Acne can be quite debilitating whether you are 15 or 45. I see many clients with acneic skin and there are some great treatments and products that I use to help clear it up.  But for severe and persistent cystic or nodular acne, I recommend that my clients see their dermatologists, who often recommend Isotretinoin (better known as Accutane),  as a solution. Isotretinoin is a powerful form of vitamin A, which has been proven to be one of the most effective treatments.

A common cause of severe acne is sebum overproduction due to hormonal imbalance which clogs pores and creates blockages. Vitamin A  is produced naturally within the body and helps regulate sebum production. It helps to speed up cellular turnover by preventing cells from sticking together and building up in the follicle;  this allows them to shed, which helps prevent blemishes. 

Additionally, Vitamin A is an antioxidant that helps to fight against free radical damage (free radical generating substances can be: sun, alcohol, smoke, fried foods, pesticides, etc.). Free radicals can cause changes to your sebaceous glands which could allow P.acnes (Cutibacterium) bacteria to flourish, leading to more blemishes. Vitamin A helps to fight against this process.

Deep cystic or nodular acne is formulated at the root of hair follicles, far beneath the surface of the skin and topical treatments can not reach the source of the pimple. Isotretinoin was formulated to promote skin cell turnover and healing from the source of the acne. It can be a terrific skin saver for people who have tried prescription topical treatments and other over the counter remedies. 

The course of treatment is typically about four to six months, but this can vary depending on the severity of the acne and the results are most often permanent. There are side effects that may include dry skin and lips, joint pain and headaches.

Isotretinoin is a powerful drug and you must take precautions to avoid adverse reactions including:    

  • Do not take Isotretinoin if you are pregnant, breastfeeding or plan to become pregnant, as it can be extremely dangerous to the fetus. 
  • Do not wax, get chemical peels, microdermabrasion or laser hair removal, as the skin is extremely sensitive and scarring or discoloration may occur.  
  • Extractions should not be done at home. If they need to be done,  they should be handled by a trained professional. 
  • It is best to avoid sunlight as much as possible and SPF should be worn anytime you are outside.
  • Alcohol should be avoided as it can lead to severe liver damage because accutane already puts a lot of stress on the liver. 
  • Try to avoid super hot baths/showers. 
  • Facials should be mostly healing and hydrating while on accutane.

As the skin is much more sensitive while on Isotretinoin,  I recommend the following products: