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Medically reviewed by Dr Hoe Ying Min Medical Director
Severe nodulocystic acne treatment with Isotretnoin (Accutane)
Severe nodulocystic acne treatment with Isotretnoin (Accutane)

Severe nodulocystic acne can affect the face and trunk and may require treatment with Isotretnoin (Accutane)

Medical Directors Note - “Isotretinoin (Accutane) is recommended for the treatment of severe acne to minimize the formation of acne scars. This prescription only medication is effective but comes with potential side effects.”

Many people who struggle with acne know the frustration of trying countless skincare products and making changes to their diet, only to see little or no improvement. Persistent breakouts, redness, and scarring can take a toll on your skin, confidence, and mental well-being. If this sounds familiar, you may wonder if there’s a more effective solution to help you achieve clear skin.

Isotretinoin (Accutane), a treatment for severe and stubborn acne, has transformed the lives of many who think they’ve tried everything. In this guide, we’ll explore Isotretinoin (Accutane), how it works, and how it can solve your acne struggles.

What is Isotretinoin (Accutane)?

Accutane, generically known as isotretinoin, is a prescription-only oral medication derived from vitamin A. It’s classified as a retinoid and is for effectively treating severe acne.

Isotretinoin (Accutane) was developed to address the underlying causes of acne, acne that doesn’t respond to topical treatments or antibiotics. Its potency means it’s typically reserved for moderate to severe cases or for individuals prone to acne-related scarring.

Isotretinoin (Accutane) addresses all 4 mechanisms by which acne develops: excessive sebum production, clogged pores, bacterial proliferation and excessive inflammation
Isotretinoin (Accutane) addresses all 4 mechanisms by which acne develops: excessive sebum production, clogged pores, bacterial proliferation and excessive inflammation

How Does it Work?

Isotretinoin (Accutane) targets all four of the root causes of acne, making it one of the most effective treatments available. Here’s how it works:

Reduces Sebum Production

This is a placeholder tab Sebum, the oil produced by the sebaceous glands, can mix with dead skin cells and bacteria, leading to clogged pores and acne formation. Accutane significantly reduces sebum production by shrinking these glands, creating a less favourable environment for acne development.

Prevents Clogged Pores

One of the hallmarks of acne is the accumulation of dead skin cells in pores. Isotretinoin (Accutane) accelerates the process of skin cell turnover, ensuring these cells shed more effectively and reducing the likelihood of clogged pores.

Decreases Bacterial Growth

Acne-causing bacteria, such as Cutibacterium acnes (aka Propionibacterium acnes), thrive in oily environments. Isotretinoin (Accutane) suppresses bacterial proliferation by limiting sebum production and lowering the chance of inflamed breakouts.

Controls Inflammation

Severe acne is often accompanied by redness, swelling, and discomfort. Isotretinoin (Accutane)’s anti-inflammatory properties help calm these symptoms, making existing lesions heal faster and new ones less likely to form.

Stages of acne formation
Stages of acne formation

Benefits of Isotretinoin (Accutane) for Acne-Prone Skin

Isotretinoin (Accutane) offers several significant benefits for individuals with acne-prone skin:

Long-Term Acne Resolution

Unlike many treatments that require an ongoing application, Isotretinoin (Accutane) can deliver long-lasting or permanent results. Many patients experience clear skin even after stopping the medication.

Minimised Risk of Scarring

One of the hallmarks of acne is the accumulation of dead skin cells in pores. Isotretinoin (AcSevere acne, predominantly cystic or nodular types, can leave permanent scars. Isotretinoin (Accutane) effectively controls breakouts and rapidly brings active acne under control, reducing the risk of developing permanent acne scars.

Improved Confidence and Quality of Life

Clearer skin can lead to enhanced self-esteem and reduced anxiety or self-consciousness, particularly for individuals who have struggled with acne for years.

Effective for Resistant Acne

Isotretinoin (Accutane) is the last line of defence e for individuals whose acne hasn’t responded to standard active acne treatments, such as topical retinoids, benzoyl peroxide, or oral antibiotics.

Who is Accutane Suitable For?

Isotretinoin (Accutane) treatment is a prescription-only treatment and is indicated only under the following circumstances:

  • Severe Nodular or Cystic Acne: These types of acne are characterised by painful, deep lesions that are challenging to treat with standard therapies.
  • Persistent Acne: If your acne hasn’t responded to other treatments, Isotretinoin (Accutane) may be the next step.
  • Acne with High Scarring Potential: Early treatment with Isotretinoin (Accutane) can prevent lifelong scars.

However, Isotretinoin (Accutane) acne treatment is not advisable for:

  • Pregnant or breastfeeding women. There is a risk of severe congenital disabilities.
  • Individuals with medical conditions like liver disease or high cholesterol.
  • People with a history of severe depression or psychiatric disorders, such as isotretinoin, have been linked to mood changes in rare cases.

Steps to Starting Isotretinoin (Accutane) Acne Treatment

Initial Consultation

A doctor will assess your medical history, evaluate your acne, and discuss your treatment goals. If Isotretinoin (Accutane) is deemed suitable, they’ll guide you through the following steps.

Laboratory Testing

Blood tests are necessary to evaluate liver function, lipid levels, and other parameters. Women must undergo a pregnancy test before starting and throughout treatment.

Informed Consent

Isotretinoin (Accutane) has potential side effects and risks, so you must give signed consent to acknowledge your understanding.

Customised Dosage

Your doctor will recommend the appropriate dosage based on your weight, acne severity, and individual response.

Ongoing Monitoring

Regular follow-ups are crucial for monitoring progress, addressing side effects, and making any necessary adjustments to dosage.

Precautions

Accutane is a potent medication with potential adverse effects, so strict precautions must be observed:

  • Pregnancy Prevention: Women must use two forms of contraception and take monthly pregnancy tests due to the high risk of congenital disabilities.
  • Side Effects: Common side effects are dry skin, chapped lips, and increased sun sensitivity. Rare side effects, such as mood changes or liver issues, require immediate medical attention.
  • Lifestyle Adjustments:  Avoid sun exposure and use sunscreen when outdoors

Alternative Treatments

If Isotretinoin (Accutane) acne treatment isn’t suitable for you due to health reasons, personal preferences, or concerns about side effects, several alternative treatments are available to manage acne effectively.

Hydrafacial

The Hydrafacial is much more than a facial, using the patented Hydrafacial MD Elite system to perform medical-grade hydradermabrasion. A 30-minute three-step protocol cleanses, extracts, and then nourishes the skin with proprietary antioxidant-rich serums.

Oral Antibiotics

Medications like doxycycline help control bacterial growth and inflammation in moderate to severe acne cases. These are often combined with topical treatments for better results.

Hormonal Therapy

Women with hormonal acne may benefit from oral contraceptives or anti-androgens like spironolactone, which regulate hormone levels and reduce oil production.

Laser Treatments

Forever Clear BBL HERO uses broad-band light therapy to eliminate acne bacteria, reduce inflammation and fade acne marks, with results seen within 3-4 treatments. PicoSure Laser effectively treats post-inflammatory hyperpigmentation and acne scars.

Experienced skin care doctors know that acne treatments can be challenging and need to be personalised to the patient, taking into account medical history, skin condition and personal goals. Starting treatment with isotretinoin (Accutane) is a significant decision and will be discussed in detail during the consultation.

Acne treatment with Isotretinoin (Accutane) Singapore
Doctor’s consultation with personalised treatment plans for acne treatment with Isotretinoin (Accutane)

Get Clear Skin with Isotretinoin (Accutane) Acne Treatment

Isotretinoin (Accutane) is an effective treatment for severe acne, but it requires commitment, careful monitoring, and adherence to medical advice. If you’re considering Accutane, consult a doctor to discuss your options.

At Bay Aesthetics Clinic and Medispa, we provide customised acne treatment plans in Singapore, including Isotretinoin (Accutane) therapy. Our experienced doctors ensure you receive comprehensive care, from initial evaluation to post-treatment monitoring. Shared decision-making is important to individualise acne care based on the potential treatment benefits and risks, acne severity and patient preferences.

Book an appointment for Accutane treatment.

Frequently Asked Questions

IHow long do I need to take Isotretinoin (Accutane)?

A course of Isotretinoin (Accutane) lasts for 3-6 months, with regular reviews during treatment. Infrequently, patients may experience a relapse of severe acne after stopping treatment and require a second course of treatment

Is Isotretinoin (Accutane) linked to infertility?

No. There is no evidence linking Isotretinoin (Accutane) to infertility. However, women should avoid pregnancy during the treatment cycle and for at least one month after stopping Accutane due to its teratogenic effects.

Is taking Isotretinoin (Accutane) worth it?

For individuals with severe or persistent acne, Isotretinoin (Accutane) is often worth it. The long-term benefits, such as clearer skin and reduced scarring, outweigh the temporary side effects for many patients.

Why am I still breaking out on month 3 of Isotretinoin (Accutane)?

It’s normal to experience an initial breakout or persistent acne during the first few months of Isotretinoin (Accutane) treatment. This typically improves as the medication continues to reduce oil production and inflammation.

Who should not take Isotretinoin (Accutane)?

Isotretinoin (Accutane) is not suitable for:

  • Pregnant or breastfeeding women.
  • Individuals with liver disease or elevated cholesterol.
  • People with severe mental health issues.
  • Those allergic to isotretinoin or its ingredients.

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