I wish I had known about the effects of Accutane years ago.

By Sheva Schapira

Most people experience a breakout of some sort over the course of their adolescent years.  Blame it on the hormones if you will, but it’s actually the most common skin condition in the United States. Some experience just the occasional pimple, while others have chronic, persistent and in extreme cases, even disfiguring acne.  And then there are the lucky ones who enjoy the delightful experience of having their acne accompany them into adulthood. Want to guess which category I fall into?  

I spent the entirety of my teen years chasing the elusive solution for my acne. I tried pretty much everything on the market; topical and oral antibiotics, masks, peels, facials that made feel like I was going to die, and Chinese herbal remedies that cost about as much as a private island and did absolutely nothing useful.  At some point, the option of Accutane (Isotretinoin) came up but my dermatologist shot it down, citing the dangerous side effects and his opinion that my acne was nowhere near severe enough to warrant such an invasive option. Maybe he was right, it wasn’t like I had “pizza face” or cystic bumps covering the entire surface of my skin.  I did not have acne on my back (aka: “backne”) and it wasn’t horribly painful to look at me.  But my skin was constantly shiny with excess oil, I had enlarged pores, and at least three or four pimples at a time.  This, combined with the fact that I am obsessive about my skin, did not make for a friendly combination.  I tried every heavy duty concealer on the market to mask the red bumps, invested in an alarming amount of shine blotting papers and powdered my nose approximately every ten seconds.  Plus, I found myself dreading Shabbos and Yom Tov because I couldn’t cover the imperfections and me without makeup was not a pretty sight.  

When I got married, I was very pleased with myself that I had landed someone with perfect skin.  Not only that—everyone in his family has perfect skin!  Hooray for me and my future offspring who now had a shot at perfect genes- at least half a shot. Speaking of offspring, a few months after my wedding, I found out that I was expecting.  My skin also got the memo and promptly responded with a vengeance. You know the glowing, beautiful pregnancy skin of which people speak??  Let’s just say that is not the kind I had.  I looked like someone was playing connect-the-dots on my face.  And then, as I was kvetching about my new, blotchy complexion one Shabbos at my in-laws house, my sister-in-law piped up and asked “So why don’t you just do on Accutane like the rest of us??”

My jaw dropped.  LIKE THE REST OF THEM?? These bearers of flawless, pore-less skin had once suffered from acne?  I couldn’t even imagine it.  Then and there, I decided that as soon as it was safe to do so, I was going to take this magical medication and finally say my final farewell to acne.

As I like to do in all situations, I researched the topic of Accutane to death.  I read every forum, every blog, and pored over every medical source I could get my hands on.  I discovered that Accutane is a drug that was initially studied as a treatment for cancer and while it didn’t do much as a cure for cancer, researchers noticed that patients in the study, who has previously suffered from acne were completely transformed and their breakouts had completely disappeared.  To date, the drug is the only known permanent treatment for acne.  Interestingly enough, Accutane is actually an extremely high dose, or “overdose” of vitamin A.   In extremely large amounts, Vitamin A reduces the amount of oil released by oil glands in the skin, actually shrinking the gland and speeding up skin turnover, causing the skin to renew itself more quickly (which is why it also helps pre-existing scars).  

Now, in the USA, due to the fact that it is a very powerful drug, doctors are very reluctant to prescribe Accutane.  It doesn’t matter if you are covered from head to toe in blistering bumps; American doctors consider it a last resort (as it should be) and they will make you try everything else on Earth first.  In Israel, however, all you have to do is ask and they’ll write you a prescription!  I joke that if a two-year-old walked in to a dermatologist in Israel with chicken pox and asked for Accutane, they’d probably go along with it!  Of course, as a married woman, they did warn me of the possibility of severe birth defects while on Accutane and insisted that every precaution must be taken to avoid overlapping the medication with pregnancy.  Additionally, one of the potential side effects of the drug is liver failure, so I was required to take monthly blood tests to screen for any abnormalities.  My husband, who is desperately afraid of needles, recalls not loving this part of the process, but for me this was hardly the worst part.

In fact, there were a whole slew of unpleasant side effects to choose from.  Some are less common, such as numbness, depression, loss of hearing, severe joint pain, and a whole bunch of other things that sound absolutely terrifying.  Thankfully, I did not experience any of the more severe symptoms.  However, this still left a number of side effects that nearly every person taking the medication experiences and I was no exception.  Firstly, the acne typically gets worse before it gets better.  When I started the treatment, my acne was what most would describe as mild.  For some reason, despite knowing this, I decided that it would be a good time for me to start taking the pills two months before my brother in law’s wedding.  In retrospect, it was a very, very bad idea.  My skin was super angry with me by the time the wedding rolled around and while neck-down everything looked perfect (dress, etc), I seriously considered wearing a bag over my head for the ceremony.

The second not-fun side effect was the dryness.  Picture anything on your face that has the potential to dry out to a painful degree (lips, eyes, inside of the nose, etc) and you get all that and more.  I went through countless bottles of moisturizers and tubs of Blistex.  And while I was lucky enough that I was able to wear my contacts throughout the entire length of my treatment, many people I spoke to wore only glasses due to dryness and irritation in their eyes.  As time progresses, the skin starts peeling, which is not an amazingly beautiful thing to look at, but is gratifying as it slowly reveals healthy, new skin underneath.  In time, as my skin continued to regenerate and the red marks and scars began to fade, I began to look less like something that would give you nightmares and more like an actual human being.  

And then…I took my last pill and noticed all the ways my skin had changed.  There was no more shine, no visible pores, and no pimples!  People started commenting and stopping me in the street to ask what skincare products and makeup I was using.  As one woman put it , “Your skin looks like a baby’s backside!”  As far as compliments go, that one was certainly creative but admittedly is true of skin after Accutane—it’s not just the absence of pimples, it’s the overall improvement of texture.  Another perk, (although I don’t do it often since I love makeup), is that I can actually leave home without a stitch of foundation and still look borderline decent.

Everyone’s experience is different.  Some people have to do a few cycles of Accutane to get permanent results and the dosages and length of treatment vary per person.  Personally, I can’t tell you that it was a particularly pleasant process, but I do feel that it was very much worth the trouble.  So much so that the results left me wishing I had gone through the process as a teen and avoided all those years of unnecessary angst.  In fact, I would go so far as to say that should they need it, I would encourage my children to do the same.  (Oh, who am I kidding?  With their gene-pool, they are going to need it!)  

Disclaimer: The opinions stated here are that of the author and is not an endorsement of Between Carpools.com. Readers are encouraged to discuss any medical-related decisions with the proper professional. 

[small_title title=”About the Author”]

Sheva Schapira is a wig stylist, author and self proclaimed beauty addict. She is also the founder of the new glam wig line Eva and Chloe. 

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