When Will I See Improvement from Accutane?

I'm currently in my 6th week of a 4-month course of Accutane 60 mg. I was wondering, when I will be seeing some sort of an improvement? I have a few cysts under my skin. Will Accutane still push these out to a head, or because of the decrease in sebum, will they just simply fade as the bacteria lessens in the cysts?

Doctor Answers 6

Patience is needed for all acne treatments including Accutane

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

Austin Dermatologist
5.0 out of 5 stars 3 reviews

Average 2-3 months

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.

Ryan Ramagosa, MD
Mobile Dermatologist

Once on Accutane, improvement is inevitable

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.

Todd Minars, MD
Miami Dermatologist
3.7 out of 5 stars 6 reviews

Improvement from Accutane is seen 2-3 months after starting treatment

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!


Dr. Mann

Margaret Mann, MD
Cleveland Dermatologic Surgeon
5.0 out of 5 stars 1 review

Accutane works miracles with enought time

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.

Jeffrey C. Poole, MD
Metairie Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Timeline of Accutane improvement

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.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.