When it comes to acne treatment, there’s a controversial drug that everyone either loves or hates: isotretinoin. It’s no exaggeration: ask anyone who has undergone treatment, and their reactions are going to be wildly different. Some people swear by it, others say the process — which typically includes severe dryness, peeling fatigue, and depression — isn’t worth it.

But there’s a reason isotretinoin is so popular. Apart from clearing severe acne in just 4-6 months, it can apparently change one’s skin type to resemble the microbiome of a person who isn’t acne-prone. Keep reading to find out how.

What is Isotretinoin?

Isotretinoin is a class of retinoids, which are vitamin A derivatives that help with a long list of common skin problems, most notably wrinkles, fine lines, and acne. Retinoids can be topical or oral, and isotretinoin is one of the more widely-prescribed oral classes of medications.

With this success rate also comes a long line of side effects and a negative online reputation. We’ll talk more about that later, but at the end of the day, the numbers don’t lie: 85% of acne-prone patients who use isotretinoin to treat their acne report clear skin by the 16-week mark. So how exactly does it work?

Does Isotretinoin (Accutane) Get Rid of Acne?

There are plenty of ways to manage acne-prone skin. A consistent anti-acne regimen is one of them; this typically includes popular acne spot treatments like benzoyl peroxide. For mild cases, a good routine is often enough to see significant improvements.

Dermatologists often prescribe isotretinoin for those who aren’t seeing any progress after the first line of defense. Dermatologist Dr. Mona Gohara, Yale School of Medicine associate clinical professor, tells Cosmopolitan:

“Accutane, aka isotretinoin, shrinks the glands in your skin that produce oils. When you shrink those glands, your organs — including your eyes — will be drier, but this side effect usually goes away after you finish your dose.”

But because it shrinks your glands, your skin is also forced to produce less oil, thereby stopping acne-forming bacteria in its tracks.

How is Isotretinoin Different from Other Anti-Acne Drugs?

Doctors will typically prescribe antibiotics first. These meds target acne-causing bacteria, which is the main culprit of many severe acne cases.

Isotretinoin is not an antibiotic. It doesn’t target or kill or fight off bacteria in your skin. Instead, it shrinks the skin’s oil glands and creates an environment that isn’t hospitable to the sneaky pimple-causing bacteria.

Benefits

The main benefit of isotretinoin is almost permanent freedom from acne. Because the drug reduces the size of your oil glands, it actually stops acne from recurring on a massive, severe scale. As many as 70% of isotretinoin users have been permanently acne-free after taking the medication.

How Long Does Isotretinoin Take Effect?

Isotretinoin typically works over the course of 4 to 6 months, sometimes longer. However, people will see results as soon as three days to one week of use.

This will largely depend on the dosage prescribed, and there’s no one-size-fits-all route, so don’t compare your progress with others.

Isotretinoin and its Side Effects

Isotretinoin has a long list of side effects that go beyond physical symptoms. They include:

• Severe dryness around lips, nose, and/or eyes
• Peeling
• Redness
• Irritation
• Scabbing
• Headaches
• Fatigue or loss of energy
• Back pains and muscle or joint aches
• Birth defects

While challenging, these side effects can be alleviated with the help of a gentle, bare-bones skincare routine.

For those with existing medical conditions, such as a blood disorder, depression, or gastrointestinal problems, the side effects may be even more severe. According to the NHS, people with blood disorders who take isotretinoin may feel extra dizzy, become more prone to infections, or get unexplained bruising. Those suffering from depression may feel exaggerated mood swings, aggression, and irritability.

Additionally, doctors will not prescribe the drug to pregnant and breastfeeding women due to potential birth defects.

While rare, it’s super important to talk to your doctor if any of these sounds like what you’re going through on isotretinoin.

How Isotretinoin Changes Your Skin

We’ve mentioned earlier that isotretinoin works a little differently than your regular over-the-counter acne medication. This is because it mainly affects your skin’s microbiome, shrinking your oil glands in order to put a stop to excessive oil production. This is how the drug transforms people’s skin over time from acne-prone and oily to normal.

Another wonderful benefit of isotretinoin is that it makes it hard for acne-causing bacteria to thrive. The presence of Cutibacterium acnes is common in greasy areas of the skin and the effects of isotretinoin on the skin’s geography make it harder for them to wreak havoc.

Does Isotretinoin Work Forever?

The best part about isotretinoin is it’s supposed to be a permanent cure for acne. Of course, even those who had a successful run with it will still get the occasional pimple because we’re all human and there are days when we can’t be 100% on top of our skin.

“Accutane permanently shrinks your oil glands so they can’t be stimulated as easily anymore,” Dr. Mona Gohara adds.

Final Note

For those who have never dealt with chronic acne, the condition may not seem like a big deal. But the thing is when you have it, and you have it bad, even the smallest social interactions can seem debilitating. There’s still a stigma surrounding chronic acne, whether we like it or not, and complicated treatment doesn’t make it any better.

Of course, no other person can make the choice for you. But if you’re at your wit’s end with acne treatment, and you’re not quite sure about isotretinoin, it’s at least worth talking to your doctor about. Because while there are dozens of horror stories that people post online, there are many more success stories that we never hear about.

So, keep in mind that the choice is yours, but don’t let fear stop you from taking medically proven steps to take care of your skin.

Got any isotretinoin-related experiences of your own? Are you currently in treatment? Share your stories with us below!

Anyone with acne-prone skin knows how troublesome it is to not only treat active breakouts but the resulting acne scars too. While they aren’t a safety concern, these scars can pose a cosmetic issue. Luckily, there are plenty of treatments available that can help get rid of acne scars. Let’s talk about them one by one.

What causes acne scars?

The appearance of acne scars happens when inflammation of the skin causes it to break, resulting in lesions. The scars can be deep or shallow in nature; the shallow ones heal quickly on their own or with treatment, but a deep break in the pore’s wall can cause bacteria to spread into surrounding skin tissue, which causes deeper lesions.

You’ll also notice hyperpigmentation or erythema after the fact. Post-inflammatory hyperpigmentation (PIH) is when the affected area of skin produces excess melanin within the scar tissue as part of the healing process, resulting in red or brown spots. People with darker skin tones may be more at risk for PIH since their skin naturally has more melanin. 

On the other hand, post-inflammatory erythema (PIE) can be seen as pink or purple-hued spots and is more common among those with lighter skin.

Can you tell me the difference between acne scars and marks?

Acne scars are much harder to treat than simple acne marks. So, how can you tell if your pimple has left a simple mark or a damaging scar? Texture.

Feel for a bump or raised skin. Acne scars usually damage the skin on a deeper level, which results in raised lesions. If you notice a red or brown discolored spot that remains smooth, you have an acne mark.

Can you show the different types of acne scars?

The severity of the scar usually depends on the acne breakouts, and not all scars are the same. It’s important to identify the type of scar before proceeding with treatment.

Atrophic/Depressed Acne Scarring

Atrophic or depressed acne scars occur when the scar occurs below the surface, resulting in an indentation. There are many classifications of atrophic acne scars depending on their shape and appearance:

• Boxcar. These kinds of acne scars are wider than they are deep, and they often have sharp edges.
• Icepick Scar. On the other hand, icepick acne scars are deeper than they are wide and resemble pinpricks.
• Rolling Scar. These acne scars are characterized by an undulating and sloping appearance with wide scars.

Hypertrophic Scars

Hypertrophic acne scars occur in people whose body tends to produce an excess of collagen as the acne spot heals. Instead of leaving indents like in atrophic scars, hypertrophic scars form bumps often accompanied by hyperpigmentation within the scar tissue.

Keloid Scars

In some cases, acne breakouts can produce keloids or excess skin tissue that can grow larger over time. According to Healthline, the symptoms of keloids include a flesh-colored, pink, or red localized area, a raised patch of skin with ridge-like texture, and itchiness. If you’re a keloid former, you’ve probably developed these types of scars in other areas of the body.

Best Ingredients for Acne Scarring: Salicylic Acid, AHAs, and more

Before you start hunting down anti-acne products, let’s do a quick skincare lesson. Acne treatments often contain ingredients that have similar functions: prevent excess oil production and remove dead skin cells, as in alpha-hydroxy acids; fade dark marks as in vitamin C and vitamin B3, or speed up the healing process by promoting faster skin cell turnover.

They can also be ingredients that soothe inflammation. The most common ingredients that help get rid of acne scars are:

• Azelaic Acid — Azelaic acid is a naturally occurring compound often used to treat acne and rosacea, but it’s also effective in prompting cell regeneration and inhibiting the production of excess melanin.  

• Vitamin C — Like AA, the dark spots left behind by acne lesions can be remedied through vitamin C. While it’s not something that treats acne directly, it can get rid of acne scars and acne marks by inhibiting tyrosinase. It’s also well-tolerated by sensitive skin and can prevent sun damage and early signs of aging.

• AHAs like Lactic Acid, Glycolic Acid, etc. You’ll find these ingredients in serums, chemical peels, and toners. AHAs help get rid of acne scars by removing dead skin cells on the outer layer of the skin’s surface. Apart from fading acne scars, they also help improve skin texture and fix dullness. Most AHAs are well-tolerated, but many recommend lactic acid for those who have sensitive complexions.

• Salicylic Acid. We all know salicylic acid can treat active acne, but they can also reduce scars by exfoliating the skin, lightening dark spots, and preventing future breakouts.

• Hydroquinone. Hydroquinone is a powerful skin bleacher commonly used to fade dark spots, acne scars included. However, it doesn’t contain properties that help in fighting acne.

• Tretinoin. One of the most widely used topical retinoids, tretinoin remains a gold standard prescription treatment for acne and acne spots. 

Do note that while these ingredients are proven to be effective on hyperpigmented skin, a raised scar or even an indented one may require dermatological procedures.

List the different dermatological treatments you can undergo for acne scars

If a person develops severe acne scarring, it is recommended to see a doctor who might provide a prescription treatment and diagnosis based on the amount of scarring. A licensed esthetician can also provide facial procedures, like a chemical peel, laser resurfacing, or micro needling, which are helpful not only to fade dark spots but also remove the “bumps” left behind.

We’ve also made a guide to our favorite Belo facial treatments that can address acne scars as well as early signs of aging.

Best Overall Products for Acne Scars: Removing Dead Skin Cells, Lifting Dark Marks, and More

Want to know how to really get rid of those pesky scars once and for all? Surprise: there’s no magic bullet or overnight fix. Each step of your skincare routine needs to work together to help keep your complexion at its healthiest and happiest. From spot treatment serums to sunscreens, here are our quick picks for the best products to reduce acne scars.

Best Hydroquinone-free Products for Acne Scars

Hydroquinone may be an effective skin lightener, but it’s not the most well-tolerated. Good thing there are plenty of other ingredients you can look for! For example, azelaic acid inhibits the formation of an enzyme called tyrosinase, which is responsible for pushing mechanisms that produce dark skin pigment. Vitamin C helps protect your body from free-radical damage and aids in repairing uneven skin tone. 

If you’re looking for a hydroquinone-free spot treatment, try The Ordinary’s Azelaic Acid Suspension 10% or their AHA 30% + BHA 2% Peelvvinvg Solution.

Best hydroquinone products for acne scars

While many governing bodies consider hydroquinone safe, it was notably banned in Europe and it could potentially cause irritations or worse pigmentation by sensitizing the skin. In the Philippines, the FDA warns against the use of hydroquinone in over-the-counter cosmetic products as their contents may be unregulated. 

This is why we recommend getting a derma prescription so they can recommend a treatment plan and guide you along the way. If you do know that your skin can tolerate at least small amounts of the product, Byrdie recommends the Ambi Skincare Fade Cream which contains 2% hydroquinone.

Best Retinoid for Acne Scars

Another great prescription drug for acne treatment is Differin Gel, a retinoid that contains adapalene. It actually improves the texture of scars by boosting collagen production.

Best Cleanser for Acne Scars

Having a good cleanser can help build a solid foundation for preventing acne as well as reducing scarring. Look for products with salicylic acid or lactic acid to reduce future breakouts. Also, look for hydrating ingredients to keep your skin barrier naturally moisturized.

For acne-prone skin, we recommend Paula’s Choice Acne Clear Pore Normalizing Cleanser and the Pyunkang Yul Acne Facial Cleanser.

Best Sunscreen for Acne Scars

Dermatologists agree that sunscreen is non-negotiable. Even if you have the best lightening products in your arsenal, excessive exposure to the sun without some form of protection can undo all their hard work. 

That’s why we recommend looking for sunscreen with at least SPF 50 to add to your routine. If you don’t have one yet, the QuickFX Sunblock is a good place to start. Just be wary of the mild white cast on dark skin tones. The Canmake Mermaid Skin UV Gel is another mild sunscreen ideal for any skin type.

Final Note

In case you needed to hear it: acne scars don’t make you any less beautiful! Textured skin is completely normal, and scarring is your body’s way of healing from trauma.

That said, we totally understand if you want to get rid of them. We’ve all been there, and it’s not an easy task. So we hope this guide has shed some light on your journey to clear skin, and just remember that it’s normal to encounter bumps along the way (pun intended).

Have any experiences of your own? Share your acne hacks and beauty tips in the comments below!