Does Everyone Experience an Initial Breakout when on Accutane?

Accutane is a great medication for the right acne patient. To prevent initial flares, I start patients on a low dose for 2 weeks, then increase to the full dose, which is dependent on the patient's weight. It is very unusual for patients to flare with this regimen. Topical medication, cortisone injections into cysts, oral antibiotics or oral cortisone may be required to control flares. Make certain you see your dermatologist monthly for assessment and blood tests... more

No, not everyone experiences as initial breakout; however, the majority of people who take Accutane have more severe acne, so yes, this does happen as the pores are changing. There's not a lot that can be done to avoid it, though some topicals do help. Consult your dermatologist about using topicals at the beginning of the course.

When starting isotretinoin, some but not all patients flare. It can depend on the severity of your acne, your starting dose of medication, and any other medications that you are on. If the flare is severe, it is sometimes necessary to prescribe oral steroids or topcial treatments in addition to the isotretinoin. I advise you to discuss your concerns with your physician to develop your best treatment plan.