I've had acne for over a decade (thanks hormones and PCOS), and through the years, I've learned to (mostly) control my breakouts and oiliness with the appropriate products. That all changed six months ago when I started taking the intense oral acne medication Isotretinoin — commonly known as Accutane — and all of a sudden I had to figure out how to deal with very dry skin, which is something I've never had before. My lips have suffered the most, and I've experienced severe dryness around my eyes, nose, face, and body — all of which has resulted in a lot of peeling.
To combat this, I've had to get serious about incorporating superhydrating products into my skin-care routine, as well as really simplifying things, making sure every product is gentle, fragrance-free, and, as best as possible, free of potentially harsh active ingredients.
An oral medication, Isotretinoin is an internal retinoid (it's retinoic acid, to be exact), which means it's a derivative of vitamin A. I took Accutane about nine years ago, but at the end of 2019, together with my doctor, we decided a second round might be beneficial as I got tired of new spots and the never-ending cycle of pigmentation they left behind. It took me about a year to agree to do a second round, due to the very severe contraindications, ranging from dry skin and dry eyes to painful joints and even depression. I knew that with proper care and the right ingredients and products, I could handle the overall dryness. Regardless, it wasn't easy going from normal/oily skin to dry.
Anjali Mahto, a London-based consultant dermatologist, has been on oral Isotretinoin herself and explained why it causes dryness. "Isotretinoin reduces the size and activity of the sebaceous or oil-producing glands in the skin leading to dryness. Lip and skin dryness are extremely common side effects of the medication, and most people on the medication will suffer; it can usually be managed with appropriate skin care and lip care."
"As a general rule, look for products targeted toward sensitive, dry, or fragile skin," Dr. Mahto says of the types of cleansers, creams, and lotions to use while on the medication. "Opt for fragrance-free cleansers and moisturizers, stripped-back skin care, and be cautious of over layering as the skin is sensitive and easily irritated."
As previously mentioned, a focus on hydration and nonactive ingredients is very important. "Keep skin care simple and basic, avoiding 'active' ingredients," says Dr. Mahto. "The skin is fragile on Isotretinoin, and many of these products can cause dryness, irritation, peeling, or flaking. Avoid retinoid creams (vitamin A), AHAs (glycolic and lactic acid), as well as BHAs such as salicylic acid. And speak directly to your prescribing consultant dermatologist if you are unclear about options."
My skin isn't sensitive at all, but because of the treatment, I now take extra care with what ingredients I use so that I don't irritate it. It took some trial and error to find products that keep my skin hydrated and happy, but once I did, it's been much easier to manage the dryness and flaking as I complete the medication. Keep reading to discover all the products I've incorporated into my routine while on Accutane, along with a few recommendations from Dr. Mahto.