“It has serious side effects. Is it worth devastating your body like that? It’ll clear the spots but may give you other health issues”, read the alarming text from my sister soon after I told her that I’m trying to get Roaccutane prescribed.

And it didn’t stop there. She went on to share a story about a hospitalized woman whose white blood cells have dropped to a critical level. This she followed with a link to possible side effects. Anemia, eyelid inflammation, nosebleeds, high triglycerides, various skin conditions from rash to exfoliation, anxiety, mood swings, and all sorts of aches were among over 20 conditions this very controversial acne drug can apparently bring upon you. Six months later, when I eventually got it prescribed, the leaflet added depressive states and suicidal thoughts to the list. Compared to this, my experience was pretty mild.

But let me start from the beginning.

A bit of a background

When I first started getting spots, I didn’t know much about acne, other than it is normal during adolescence. But I didn’t expect it to torment me well into my adulthood. I treated it with random beauty products, including a dodgy tonic recommended by a dermatologist. None of those helped me much. If anything, some of them only irritated my skin even more.

May 2011

Spots were concentrated mostly on my forehead, and for a long time, I would hide them under a fringe. Later, they “invaded” my neck, shoulders, upper back, and sometimes even arms and chest. Years went by, and every new cosmetic turned out as helpless as the one before. Without deep skin cleansing and proper moisturizing, my complexion was getting worse. Bad diet only hindered any efforts.

I lived my life hoping that acne would naturally clear up, but I was well after puberty and started to lose hope. It made me feel embarrassed and very self-conscious.

Struggle to get it prescribed

A colleague told me about Isotretinoin which her daughter had taken to much effect. (This is the actual name of the drug I’m discussing here. Roaccutane is only one of its many brand names.) So, I went to my local GP in London and asked specifically for it. The patronizing doctor dismissed what I said and prescribed something else instead. For the life of me I can’t remember what it was… But the point is that it just didn’t help.

March 2013

I gave it another go in June 2013. This visit was even worse than the one before. I insisted on getting Roaccutane prescribed and it escalated to the point where the GP refused because “it will costs the government a lot of money”… (I would pay for it myself and didn’t expect otherwise anyway!) I left, very angry.

I started using concealer to cover the spots, which did an alright job. I also learned to ignore advice from people who tried to divert me from chasing Roaccutane. I know they were speaking from a place of care and worry, but it only made me feel misunderstood. Honestly, if you can’t shave without cutting spots to blood, or if spots on your arms hurt when you lean against the wall, it is time for drastic measures. At that point I needed a treatment, not just a superficial cosmetic care.

October 2013

Tried my luck again in December. I was so resigned that this time I didn’t bother to ask for anything specific. As it often happens, you get what you want just when you stop chasing it. Without hassle, the GP referred me to a dermatologist, recommending Roaccutane. I had the appointment on 10th January 2014 and got the prescription on the spot. My hunt for the Holy Grail finally came to an end! With much relief and excitement, I was about to start the treatment.

The Treatment

I started the course taking one 20 mg capsule a day. Just under 4 weeks later, it was increased to two a day. After about nine weeks, it went up to 60 mg (3 capsules) a day until the end of the course. The whole treatment lasted around 5 and a half months.

February 2014

For the duration of the treatment I had to make sure I don’t expose my skin to too much sun. It didn’t help that it coincided with a trip to scorching India! I also had to cut down on exercise, and suspended my gym membership altogether.

My blood and mood were regularly monitored. The dermatologist took it very seriously and even threatened to end the treatment when at one point I missed a blood test. Three months into the treatment, she noted that I’m “tolerating Isotretinoin well and [my] acne has started to improve”. That’s correct; it was April and people started complimenting on my healthier complexion. In early June, she observed that I’m “only getting the occasional acneiform lesion. His mood is okay. On examination, his chest and back were clear and there was a single pustule on his forehead.” I continued the treatment for the final few weeks, and that was it!

May 2014

Side effects

Compared to what you read online, my side effects were pretty mild. Maybe thanks to the relatively low dose, even towards the end of the treatment. Cracked and bleeding lips were the biggest inconvenience, and the only physical side effect I can think of. Isotretinoin tends to extremely dehydrate the body.

I do remember having frequent mood swings, and generally feeling “uneven” around that time, which I now attribute to the medication, but it may well have been something else. Anyway, it was far, far from the infamous depressive states. In fact, the end result much improved my wellbeing and gave renewed confidence.

June 2014

Final Thoughts

After one course of Roaccutane, I never had acne again. Yes, I do get an occasional spot, like every adult, but it’s nowhere near as pathological as it used to be.

Looking back, I can see that I was making two huge mistakes. Number one: inadequate skincare. With next to no moisturizing, oil glands start producing more grease, which in turn feeds the bacteria. Number two: bad diet! But that’s a topic for another post…

How do I feel about Roaccutane ten years on? It was definitely worth it, and I absolutely recommend it if persistent acne is causing you unrest. But first, do assess your skincare routine and eating habits. Your experience is likely to be different from mine, depending where you live. Ten years ago, when I got hold of Roaccutane in the UK, it was already withdrawn in many countries, and a lot would have changed since then.

I hope you found this post useful. Please share it with someone who you think can benefit from reading it. Leave a comment if you have any questions, I’ll be happy to help!