Dangers and side-effects of Accutane

side effects and dangers of using accutane

When I filled my first Accutane (isotretinoin) prescription, my acne was the worst it had ever been, despite seeing a dermatologist regularly. Over the course of three years, I had tried everything: antibiotics, retinoids, and every combination of prescription topicals under the sun. At one point, I shelled out for monthly in-office photo pneumatic therapy sessions (a pulsed light and suction treatment that promised to clear my perpetually congested skin.) It was starting to seem like the more I did, the worse my skin looked. When my dermatologist finally suggested I try Accutane, I spent all my free time figuring out where I had gone wrong and how I could change to get clear skin. Was it my diet? Did I need supplements? What about probiotics? Treating my acne seemed impossible, and I thought Accutane was the solution. What I didn’t know was how difficult it would be to stay on the medication, how damaging the side effects would be to my body, and that I had other, safer options.

Getting On Accutane 

Accutane (Isotretinoin) is a prescription-only treatment for severe nodular or cystic acne that has failed to respond to other first-line treatments. It’s usually effective for cases of acne that are otherwise difficult to treat, which is why it’s used so frequently by dermatologists, and why you may have heard rave reviews. But getting your hands on a prescription isn’t easy, because taking Accutane comes with a lot of risks. Particularly if you are biologically capable of bearing children, and Accutane prescription means taking on additional medical expenses for the pregnancy tests and contraceptives required by law to prevent the severe birth defects the medication can cause. Accutane users of all sexes need to get regular bloodwork to make sure their levels of vitamin A (the ingredient that makes Accutane effective) don’t become toxic to the liver. For this and other reasons, dermatologists typically exhaust all other options before giving a patient Accutane. For patients suffering from severe acne (and dealing with its emotional toll), it’s a frustrating waiting game of trying and failing medications until they qualify for treatment with Accutane. After all, what could be worse than acne?

The Side Effect Cascade

According to the Mayo clinic, Accutane is known to cause 130 possible side effects, encompassing everything from “loosening of the fingernails” to “sudden loss of consciousness.” I can’t speak for everyone, but when I was finally at the point of being prescribed Accutane, losing my fingernails (or consciousness) was starting to sound better than looking at my face covered in acne for even one more day. I agreed to participate in the mandatory iPledge program and started getting monthly bloodwork to monitor the levels of medication in my body. Within weeks, I was starting to feel different.

No, my acne hadn’t started to clear (yet.) But seemingly overnight, I felt as though I had aged fifty years. My joints were achy, I got winded going up just one flight of stairs, I started losing my hair, and I was so dehydrated that I needed Pedialyte to keep from feeling lightheaded. In a panic, I called my doctor. I was worried that my blood levels of Accutane might be dangerous and that my health was at risk. As it turns out, all my side effects were considered “normal," and since my bloodwork looked fine, my doctor wasn’t concerned. This was just life on Accutane.

Unlike some prescription medications, where adverse reactions are considered rare, Accutane causes side effects for the majority of its users. While they vary in severity and type, over 90% of patients will experience some adverse effect.


Here are ten of the most common side effects experienced by Accutane users:


  • Chapped lips/Cheilitis
  • Eye irritation and dryness
  • Skin inflammation, dryness, and peeling
  • Hair loss
  • Muscle aches, stiffness, and weakness
  • Skin infection or rash
  • Headache
  • Nosebleeds
  • Vision changes
  • Depression, mood changes


By the time I completed my 12-month course on Accutane, I had experienced all of these side effects and more. The “normal” that my doctor reassured me about in my first weeks of treatment wasn’t exactly an “everything’s fine” normal, but more of a “you’ll get used to it” normal. Months of miserable side effects later, my acne was finally gone, but my overall health had totally deteriorated. And despite my skin finally being clear, it was irritated, inflamed, and so dry that I needed to apply moisturizer four times a day. I had also gained a significant amount of weight— the joint pain, dehydration, and exhaustion made it difficult for me to exercise. No one warned me about the long road to recovery I would face after Accutane.

Sacrificing My Health For My Skin

Whatever the consequences, Accutane delivered on its promise to cure my acne. I was flooded with relief— something had finally worked! I no longer felt anguish and shame every time I glanced at myself in a mirror, and I stopped obsessively worrying about my diet causing acne. At the same time, my physical health was in terrible shape, and although I no longer felt self-conscious about my skin, I was extremely uncomfortable with my thinning hair and weight gain. I had to begin the slow process of un-doing Accutane’s effects on my body: regaining my strength, flexibility, and cardiovascular fitness and rebuilding my severely damaged skin barrier. Things slowly started to improve. Still, a terrifying thought kept creeping back into my mind: what if the acne came back? Could I put myself through all this again? What was the alternative?

Hypochlorous Acid: Results Without Regrets

Fast forward three years and my skin has never been better. My cystic acne never did come back in the way I feared it might, but as my skin normalized and my hormones shifted, I started noticing the occasional pimple. In addition to a solid cleanser and moisturizer, I decided to add a hypochlorous acid spray into my routine. It’s a product that’s both anti-microbial and anti-inflammatory. Unlike antibiotics, bacteria don’t develop a resistance to them. It’s been used in wound care and hospital settings for decades, and only recently has dermatology caught on that it's the ideal ingredient to treat acne without causing negative side effects or irritation. In other words, it’s exactly what I wish I knew about three years ago before I started taking Accutane. Instead of suffering through a year of painful and potentially dangerous side effects (plus all the months it took me to recover) I could have targeted my acne with a safe, effective hypochlorous acid treatment (like this one from Purclarity Skincare.) It’s helped other people with acne-like mine, who were frustrated with conventional treatments that seemed to do nothing or make the problem worse. I can’t change my experience, but I can tell you this much: If I had to do it all over again, I’d give hypochlorous acid a try before signing on to the side effects (and expense!) of Accutane.

You can pick up a bottle of Purclarity’s Revitalizing Skin Mist here.