Isotretinoin 20mg, commonly known by brand names such as Accutane, is a powerful oral medication prescribed for severe and persistent acne. It’s widely regarded as one of the most effective acne treatments available. But a common question among users is: how long does isotretinoin take to treat acne?
In this article, we’ll explore the expected treatment timeline, how isotretinoin works, what affects its speed and efficacy, and what you should expect during the course of therapy.
What Is Isotretinoin?
Isotretinoin is a derivative of vitamin A and belongs to a class of drugs called retinoids. It works by targeting several key causes of acne:
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Reducing the size and activity of sebaceous (oil) glands
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Lowering sebum (oil) production
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Decreasing bacterial growth in the skin
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Preventing the clogging of pores
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Reducing inflammation
Because of its multi-targeted mechanism, isotretinoin is typically reserved for cases of severe cystic acne, nodular acne, or acne that hasn’t responded to antibiotics or topical treatments. You can also buy accutane online from dosepharmacy.
How Long Does It Take to See Results?
🗓 Initial Improvements: 6 to 8 Weeks
Most patients begin to see visible improvements in their acne within 6 to 8 weeks of starting isotretinoin. However, it’s not uncommon for acne to worsen during the first few weeks. This temporary flare-up is known as an initial purge and can be discouraging—but it’s a sign that the medication is starting to work.
📈 Significant Improvements: 3 to 4 Months
By the third or fourth month, many users notice substantial improvement in their skin’s appearance. Inflammatory lesions (such as nodules or cysts) often start to flatten, and breakouts become less frequent.
✅ Complete Treatment Timeline: 4 to 6 Months (on average)
Most isotretinoin treatment plans last between 16 and 24 weeks (4 to 6 months). Some patients with very severe or resistant acne may require a longer course or a second round of treatment. Doctors often adjust the dose based on weight and how well the patient tolerates the medication.
Treatment Duration Based on Dosage
The speed and effectiveness of isotretinoin also depend on the daily dosage and the cumulative dose—which is the total amount of medication taken over the course of treatment.
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Low-dose regimens (e.g., 10–20 mg/day): May take longer to show results but have fewer side effects.
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Standard-dose regimens (e.g., 0.5–1 mg/kg/day): More commonly used, typically over 4–6 months.
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High-dose regimens: Rarely needed but used in severe or relapsing cases.
Your doctor will calculate your cumulative dose target (usually around 120–150 mg/kg) to determine how long you’ll need to continue the medication.
What to Expect During Treatment
✅ Month-by-Month Breakdown
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Week 1–4: Skin may worsen; dryness begins; lips and nose start feeling chapped.
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Week 5–8: Some mild improvement; dryness increases; possible joint aches.
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Week 9–12: Visible acne reduction; fewer cysts; better skin texture.
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Week 13–16: Marked improvement; less oily skin; reduced new breakouts.
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Week 17–24: Near-clear or clear skin in many patients.
Can Acne Return After Isotretinoin?
For many patients, isotretinoin provides long-term or even permanent relief. Studies show that up to 85% of users experience long-term remission after one full course. However, about 10–20% may experience a relapse, especially those with:
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Severe acne
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Hormonal imbalances (e.g., PCOS)
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Incomplete cumulative dose
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Very oily skin
In such cases, a second course may be recommended after a few months of recovery.
Factors That Affect How Fast It Works
Several factors influence how quickly isotretinoin starts to work:
1. Severity of Acne
People with mild to moderate acne may respond faster, while those with extensive cystic acne might take longer.
2. Dosage and Compliance
Sticking to the prescribed dose and taking the medication consistently is key to quicker results.
3. Skin Type and Oil Production
Oily skin types often see significant improvement, but the changes may be gradual.
4. Hormonal Influence
In individuals with hormonal acne, isotretinoin may work slower, and hormonal therapies may be required alongside or afterward.
Is Faster Better?
Not necessarily. While everyone wants quick results, higher doses taken too quickly can increase the risk of severe side effects, including:
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Dry skin and lips
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Muscle and joint pain
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Liver toxicity
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Increased cholesterol levels
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Mood changes
Doctors aim for a balance: an effective but tolerable pace to minimize side effects and achieve lasting results.
Tips to Maximize Results
Here are some helpful tips to get the best outcome from your isotretinoin treatment:
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Be patient: Improvement is gradual but lasting.
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Stay hydrated: Dryness is a common side effect.
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Moisturize daily: Use non-comedogenic lotions and lip balm.
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Avoid waxing, peels, and harsh exfoliants during treatment.
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Use sunscreen: Skin becomes more sensitive to UV rays.
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Follow up regularly: Blood tests and monitoring are essential.
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Avoid alcohol: It can strain your liver when combined with isotretinoin.
What If It’s Not Working?
If you’ve been on isotretinoin for 10–12 weeks with no improvement, consult your dermatologist. They may:
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Adjust your dosage
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Check for adherence issues
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Recommend blood tests to evaluate other factors
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Consider hormonal evaluation (especially in women)
In rare cases, a different treatment strategy may be needed.
Isotretinoin usually begins to show visible improvements in 6 to 8 weeks, with most people experiencing clear or nearly clear skin by 4 to 6 months of consistent use. It’s a powerful and effective treatment, especially for those who have tried multiple other options without success.
While the results are not instant, the benefits of isotretinoin are often long-lasting—and in many cases, life-changing. By understanding the expected timeline and staying consistent with treatment and follow-ups, patients can look forward to clearer, healthier skin in the months ahead.
