Four years ago, I got to the point where I just couldn’t take any more painful cystic zits popping up and leaving scars on my face. After trying everything else, my dermatologist and I decided it was time to call in the big guns, and she wrote me a prescription for isotretinoin (once known as Accutane).
Isotretinoin is an oral retinoid—a derivative of vitamin A—and it’s the most effective FDA-approved treatment for severe nodular acne. There are other highly effective retinoids out there, but isotretinoin is still considered the most effective one we have. However, because of the potential side effects (which include birth defects), it’s usually saved for only the most severe cases of acne or after other retinoids have failed to help.
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What side effects, exactly? Well, besides birth defects, isotretinoin most commonly causes joint pain, nosebleeds, and skin changes, including extreme dryness, scaling, redness, and irritation.
“If you’re not dry, you’re either not taking the medication or your body isn’t metabolizing it,” Shari Marchbein, M.D., a board-certified New York dermatologist and assistant professor of clinical dermatology at NYU School of Medicine, tells SELF. That’s because isotretinoin works by speeding up the skin cell turnover process, which can cause that characteristic dryness, flaking, and irritation.
But after dealing with severe cystic acne for five years, my dermatologist and I decided it was the best option. I was thrilled when my skin completely cleared up within about three weeks. Fast-forward four years later, and I’m still mostly free of acne (though I do still get the occasional whitehead or hormonal pimple). So the good news is, this stuff really worked for me. But…my whole body was so dry that I felt like the physical embodiment of the Saltine challenge.
In fact, while taking isotretinoin, I had to replace my lifelong arsenal of skin-care products with a whole bunch of new, gentler moisturizing products. Thankfully, the drying side effects faded for me within a few weeks of finishing my last dose—I can finally leave the house without a tube of Aquaphor—but the scorched-earth skin struggle was real.
So if you’re considering starting isotretinoin or a topical retinoid like tretinoin, I highly suggest you prepare yourself (and your skin-care regimen) for the dryness that is about to ensue. Here are the products that got me through the driest times—and Dr. Marchbein’s pro advice on why these products actually work for skin dealing with isotretinoin.
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