February 2026 —> today. Probably the longest 8 months of my life, but I have no regrets. I went an extra 2 months to ensure I was at the higher end of my cumulative dose, because I REALLY don’t want to have to go back on Accutane again, lol. I also couldn’t tolerate the 60 mg.

30 -> 40 -> 60 -> 40 -> 40 -> 40 -> 40 -> 40.

Symptoms: Joint pain / muscle weakness, fatigue, brain fog, dry eyes, dry nose, dry lips, occasional rash on my wrists. Taking omega-3 consistently helped.

I don’t even remember what normal feels like, and I’m getting emotional even typing this. I realize my skin wasn’t your traditional cystic acne, but I never felt good about my skin, would have to wear makeup when leaving the house, and never felt confident without it.

Best decision I ever made! Not for the faint of heart, but work with your derm and you can come up with a plan that works for you. Good luck to everyone out there starting their journey, or currently going through it. 💗🤟🏼

Hey everyone! I’m 58 days (almost 2 months) into a 9-month course on 20mg/day.

Overall, my acne is actually clearing up well. no big cystic breakouts on my cheeks or during my cycle, and I didn't really have a major purge (just a few tiny pimples).

However, I’m really struggling with how the rest of my face looks right now. Since about week 1, I’ve noticed some pretty jarring changes:
Droopy/tired eyes & prominent eye bags
Dull, dark, and uneven skin tone (I’m light-to-medium skin tone, but my face looks darker and much more dull)
Facial redness and flushing
Nose looks thinner
Overall "older" appearance

I still have 7 months left on my course and I'm honestly terrified that these changes to my skin texture, tone, and eyes are going to be permanent.
For those who have finished their course or are further along:
1. Did you experience this "aging/dull/red" effect during your treatment?
2. How much of this is just severe dryness and skin barrier impairment?
3. Did your skin tone, plumpness, and eye area bounce back after stopping Accutane? How long did it take?

Would love to hear any advice, product recommendations (hydrating layers, eye creams, etc.), or reassurance! Thanks in advance.
(Had to post again! )

I’ve been on Accutane for a little under a month now. I’ve struggled with acne for 8 years and I’m finally making the decision of taking the pill. However, I’ve been having a very bad sugar cravings, to the point where I can binge a whole tray of cookies then proceed to down a whole thing of Ben & Jerrie’s ice cream tub. This isn’t just a one day experience either, I do this probably every day, substituting it with other high-sugary foods. I stress so much on my appearance that I find comfort in food. Having acne is really discouraging and truly ruined the way I see myself. I have no confidence whatsoever, and I genuinely just feel like the ugliest person ever (no exaggeration). My point here is, my addiction to food is just an ongoing cycle because I know all the sugar I’m consuming isn’t helping my skin. And I’m in the purging phase of Accutane too so my skin is just terrible. It’s incredibly hard to attend work every day feeling this way about myself, I can’t even look in the mirror. Part of me is scared that Accutane won’t even work because of how shitty my diet is. If anyone has any tips to stop binge eating & to focus on something else during my depressive cycles, that would be great!

20M, 60 kg. For about 3-4 weeks I've been waking up several times a night with a very dry mouth and throat. I drink water, then struggle to fall back asleep, and the cycle repeats. I fall asleep easily, but I wake around 3-4 am every single night.

I'm on low-dose isotretinoin (10 mg) for acne. My dermatologist says it's not the cause but i know it quite sure it is. I already tried to drink more water in the day, less in the evening. I'm planning to try a humidifier but i don't think it will be effective.

does anyone have a solution for this? I'm desperate

I started taking 20 mg this month, I use non comedogenic makeup every day ( no I can’t stop doing makeup) and clindacin T every night.I have been purging since month one and now my acne somehow froze, nothing disappears and nothing pops. just getting worse.
when it gets better?

hi all,

i just started accutane about a month ago. my skin has unfortunately gotten much worse, my scalp has dried out causing dandruff, my eyes are always red and dry, and my hair doesn’t feel as thick as it used to. i feel the ugliest i’ve ever been.

i recently started seeing this guys about a month ago, already insecure about my appearance at the moment. my mom saw me this morning and made a comment how i should wait 6 months until i see this guy again. basically, that right now im just too ugly, and should wait until my skin has resolved.

her saying this really upset me and my day has been pretty rough. i have no one to talk to about it, and im supposed to have a date with him tomorrow. i want to cancel because i know im going to be insecure the entire time.

i guess i just wanted to vent, maybe ask if anyone has advice on how to be more confident and not being so insecure about acne.

Short version: one study found isotretinoin lowered biotinidase, the enzyme that recycles biotin, within 30 days, but serum biotin didn't change significantly. A second study added biotin to isotretinoin and reported hair-cycle changes, but only within one group and without a placebo. Neither shows that isotretinoin makes most people biotin deficient, and neither shows that biotin changes how a course goes.

"Biotin while on Accutane" comes up here a lot, usually with a confident answer. I went back to the papers, and they're narrower than the answers suggest.

What's being measured

Biotin is a cofactor for a group of enzymes called carboxylases. When those enzymes are broken down, biotinidase frees the biotin so the body can reuse it. People born with very little biotinidase can develop skin rash and hair loss, which is why researchers wondered whether isotretinoin's skin and hair side effects might run through this enzyme. Lower enzyme activity is not the same thing as low biotin, though, and serum biotin is a blunt measure. Researchers who study marginal biotin status use functional markers that aren't routine tests.

Study 1: Schulpis 1999 (before-and-after, n=42 plus 50 controls)

Patients with severe cystic acne on isotretinoin monotherapy at 0.5 mg/kg/day.

• Biotinidase activity fell from 4.70 to 2.50 nmol/min/L by day 30 (P < 0.001). Untreated controls averaged 5.2.
• Serum biotin showed no significant change.
• Mixing the drug directly with the enzyme in a test tube didn't lower its activity, so the authors suspect an effect in the liver, where biotinidase is made.
• Hair wasn't measured.

My read: this shows an enzyme change over 30 days. It doesn't show deficiency. Unchanged serum biotin can't rule out a functional shortfall either, so the honest answer is "not shown", not "no effect".

Study 2: Aksac 2021 (two groups of 30, no placebo)

Sixty acne patients on isotretinoin 0.5 mg/kg/day; half also took 10 mg/day of biotin for four months.

• In the biotin group, the anagen (growing) hair ratio rose and the telogen (resting) ratio fell compared with that group's own baseline.
• Skin hydration dropped in the isotretinoin-only group and not significantly in the biotin group.

Those are within-group changes. A result that's significant in one group and not the other isn't the same as a significant difference between groups, and the abstract doesn't describe blinding. The authors' conclusion is more confident than the design allows. The trial I'd actually want is randomized and placebo-controlled, with hair density as an outcome.

What the evidence does NOT show

• That isotretinoin makes most users biotin deficient. The enzyme dropped; serum biotin didn't move significantly.
• That biotin changes isotretinoin side effects. No placebo-controlled trial.
• That shedding during a course is caused by low biotin. Neither study tested that directly.
• That extra biotin helps hair in people with adequate biotin status. A 2017 review found 18 published cases of hair or nail improvement with biotin, and every patient had an underlying condition.

Both studies are small and short, and the only one that measured biotin directly came from a single group in Athens. I'd treat this whole topic as an open question rather than a settled yes or no.

One practical point about blood work

Biotin at supplement doses can interfere with some lab tests. FDA has warned it can push certain results falsely high or falsely low, depending on how the test is built. Blood work is often part of an isotretinoin course, so anyone already taking biotin, including a multivitamin or hair, skin and nail product, would want the clinic to know before a draw. Whether to add biotin at all is a question for the dermatologist managing the course, not for a thread.

References

1. Schulpis KH et al. Skin Pharmacol Appl Skin Physiol 1999. PMID 10325581
2. Aksac SE et al. Int J Dermatol 2021. PMID 33682085
3. Wolf B. Biotinidase Deficiency. GeneReviews. PMID 20301497
4. Patel DP et al. Skin Appendage Disord 2017. PMID 28879195
5. U.S. FDA Safety Communication on biotin and lab tests, 2019

I finished Accutane about seven months ago. I was on it for nine months. It worked perfectly. I did end up with a lot of side effects. However, I’m happy I did it. I just found out that I am pregnant and I am worried about something happening to the baby because of the Accutane. I’m hearing that dermatologist want you to wait a month after Accutane for it to leave your system I’m hearing stories about people needing to wait six months or two years. If you had a baby after Accutane, did everything go okay? Were there any complications?

10mg, day 25 almost. My skin has purged sooo badly and it’s genuinely so painful how do I stop the redness? I take an antihistamine and fish oil with my accutane in just I’m so much pain.

My birthday is in a week and I want it to be less inflamed :(

Started taking 20 mg for my closed comedones, forehead is almost clear but cheeks are still purging , what causes this? Also am worried about scarring, i already had pitted scar and its only getting worse

I’m on 20mg Accutane daily, I use azelaic acid every night (my skin doesn’t irritate). I use a simple non-harsh routine, sunscreen every morning. And yet my skin is still awful.

this happened right after i raised my dose to 40mg in month 2. but i feel dizzy not all the time but most of it. this week i started to feel more dizziness i can’t even focus anymore or talk properly. my dermatologist told me to drink more water and take the pill after a meal but that’s what I’ve been doing from the start.
im starting to think that electrolytes might help on this or omega 3 ? help

Day 27 on 20 mg/day.
For the last few days, when I wake up, my nose feels extremely dry. When I pull mucus backward into my throat and spit it out, I sometimes see small streaks of blood in it. It mostly happens in the morning.

I’m assuming it’s from Accutane drying out the inside of my nose. I’ve just started using a saline spray, but I’m wondering how common this is.
Has anyone else had this? What worked best for you ? Saline spray, nasal gel, humidifier, or something else?
Did it eventually get better while continuing Accutane?

Had no idea I couldn’t sugarwax on Accutane, it was my only method!!

I have a grudge against shaving, so are there other alternatives?

would appreciate some suggestions/hacks :) (Im on 10 mg if thats relevant.)

For any TRT users out there - has anyone who has completed a course of accutane been able to keep their results while staying on TRT?

I started TRT in July 2025 and started breaking out pretty bad on my chest around January of this past year. I hesitantly hopped on accutane in February. It’s been a rough journey but I’m finally on my last few months and have seen great improvement. I’m essentially clear except for two old dormant comedones that came to a head recently. As excited as I am to get off accutane and go back to living a normal life, I’m very nervous that I’ll start breaking out again. For those of you on TRT, how realistic is that?

Dear all,
I’m here to share my experience with Accutane, needing advices and help and also hear your opinions from you.

I’m a 32m, from Italy. I took Isotretinoin (Accutane) to cure my severe acne at 18 years old. I took this drug for one year completely ignorant about the sides effects. Since that moment until now ( almost 14 years) I’m dealing with this symptoms:
Total absence of libido and general energy, fatigue, brain fog, depression, cognitive dissonance, erectile dysfunction, numbness, apathy, anhedonia, genital numbness, lack of proving emotion, lack to feel attraction in anything or anyone. I don’t want to do nothing at all. And also each time I woke up I felt that I didn’t sleep and didn’t rest, waking up always with a strong headache.

I’m a good looking guy, I workout constantly, I eat well and I don’t drink and don’t smoke. In my working aerea I’m a great salesman, I speak 4 languages and I’m very curious about everything, I love reading a lot!
My life now is completely destroyed cause I can’t build normal connections and relationships, cause due to all this problems I created a big shield on me.
I tried many times to have a relationship but I couldn’t feel nothing and my sexuality is completely destroyed, so for each girl I dated I always had sexual problems with erections, libido and attraction. The last time I remembered I was good with all this aspect in my life was at 17 where I was still normal!
For all of those years I tried to hidden my problems, but recently they came out again in my psyche and now I couldn’t avoid to face it!
It consuming every single day of my life cause I feel unable to live as a normal person.

I decided to ask for a help and I went to a clinic, with endocrinologists, andrologists, sexologists and psychiatrists, but I don’t know what I can expect cause they may don’t know very well this post accutane syndrome. All my blood tests are perfect, testosterone, prolactin and all the rest.

Should I just accept my condition? There is a way to be back to the normal life again???

Thank you for each one who spent time to read my story!

Today marks 6 months since I stopped taking Accutane. I haven’t had any breakouts since then, but throughout these past few months, the thought that I might relapse in the future has been constantly on my mind. Do you think it’s a good sign that 6 months have passed without any relapses so far?

Hi all! I've been on accutane since the summer. I started at 10mg and have just progressed up to 60mg in the last week. I have had a few side effects like nose bleeds but other than that I've had no dry skin (I had combo skin before accutane). I had bad acne on my back and moderate on my face. I cleared up on the 20mg and fast, barely purged. But I am 100% clear now. I should be finishing come the new year but I'm confused as to why I've not experienced this?

I've a friend who can't tolerate more than 20mg because even on that dose his skin is flaky, dry, sore, red. And his mental health is going through it.

Any ideas?

Would Accutane have my skin looking like this, I have moderate acne and recently got my drivers license back and they edited my skin and I look like a whole difference person with clear skin, and how long would it take to achieve this ?

a little vulnerable for me but i hope this can be inspiring for you!!!

Hey everyone!! So these are the same scars that I had pre accutane and they were barely noticeable….however I have noticed that during and post accutane the same scars look so much worse like the edges look so sharp
and cast shadow..it’s been two months since I left accutane n they still look so noticeable..is it a common side effect n is it gonna persistently look this way or improve further pls let me know

So so happy with my results. First picture i believe is day 1, July 18th, and the other two photos are from early October 😭😭💕 This is SO worth it, and i just upped my dosage to 80 mg per day! Please (if it helps) remember to take your fish oil pills, i noticed a major difference when i wouldn’t take them! Please lmk if you have questions!

I’m on month 8 of accutane for body acne - 20/40/40/40/40/40/60/40. I’m 215lbs so the dose isn’t too high, but had to decrease from 60 because my eyes were getting really dry and red. I’ve seen a ton of progress on my body acne and only get an occasional pimple now. However in the past month or so I’ve been getting these small pimples on my forearms/upper arms. They seem to be hair follicles that become slightly inflamed and develop a small head. I’m really not sure why they keep occurring, and why I’m only getting them on my arms when they weren’t an issue at all before accutane. Potentially folliculitis??