Does Accutane Work? Everything You Need to Know + Holistic Alternatives

So you may have found yourself googling, “does accutane work”?

Accutane has long been touted as a miracle drug for those who struggle with acne. With countless online testimonials from those who’ve had success on the medication and the abundance of dramatic before and after photos, it’s likely that anyone who has endured a long-term battle with acne has at some point been enticed by the medication. The question that many people end up asking themselves is, is Accutane worth it? 

For those whose self-esteem and confidence has been or is currently being ravaged by acne, it often feels like anything would be worth it to have clear skin. With the fairly recent rise in popularity of holistic skincare and acne management, many people are beginning to consider a more holistic approach to clearing their skin in lieu of harsh pharmaceutical drugs like Accutane. The main reason for this is presumably due to the intense effects of Accutane and its potentially serious side effects. 

Please note this post is for information purposes only. Please speak to your medical professional prior to taking any medication or supplements.

What is Accutane?

Accutane is actually, well, not Accutane. Wait, what? The drug formerly prescribed under the brand name ‘Accutane’ is a retinoid called isotretinoin. While the brand ‘Accutane’ was discontinued back in 2009, generic versions of isotretinoin are still widely available. The fact that people still refer to isotretinoin as Accutane colloquially certainly speaks to its power and significance.

Though there are different isotretinoins out there, for the purposes of this blog post, I will use the term ‘isotretinoin’ to broadly refer to all prescription isotretinoin drugs prescribed for the treatment of acne. Isotretinoins may also be prescribed for other dermatological conditions which we won’t discuss in this post. Moving on!

Isotretinoin is a derivative of Vitamin A, known as a retinoid. While isotretinoin drugs are made synthetically, our bodies actually naturally produce small amounts of isotretinoin in the liver from vitamin A. Before you run off to your local health food store and start knocking back the Vitamin A, know that megadosing Vitamin A requires regular monitoring of liver enzymes by a Naturopathic or Medical Doctor and is unsafe to do on your own. 

Efficacy and Effects

Does Accutane work?

So, does Accutane work? The long and short of it is a pretty resounding yes. Accutane has a high success rate, with a relatively low relapse rate compared to other pharmaceutical acne treatments including antibiotics. However, it comes with a lengthy list of side effects and requirements compared to managing acne through diet, supplements & lifestyle changes. 

Under indications and usage, the Accutane label reads, “Because of significant adverse effects associated with its use, Accutane should be reserved for patients with severe nodular acne who are unresponsive to conventional therapy, including systemic antibiotics.” Despite this quote from the label, isotretinoin is more and more commonly prescribed for moderate acne, reasons for which I haven’t been able to find in my research. 

It’s important to know what you’re signing up for when considering taking medication and it’s also important to know your options. Isotretinoin is often referred to as a ‘last resort’ drug for acne, but many people only exhaust their pharmaceutical options before turning to isotretinoin and fail to attempt to heal their skin through holistic methods. This is no fault of the acne sufferer and is likely simply because holistic acne healing is less mainstream and typically not discussed in the medical community. 

So we’ve answered, “does accutane work”, but now let’s dive into my thoughts…

How Does Accutane Clear Acne?

Isotretinoin works by shrinking sebaceous glands (oil glands), inhibiting sebaceous gland function and inhibiting keratinization. Through all of my research, I’ve found that it is accepted that exactly how isotretinoin achieves this is still unknown. However, a statement that came up multiple times was that isotretinoin works ‘independently of hormonal mediation.’ This is pretty interesting since SO many people struggle with hormonal acne nowadays. 

Although it is known that the exact mechanism of isotretinoin is unknown, it is still unclear on how isotretinoin acts on many of the other systems that are often connected to acne like the microbiome or the immune system.

Many clients come to me after countless rounds of isotretinion, begging for help. And here’s why…

The Problem with Accutane

The biggest concern that I have in my practice is that accutane, or isotretinion, does not look at the root cause of your acne. This means that if your acne was triggered by one (or more) of the following, it’s very likely to come back raging even stronger post-medication:

• digestive issues such as constipation or poor microbiome health
• stress
• inflammation
• nutrient deficiencies
• immune problems
• hormonal imbalances
• & more

If you want to clear your acne for long-term, it’s important that we take a look at the root cause.

What Are the Side Effects of Accutane?

Different people experience different degrees of effects on isotretinoin, meaning some may feel relatively normal while others experience harsh effects. Some of isotretinoin’s common effects are:

• Extremely dry, flaky skin
• Mood changes such as irritability or sadness
• Mood swings
• Joint pain
• Muscle pain
• Problems throughout the entire digestive tract
• Nosebleeds
• Headaches
• Redness of skin
• Thinning hair
• Dry scalp and hair 
• And SO many more

Isotretinoin has also been known to have severe effects on some individual’s mental health including depression, psychosis, suicidal ideation and even suicide. It’s important to note both that the severe side effects are rare, but also that they have occurred.

In addition to the side effects one may experience while on isotretinoin, patients are also expected to do the following:

• Avoid sun exposure and any type of dermatological procedures such as waxing or microdermabrasion due to increased skin sensitivity 
• Avoid alcohol due to Accutane’s effect on the liver
• Regular lab tests are required to monitor liver function and other biological markers 
• Women of child bearing age are required to commit to two forms of birth control as well as not getting pregnant due to the serious birth defects associated with isotretinoin use

How Can Holistic Nutrition Clear My Acne?

In short, holistic nutrition uses food, herbs and supplements to get digestion, absorption and elimination working optimally, which in turn helps to both balance nutrients and hormones required for healthy skin and eliminate toxins that contribute to acne. Holistic healing may sometimes be a longer route, but it comes with a lengthy list of benefits rather than side effects and arms you with the knowledge of how to care for your body long term. When your body is nourished and able to absorb and eliminate properly, not only can your skin dramatically improve, but you can also see benefits such as improved energy, mood, sleep, recovery and so much more. 

A gentle reminder that there is no shame in how you choose to deal with any health issue, including your acne. The thing with acne is, although it can deeply affect mental health, self-esteem and confidence and therefore affect really any aspect of one’s life, it’s not going to kill you.

I am in no way minimizing the difficulties associated with having acne and I certainly don’t say that to be insensitive, but rather to remind you that unlike many other health issues, you have time. You have time to explore all of your options, arm yourself with as much knowledge as possible and to try different methods. And although you may not want to spend even another second with acne, investing your time and energy into listening to your body, understanding it and giving it what it needs is sure to be of great benefit to both your skin and your health in the long run. 

So the next time you find yourself googling, “does accutane work?”, I invite you to explore all of your options.

Ready to start on your holistic acne journey? Make sure to download my Free Guide “6 Steps to Clear Skin” below, read this post first and follow me on Instagram for tons of acne tips daily.

Sources used:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347928/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113073/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350794/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463189/
• https://www.medicalnewstoday.com/articles/accutane-side-effects#summary
• https://dermnetnz.org/topics/isotretinoin/
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/018662s059lbl.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835909/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105656/
• https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects

This post was written by our Practicum Student, Samatha Gilburg, of Peachy Keen Nutrition for The Pure Life.