Everything I wish I knew about Accutane (And everything you should know)

Me before and after accutaneHere’s another post that has absolutely nothing to do with the rest of my site. I seem to be doing a lot of that lately.

Find me an F word where I can categorize these “Nothing Posts,” and I’ll throw ‘er up on the top nav.

Anyway. Guess what? I have two more weeks of Accutane!! Woot woot! It’s been a (very) long six months, but I’m seeing the light my friends.

I was this close to going on Accutane two other times in my life. Once, I went on Spironolactone, a drug originally intended to treat high blood pressure. That bad boy worked like a charm—if you’re not ready for the last-resort option, go ask your dermatologist about it.

This time however, I was ready for the big guns. After a second round of Spironolactone failed miserably, I went straight for the mothership. I was twenty-six and breaking out worse than I had as a teenager, for crying out loud. Everyone says Accutane should always be an absolute, nothing-else-is-working option, and I was so there. I was sick of analyzing my face each morning thinking, “Alright, what’s new today?”

So, I went for it. Six months later, I can tell you it was so, so worth it. For one, in the photo above I’m wearing zero makeup, I’m hungover, and it was taken with my iPhone.

I’ve had four friends seriously ask me about Accutane—complete with the side effects, mood swings, and hassles—so I finally decided to compile my tidbits of knowledge for dealing with this drug.

Accutane is a behemoth, but 100 percent manageable. Here are all the nitty gritty details not everyone knows about Accutane, and how I made the drug more tolerable.

  1. One does not simply go on Accutane.

If you want a minor panic attack, Google all the side effects for Accutane. You think you’re going to waltz into Dr. Zit’s office and get handed that sh*t over the counter? Wrong! They are going to try every.other.drug. on planet Earth before that sacred prescription. Once your doctor recommends you for the drug, you have to wait an entire month before you begin. You’ll receive your first round of blood work, get a pregnancy test (hopefully this goes without saying, but this applies only to women), and then wait a full thirty days before you receive your first dosage.

  1. You’re not supposed to drink alcohol.

Supposed to being the key phrase here. I went to Costa Rica with my friend Keena while she was on Accutane, and we ripped shots of Patron. Why? Because her doctor never told her otherwise! I myself was a good little girl until Month #3, where all shits went out the window. So here’s to *hopefully* no liver damage.

  1. It can cause joint pain.

Out of all the Steven King-level side effects, this one scared the bejesus out of me. I am a piece of work when I don’t hit the gym.

I have never been more injured than while on Accutane. Who knows, maybe I’m just getting old. All I know is I have never, ever had knee or hip pain until I started this drug.

  1. You can drink caffeine.

Thank. God.

  1. Buy half a dozen tubes of Aquaphor and store them in every coat, wallet, backpack, and purse you own.

Your skin WILL dry out, and it will dry out DAYS after you start the drug. This is the one guaranteed side effect. Drink as much water as you can to stay hydrated. 

I’ve tried every brand of ChapStick and Vaseline on Wallgreens’ shelves, and Aquaphor is the only one that worked. Rather than buy one large tube, I bought six small ones, and stored them everywhere. You will apply Aquaphor every three hours like clockwork. [If I go to bed without applying, I’ll wake up with bleeding lips.]

  1. Buy jojoba oil

Jojoba oil is my greatest discovery of 2016. I wish I found it years ago. It’s a natural oil (just like olive, coconut, or sesame), but has the same makeup of skin oil. My face is NEVER dry because of it. I cover my face in it before I go to bed and after I take a shower. [Side tip for the ladies: It’s the best makeup remover ever!]

  1. Shove jojoba oil or Aquaphor up your nose.

Nosebleeds are a common side effect because your naval cavity gets so dry. So take those two lovely products and shove ‘em up your nose. You can thank me later.

  1. Tell your coworkers, friends, and roommate(s) you’re on it.

I have a temper to begin with, but my friend Lexi (who is the most kind-hearted person ever) warned me, “Kara, all I remember about Accutane is wanting to kill someone.” Well then.

There are going to be days when you are inexplicably angry for no reason, and you will never know if it’s Accutane-related or not. Just do yourself a favor and give everyone around you a heads-up.

  1. Take it with food.

About three months in, I started getting really, really nauseous. My doctor told me to take it after breakfast, rather than before, and boom—problem solved.

  1. Treat it like birth control.

Meaning, take it at the same time every day. Simple, right?

  1. Speaking of birth control…

Everyone knows you must use two forms of birth control while on Accutane (hopefully). Here’s what you may not know: You cannot switch methods. If you do, you are required to stop Accutane for thirty days, which may decrease the effectiveness of the drug. Choose wisely, because you cannot switch.

  1. Your insurance will probably reject it, but have no fear.

I’m actually not on Accutane. I’m on xxx. Like most prescription drugs, off-brands are just as effective, and tend to keep the peace between you and your insurance company.

  1. On the insurance note—How much does Accutane cost?

Here are the three questions you need in order to calculate your out-of-pocket costs: 1) How much is your co-pay to see a dermatologist 2) How much do you pay for lab work and 3) How much do prescription drugs cost. Add those three numbers to tally your per month cost.

  1. Accutane is a pain in the ass. At least for your schedule.

To go on Accutane, you better A) have a flexible job or B) find a dermatologist open on the weekends. Every single month you must get your blood drawn, then go visit your dermatogogist, then answer a bunch of questions online promising you won’t get pregnant, and only then can you pick up your prescription.

  1. Get the biggest FSA account available.

Again, because of the costs associated with this drug, I chose a huge FSA account when I enrolled in my employee benefits. It might not be free, but at least it’s tax-free.

  1. You might not see the results until after you finish the drug.

With two week to go, I still have deep pores in my nose. My friend Keena was on Accutane for nine months, and only after she told her doctor, “I’m done with this!” did her skin clear up.

  1. Buy over-the-counter Claratin to help with flare-ups

The common phrase with Accutane is, It gets worse before it gets better. Praise everything good, I did not fall victim to the infamous Month #2 Flare-Ups. However, my doctor advised me to start taking Claratin (not Claratin-D) as the antihistamine helps with flare-ups. Again, I never tried this, but thought I’d share.


Again, I know that’s a lot to take in, and I probably have everyone thinking “F———— that. No way I’m going on Accutane,” but I would still recommend it. At the end of it, it’s just one pill to take every day. For crystal clear skin the rest of my life (or at least the next ten years), I’ll take it.

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