On Isotretinoin

I recently started a course of Isotretinoin, a strong medication used to cure severe acne by altering DNA transcription. For some reason, my acne has really flared up in my late twenties. I would get huge cysts on my face that would last for weeks, not to mention the hyper-pigmentation that would last even longer after the cyst went away. Needless to say, it was making me very anti-social when I was talking to people and felt like there was a huge distraction on my face.

I was referred to a dermatologist, who gave me a prescription for “full strength” (according to my body weight) to see if I could handle the side effects. The pharmacist asked me if she made a mistake because they don’t offer a dosage that strong, so now I take a combination of two dosages.

Due to the potency of the medication, there’s a huge list of side effects. The scariest is the mood changes. I’m supposed to stop the dose if I start experiencing:

  • changes in my mood such as becoming depressed, feeling sad, or having crying spells
  • losing interest in my usual activities
  • changes in my normal sleep patterns
  • becoming more irritable or aggressive than usual
  • losing my appetite
  • becoming unusually tired
  • having trouble concentrating
  • withdrawing from family and friends
  • having thoughts about taking my own life

As a person who’s suffered from suicidal thoughts in the past, this was quite a frightening proposition. I asked my friends to be aware, just in case I don’t notice any changes in myself.

So far though, the only side effect has been extremely dry skin, especially on the face. The lips have been the worst; I can’t eat or drink anything without applying a thick layer of moisturizer on them, otherwise they peel like mad.

There’s also a drying of mucous membranes. To relieve the chapping, I’ve started smearing Vaseline in my nose.

Prior to this, the only time I used Vaseline was as a sexual lubricant.

Now I get aroused every time I breathe in.


  1. I once had a gigantic cyst next to my eye that wouldn’t go away, the doctor used a syringe to draw it empty. There were a few times when the cysts were not so gigantic, the dermatologist would use a syringe to directly inject some medication into them, and the cysts would flatten in a day or two.

    I doubt if acne is something completely curable, it’s hereditary, like baldness. You can only keep it under control by maintaining cleanliness, controlling you eating and sleeping habits, keeping you gut regular—lots of fruits, adequate sleep.

  2. I tried everything except the sleeping habits, which I found very difficult. When I saw a Chinese medical practitioner, he told me that it wasn’t something that could be fixed, or even controlled, but lessened with the right diet. The diet wasn’t an easy adjustment though. I have my doubts too, but this drug is worth one last shot for me.

  3. You know how bad my acne used to be. It lasted till the age of 26. And it has really disappeared now. I think there are 4 major things that changed. Don’t know if it’ll help you or not.

    1. Overdose with water everyday (~1L)
    2. Stopped touching my face
    3. Sleep at least 7 hours a day
    4. Make sure that I don’t sweat everyday.

    I find that the cyst like acne appears more often after a days of bad sleep schedule.

  4. I was on antibiotics for 2+ years but it still didn’t completely clear it up. I’m using Proactive now and it’s actually working OK, but it’s still not completely clear.

  5. @Causalien — I didn’t think your acne was very bad…not even noticeable actually. I think you also have to consider the fact that our bodies change as we grow older, and hormones along with it. My acne has gotten much worse without any lifestyle changes. Yours may be due to aging as well.

    @trolley — Antibiotics apparently aren’t supposed to clear one up completely. It’s a temporary solution; as soon as we get off them, the acne comes back, sometimes worse. And taking antibiotics is very bad for the body long-term. I’ve heard good things about Proactive. Maybe my acne was bad enough that the doctor recommended I skip straight to the strong stuff.

  6. Yeah, I’ve thought about the aging factor… but mine was bad. I guess you’ve only seen me during the first 2 years of university. It got worst at around 2003 and I also experienced the cyst like acne.

    My brother got it worst than you, but his problems are isolated to his back and he had to go on antibiotics for a year which did jack for the problem. It is only recently that it got better, so age could be a factor, but he also made a huge lifestyle change, including eating habits.

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