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If you’ve ever researched acne treatments online, there is a good chance you have come across isotretinoin, or, as it was once commonly known as, Accutane. Once reserved as the prescription acne treatment of last resort, this oral acne medication was responsible for eliminating acne in two-thirds of the 13 million patients who suffered from severe, cystic, inflammatory acne and used the drug.
However, Accutane, the brand, is no more. Its parent company Hoffmann-La Roche Inc. halted the production in 2009 after generic versions costing up to 50% less took too big a bite out of the sales. That doesn’t mean the prescription is down for the count. Isotretinoin is still readily available by prescription, with all the same warnings of the name brand that came before it.
We reached out to Dr. Michele Green, a cosmetic and medical dermatologist and expert on acne and Accutane, to get the low-down on Rx zit-zapping treatment. She told us about the benefits of Accutane and addressed some of the perceived risks that may have you searching for the best Accutane alternatives.
Why Consider Using Accutane?
Why consider using Accutane? The short answer is because Accutane works for those who need it most — longtime sufferers of severe acne or those with severe acne scarring.
“There is no alternative to Accutane,” Green says, because Accutane, a vitamin A derivative (13-cis-retinoic acid), can permanently reduce skins oil production, skin bacteria and inflammation, stopping the sources of acne and lessening them over time.
Green also notes there are no genuine alternatives to Accutane beyond the topical products you’re already familiar with, such as acne face washes, masks and exfoliators. And in her experiences with her patients, those alternatives aren’t nearly as effective in the long term as Accutane.
Though she acknowledged Accutane could come with side effects, she suggested that it was highly effective and safe when used as prescribed and in consultation with a doctor. “If you let me put you on Accutane, I’m going to be your last dermatologist,” said Green, adding that she’s never had a patient tell her they regretted going on Accutane.
The successes from Accutane can’t be denied — look at the before and after photos to see yourself.
Why Consider Accutane Alternatives?
Accutane has known, proven side effects and several reported side effects that could give some acne sufferers pause.
The worst known side effect is congenital disabilities. Pregnant people or people trying to become pregnant cannot be prescribed Accutane and must prove they are not trying to get pregnant while on the medication. Another side effect to consider is some Accutane users — around 1% — have reported increased suicidal ideation and feelings of depression.
In another point against the treatment, people on Accutane should also avoid consuming alcohol for the duration of their treatment because it can affect the metabolization of Accutane.
However, Green said, studies haven’t borne out the mental health issues, and potential congenital disabilities are wholly avoidable when Accutane is taken as prescribed. Also, the tradeoff between chronic dry skin and permanently reduced cystic or inflammatory acne could be worth it for many patients, especially if they have lived with severe acne their entire lives.
Accutane Side Effects
Side effects of Accutane are generally mild, and you can find a more detailed list on Green’s website. An abbreviated list of the most common side effects are:
- Dry skin, peeling skin
- Dry lips (cheilitis)
- Dry Eyes
- Skin peeling
- Sun sensitivity (sunscreen use is essential while on Accutane)
- Joint pain
- Gastrointestinal (GI) side effects
- Mood changes
As with this or any other medication, always consult your doctor.
“Accutane can be highly effective and incredibly safe,” says Green, if you can manage the restrictions.
But if you’re worried about having to apply lip balm more often or you’re trying to get pregnant, then you should consider looking at the best alternatives. Though some acne sufferers may decide to try their luck with isotretinoin, in consultation with their doctor, the best Accutane alternatives, such as acne face washes or the best face serums for acne, can be a great place to start.
Below, we’ve selected some of the best over-the-counter (OTC) Accutane alternative acne treatments. While these alternatives are not the same as Accutane, each has provided positive results to many who have used them as directed. Take a scroll through and find the right option for you.
BEST ACCUTANE ALTERNATIVE OVERALL
As pioneers in the Accutane alternative OTC options, Proactiv now has tiers of treatments available for those needing respite from acne. We are big fans of ProactivMD, the latest collection from the brand, which features ingredients shown to target more severe acne. Purchase the trio together to get a gentle cleanser, the prescription-strength retinoid adapalene gel and a super hydrating moisturizer. Proactiv now also offers its products a la carte so that you can personalize your regimen. Remember, more often than not, less is more when dealing with acne. Excessive washing or too much exfoliation can make matters worse.
2. PanOxyl Acne Foaming Wash
BEST ACNE CLEANSER
This dermatologist-recommended acne foaming face wash from PanOxyl features 10% benzoyl peroxide — the most potent dose available without a prescription. According to the National Health Service (NHS): “[Benzoyl peroxide] is proven to kill the bacteria that causes acne when used as directed. It works as an antiseptic to reduce the number of germs (bacteria) on the surface of your skin.”
3. Neutrogena Oil-Free Acne Face Scrub
BEST ACNE SCRUB
An acne face scrub offers even more exfoliation than an acne face wash. The Neutrogena Oil-Free Acne Face Scrub provides even more than many other scrubs thanks to the addition of 2% salicylic acid. Gentle mechanical exfoliation physically removes dead skin cells allowing the 2% salicylic acid to unclog pores. According to Neutrogena, this is great for daily use to help prevent breakouts.
4. Differin Gel Adapalene Gel 0.1% Acne Treatment
BEST RETINOID TREATMENT
Vitamin A derivatives such as retinoids help with acne by increasing skill cell turnover. As another member of the vitamin A family, that’s partly why isotretinoin is so effective and why you might consider a treatment like Differin Adapalene Gel 0.1% Acne Treatment. Adapalene is a retinoid that has been shown to yield positive results in users. According to Differin, in a clinical study, Differin gel provided up to 87% reduction in acne lesions after 12 weeks. Suitable for teen or adult acne, apply a thin layer of this gel all over your face once per day.
5. Clean & Clear Persa-Gel 10 Maximum Strength Acne Medication
ACNE SPOT TREATMENT
This acne medication was once only available through a doctor’s prescription, so it’s easy to see why it’s such one of the best Accutane alternatives. Like many of the most effective acne treatments, the Clean & Clear Persa-Gel 10 Maximum Strength Acne Medication contains 10% benzoyl peroxide. This fast-acting acne treatment helps fight more targeted breakouts.
6. DRMTLGY 24 Hour Acne Serum
BEST ACNE SERUM
Benzoyl peroxide and glycolic acid — a simple exfoliating alpha-hydroxy acid (or AHA) derived from sugar cane — make the DRMTLGY 24 Hour Acne Serum effective for many who are targeting particularly stubborn acne. These two ingredients break down dead skin and promote skin turnover, likely resulting in less acne over time.
7. ZitSticka Skin Discipline Acne Vitamin Supplement
We will admit we are skeptical of supplements promising life-altering results, but if we had to pick a supplement to try, it would be ZitStika Skin Discipline. According to the brand’s 2020 3-month clinical study run by Princeton Consumer Research, 88% of participants reported a significant reduction in common acne after 12 weeks. Accutane was a pill administered orally, so if that is a method of delivery you prefer, this may be worth considering. The brand claims optimum results following two to three months of use.
8. Omnilux CLEAR Face Mask
BEST LIGHT MASK
Blue light therapy has been shown to help treat mild to moderate acne. Suppose you’re willing to put in the effort (like any acne plan, patience and consistency are key) and have deep enough pockets; Omnilux CLEAR blue and red light therapy mask is another Accutane alternative you can buy. Thankfully, you don’t need to sit for two hours a day to see results: Suggested use for best results is four times a week on the blue light setting in 10-minute increments for six weeks.
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