Roaccutane: Early Days

So I've talked a lot here about the variety of skin care undertakings that have defined my year. I've trialled all different cleansers, exfoliators, toners, topical treatments, vitamin C, masques and oils. It's been fun. My forehead has smoothed out to that of an 18 year old (okay…a stressed 18 year old, but it's better than the 40-year-old vibes I was getting at the end of 2016). My skin looks much brighter and is softer to touch.

But I could not move the angry red marks on my cheeks. No matter how patient I was, they refused to budge. I over and under exfoliated. I moisturised. I tried gentle cleansers. I switched birth control methods. Then I cracked the shits, got a referral to a dermatologist and, after a bit of fussing around, began the confusingly controversial acne wonder drug, roaccutane.

Roaccutane is basically a big fat dose of vitamin A, that you take orally by tablet. You may recall I tried the topical treatment Differin, which is a retinoid (or vitamin A derivative) a while ago, unfortunately to minimal effect. Roaccutane (also known as accutane), works from the inside to shrink your pores and effectively cure you of acne (this description is definitely woefully inadequate, so I'd give it a Google if you'd like a more comprehensive / accurate summary of the work it does).

When I was younger, I remember a few people (my brother included) going on it, and the litany of scary side effects: depression and suicidal tendencies; not being able to even look at alcohol for fear your liver would curl up and die; severe sun burn; thoroughly dried out skin (think shrivelled up like a sultana); painfully dry lips; and not being allowed to fall pregnant, admittedly not as much of a fear when I was younger. Turns out the main, legitimate, side effects are dry lips and an absolute kibosh on falling pregnant, as vitamin A causes severe deformities to unborn foetuses.

The main things I was warned about was to take care in the sun (particularly living in Western Australia, renowned for its particularly burny sun, and also my painfully pale skin), mitigate the guaranteed dry lips by regular chap stick application, and, as said above, adopt two forms of birth control because pregnancy is a big no. Otherwise, alcohol is fine, just not to excess all the time (although the occasional drunk night is fine), and I would need to have a blood test prior to starting the drug, and before my six week check up.

I was prescribed a 20mg dose once a day for 60 days (leading up to my next appointment), equating to one tablet to be take with food a day. While waiting for the results of my blood test to begin taking the drug, I spent many hours looking at before and after photos, and looking for blogs where people shared their roaccutane experiences. Of course, most were over dramatic. I read posts of people who claimed they were so dry they moisturised their entire body ten times a day, or felt deeply depressed. Some people said they stayed on the drug for years. Some people said they had hangovers for days. On a straw poll of the many friends I have who have taken it in recent years to farewell adult acne, the worst side effect was dry lips and, for some, a sweatier face when exercising.

I've now been on the drug for 2.5 weeks. In the interests of honesty, I'll share my 'progress' in the form of extraordinarily unflattering photos.


All I felt was embarrassed. Big red marks and bumps all over my face.

Week One:

At the end of week one, I'd experienced dry lips (although not as bad as I thought they'd be) and a noticeably dry mouth when I woke up in the morning. Otherwise, generally fine and no emotional swings, no noticeably dry skin anywhere but my lips and thanks to it being winter and me applying sunscreen, no issues with sunburn.

Week Two:

At the end of week two, my lips continued to be slightly dry, and I had the occasional dry mouth. Again… that's pretty much it. As you can see, not much has changed at this stage. I feel as though the acne is getting slightly worse (which I was warned about prior to commencing treatment – minimal to no change in the first six weeks, with a high likelihood of things worsening a little as the drug begins to take effect from the inside out.

I've pared back my skincare routine, as many people warned me your skin gets very sensitive while taking roaccutane. I'm now using a gentle milk cleanser in the morning, followed by serozinc, hydroluron and miscellaneous moisturisers, before slathering on the sunscreen. Evenings, I double cleanse with Clinique Take the Day Off and another milk cleanser, followed by serozinc, hydroluron, moisturiser. Sometimes I'll use an oil because I just love face oils – but generally, this is all my skin has wanted. And during the day, as some of the red cystic acne had come to a head, I will use a little of the Aesop control gel to try cool them out.

I miss using Vitamin C, but I'm holding off to see how my skin goes. I've gifted on some of my fancier products so they get used instead of expiring in my cupboard. But generally – that's all I do!

I'll keep you updated on progress. It's a slow burn, and generally a six month treatment, but I'm feeling confident this is the right choice for me.