Alternatives to Accutane for Severe Acne Treatment

— BY Dr. Alexandra Smith | Reading Time: 4 min


When you have acne, your medicine cabinet tends to overflow with topical ointments, Instagram-endorsed elixirs, and an assortment of antibiotic medications. At times it feels like you’d try just about anything to get rid of stubborn whiteheads or inflamed blackheads for good. But Accutane? Those side effects seem a bit too harsh, even for severe acne treatment.

The truth is, Accutane side effects are incredibly harsh — to the point that some patients must enroll in a risk evaluation and safety program before they can receive their first dose. Before taking your chances with the potential life-threatening risks of Accutane, take a look at safer treatment alternatives that can help identify and solve the true source of your acne once and for all.

What is Accutane, and Why is It So Harsh?

Accutane is the brand name for the drug isotretinoin, a vitamin A derivative related to retinol and other retinoids used in skincare. It targets oil production, clogged pores, bacteria, and inflammation to treat severe acne that hasn’t responded to other treatments, such as antibiotics. Isotretinoin is also available to purchase under the names Absorica, Amnesteem, Claravis, Myorisan, and Sotret.

Since Accutane is a vitamin A derivative, your body will react to the drug much like it would to increased doses of vitamin A. While normal doses of vitamin A found in fresh fruits and vegetables are relatively harmless, higher doses can cause acute toxicity of the liver within as little as three months. Side effects of liver toxicity can include vertigo, muscle aches, and alopecia.

Vitamin A with Chemical formula

Once introduced to the body, Accutane can build up in the bloodstream over time. It can impact your central nervous system (CNS), with potential impacts that range from headaches to increased pressure on the brain, a life-threatening condition. There is a risk of serious mental health problems, including depression, psychosis, and suicidal thoughts. Studies have also linked Accutane to inflammatory bowel diseases like Crohn’s disease and ulcerative colitis (UC).

Accutane is fetotoxic, which means it can poison or cause degenerative effects in a developing fetus. Patients who experience a monthly period must be on some form of birth control while taking Accutane to avoid pregnancy, as the drug can cause miscarriage, premature birth, and severe birth defects. Patients must enroll in the iPLEDGE risk prevention program in the U.S. and Pregnancy Prevention Program® in Canada to confirm they are not pregnant to fill an Accutane prescription.

Potential Side Effects of Accutane Treatment

Accutane works to clear acne by reducing the amount of oil released by the oil glands in your skin. As a result, one of the most common side effects of Accutane treatment is incredibly dry skin and lips that may crack and bleed. While this side effect may fade within a few weeks after stopping Accutane, other more harmful side effects may be permanent. 

Known potential side effects of Accutane treatment include: 

  • Headache and fatigue
  • Joint and muscle pain 
  • Dry skin and chapped lips
  • Dry nasal passages and nose bleeds
  • Heightened sun sensitivity 
  • Faint yellowing of the skin
  • Fragile or peeling skin on the palms and soles
  • Mood changes, such as irritability or sadness
  • Dry eyes or trouble with eyesight  
  • Stomach and bowel pain
  • Heartburn or indigestion 
  • Nausea and vomiting
  • Lack of appetite 
  • Dark urine
  • Diarrhea

More severe side effects of Accutane treatment include:

  • Suicidal thoughts
  • Thinning hair or alopecia
  • Ringing in the ears or tinnitus 
  • Temporary or permanent hearing loss 
  • Reduced night vision
  • Rectal bleeding
  • Bleeding gums

Why is Accutane Still a Common Treatment Option?

With the above laundry list of potential side effects — some as severe as hearing loss or suicidal thoughts — it might seem impossible for Accutane to remain as common of an acne treatment. So, why is Accutane still so popular? The short answer is that some patients still have success with Accutane for severe acne, which makes it desirable despite the drastic side effects.

The long answer is that acne is often only looked at skin deep, when it is often much deeper than that. Accutane is considered a last-ditch effort once topical ointments and antibiotics are unsuccessful at clearing acne. However, when those treatments aren’t successful, it’s typically because the source of acne is not bacterial in nature.

How Does Naturopathic Acne Treatment Differ?

Acne is rarely skin deep. That’s why naturopaths look inside of your body to determine what’s causing acne from the source. Your practitioner will order diagnostic testing — including hormone and gastrointestinal testing — to better understand what’s happening beneath the surface of your skin. There are often four primary non-bacterial causes of severe facial and body acne.

  • Hormonal imbalances like too much or too little estrogen and testosterone can cause frequent breakouts as well as skin that’s overly dry or oily.
  • Blood sugar dysregulation caused by hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar) can put your oil glands into overdrive and clog skin. 
  • Gastrointestinal (GI) dysbiosis or when the bacteria in your stomach and intestines become unbalanced can also equate to imbalances in the skin.
  • Diet and lifestyle can contribute to the overall health of your skin, including eating foods high in processed sugar and fat or foods that are difficult for your body to digest.

Naturopathic acne treatment works to identify the root source of your acne and then eliminates triggers that can be causing skin troubles. For instance, if hormonal imbalances are to blame for severe acne, your naturopath can begin a regimen of supplements or nutraceuticals to support the structure and function of your hormone cycle, and implement diet and lifestyle modifications.

Is it Possible for Me to Have Clear Skin?

Yes, it is possible for you to have clear skin! All we need to do is figure out the true cause of your acne, and we can use targeted supplementation as well as diet and lifestyle modifications to address it. From removing foods that cause inflammation in your skin to supporting a healthy hormone cycle, there are tons of steps we can implement to achieve clear skin without harmful Accutane.

Keep you (and your skin) healthy.

Clear skin shouldn’t involve life-threatening side effects. Discover how a naturopathic doctor in Calgary can help eliminate acne and support a healthier, happier you.