Understanding the Accutane Purge

Accutane

Accutane can be an incredible weapon in your fight against acne, but it is so important for new patients to understand the phases of Accutane usage and what to expect from the well-known “Accutane Purge.”

Accutane (generic version: isotretinoin) is a prescription acne medication commonly used for severe or resistant cases of acne. At the Advanced Acne Institute we prescribe it for severe cases of acne that don’t respond to at-home remedies or prescription-strength pills and creams.

It is an incredibly useful medication, but some patients initially have a flareup of their acne when they start taking it. This usually occurs within the first month of treatment. The “Accutane Purge” is certainly a big concern for many patients, and we understand why! Starting a medication to reduce acne only to experience an increase in acne symptoms can be frustrating and discouraging.

Let’s explore the facts about the Accutane purge so that you can be fully prepared for what to expect.

What is skin purging, and why does it happen?

First of all, the term “purge” is misleading.  Many patients believe that Accutane works by forcing all of the deeper pimples to the surface in order to finally rid the skin of acne.  The truth is, however, that we don’t really know what is behind the “purging” process.

Accutane, which is a form of Vitamin A called a retinoid, has many different effects on the skin, many of which we do not fully understand.  However, Accutane has effects on the cells within the skin pores where acne develops and in some people, this can cause the acne-prone pores to temporarily lose control and become even more inflamed.  The cells that line the pores begin to function abnormally and produce chemicals that create even more inflammation, leading to a more intense acne breakout that many refer to as a “purge.”

This process of “purging” can also be seen in other forms of retinoids that are commonly applied to the skin surface as creams or gels that work in similar ways as Accutane and can cause acne to become worse at the beginning of treatment. Retinoids can cause skin purging.

Not everyone who starts Accutane will experience skin purging. If you start Accutane and experience an initial increase in breakouts, you should check with your dermatologist about the best course of action.

What can you expect from an Accutane Purge?

The risk of an acne flare or period of exacerbation has been reported to be more common in male patients, although at the Advanced Acne Institute we  also see it occur in female  patients.

There is also literature that states that younger patients are more likely to experience the Accutane Purge. However, we’ve seen it in all ages, not just those in the 13-16-year-old age range.

Some have noted  that patients who have a lot of blackheads or who have at least one or two very large, deep pimples called “nodules” may be more likely to experience the Accutane Purge, although at the Advanced Acne Institute we have seen it emerge in all different forms of acne.

How many people experience a short-term increase in acne after starting Accutane?

Approximately 5-20% of patients experience worsening of their acne in response to starting Accutane. This typically occurs very early in treatment, within the first month. Sometimes, though, it doesn’t appear until the second month of treatment or if the dose of Accutane is increased during the treatment course.

Although the breakout can be minor — with just a few more pimples than usual — it can also be somewhat severe, with large pimples and cystic breakouts. Like any acne breakout, it can cause prominent scarring, which is why it is important to check in with your dermatologist at the first sign of an increase in acne after starting Accutane treatment.

Strategies for reducing the Accutane Purge

Your dermatologist can help you determine the best course of action for treating skin purging that occurs when you start Accutane.

Some options include:

  • Your doctor may recommend starting treatment with a lower dose of Accutane.
  • Antibiotics may be prescribed to lessen an acne exacerbation.
  • Steroid treatments are sometimes used  to control exacerbations and breakouts associated with skin purging.

Seeking acne treatment from the Advanced Acne Institute

At Advanced Acne Institute, we monitor our patients very closely and make certain adjustments to their treatments as needed if a “purge” is detected. Our significant experience in advanced acne treatment helps us to reduce the incidence and severity of an acne flare that can occur after starting Accutane.

We are the only dermatology clinic in Florida that only treats acne. This allows us to focus on providing specialized care to each of our patients.

If you are concerned about acne, acne scarring, or acne-related skin conditions, you can reach out today to schedule an appointment. We also offer acne appointments by telemedicine!