I didn't believe it would actually work. Like, seriously, I thought Accutane was just a myth for people with really deep problems until my dermatologist looked at me and said, "If we're going to do this, you have to commit." So here's the thing—I've been taking it for four months now, and looking in the mirror is still weird.
First off, I'll describe my situation so you know where I started. My skin was that classic combo-oil type but leaning heavily toward cystic. Big, hard, boil-like bumps on my jawline and cheeks that sat under my skin and made my face feel hot and sensitive even after they popped (and let me tell you, popping them is a whole nightmare). It wasn't just surface-level; it was deep inflammation. My pores were clogged with this heavy oil, and I felt like a walking zit magnet no matter how much I washed my face or changed sheets.
The routine I built up before starting was simple but flawed—I'll get to that. But the actual Accutane part started with a week of blood work and a lot of questions about pregnancy precautions (if you're a girl, you have to do this every single month). The pills themselves are weird. They're big blue and white softgels that slide down your throat easily but smell kind of like synthetic chemicals if you bite one open or drop it in your mouth. Nobody told me they'd make me feel a bit sick initially.
Weeks 1-2: The "What Did I Just Do?" Phase
I started with 20mg a day, maybe split between morning and night. Week one felt… nothing? That confused the hell out of me because I expected my face to just start shrinking overnight. But then came the purging phase. This is when you get those old zits coming back faster than usual before they clear up, plus new ones appearing.
Around week two, I noticed dryness creeping in. Not like "my face feels nice and hydrated" dry. More like "my skin feels like sandpaper." My nose started itching constantly, and my lips got so chapped I couldn't even feel them move. One morning I woke up with a split corner on my lip that was bleeding slightly. It hurt just touching it. I thought, Oh god, is this supposed to be normal? The dermatologist said yes, but hearing that didn't make the pain go away.
I kept doing my usual stuff—washing my face twice a day, maybe using a toner because I'm obsessed with skincare—and I felt like I was torturing myself. One night, the dryness felt so bad on my skin that I stopped washing it all together for about three days. That might have been better.
Weeks 3-6: The "Ghost" Stage
By month two, my face looked different, but in a ghostly way. Everything peeled. My forehead was like cracked leather. You can see the red lines where things peeled off. It smelled like old dust sometimes when I touched my skin, which is probably just dead skin cells flaking off.
This is where people make mistakes. I tried to put on some harsh acne serum from my usual bottle that had salicylic acid. My face went stingy immediately, and I panicked. I threw it away the same night. The lesson learned: you don't layer extra actives on top of Accutane while your skin is this thin and raw. Just plain water and nothing else for a while.
Also, drinking water was important. Not because some guy said so, but because if I forgot to drink, my lips would crack even worse and sometimes bleed. I tried putting Aquaphor everywhere on my face at night—cheeks, chin, forehead—because it felt like it sealed the cracks in my skin like a good plaster.
Months 3-4: The Turning Point
Around month three, I finally stopped feeling like I was peeling off a shell every time I washed my hands on the sink. My cheeks started clearing up first, then the jawline. The cysts that used to feel like hard marbles in my skin flattened and went away without leaving scars for once.
But it wasn't instant. One day, I noticed a small bump on my chin and panicked. Do you know what happens when you have an Accutane face? Any spot looks bigger than it really is because everything else around it is so tight. I just stared at it in the bathroom for like twenty minutes until I went to sleep.
I made a mistake early on with sunscreen, which you have to do religiously if you use this pill. I didn't wear enough of it during my third month, and by the end of the summer, my cheeks were sunburnt red. That taught me that Accutane makes your skin super sensitive to the sun, even just being outside for an hour can leave marks.
What Actually Worked vs. What Didn't
- Did: Thick moisturizer every single time I wash my face (even if I just splashed water). Lip balm that wasn't sticky—I found one that felt like cream and didn't make me look greasy. Sunscreen that was non-irritating (like a chemical-free one) because it burns easier now.
- Did Not: Any scrubs or exfoliators. I stopped using my toner with alcohol in it. It burned like crazy. And I stopped trying to pick at the flaky skin on my nose. That's just the part that peels the most.
Side Effects & Handling Them
The dryness wasn't just a nuisance; it was real. My eyes got itchy sometimes, and I cried more easily than usual. My skin felt so tight that when I brushed my teeth, my lips would hurt from the air in the room. One day I had a nosebleed because my mucous membranes were so dry inside. It lasted like ten minutes until I pressed down with a cold cloth.
I handled most of this by just being patient and slathering moisturizer. Some people say you need to eat fish oil supplements, and I guess that helped the chapped lips. But honestly, just eating food at normal times helped too—my body feels more hydrated now than it did before.
Looking Back Now (Month 4)
Right now, my skin is mostly clear. There are a few red spots from old scars fading, but the acne is gone for good, which means no new ones forming anymore. It feels like a relief not to have to wash my face every hour or cover up with heavy makeup.
I think a lot of people underestimate how much mental energy Accutane takes up. I felt anxious a few times wondering if it was working because sometimes my skin just looked the same in the mirror. But I kept taking the pills even when I felt like giving up. The only time I almost quit was month one, right before the purging peaked.
If you're thinking about doing this:
- Listen to your doctor and follow their dosage plan. Don't go off just because your skin feels bad for a week or two.
- Moisturize like it's your job. I joke, but seriously, dry skin gets worse with this treatment than you think.
- Don't be afraid to mess up. If you forget sunscreen one day, don't stress. If you eat something spicy that makes your lips burn a bit more, rinse it off. It's not perfect.
This was hard work. My face felt like I was in a dry desert for months, but the end result is skin that actually breathes without being inflamed. It still takes time, and some days will feel weird, but seeing yourself without the redness from the acne… it's worth whatever the struggle feels like. Just don't forget to drink water. I'll bet on that as my last piece of advice.
