“Always” is a strong word whenever we refer to the effectiveness of any medication including Accutane.  However, that doesn’t mean that we can’t still describe Accutane as “the most effective treatment for acne in the world.”  This label sounds so impressive and understandably creates the expectation that Accutane just can’t fail.

The reality is, however, that there will always be a proportion of acne sufferers that do not respond favorably to treatment with Accutane.  The good news is that the vast majority of those treated with Accutane achieve successful results.

Estimates of Accutane’s effectiveness rate the percent of success up to approximately 85% of all acne sufferers treated.  But that’s just an estimate.  It’s very difficult to state with any certainty what the true figure is.

Effectiveness of Accutane depends on real-world circumstances

There are a number of reasons why it’s so difficult to calculate a definitive number for Accutane’s real world efficacy.

For one, Accutane is not always prescribed in the same exact way.  Some dermatologists prescribe a low dose of Accutane while others prescribe a higher dose.  Also, some dermatologists treat for a short duration with a smaller cumulative dose while others prefer to treat for a longer duration to result in a higher cumulative dose.

These factors alone can affect the response to Accutane and the likelihood of experiencing a return of acne.  For example, a lower dose regimen and a lower cumulative dose of Accutane correlate in some reports with a higher rate of relapse.

Another factor that can influence Accutane effectiveness is the age of the patient under treatment.  It seems that younger patients tend to be at greater risk of experiencing a relapse of their acne after completing a course of Accutane than that experienced by older patients.

Also, males tend to be at greater risk of relapsing than female patients although this is not so straightforward and can be highly dependent on underlying circumstances such as hormonal factors for one.

Additional factors can further influence the effectiveness of Accutane.  For example, some dermatologists treat a variety of acne types with Accutane while others only treat severe, cystic acne which can be more challenging and often require higher doses and longer treatment durations.

Also, the body location can play a role in the treatment success rate.  Acne breakouts on the trunk, for example, especially in males, can be more difficult to treat than acne on the face.  Body acne also tends to have a greater relapse rate.

Some cases of acne are more resistant to treatment

Complicating things even further is the fact that some cases of acne are related to underlying medical conditions often making them more difficult to treat. Polycystic Ovary Syndrome (PCOS), for example, is a medical condition in some female acne sufferers that is associated with abnormal hormone patterns that can make acne breakouts more resistant to treatment and more likely to return after treatment.

Yet another factor that has been suggested to make acne less responsive to treatment is that acne that has been very long-standing may be more resistant to Accutane treatment than acne breakouts that are more recent, although this has not been definitively supported.

The “Accutane purge”

Some acne sufferers may have a predisposition to experience a flare of their acne at the start of Accutane treatment.  This early worsening is often referred to as the “Accutane purge” and is   often described by acne sufferers as a drawback to considering Accutane therapy.

This period of worsening can be very frustrating and uncomfortable.  Estimates of the risk for this unwanted occurrence range from as low as 6% to over 40% of patients.  At the Advanced Acne Institute we note that approximately 24% of acne sufferers experience an initial acne flare when starting Accutane.

Many of those who are affected by this initial worsening of their acne experience a very mild increase in pimples such that it is not very noticeable and does not affect the treatment course.    Some, however, experience a more obvious flare of their breakouts and require close monitoring to make sure that the increased breakouts do not progress and become more severe.

Others, however, experience a very severe acne flare that can require Accutane treatment to be suspended until the flare subsides.  Sometimes other interventions are necessary to lessen the flare before resuming treatment.  Rarely, patients who experience very severe worsening are not able to continue treatment with Accutane.

Conclusion

Taken together, these considerations underscore the difficulty in determining a universal rate of success of Accutane treatment and can depend on the individual circumstances of each patient.

Overall, however, the vast majority of those treated with Accutane achieve a successful outcome supporting the continued labeling of Accutane’s as “the most effective treatment for acne in the world.”

The Advanced Acne Institute is a unique dermatology practice located in Miami, Florida specializing only in the treatment of acne.   We focus solely on providing the most effective treatments to help our patients achieve clear skin.  We are pleased to share our insights and perspectives in acne treatment as an educational service, however this information is provided strictly for educational purposes only and should not be considered medical advice and is not a substitute for seeking the advice and treatment by an appropriate medical professional