When Will I See Improvement from Accutane?

Most patients will have significant improvement after 2-3 months on Isotretinoin at the proper titrated dose.  Dryness is a common and expected temporary side effect.  It is important not to stop treatment before reaching therapeutic dose range.It is important to be under the supervision of a board certified dermatologist for the best results.

My average patient sees significant improvement during the late second or early third month of therapy.  Only about one in three patients has great improvement 4-6 weeks in, in my experience.  Stay the course.  Accutane is a terrific therapy.

Be patient, I find that Accutane works every time.  Some patients start to improve during their first month, others take the entire 6 months to get better.  But everyone gets better.

While Accutane is the most effective treatment for acne, it does take time to work-- most patients should expect some improvement at month 2 or 3 of treatment.  This is because the effects of accutane-- reducing oil production, reducing inflammation and unclogging pores-- takes time.  Most patients notice fewer new acne lesions developing and the old ones shrink over time.  

You are on a great course of therapy, be patient and you will get better!

Best,

Dr. Mann

I tell all my patients to be patient for the first couple months. Everyone responds to Accutane; however, the timeline varies for everyone.
The usual goal for each patient is to reach a total dose of 120-150 mg/kg, with the daily dose usually being 1 mg/kg per day. Thus, it usually takes 4-6 months to reach this total dose. However, the daily dose and the final dose may vary depending on the patient.
Your doctor will determine your daily does and your final dose depending on your individual response. If you would like percentages, I would say in my patients that about 10-15% of patients improve dramatically in the first month, 40-50% during the second month, another 25-35% will doing the third and the remainder may take a little longer. In treating over 750 patients with isotretion (Accutane and its generic equivalents), I have never had a patient who did not respond. A few how gone on down the road to need a second course, but acne is the magic bullet.
I hope that helps.
Dr. R

Within the next 4 weeks you should see some degree of improvement. The cysts may or may not come to a head (frequently not). I expect to see few new acne lesions developing after 2-3 months of therapy. For the cystic acne, a helpful additional treatment even while a person is on accutane is intralesional injections of cortisone.
Good luck.

Accutane is by far our most effective treatment for acne, and I rarely see a patient that does not get fabulous results.
A typical course of Accutane is a 5 month course, and I maintain patients at 1mg/kg/day -- so at typical teenager of about 130lbs would get 60mg/day. Our goal is to get a total dose of 120-150mg/kg of medicine in over 5months-- I generally prefer the higher end of the dose. Some more severe or resistant patients may require a 6th or 7th month.
Most patients see little change except drying and peeling in the 1st month. By the end of the 2nd month positive results are beign seen. At the end of month 3, most patients have seen a dramatic change, and at the end of month 4 most patients are clear to nearly clear. Results, of course, may vary-- so be patient. I have NEVER seen a patient not improve with Accutane.