If you are considering isotretinoin for acne, one of your first questions may be “Accutane – how long does it take to work?” You might also be wondering when does Accutane start working, what the first signs Accutane is working might look like, or whether there is a typical Accutane purge timeline. Accutane and Roaccutane are both brand names for isotretinoin, so if you are wondering how long does Roaccutane take to work, the same treatment timeline applies.
Isotretinoin does not usually clear acne straight away. Improvement tends to happen gradually over several weeks and months, and everyone responds differently. Some people may notice early changes within the first few weeks, while more significant improvements can take longer.
It is also possible for acne to temporarily worsen during the early stages of treatment. This does not necessarily mean isotretinoin is not working, but any significant changes or concerns should be discussed with the clinician overseeing your treatment.
Below, we look at what you might expect during your isotretinoin treatment journey, from the first few weeks to the later stages of your course.
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What is Accutane?
Accutane is a former brand name for isotretinoin, a prescription medicine used to treat severe acne.
Although the Accutane brand itself is not commonly used in the UK, the name is still widely used when people talk or search online for isotretinoin treatment. You may also recognise the name Roaccutane, another brand name for isotretinoin.
Isotretinoin works differently from many other acne treatments. It reduces the amount of oil produced by the sebaceous glands and helps prevent pores from becoming blocked, as well as reducing inflammation.
In the UK, isotretinoin is generally used for severe acne, particularly where there is a risk of permanent scarring and other appropriate treatments have not been effective.
So, how long does Accutane take to work?
There is no exact point at which isotretinoin suddenly starts working.
During the first few weeks, you may notice changes such as your skin and lips becoming drier. Your acne itself may take longer to respond, with improvement becoming more noticeable as treatment progresses.
For people wondering when does Accutane start working, it is helpful to think of treatment as a gradual process rather than expecting your acne to change at a particular point.
A general treatment journey may look something like this:
First few weeks: You may notice increased dryness, particularly of the lips and skin. Some people find their acne temporarily gets worse during the early stages of treatment.
1–3 months: You may begin to notice fewer new spots developing and existing acne gradually settling. The timing varies considerably between individuals.
Later months: Improvement may become more noticeable as treatment continues, although the length of your course will depend on your individual response and prescribed dose.
The length of treatment varies according to your symptoms, dose and individual response, so some people will need to take isotretinoin for longer than others.
When does Accutane start working?
There is no single answer to when does Accutane start working, as everybody responds to isotretinoin differently.
The changes can also be more subtle than suddenly having clear skin. You might initially notice that your skin becomes less oily or that you are developing fewer new inflamed spots. Existing breakouts may also begin to settle more quickly.
Your dose, the severity and type of your acne and how you respond to the medication can all affect your treatment journey.
Your dermatologist will review your progress throughout treatment and decide whether your dose or treatment plan needs to change.
What are the first signs Accutane is working?
The first signs Accutane is working can vary between patients. Rather than your acne disappearing suddenly, you may begin to notice smaller changes to your skin.
These can include:
- your skin becoming less oily
- fewer new spots developing
- existing breakouts beginning to settle
- fewer severe or inflamed breakouts.
Remember that experiencing dry skin or lips does not necessarily indicate how well isotretinoin is treating your acne. These are common side effects of treatment rather than a measure of your eventual results.
The first signs Accutane is working may also appear at different stages for different people, so try not to compare your progress too closely with somebody else’s.
Does Accutane make acne worse before it gets better?
It can.
Some people experience a temporary worsening of their acne after beginning isotretinoin. This is sometimes referred to online as the “Accutane purge”.
Not everyone experiences an initial flare, however, and you should not assume that worsening acne is something you simply have to tolerate.
Although you may come across an Accutane purge timeline when researching treatment online, there is no standard timeline that applies to everybody.
If your acne becomes significantly worse, painful or you are concerned about any changes to your skin, speak to the clinician overseeing your treatment rather than changing or stopping your medication yourself.
What is the Accutane purge timeline?
There is no set Accutane purge timeline because not everybody experiences an initial worsening of their acne. Among those who do, its timing, duration and severity can vary.
This makes it difficult to predict exactly when an initial flare will begin or how long it will last.
If your acne does worsen after starting isotretinoin, your dermatologist can assess whether this is an expected response or whether your treatment needs adjusting.
This is one reason regular follow-up is an important part of isotretinoin treatment. It allows your clinician to monitor both your acne and any side effects rather than relying on a fixed week-by-week timeline found online.
How long does a course of Roaccutane last?
The length of an isotretinoin course varies from person to person. Your dermatologist will determine how long you need to take the medication based on factors including your prescribed dose, response to treatment and any side effects.
It is also worth distinguishing between how long does Roaccutane take to work and how long a complete course of treatment lasts. You may begin to see changes to your acne before reaching the end of your prescribed course.
Rather than treating every patient for exactly the same number of months, treatment can be adjusted to the individual.
NICE recommends a standard daily dose of 0.5–1 mg/kg for oral isotretinoin, although a reduced dose can be considered in some circumstances. Treatment will be monitored by your clinician, who will determine when it is appropriate for your course to end. A typical course of isotretinoin lasts around five to six months, although some patients require longer treatment, particularly if taking a lower dose. Your dermatologist will assess your response and determine when treatment can be stopped.
This means somebody else’s Roaccutane treatment journey may be quite different from yours.
Why might Accutane take longer to work for some people?
There are several reasons why one person’s acne may improve more quickly than another’s.
These include:
- the type and severity of acne
- the dose prescribed
- whether the dose needs to be adjusted because of side effects
- how your acne responds to treatment
- the overall treatment plan recommended by your dermatologist.
The first signs Accutane is working can therefore appear at different stages for different people.
A slower response does not automatically mean treatment has failed. Your progress should be assessed by the clinician prescribing your isotretinoin.
What if my acne isn’t improving?
If you have been taking isotretinoin and are concerned about your progress, you may find yourself wondering when does Accutane start working and when should I expect to see an improvement? Your response can vary, so discuss any concerns at your follow-up appointment.
Do not increase your dose, stop taking isotretinoin or change how you take it without speaking to your prescriber.
Your dermatologist can assess your response and decide whether your current treatment plan remains appropriate.
Can your skin continue to improve after Roaccutane?
Yes. Your acne may continue to improve for up to eight weeks after finishing isotretinoin, so the final result is not necessarily apparent when you take your last capsule.
Your skin can continue to settle following treatment, and your dermatologist can advise you about ongoing acne care once your course has finished.
Some people may experience acne again following treatment. If this happens, it does not necessarily mean you will need another course of isotretinoin. The appropriate next step will depend on the severity of the acne and your individual circumstances.
Is isotretinoin safe?
Isotretinoin can be a highly effective treatment for appropriately selected patients, but it is a prescription-only medication that requires specialist assessment and monitoring.
In the UK, there are specific safety requirements surrounding its use. Patients must be counselled about potential side effects and monitored throughout treatment. Isotretinoin can also seriously harm an unborn baby, so people who could become pregnant must follow the appropriate pregnancy prevention measures.
Current UK guidance also requires appropriate assessment and ongoing monitoring for potential side effects, including mental health and sexual function concerns.
This is why isotretinoin should only be taken when prescribed and appropriately monitored by a qualified healthcare professional.
Considering isotretinoin for acne?
If acne has persisted despite other treatments, is severe or is putting you at risk of permanent scarring, a dermatology consultation can help establish the most appropriate next step.
At Freyja Medical, our experienced dermatology team can assess your acne, discuss the treatments you have already tried and determine whether isotretinoin may be appropriate for you.
Where isotretinoin is recommended, treatment is carefully prescribed and monitored, with regular follow-up throughout your treatment journey.
Book a dermatology consultation to discuss your acne and the treatment options available to you.
Frequently asked questions
How quickly does Accutane start working?
There is no single timeline that applies to everybody. Changes may begin during the first few weeks, while visible improvement in acne can take longer. Your response will depend on factors such as your acne, prescribed dose and individual treatment plan.
What are the first signs that Accutane is working?
You may notice that your skin becomes less oily, fewer new spots develop or existing breakouts begin to settle. Dryness of the skin and lips is also common during isotretinoin treatment, although experiencing dryness does not tell you how successful your final result will be.
Is it normal to still get spots while taking Accutane?
Yes. Acne does not necessarily disappear immediately after starting isotretinoin, and new spots can still develop during treatment. Some people also experience an initial worsening of their acne. Speak to your dermatologist if you are concerned about your progress.
How long does Roaccutane take to work?
Roaccutane contains isotretinoin, so the treatment timeline is the same principle as for other isotretinoin products. Improvement is gradual and the length of treatment varies according to your dose and response.
Does a higher dose of isotretinoin work faster?
Your isotretinoin dose should be determined by your prescriber rather than adjusted in an attempt to achieve faster results. NICE recommends a standard daily dose of 0.5–1 mg/kg, with reduced doses considered for some patients. Your dermatologist will determine an appropriate dose based on your individual circumstances.
What should I do if Accutane isn’t working?
Speak to the clinician overseeing your treatment. Your response can be reviewed and your treatment plan adjusted if appropriate. Do not change your dose or stop taking isotretinoin without medical advice.
How to book a consultation
If you are struggling with persistent or severe acne and would like to find out whether isotretinoin may be suitable for you, our experienced dermatology team can assess your skin, discuss treatments you have already tried and recommend an appropriate treatment plan.
Freyja Medical offers private dermatology consultations for acne in Wrexham, Nantwich, Chester and Shrewsbury, with no GP referral required.