Acne can be one of the most frustrating skin conditions to manage, especially when it persists even after aggressive treatments like Accutane.
Accutane is often considered the gold standard for treating severe acne, with many people turning to it after other treatments fail. But what happens when you experience a resurgence of breakouts after stopping Accutane?
For some, the acne returns after one month, while others may notice it reappearing a year later. In this article, we’ll explore why this happens, and more importantly, how to tackle breakouts when Accutane hasn’t solved the root problem.
What Is Accutane and Why Do People Use It?
Accutane, also known by its origin name Isotretinoin, is a powerful oral medication used to treat severe, cystic, or nodular acne. It works by reducing the amount of oil (sebum) produced by the skin’s sebaceous glands, shrinking them in the process.
This reduction in oil helps to prevent clogged pores, which is a key factor in acne development. Isotretinoin is often prescribed for individuals who have tried various topical treatments, antibiotics, and other oral medications without success.
According to an article at The American Osteopathic College of Dermatology, Accutane successfully ‘cures’ around half of its users, eliminating the need for further acne treatments. However, in the early weeks, about 20% of patients experience a slight worsening of their condition, while 1 in 500 see a significant increase in their acne (Source.)
Many people see remarkable results while on Accutane. Acne lesions clear up, skin becomes less oily, and for some, their skin remains clear for years after completing the treatment. But for some, the journey isn’t quite as straightforward, and that’s not even in reference to the potential side effects. But we’ll leave that for another article.
Why Does Acne Come Back After Stopping Accutane?
While Accutane can be effective for many, it doesn’t always offer a permanent solution to acne. Here are several reasons why breakouts might return after stopping Accutane, whether it be a month or later:
Hormonal Fluctuations
One of the most common reasons for recurring acne is hormonal imbalances, particularly in women. Conditions like polycystic ovary syndrome (PCOS) can trigger hormonal acne that persists even after Accutane treatment.
Testosterone and other androgens can stimulate the sebaceous glands to produce more oil, resulting in new breakouts.
Incomplete Treatment Course
In some cases, acne returns because the treatment course wasn’t long enough or the dosage was too low. Accutane is typically prescribed for a period of 4 to 6 months, but the duration and dosage depend on the individual’s body weight and severity of acne. If the overall dose isn’t sufficient, there’s a higher chance of relapse.
Underlying Skin Conditions
Sometimes, what appears to be acne could be a different skin condition that wasn’t accurately addressed by Accutane. Conditions like rosacea, folliculitis, or fungal acne (Malassezia) may be misdiagnosed as traditional acne and can persist or worsen after Accutane treatment.
Diet and Lifestyle Factors
Acne isn’t solely a skin condition; it often reflects deeper concerns within the body, including gut health, stress, and lifestyle choices. Diet, in particular, plays a significant role in inflammation and hormonal balance, both of which are major contributors to acne.
After stopping Accutane, if diet and lifestyle factors that trigger acne remain unaddressed, breakouts can reappear.
Expert Recommendations for Post-Accutane Care
When breakouts return after Accutane it’s important to approach your skin with a comprehensive plan. Rather than relying solely on medications or topical cleansers, consider adopting a holistic approach that addresses diet, lifestyle, and skincare. Here are some expert-backed recommendations for treating acne that persists post-Accutane:
Assess Your Hormones
Since hormonal imbalances are a common trigger for acne, particularly after isotretinoin treatment, it’s crucial to get a comprehensive hormonal panel. Work with functional doctors or functional nutritionists instead of family medicine doctors who might recommend more medication.
Optimize Your Diet
Dietary changes can play a significant role in controlling acne. Studies suggest that high-glycemic foods (such as sugary snacks and refined carbs) and dairy may contribute to acne flare-ups by increasing insulin levels and promoting inflammation.
Focus on a diet rich in whole foods, including vegetables, fruits, lean proteins, and healthy fats. Omega-3 fatty acids, found in fish like salmon and flaxseeds, have been shown to reduce inflammation and improve acne.
A study from the Journal of the American Academy of Dermatology emphasized the importance of a low-glycemic diet in reducing acne severity. Avoiding processed foods, sugary snacks, and excessive dairy can help manage acne source.
Avoid foods that are known to trigger acne for some people, including:
- Sugary and Processed Foods
- Dairy (especially skim milk)
- Foods High in Saturated Fats
- Peanut/Peanut Butter
- Peanut Oil
- High Amount of Iodine
- Soy
You can also consider adding probiotics to your diet. There is emerging research that links gut health with skin health, suggesting that a healthy gut microbiome can reduce acne severity.
Rebuild Your Skin Barrier
Accutane can leave the skin dry and sensitive, so post-accutane care should focus on rebuilding the skin barrier. A compromised skin barrier can lead to further irritation and breakouts, especially when exposed to harsh skincare products. Use a gentle, non-comedogenic moisturizer and avoid overly drying cleansers or exfoliants.
Look for ingredients like:
- Ceramides: These help restore the skin’s natural barrier.
- Niacinamide: A form of vitamin B3, niacinamide can reduce inflammation, strengthen the skin barrier, and improve acne.
Manage Stress
Stress is a well-known acne trigger. Elevated cortisol levels, the body’s main stress hormone, can lead to increased oil production and inflammation.
An article from the Dermatology of Northwest Houston emphasizes that High levels of stress can affect your body physically, causing skin issues like acne to heal more slowly than normal. Managing stress through techniques such as mindfulness, yoga, and regular exercise can help keep acne under control source.
Consult your Local Skincare Provider If your acne persists despite trying lifestyle and skincare changes, it may be time to revisit a skin care provider. They can assess or suggest alternative therapies, such as laser treatments, chemical peels, or light therapy.
Conclusion: Breaking out again after Accutane?
After months of treatment from Accutane, just to break out again can be discouraging, especially when you’ve hoped for lasting results. However, it’s important to understand that treating acne often requires a multifaceted approach. Acne isn’t just a skin-deep issue; it can be influenced by hormones, diet, stress, and lifestyle.
Taking a holistic approach to post-Accutane care can not only help you achieve clearer skin but also improve your overall health and well-being. Remember, persistence is key, and with the right strategy, you can manage and reduce the chances of breakouts in the future.
For those struggling with persistent acne, consulting with a specialized acne clinic, like Face Five Acne, can provide personalized advice and treatment options. By considering all dietary factors and maintaining a holistic approach to skincare, achieving clear and healthy skin is within reach at Face Five Acne Clinic.
References
- American Osteopathic College of Dermatology. “Accutane.” https://www.aocd.org/page/accutane
- Zouboulis, C.C. (2010). “Isotretinoin Revisited: Pluripotent Effects on Human Sebaceous Gland Cells.” Journal of Clinical Investigation, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
- Dermatology Northwest Houston. “Does Stress Cause Acne?” https://www.dermatologynwhouston.com/does-stress-cause-acne/
- Face Five Acne Clinic. “About Face Five.” https://facefiveacne.com/
Yuki Stauffer, is a licensed Colorado Esthetician, Functional Nutrition Coach, Certified Acne Specialist, Preventive Health Instructor, and Medical Interpreter. Her Acne Solution Program offers personalized skincare, diet, and lifestyle guidance to empower clients in overcoming acne.
With expertise in skincare and a dedication to helping others, Yuki provides customized consultations and Face Five Skincare products, both in-office and online.