My Accutane Journey
before & after pics, side effects, and would I do it again?
Before I dive into my Accutane journey, I want to thank Lands’ End for sponsoring today’s newsletter. The Power Nap is free each week, and sponsors like Lands’ End help make that possible!
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And now, my Accutane journey…
Hey friends! I have now been off Accutane for six months (I started in November 2024 and went through May 2025) and wanted to give you all a good recap of the journey. This is a bit more vulnerable for me, but every time I would share on Instagram about my skin I would get a massive amount of messages from women who are also struggling with acne—women feeling embarrassed and ashamed, women spending tons of money on serums and creams hoping something will cure their acne. Now, six months out, I get complimented on my skin and so many people have no idea it was ever an issue! So, here are the answers to all the Accutane-related questions I have gotten over the last year.
As I was putting the photos in for this, I got emotional looking at them. I kept a hidden album on my phone to track my skin progress, and I can’t believe this was my face last year. It was so miserable, not to mention painful. But I want to give the full picture, so I included photos I took along with timestamps.
One more note because this is the internet: I am not telling you that you should go on Accutane. I cannot promise it will work for you. All I can share is how it went for me. You’ve got to do your own research, talk to your doctor, and make your own choices.
Q: Why did you decide to go on Accutane?
I have struggled with hormonal acne for the majority of my life. I actually considered Accutane in high school but was scared off by the booklet they forced you to read featuring tons of images of deformed fetuses. I saw little reprieve save for my years of pregnancy and breastfeeding (I know for some women pregnancy triggers acne; for me, it cleared it.) After having Alberta, I went on birth control (not for acne, but for—well—birth control), and while it helped, around age 35 I noticed my skin taking a real turn for the worse. I went to an aesthetician who specialized in acne and unfortunately, from there, things got far worse.
I changed my diet and my products. I was insanely anal about what went on my face, checking every label. I went through a “purge phase” that was less of a phase and more of a constant battle. My skin was so painful with cystic acne. This was mentally tough considering my job involves me showing my face on camera daily. I hated seeing my pimples and would do my best to cover them before filming.
I was so embarrassed and tired of trying to cure my acne. I went to my dermatologist and decided to try out Spironolactone, which I knew many people had had success with. It worked okay, but after doubling my dose over almost a year, I was still struggling with painful cystic acne all around my jawline. I brought up Accutane and my dermatologist agreed we should go for it.
Q: What is it?
This question is great because I wasn’t sure until I started! Is it a shot? A pill? How often do you take it? Accutane is a pill you take 1x/day to begin and then move up to 2x/day (the strength and 1 vs. 2x depends on your provider’s prescription). If you really want to understand how it works, go on ChatGPT and say “explain Accutane to me like I’m not a doctor” — it does an amazing job.
Q: How long were you on it?
I was on it for six months (the typical round length), taking 30 mg the first and last month, and 60 mg the middle four months. My skin was really clear by the end of month five and my derm said I could stop there, but I opted to lower my dose and stay on it the final month.
Your dose is dictated by your body weight, and most people split the dose into two daily pills. So for the first and last month I took one pill, and the middle four months I took two pills. Some people also microdose and go on it for longer periods of time if the higher dosing gives them side effects that don’t enjoy or for one reason or another they don’t need the full dose.
Accutane is meant to be curative—meaning you go on it for around six months and you are “cured” from acne. It doesn’t work for everyone; some need more than one round, and some who went on it in high school end up needing a second round in their late thirties, but on the whole, it tends to work miracles for most people. What I was surprised to learn was just how many women go on it in their late thirties. My dermatologist said they had just as many patients in that phase of life going on it as teens!
Can you start whenever?
It’s not that easy. You have to have bloodwork done before you begin—namely (I believe) to look at your liver health (Accutane is processed through the liver). So if you think you want to go on it it’s best to get the bloodwork ordered fast to check that part off. You then have to have a monthly doctor’s appointment (I did most of mine virtually) and provide a negative pregnancy test each month.
You also have to go online and answer these questions regarding how getting pregnant works. It’s asinine, really, but I think a ton of teens get on Accutane and it is really bad if you get pregnant (terribly bad), so they want to drill in how getting pregnant works.
You also have to vow that you are using two forms of birth control, which we did (I was not messing around with the chance of getting pregnant while on Accutane). You also get bloodwork done again halfway through to check your liver levels.
NOTE: because Accutane is processed through the liver, it’s best not to drink because alcohol also processed through the liver. I had an occasional drink but on the whole steered clear of alcohol while taking it.
Q: What is the cost?
This really depends on your insurance. I paid $39/month for the pills and $60 per doctor’s visit, which have to happen monthly. However, I didn’t use a single fancy face product while on it and now that my skin is clear I am not spending a fortune on products promising to cure my acne.
Q: What were the worst side effects?
This varies based on the person, but my two worst side effects were my eyes and my joints.
I moisturized like a maniac. I used Vaseline/Aquaphor before bed and had Cortibalm chapstick attached to my key ring. But the eyes truly about killed me. They were so dry all the time. I had more styes than I have had in my entire life. I stopped reading before bed and would instead use eye drops, ointment, and a steam eye mask. The dry skin didn’t bother me, but my eyes really did.
My joint pain didn’t start until around month 3 (that’s known to be the climax—and when the eyes got the worst as well). It wasn’t debilitating but I did notice that my joints bothered me more. Luckily, within a month of being off Accutane my joint pain was gone. My eyes still seem a bit more dry than normal, but I am not sure if that’s aging or a residual side effect. For the first few months off I continued to struggle with styes, but after going to the eye doctor and getting a prescription they are gone. He said it is common to have stye issues as the eyes adjust post-Accutane, and the ointment he gave me was a lifesaver.
Oh! One more side effect I actually miss — my hair! Accutane is super drying so my hair was more on the dry side, which for me meant I could go longer between showers. Once getting off my hair felt more greasy and I am pretty sure this was it coming back to normal post Accutane.
I was also way more sun-sensitive (a large reason I chose November 12 – May 12 as opposed to peak summer), and made sure to always wear sunscreen and bring a hat with me everywhere I went.
The good news: the side effects on Accutane tend to last the course of Accutane. I dealt with the dry eyes knowing it would likely be six months. My eyes were dry, but my skin was completely clear. My eyes were dry, but for the first time in months I wasn’t dealing with painful acne and cover-up. It was a trade I was willing to make.
Q: What surprised you?
First, when I went on Instagram and told people I was starting, I was shocked at how many people had been on Accutane and had amazing results. A ton of people I knew in real life had used Accutane and I had no idea! I mean, I get it. It’s not like you meet someone and say, “Hey, by the way, I was on Accutane five years ago.” But it was hundreds upon hundreds of success stories. A few negatives, but far (far!) more positives.
Second, the pill packs surprised me in the worst way. Each pill was insanely hard to open and came individually wrapped in this foil sheet. Between the wrapping and the questionnaire, I firmly believe if we could treat painkillers more like Accutane (having you answer questions pertaining to how the pill works, what not to mix it with, what to avoid while on it, and making each pill individually wrapped), we could prevent a lot of tragedies surrounding painkillers.
Third, the dry eyes. I was prepared for dry skin, but the eyes got me.
Q: Would you do it again?
1000% yes. For anyone who has struggled with painful acne—or acne in general—this was a lifesaver for me. I’m six months out and I believe I have had one pimple since May? I can go out with a tinted moisturizer on and feel great. It absolutely changed my life. My only regret is not doing it sooner.
Still have more questions?
Feel free to ask me below, but your dermatologist can answer better than me. I also found that ChatGPT did an incredible job answering questions I had around how it works, dosing, etc. Any question regarding what it is and why it works I could ask and get a really good explanation from ChatGPT—and ask follow-up questions. Also, linking my skincare items I am using now as well as what I used while on Accutane below.
This is such a great write up! I'm micro dosing, staying at 30mg, been on it since March and will stop next month. The side effects are minimal (joint pain and dry lips) but man, I am going to miss my hair being like this!!
I tell people the same thing about the process. If we really wanted to stop the opioid epidemic we should make opioids as hard to get as accutane is. The ipledge system alone would help drastically reduce misuse!
Awesome to hear! As a dermatologist, I love your feedback. Accutane is the best. I just joined this app mainly to make a post about the beauty of Accutane.