I took the miracle acne drug twice—and here’s what happened

Coming from a non-pill popper who held back just short of a decade before succumbing to the anti-acne drug, I’m going to lay my cards on the table here. Isotretinoin works, there’s no two ways about it, but it’s no permanent fix...or so I’ve come to believe, for myself anyway. I first became acquainted with the wonder pill during my teens...my dermat was quick to recommend Accutane—a brand name of isotretinoin that is no longer manufactured—when she diagnosed my condition as ‘cystic acne’.

Iso, for the fortunate few with spotless skin—who are likely unversed in pimple prate—is an oral retinoid for recalcitrant acne. Known to shrink your sebaceous glands, this prescription drug is the holy grail for us acne sufferers.

As for me, the run-of-the-mill spot treatments just didn’t cut it, and while I was apprehensive about dosing on the “closest cure to acne”, my compromised self-esteem prevailed.

It wasn’t until a week after, that I dropped the dose. You see, tretinoin has earned a reputation for being contentious. It strips the skin off moisture—think cracked lips that sometimes bleed—can impact your gut microbiome, and even trigger suicidal thoughts. As prep, lipid panels and liver function tests aren’t uncommon, and if you’re expecting, it’s a big no-no. To cut to the chase, I was scared as f**k, so I quit merely a week after popping my first pill.

I grappled with acne for years...it followed me well into adulthood—pimple patches, tea tree oil, Lacto Calamine, toothpaste, you name it, I’ve tried it. I’d reached a point of such despair that I had to give the miracle med another shot, a fair one. So when greeted with a bad bout of breakouts the nth time, I got back on the pill.

It coincided with a time of change in my life; in the pursuit of independence—both financial and emotional—I’d moved cities, made new friends, dropped some, which, I now realise, wreaked havoc on my hormones (a little heads up would’ve been nice, but anyway).

I’ve also been diagnosed with polycystic ovarian syndrome (PCOS), which quickly turns blackheads and whiteheads into angry, inflamed spots that, more often than not, leave nasty marks. So, at 26, with visual reminders of a “scarred” past, I began a 20mg Sotret® dosage twice a day.

Trust me when I say, it gets (a whole lot) worse before it gets better. The first couple of months, my will to step out of the house was lost...I endured persistent purging, flaking, and seldom bleeding. My self-worth was directly proportional to my skin, and I truly believed it would never end. But it did, all of four months later.

My skin was clear as day—a sight to behold—and the scars began fading with the topical ointments and oral supplements the dermatologist had prescribed. The dosage dropped to 10mg, and was extended for two months to avoid chances of a relapse.

Upon completing a six-month iso diet, I jumped on a rotational buffet of niacinamide, salicylic acid, retinol, and benzoyl peroxide. The diligent application of a serum, moisturiser, and sunscreen restored my skin integrity, while alpha-arbutin diminished the appearance of dark spots. And just like that, a year went by, with clear skin...until I shifted back to my hometown.

The flare-ups were back—bigger and better than ever, and my mental health was in the dumps. Since it had only been a year, I was advised against a second round of isotretinoin just yet. I’m currently on antibiotics, both of which have (finally) begun giving the desired results after three long months.

Let’s just say I’ve come to terms with it. I understand my condition is chronic, and occasional eruptions are inevitable. Today, I’m more mindful about what I put on my skin—no more nuskhas (home remedies), TikTok fads, or over-layering of concoctions. I’m also open to another course of tret, given my skin demands it—and with my doctor’s seal of approval, of course.

To those on the short end of the stick, hang in there. Every iso journey is different...own yours. While it didn’t really work for me, it sure does for many.

Cut down your dairy and sugar intake, and, most importantly, don’t self-medicate. Professional guidance is paramount; your doctor might have you go in for chemical peels, oral vitamin A, antibiotics, or the usual salicylic acid-retinol-benzoyl peroxide combo. Stick to a non-comedogenic, oil-curbing cleanser and a lightweight, broad-spectrum moisturiser and sunscreen for optimal skin hygiene.

Easier said than done, don’t let your appearance dictate your self-worth. Acne tends to wax and wane, and as long as you follow a clean diet, up your water intake, and medically intervene at the right time, you’ll be just alright. Good things take time, as they almost always do.

All images: Shutterstock 

This article originally appeared in the January-February 2025 print edition of Cosmopolitan India.

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