by Michelle Young, Copy Editor
In 2019, I thought I found peace with my skin. After years of closely examining myself in the mirror, experimenting with more skincare products than I can count, and using dozens of medications — I accepted the state of my skin. It wasn’t perfect, but I didn’t particularly feel a need to pursue perfection either. I had gone on and off from flawless to blemished skin and resigned myself to a comfortable in-between. Then came 2020, and I had the worst breakout I’ve ever had.
It was a pretty big deal. My skin was tender to the touch, cystic acne crept underneath the skin, and it was impossible to get rid of. I went to my dermatologist, and once again started the cycle of pills and topicals. Throughout my life, I’ve tried products such as doxycycline, minocycline, tetracycline, TactuPump, benzoyl peroxide, ivermectin, and things I don’t even remember the name of.
This time, I was particularly sick of it. I certainly wasn’t going to get out of this one with the medications I had taken in the past — much less “change my lifestyle,” which already included drinking water, eating well, and resting. I knew my skin was much too stubborn for that. I had been recommended isotretinoin (more commonly known as Accutane) many times in the past and never felt the need for it. But during the fall of 2020, I decided to finally take the plunge.
Anyone with mild to severe acne has likely heard of Accutane. It’s the “final resort” drug, the cure, the one that’s supposed to leave your skin spotless after a few months. It’s associated with severe acne and wouldn’t usually be the first drug anyone takes. It comes with some side effects and scary warnings: dry skin, joint pain, fatigue, sensitivity to the sun, mood swings, thinning hair, birth defects, and liver damage. To prevent the last two, patients take monthly blood tests while on Accutane and check their organ function before starting. Those who can become pregnant typically take birth control and pregnancy tests. To protect the liver, patients need to also avoid alcohol entirely. Accutane is an oral medication you take anywhere between 4–12 months based on your dosage and body weight to reach a cumulative dosage of the drug. I personally had to take it for 6 months.
I was terrified of starting this drug, but I knew what to expect. When my skin and lips began peeling and cracking, I whipped out my heavy-duty moisturizer and vaseline. I diligently went for my blood tests, and frankly, I was always in pain. I woke up every night with nosebleeds and I was always stiff and tired. I religiously used eye drops to soothe the dryness in my eyes. Though the experience wasn’t nearly as bad as it could have been, it was far from pleasant.
As my skin started to clear, I opened up to my friends and family about taking Accutane. I wanted to be transparent about my symptoms and didn’t think pretending my sudden improvement was due to skincare products would be honest. As I talked about it more, I realized more people had taken Accutane than I thought. Some told me nonchalantly; others preferred I kept this detail to myself. But finding those who shared the same experience made the process less scary, and made me feel less isolated.
We shared tips on what helped us get through the symptoms, how to prepare for blood tests, and reassured each other that acne isn’t something to be embarrassed or ashamed of. I was open with my experiences with friends who’ve been blessed with clear skin and found support among them too.
Many people go on Accutane and keep it a secret. It’s not a fun thing to advertise, and maybe it feels like our skincare routines failed us. The number of uninformed people who told me to avoid Accutane entirely and “just drink water” and “eat healthy” is more than I would have liked. Frankly, everyone is different and there’s nothing wrong with going on Accutane if you think it’s right for you. It’s just important to be aware of the side effects, time commitment, and to have a doctor or dermatologist who is willing to patiently walk you through the process.
The people around me have seen how difficult it’s been to calm my incredibly sensitive, angry, and irritable skin. Trends like “glass skin,” which encourage a plethora of serums and toners, are definitely not for me. Many people have a variety of skin issues, and I’m a little tired of skincare being portrayed as something that will guarantee clear skin. The most important part of skincare is the caring of your skin, which looks different for everyone — it doesn’t necessarily entail a poreless, glowly, face.
Fast forward a couple of months to the spring and I completed my dosage. I could not have been more thrilled. My skin was the best it had been since high school. It isn’t perfect, I still have redness (rosacea) and deep acne scars — but to me, it’s more than enough. The thing that got me through the process was being vulnerable with those around me and trying to actively accept my imperfections. While no one is obligated to share their physical insecurities with others, talking about them and supporting one another has been extremely valuable to me. Skincare is unique to each person, and while Accutane is considered to be a last resort, I’m happy I took it at a time when I was fully confident in my decision.