Will Acne Return if I Stop Taking Accutane?

Question

Im planning on ending Accutane, but I'm worried that I have become too dependent on it, and I'm worried that my acne will return. Are these possible?

Sonia Badreshia-Bansal, MD · Answer

The majority of patients who complete a course of Isotretinoin will be acne free but there are some who may need to repeat after a year if scarring cystic acne returns.  To reduce risk of treatment failure, a patient who completes the full course can use a topical retinoid for preventive maintenance. It is best to be under the supervision of a board certified dermatologist for the best results and safety.

Jason Emer, MD · Answer

Thank you for your question!There is a chance of your acne returning after you stop using Accutane, however, it depends on how long you were taking the medication for and if you were combining it with any other acne treatments.Acne requires a combination approach to get long-term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling with PRP, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with an expert. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Acne is influenced by genetic, hormonal, environmental, stress, and possibly even food related factors. Accutane can do little to treat any of these multifactorial causes. Thus, depending on your variant of acne, it is unlikely to 'cure' your condition.

Maria Bou-Sleiman, MD · Answer

Thank you for your question!
It all depends on the dosage of Accutane that you have already taken. There is an appropriate cumulative dose that your doctor prescribes according to your weight. If you have reached that dose your chances of getting a good outcome are high. Eighty percent of the patients who take accutane are cured from their acne or at least have a very significant improvement with respect to their baseline acne. Twenty percent have a chance of relapse and might need to take another course. So all you have to do is to take the appropriate dose and then wait and see. 
Hope this helps!

Steven L. Greene, MD · Answer

It usually takes 5 months to completely clear severe nodulocystic acne with Accutane therapy. 80% of cases will never have acne ever again based on my experience. 20% will experience some form of acne down the road usually needing milder treatments.I hope this is helpful.Steven Greene MD, Advanced Dermatology and Laser Institute of Seattle

Supriya Tomar, MD · Answer

Most patients respond very well to Accutane. Usually I keep my patients on Accutane 2 months after acne clearing, which ends up being an average of 5-6 month’s time in total. Long term acne control in most cases is achieved. I would not be worried to stop the medication if you’ve responded to the course of treatment and have been on it for an appropriate amount of time.
I usually recommend to my patients that they stay on a topical medication (like Differin or Retin-A) to help the skin stay acne free post Accutane. If your acne returns, which does occasionally happen, your doctor may want to look into other possible causes if he/she has not already so. Food allergy testing or hormonal testing should be done for recurrent or recalcitrant acne.

Sameer Bashey, MD · Answer

2 out of 3 people will not have acne issues after taking accutane appropriately. Some people may need to do an additional cycle of Accutane after completing the first one but this is not all that common.

Joshua L. Fox, MD · Answer

Typically acne does not return after completing the full
course. Of course, there are a couple of factors that can affect the outcome
such as severity of acne, proper dosing, and patient compliance.

Michael A. Greenberg, MD · Answer

The answer is a resounding "maybe" but highly unlikely as bad as before the Accutane.My experience with over 30 years of Accutane is that many patients are almost totally clear of acne, but lots still get some lesions, just not the big cystic ones.If you think of Accutane as a cure, you're headed for trouble.With Accutane as well as any and all treatments, unrealistic expectations lead to anger and resentments.Be sure you have an honest talk with your doctor about what to expect.  Ask all the questions you want until you feel satisfied and good about the choice of treatments.Don't set yourself up for an unhappy result by worrying that the doctor is so busy that they don't have time to answer your questions...actually, if you feel rushed or don't feel your questions and time are respected, find another practitioner.   There are so many great doctors out there.

Todd Minars, MD · Answer

I get respone rates close to 100% with Accutane.  By that I mean, that almost every patient is clear by the time they finish 6 months of Accutane.  And in most cases, the acne does not come back.  That does not mean you will never get another pimple for your entire life.  But most patients never go back to the severe acne that they had prior to treatment.

	Who is at most at risk for their acne to recur after Accutane? 

	Younger patients (16 years old and younger) are more likely to need a second course of Accutane. Perhaps because they have more teenage "acne years" ahead of them.

	Females have higher recurrence rates than males (but still low).  Perhaps because of hormones.

	Patients who do not get the correct total dose are more likely to relapse.  This includes both patients who have not achieved a high enough daily dose and those who ended treatment earlier than advised.

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