When can you expect Accutane results to show?

Is it a matter of days (I'm being a bit too optimistic), weeks, or months? I'm anxious to see my skin clear again. I've been living with this horrid acne since I was 14. I'm ready to let it go. Lol!


F, 29, Tennessee

That's a question that depends on how long you have been taking isotretinoin, what dose you are taking and how serious your acne is to begin with. Also, everyone responds differently to isotretinoin. Some patients see a partial reduction in acne lesions within the first month. Other patients don't see real results until the fourth month.

Generally speaking, isotretinoin takes 20 or more weeks to work completely.

Remember to stick to the guidelines given to you by your dermatologist. And please remember (I’m assuming you are female from your username) to stay true to your iPledge agreement. Stick closely with your two forms of birth control (usually abstinence and birth control pills), and don't miss any of your daily isotretinoin doses.

Remember to communicate any side effects like headaches, depression or anxiety to your dermatologist when you go in for your monthly blood/pregnancy tests.

Also please note that the American Academy of Dermatology recommends patients taking isotretinoin use a sunblock of at least SPF +30 when going outside.

Isotretinoin is a very powerful anti-acne medication. I have had many patients who respond extremely well to Isotretnoin when other treatments like tazorac, doxycycline, and spironolactone have failed. My advice is to be patient and wait. I can't say how soon it will work, but in my experience it almost always does.

Your question isn’t clear as to how long you’ve already been taking isotretinoin (or how severe your cystic acne is) so I can't make any case specific predictions, but most acne patients see a reduction in lesions by the end of the second month.

During the first month there is often no visible change other than some common symptoms like dry skin, dry lips or sore joints. Some patients see an occasional nosebleed due to the drying of their mucous membranes. My advice is to have some lip balm on hand to keep your lips from cracking.

By the end of the second month you should start seeing positive results, like fewer new acne lesions forming and a gradual shrinking of existing acne.

By the end of the third month you should see a clear and obvious reduction in the number of acne lesions, painful cysts and blemishes.

In my experience most patients have clear or nearly clear skin by the end of the fourth month.

It's easy to understand your impatience having suffered with acne this long already, but the first two months can often be rather uneventful.

Isotretinoin (Or Absorica or Amnesteem or whichever brand name you are taking) is an extremely effective acne fighter that has improved the lives of thousands of people suffering from severe hormonal acne. Don't be discouraged if you don't see results within the first month.  If you begin to experience severe anxiety, depression or any unusual mental health issues, be sure to notify your dermatologist at once.

Have patience. In some rare cases, patients show some improvement within the first two weeks, but often there are no signs of improvement during the first month at all. It depends on the type of acne you have, the dose you're taking, and other factors.

For some patients, the first sign isotretinoin is working is that they start getting side effects like dry lips or dry skin before they actually see a reduction in acne.

In most cases you will start to see some signs of improvement by the end of the second month, but for some people there are no real visible signs of improvement until as late as the fourth month.

Isotretinoin is a very powerful drug for treating teen and adult acne. My advice is to worry less about how well it works and focus on taking the medication daily as per your prescription. The positive effects of isotretinoin can be long-term and life changing.  Patients commonly report greater self-esteem and more confidence in social situations.

Give it time. I'm not sure from your question how long you’ve already been taking isotretinoin, but based on my own experience, clear skin is most likely a matter of "when" and not "if" for you at this point.

It's important to manage expectations for the first two months of isotretinoin treatment. I make a point of explaining the need for patience when starting any patient on a new course of acne treatment.

Without knowing anything about your particular case, I can't comment as to when you'll start seeing results from your acne treatment, but the vast majority of my own acne patients begin to see results from isotretinoin by the second or third month.

The effects of the medication on sebum production, bacterial infection and inflammation can all take time to show a visible reduction in acne lesions. While I understand your impatience after suffering with acne for many years, the positive effects of isotretinoin can be slow in coming.

The most important part of taking Accutane from a patient perspective is to stick carefully to the prescription and stay vigilant about the iPledge program. As you know, isotretinoin can cause serious birth defects. (Not that any 14 year old patients are planning on getting pregnant, but please understand that the FDA requires all patients taking isotretinoin to sign on to iPledge and submit to in-office pregnancy tests).

Isotretinoin (formerly sold as Accutane and Roaccutane) is the most effective weapon we have in the fight against severe acne. In my experience it is extremely rare to see anything but great results. My best advice at this point would be to trust your dermatologist and have patience.

Dr. Lawrence Broder has 1 Acne treatment before & after:

Acne treatment before image performed by Dr. Lawrence BroderAcne treatment after image performed by Dr. Lawrence Broder

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Knowing nothing more about your condition, Accutane may take months to show the results you are looking for.