If you struggle with chronic, severe acne, chances are that your everyday run-of-the-mill spot treatment just doesn't cut it. Fortunately, there's an effective acne-fighting medication that dermatologists have been recommending for decades: Accutane (aka Isotretinoin).

However, before you consider this treatment, it's important to understand what it entails, from when to expect results to possible side effects — and everything in between. Check out my personal experience and learnings from taking the medication, including my Accutane before and after, along with an expert's insights below.

Meet the expert

Keep reading for our complete guide to understanding and using Accutane.

How Accutane Works

"Accutane affects your skin and body in a number of different ways, one of which is by decreasing the size of the oil-producing glands in your skin, known as sebaceous glands," Dr. Marinelli shared with InStyle. "This decrease reduces the amount of oil your skin produces, which effectively starves the acne-causing C. acnes bacteria that live in your pores. However, by doing so, Accutane also makes your skin much dryer and more sensitive, meaning that after a course of Accutane, it may be in need of some serious TLC."

Unfortunately, the impact may not last forever. 

"Accutane helps to reduce the number of C. acnes on skin, but they can creep back up over time," Dr. Marinelli added. 

That's why she also suggested developing an alternate skin care plan for the duration of the treatment along with taking the medication.

How to Use Accutane

While on Accutane, your skin becomes extremely sensitive, limiting the types of products you can use within your skin care routine. In the morning, Dr. Marinelli suggested washing your face with a gentle cleanser that won't strip the skin, followed by a non-comedogenic moisturizer and sunscreen to nourish the skin and add a layer of UV protection. You may also incorporate a serum before your moisturizer, but be sure not to use any that contain high concentrations of AHAs/BHAs or vitamin C, as it may cause irritation. 

"At night, you can repeat this same routine without the SPF," she added.

What to Expect

The thing about Accutane is that it typically purges your skin before it begins to work, essentially meaning that your acne is going to get worse before it gets better. In my case, my skin was constantly dry and required consistent hydration; the corners of my mouth and inside of my nose would crack and bleed, my joints would ache, and my head would hurt almost all the time.

The first time I used the medication, my day and nighttime routines were very simple. I stuck with the basics: Cetaphil Gentle Skin Cleanser and Daily Facial Moisturizer, as recommended by my dermatologist. I was also advised to stay away from any heavy exfoliation or products that were not made for sensitive skin.

The rigorous requirements involved with taking Accutane definitely made my life quite difficult. Not only did I have to deal with having monthly blood work done and unexpected medical costs, but the physical and mental toll that Accutane took on me wreaked just as much havoc.

Imagine this: You have just started your first week at an internship with a well-known PR agency on their fashion and beauty team. You want to try to look your best every day and seemingly blend in with all the stylish women around you, but it literally hurts to put makeup on your face. Not to mention, you also are attending a fashion business school, where your whole look from head to toe is silently judged by your peers on a daily basis.

There are some days when you don't even want to go to class or your internship because you're breaking out so badly and are embarrassed to show your face. This was me during the fall of 2018, as I had Aquaphor glued to my hand along with a full bottle of water at all times to deal with the dryness caused by the meds.

The mental and emotional component of being on this medication truly tests you in ways you might never have thought of otherwise. So, preparing yourself for these side effects is crucial if you and your doctor decide Accutane will be the acne treatment for you.

While I was on it, I tried to indulge in my favorite activities. I made sure I took walks outside when the weather was nice, got my favorite snacks, and tried to relax as much as possible. I found that trying to distract myself by watching movies and reading up on other people's experiences helped me cope when I was having a particularly bad mental health day.

The Results

After nearly six months of constant agony and annoyance in relation to my skin, there was finally a breakthrough. All of a sudden, my skin began clearing up, and my pimples all started to fade away. What I was left with was certainly not a blank canvas due to the scarring and discoloration caused by previous breakouts, but I was happy to see progress nonetheless.

For the next eight months or so, my skin was in a place I had never imagined it would be: clear, glowing, and improving by the day. I began to have some professional skin treatments done (i.e. chemical peels) and was loving all the improvements I was seeing in my overall complexion. Then, I went off of Accutane.

Aftercare

Post-Accutane, your skin should be pretty low maintenance, but it may take some time to adjust. I developed an entirely new skin care routine and was trying out new products I could finally withstand now that I was off the medication. At the time, I was using the Tatcha Rice Polish Foaming Enzyme Cleanser, Skinceuticals C E Ferulic Serum, and First Aid Beauty Ultra-Repair Cream.

The Tatcha powder cleanser offered light physical exfoliation that my skin could handle. The Skinceuticals serum was given to me by the esthetician I went to for the chemical peels, and it really helped with the dark spots that were left behind from my acne. As for First Aid Beauty's cream, it helped to keep my skin hydrated and soft.

However, a few months later, my acne slowly began to creep back. After trying out several different remedies, I made the difficult decision to restart Accutane, something I had hoped I would never have to do. This time, though, I knew what was ahead of me. I was prepared to roll with the punches, ready for round two — and all the subsequent side effects — from incredibly dry skin and hair to headaches and mild joint pain.

Now that I've passed the finish line, I'm incorporating products like The Ordinary Azelaic Acid Suspension 10% and The Ordinary Niacinamide 10% Zinc 1% into my routine. I'm also using Kiehl's Ultra Facial Cream SPF 30, The Ordinary "Buffet" Serum, and Ole Henriksen Banana Bright Eye Cream.

VIDEO: Salicylic Acid vs. Benzoyl Peroxide — Which One Should I Use to Treat My Acne?

Final Thoughts

Despite the side effects and discomfort, I found Accutane to be an excellent solution for my long-term acne. If you decide to give it a try, you'll definitely want the guidance of a good dermatologist to help you through — especially when the side effects get intense. I was able to stick it out, and I'm so glad I did.

Frequently Asked Questions

• How long does the Accutane purge last?

  After beginning treatment, one in five patients gets a bit worse, while one in 500 gets much worse. The remaining get better, per the American Osteopathic College of Dermatology (AOCD). Purging typically doesn't last more than six weeks, so consult your dermatologist if your skin is still not getting better beyond that point.

• Can Accutane cause depression?

  There is anecdotal evidence that some patients who take Accutane develop mental health conditions, such as depression. However, more research is needed to determine whether Accutane can cause depression. According to the American Academy of Dermatology Association (AADA), patients who exhibit any symptoms of depression or another mental health condition on the medication should stop taking it immediately.

• Does Accutane cure acne forever?

  Isotretinoin can treat severe acne and is a cure-all for about half of those who take it. Most patients will take Accutane for about four to six months, but some may need it for up to a year (via AOCD).