I have worked with many women over the years who have tried to treat their acne with Accutane (or a generic version of isotretinoin under other brand names), some more than once. However, their acne often returned within a few months to a year after completing the treatment.
Why does this happen?
Isotretinoin, in the form of the drug Accutane/alternative brands, does not address the root causes of acne, regardless of whether they stem from insulin dysregulation, poor gut health, ineffective detoxification, systemic inflammation, or cortisol imbalance. Instead of tackling these underlying issues, Accutane-type medication targets only the symptoms. This means that sooner or later, the unresolved health problem will resurface, and acne, as a symptom, is likely to return.
What is Accutane (or similar oral isotretinoin treatments) and what are its effects on the body?
Accutane contains isotretinoin, a derivative of vitamin A, classified as a retinoid. It is prescribed for severe acne cases when other treatments have failed. If conventional therapies do not work, your dermatologist may recommend Accutane or a derivative of it depending on what country you live in as a treatment option. (Note that Accutane is not available in the United States since 2009. However, the generic version of Accutane, isotretinoin, is available under other brand names and is still being prescribed – Asorica®, Claravis®, Sotret®, Amnesteem®, Myorisan®, and Zenatane®.)
Isotretinoin binds to specific receptors, triggering the programmed death of sebaceous gland cells and reducing oil production. It also normalizes keratinization and the shedding of dead skin cells.
Scientific research suggests that isotretinoin interacts with the human FOXO1 protein, which may explain its numerous side effects.
One of the most important things to understand
One of the most important things to understand before committing to oral isotretinoin therapy is that isotretinoin is not exclusively targeted at the apoptosis (cell death) of sebaceous glands. These effects are also observed in various cell types, including muscle cells, brain cells, bone cells, and granulosa cells in the ovaries.
Think carefully about this!
This explains side effects such as extremely dry skin, joint pain, depressive states in some individuals, and changes in menstruation.
In 2009, the drug, under the brand name Accutane, was withdrawn from the markets in over 10 countries due to the large number of lawsuits filed over its side effects. It was later reintroduced in most, and as of now, oral isotretinoin remains available.
Does acne come back after oral isotretinoin treatment, and to what extent?
After a 4–5 month treatment, oral isotretinoin reduces acne in 80% of patients. However, the long-term cure rate is not as high as many expect.
A 2023 study with 225 women found that after two years, about 36% experienced acne relapse within 6 to 18 months post-treatment.
Tempting but Risky
We are all aware that oral isotretinoin therapy is very tempting and sometimes seems like the only option. However, it carries health risks and side effects, and, once again, it’s important to emphasize that it doesn’t address the root causes of acne.
Instead of taking oral isotretinoin for 4-5 months to temporarily eliminate a symptom, invest that time and energy in your overall health and true healing. Your skin can glow, and you can have incredible energy and vitality for a lifetime, all without potential harm to your health.
Are you considering taking oral isotretinoin?
Email me to discuss other options that target treating the root cause for your acne or take a look at the Basics for Clear Skin Program.
If you know someone who is considering Accutane, share this article with them, so they can think carefully about their options.
