Accutane (isotretinoin) is a powerful medication often prescribed for severe acne that hasn't responded to other treatments. Here are some considerations based on your concerns: Dry Skin: Accutane is known to cause dryness as a side effect, which can affect the skin, lips, and eyes. Since you already have dry skin, it's important to be prepared with a thorough moisturizing routine. Use a heavy-duty, non-comedogenic moisturizer and lip balm regularly to manage this side effect. Hair Thinning: While hair thinning or hair loss can occur with Accutane, it is generally a less common side effect. If you are particularly concerned about this, discuss it with your dermatologist to weigh the risks and benefits based on your specific situation. Initial Breakout: Some patients experience an initial worsening of acne when starting Accutane, known as the "initial breakout." This phase is temporary, and your dermatologist can provide strategies to help manage it. Acne Picking: If you have a tendency to pick at your skin, it’s essential to address this behavior as it can lead to scarring, especially if your acne initially worsens. Consider techniques such as keeping your hands busy, using hydrocolloid bandages on cysts, or seeking behavioral therapy for support. Overall Consideration: Given your history with various treatments, Accutane might be a suitable option, but it requires careful monitoring. Regular follow-ups with your dermatologist are crucial to manage side effects and ensure the treatment is effective. Before proceeding, it’s vital to have a detailed discussion with your dermatologist about your concerns and to ensure that Accutane is the right choice for your skin condition. They can provide personalized advice and adjust your treatment plan as needed.