As a skincare enthusiast who sailed through my teens with flawless skin, the sudden emergence of adult acne was a nightmare. My late 20s were marred by severe breakouts—painful cystic eruptions followed by scarring that resisted antibiotics and topical treatments. Desperate for a solution, I turned to isotretinoin, a powerful oral medication known for its effectiveness in treating severe acne.
Isotretinoin works by shrinking the sebaceous (oil) glands and drastically reducing oil production, explains Dr. Mikki Singh, medical director at Bodycraft Clinics. This prevents pores from clogging, stops new acne from forming, and promotes skin cell turnover for clearer skin. However, consistency is key. My own experience revealed noticeable improvements only after six months of continuous medication.
Before embarking on this journey, it’s crucial to understand the potential risks. Dr. Neha Khuraana, founder of House of Aesthetics, cautions that isotretinoin commonly causes prolonged dry skin, making it more sensitive and prone to irritation. I personally experienced dry, flaky skin, cracked lips, and increased sun sensitivity. While less common, severe side effects like elevated liver enzymes and increased cholesterol can occur, but typically resolve after stopping the medication.
Isotretinoin, or ‘Tret’, can alter your gut microbiome, increasing the risk of inflammatory bowel diseases, particularly if you have pre-existing conditions like ulcerative colitis or Crohn’s disease.
Isotretinoin and Pregnancy
Isotretinoin is strictly prohibited during pregnancy due to its known potential to cause severe birth defects, affecting the baby’s nervous system, heart, and facial development. Dr. Khuraana emphasizes the extreme risk, stating, “Isotretinoin usage during pregnancy is highly unsafe, posing a risk of adverse birth defects even with minimal doses.” If you plan to become pregnant while on isotretinoin, consult your doctor to determine the safest time to do so.
Precautions to Consider
While Tret was challenging, a few lifestyle adjustments helped me navigate the journey and complete the course in less than eight months. Dr. Singh advises, “To minimize side effects, use a good moisturizer and sunscreen daily, even on cloudy days.” Avoid vitamin A supplements and harsh skin products like alcohol-based toners and exfoliants.
Research suggests a possible link between Tret and mood changes like anxiety and depression, though this is still under investigation. Closely monitor your mental health and speak to your doctor immediately if you experience any mood swings or emotional instability. Additionally, stick to a consistent medication routine and undergo regular liver function tests and lipid panels to monitor your overall health.
Isotretinoin and Diet
If the potential risks seem daunting, Dr. Khuraana recommends alternative options like topical retinoids (retinoic acid or adapalene), which have fewer side effects. “Acne with a hormonal basis may benefit from hormonal therapy, such as oral contraceptive pills (spironolactone),” she adds.
The decision to take Tret is entirely yours, guided by a trusted medical expert. Carefully weigh the benefits against the potential risks before committing to a treatment that requires at least six months of dedicated care to heal your skin from within.
