4 Ways Accutane Helps to Clear Hormonal Acne Breakouts 

Accutane is one of the most powerful compounds for treating hormonal acne breakouts. While Accutane (Isotretinoin) will help reduce the symptoms of hormonal acne by reducing the severity of the breakouts itself, it will not actually treat the root cause of the underlying hormonal imbalance. These imbalances are a major contributing factor to the breakouts, and hence need to be treated. 

Accutane works to reduce hormonal acne by reducing congestion within the pore, as it shrinks the size of the sebaceous glands which secrete sebum. Less sebum available in turn reduces the population of the bacteria which cause acne within the skin, but also pores clog less easily in general. Other benefits of Accutane include increased skin cell turnover and reduced inflammation.

In this article we will review exactly how Accutane helps treat hormonal acne including how it shrinks the oil glands, increases cell turnover, reduces inflammation, and prevents bacterial outbreaks. Additionally, we will review common side effects associated with accutane and less invasive options for treating your hormonal acne.

1. Accutane shrinks oil glands

Accutane works by altering how DNA works, by amending the process known as transcription. This change shrinks sebaceous glands, which is where the oily substance sebum is created; meaning overall less sebum is produced. As there is less sebum produced, dead skin cells skin together less meaning they won’t form spots – blackheads or whiteheads, as easily. The reduction in sebum also reduces the population of acne causing bacteria in the skin, as they use sebum as a food source. 

Whilst there are obvious benefits, one of the most well known side effects of accutane is the irritation and excessive drying out of skin. Often this can be combated using a thick moisturizer multiple times a day, but many people still find their skin feels uncomfortable or requires a prescription cream. 

2. Accutane increases skin cell turnover

Accutane, like any form of vitamin A, increases the rate of skin cell turnover – meaning new skin cells come to the surface much more quickly than if the treatment wasnt being used. This increased cell turnover means that congestion is eased, imagine having to direct more cars off the motorway – there would be less left on the motorway, hence reducing the likelihood of a traffic jam! This is the same for the skin, less skin cells in the pore means less likelihood of congestion and clogging, and spots are less likely to form. The only real side effect of this is increased skin sensitivity, as freshener skin comes to the surface more quickly. 

3. Accutane reduces inflammation

Inflammation and acne are very much a hand-in-hand topic, where there is acne there is likely to be some form of inflammation – as the body is trying to fight the acne causing bacteria and reduce the population. So, what actually is inflammation? It is a process where the body’s immune system responds to something perceived as a ‘danger’ – this may be an external pollutant, pathogen or aggressive skin treatment, hence the immune cells begin attacking the ‘danger.’ For acne the root of this inflammation will be the acne causing bacteria, and as accutane helps to reduce the sebum, and hence the population of acne-causing bacteria, the inflammation will naturally decrease within the skin.

4. Accutane reduces bacteria

Bacteria within the skin thrives when there is a plentiful supply of the resources required for their survival – sebum being one of the most important ones. Accutane reduces the availability of sebum, by shrinking sebaceous glands and reducing the output of sebum over time. This scarcity of sebum puts pressure on the food supply for bacteria, reducing the population of the acne causing bacteria – reducing acne lesions. However, it’s worth noting good bacteria are also reduced, and the skin generally becomes much more susceptible to sun damage.

What are other oral medications you can take as an alternative to Accutane?

Accutane isn’t the only oral medication which is effective as an acne treatment, with different treatments being more suitable for different people’s lifestyles and current health. None of the below are as potent as accutane in reducing acne, but are worth considering 

  • Oral antibiotics like tetracycline, doxycycline and minocycline: Antibiotics work to kill bacteria, reducing the overall population and hence the amount of acne lesions formed. Antibiotics are usually non-selective, meaning they kill both good and bad bacteria, which can be problematic – meaning it’s important to nourish the skin with pre- and probiotics to ensure the good bacterial population isn’t overtly negatively harmed.
  • Spironolactone: This is an anti-androgenic medication, which is helpful for hormonal acne as an excess of androgen hormones (male hormones) is associated with painful and inflamed acne often found along the jawline and chin especially for females. 
  • Hormonal birth control pills: These medications help to regulate the hormones within the female cycle, which in turn regulate oil production. Birth control pills regulate estrogen and progesterone, so the fluctuations occur at the same time each month, whilst also decreasing the androgen hormones which are a key driver for inflammatory acne formation.

What are the side effects of Isotretinoin usage?

Although accutane is incredibly effective at clearing acne, it comes with some very serious side effects including sun sensitivity (making SPF even more vital!) alcohol intolerance, birth defects, fatigue, blurred vision, depression – often making it more of a difficult treatment for anyone with mental health issues, as well as the previously mentioned excessively dry skin. As well as these side effects, accutane would cause birth defects and miscarriage, hence all females of reproductive age must be using two forms of contraception throughout treatment with Accutane. 

Should you change your skincare routine on Accutane?

You should avoid using skincare products with active drying ingredients like salicylic acid and benzoyl peroxide while taking Accutane. During the course of an Accutane treatment your skin will be incredibly sensitive, using powerful active ingredients will likely cause irritation in your skin. In order to properly soothe and nourish your skin you should use a hydrating, non-comedogenic moisturizer that will nourish your sensitive skin. Additionally, if you are naturally prone to hormonal acne breakouts your should be using a non-comedogenic, hormonal acne friendly cleanser.

What are the natural alternatives to Accutane?

If you’re at the start of your acne treatment journey, it may be best to try to alter your diet and lifestyle first – as this comes with little to no side effects unlike Accutane treatment. Altering lifestyle and diet will take longer to see improvements, but some great examples of changes you could make would be following an anti-inflammatory diet, reducing dairy intake, washing pillowcases and towels more frequently as well as decreasing alcohol and sugar intake. 

What is Accutane?

Accutane is the well known brand name of the drug Isotretinoin, which is an oral medication – meaning you take it as a pill. Isotretinoin is a vitamin A derivative (you may link this to the retinol creams and serums applied to the face – they are also vitamin A derived!)

Originally Published: August 29, 2023

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Analyzed by Beth Cooper
I'm a beauty content creator from the UK, on both Instagram and TikTok. I adore exploring new beauty products, whilst also learning the science behind the skincare (I'm a major science nerd - currently studying a Bachelors Degree in Health Sciences!) I'm passionate about making acne care accessible for all, whilst empowering people to feel like they are good enough and beautiful with or without their acne. It's such a complex condition, so getting good information to people is so important to me, years of those horrendous internet DIYs really damaged my skin! Read more of Beth's articles.

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