I was very reluctant to try Accutane due to all of the horror stories of side effects and problems caused by this medication. For a couple of years prior to Accutane, I was on different pills & topical creams and none of them worked. I tried everything you can think of, including proactive! I was very disappointed that nothing could be done. My acne was severe and extremely detrimental to my self esteem! One day I was desperate and called the dermatologist office to set up an appointment to get more info about Accutane. My Dr. Told me that much of the bad effects I heard about are quite rare and that they will moniter my vitals, perform blood work, and watch for other internal things along the way. I agreed to try Accutane & he started me off with the highest dose there was. I took this huge pill once a day at night. The first couple of weeks nothing is really happening because your body is getting used to the medication. I had moderately dry lips & maybe a couple of different breakouts that's about it. The one month mark is when things get "bad." You WILL breakout much worse and your lips will be extremely dry to the point were they bleed and crack. You will be blowing the dry skin and blood from your nose every 15 minutes because the inside is so dry/raw. For my lips & the inside of my nose I used the Aquaphor samples my Dr gave me. The crease of your nose where it meets your face will crack( hurts pretty bad) also used aquaphor for this. I experienced lower back pain which I took Tylenol for (which I believe was okay to take with the Accutane,just not ibuprofen. Check with your Dr. First though.) I would get occasional headaches & muscle cramps. You need to drink an incredible amount of water. Even if you arent thristy DRINK WATER! This medicine dries you up from head to toe! Around the month 1/2 to 2 month mark your skin will gradually get worse. I wanted to stop the pills some days because its a horrible feeling when you already had bad acne and it gets worse! I had to consult with my Dr every month with the "green book" which basically gives you all of the info about the medication, the risks , and the benefits. I also had to have some blood work done at key points in the course of the 6 month treatment to watch for anything that might be of concern, internally. Alot of times these monthly consults would consist of me asking my Dr to take me off these pills because they were making me worse! He told me I WILL get better I just have to have patience and trust it will work. I thought, I came this far I might as well just see what happens (since every other medication failed me.) I stuck with it and around the 3 month mark you FINALLY start FEELING results. You FEEL better , you FEEL less "ache-y" , you FEEL less stressed since youve been "used" to living with the horrible breakout for a month or so. The 3 1/2 to 4 months you WILL start SEEING results!! :) Very gradually , but promising! Your lips won't be as dried / cracked anymore. Your cysts and under the skin acne will begin to go down. Your white heads will also go down on their own. DO NOT TOUCH THEM. 4 1/2 to 5 months you will have less breakouts then when you first started Accutane, but you will ask yourself " are these my final results? " the answer is NO! The best is always saved for last. Finally the 5 1/2 to the end of the 6 month mark your whole is COMPLETELY clear! I had a FEW black heads on my nose but that's it! Your face might have scarring, including ice pick & rolling (or shallow/ "crater") scars. Make sure you take pictures the day of your very first pill. Take PLENTY of pictures every week or so! Do not be afraid of "bad angles" and do not try to hide the acne! Selfies will be the last thing on your mind ,but when you are finally off the treatment and look back you be shocked how far you have come. I cried when I saw my " before & after." It's a TRAUMATIC experience to have severe acne and it really hurts your self confidence & self esteem, whether you know it or not. I knew my acne was bad ,but I didn't realize HOW bad until I was completely clear. The 1st set of pictures I have below show my face about a month into Accutane ( before) and the day of my last pill February 2014 (after) the 2nd set is my face ONE year later! My pigmentation is ,almost, completely gone and I am now left with ice pick and shallow scarring. I am looking into getting a series fractional resurfacing laser treatments to help improve my scars. Although the laser is a bit expensive, it's totally worth it! Accutane saved my life figuratively and almost literally. I did a ton of research on the side effects and risks before I decided to take this Medication and I encourage you to as well. I hope that my story will help at least one person see that there IS hope and to help them find the courage to change their acne condition for good and ultimately their life. Updated on 12 Feb 2015: Dr. Joseph Rheim is the dermatologist I am speaking of. He and his father , james rheim, share the same office for both of their practices.