3rd month of accutane: still breaking out (cystic acne)?

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question. It is not uncommon to have breakouts when starting any acne treatment, especially Accutane. Usually the flare-up lasts a couple of weeks, but in some individuals, the flare-up can be very severe and occur for several months. Breakouts also vary depending on the dose you are taking because dosing is based on your weight. Therefore, if 30 mg is only half your daily recommended dose, then breakouts may occur more frequently, especially now that you are increased to 40 mg. Please be patient with the treatment because acne tends to get worse before it gets better. I highly suggest you consult with your prescribing dermatologist regarding your concerns and to discuss any further questions you may have with therapy. Take care and good luck.