Isotretinoin: what the first month is really like

Isotretinoin is the most effective treatment we have for severe or scarring acne, and it is also the one with the most rules. Before you start, you have blood work and, if you could become pregnant, two forms of birth control and monthly pregnancy tests through the iPLEDGE program.

The first month is usually the least rewarding. Your lips dry out within days, your skin gets drier and more sensitive, and some people have a small flare before things improve. Keep lip balm everywhere, switch to a gentle cleanser and a plain moisturizer, and skip waxing.

We see you every month to check how you feel, review labs and adjust the dose. Most people notice real change by month two or three, and a full course usually takes four to six months. Call us between visits if you have headaches, vision changes, mood changes or severe joint pain.