.

For me, I felt acne was directly worsening my mental health, but I was willing to do whatever it took to get clear skin. I'm not alone in this experience; a study published in the British Journal of Dermatology last year suggests that people with acne have a shown a 63% higher risk of major depression than individuals without acne in the first year of their acne diagnosis.

As a safeguard, I went to a therapist regularly during the six months I was on the medication. I didn’t experience severe changes in my mental health, but I did notice a change in how I express my emotions. While taking the medication and even after getting off it, I have become more prone to crying over things I wouldn't have cried about before. While this may not be directly linked to the medication itself, it was unexpected; however, it was ultimately not serious enough for me to stop taking the medication—just something my doctor had me keep an eye on.

Going on isotretinoin as a woman is an especially complicated and annoying process.

Isotretinoin puts your body through a lot, but for a woman it becomes even more complicated. There have been previous instances of the medication causing birth defects, so in order to obtain a prescription, you must register for iPledge. This is an FDA-regulated program that focuses on preventing women on isotretinoin from getting pregnant. To pick up your monthly prescription, you have to schedule a derm appointment to keep an eye on side effects, provide blood samples for blood pressure checks, take a pregnancy test, log into iPledge for a quiz confirming you’re not pregnant, and verify you’re on at least two methods of birth control.

It's a huge undertaking. I'm afraid of needles, and getting my blood drawn monthly took a lot of getting used to. Be prepared to invest a lot of time into the process.

Isotretinoin dries out more than just your face.

It was unexpected when I got a gushing nosebleed on the dance floor of a club, but that’s another side effect I experienced. Because the medication slows down your oil production, it’s common to experience extreme dryness all over your body—and yes, that includes inside your nose. Although it wasn’t anything like the snakelike shedding some patients experience, the skin on my face was super flaky. I also had eczema flareups all over my body, something I haven’t dealt with since I was 10. But the worst part was undoubtedly the random nosebleeds due to the mucosa of my nose drying out. And lest I forget, lips that cracked and flaked no matter which balm I used (but the Laneige Lip Sleeping Mask did help).

Your skin might not be perfect—but it should be better.

When I finished my course of the medication, I had the skin of my dreams. Despite some lingering scars, I was finally comfortable leaving the house without wearing foundation for the first time in almost a decade. Then after a summer of clear skin (and shortly after starting my first real job), I began breaking out again. While it’s nowhere near as bad as it was before, my skin isn’t as flawless as I had imagined it would be. I’m convinced it’s due to my new lifestyle—trying tons of products, eating too much sugar, and not getting enough sleep—but Ciraldo notes that the effectiveness of isotretinoin can also depend on the dosage in relation to your weight. If you're not satisfied, you can check in with your doctor about adjusting it.

It might be an option even if you think your acne isn't severe enough.

Since high school, I’d wanted to be put on isotretinoin but never brought it up to my derm. I thought my case wasn't severe enough; the "before" photos I researched tended to show acne that covered the patient's entire face, whereas mine was more concentrated. However, I obviously needed something stronger, as nothing else worked for me. “Isotretinoin is a valid option for someone who does not clear on antibiotics and other oral medications for acne,” says Ciraldo. Despite Accutane's side effects and complicated process, I wish I’d realized it was an option sooner.

Bella Cacciatore is the beauty associate at Glamour. Follow her on Instagram @bellacacciatore_.