Do you really have to get worse to get better?

One of the biggest misconceptions about Accutane is the belief by many that everyone who takes it will almost certainly suffer through the dreaded “Accutane purge.”

Acne sufferers are so fearful of the “purge” that they delay or even refuse to consider Accutane as a treatment option.  Even those who are severely affected by their acne often express their hesitancy over using Accutane because they are concerned about the possibility of getting even worse from the “purge.”

But is it true that the “Accutane purge” is unavoidable?  Do you really have to get worse in order to finally get better?

The short answer is “no!”  There is no medical reason that an acne sufferer should have to suffer even more in order to make it to the other side.

Myths About the Accutane Purge

Of the different reasons given for the “Accutane purge,” it is commonly suggested that the pimples hiding beneath the skin have to be “purged” to the surface in order to be expelled before acne can begin to heal.  This false belief has become a universal expectation of acne sufferers around the globe.

However, as I explained in a prior blog post, the real reason for the so called “Accutane purge” is not known.  It likely has to do with the way Accutane affects acne-prone pores that causes acne to get worse.  So it is more appropriate to refer to the worsening of acne caused by Accutane as an acne “flare” rather than an acne “purge.”

Nevertheless, in keeping with the theme of our discussion, the “purge” usually takes place within the first few weeks of starting Accutane but sometimes can occur a little later but usually within the first two months of treatment.

Who is at risk of experiencing the Accutane purge?

So is every acne sufferer doomed to suffer through the so called “Accutane purge?”

The answer is that not everyone who takes Accutane is at risk of developing a “purge.”  At the Advanced Acne Institute we find that approximately 24% of patients treated with Accutane are at risk of experiencing an acne flare in the beginning of treatment. The majority of patients do not experience a “purge.”

Also, the way that Accutane is used can influence the risk of developing an “Accutane purge.”  For example, the starting dose of Accutane can influence the chances of a “purge.”  For this reason, most dermatologists will go slowly at first with a low dose of Accutane in the first month of treatment and then increase the dose later on.  Depending on the circumstances, the starting dose can differ between patients and is also dependent on the patient’s weight.

Close monitoring during the first weeks of Accutane treatment is also very important in order to watch for signs of a “purge” and use appropriate interventions to limit or prevent worsening.  For example, an acne treatment specialist may alter the initial Accutane regimen or implement a reduction of the starting dose in an attempt to limit or reverse signs of an early acne flare.

Infrequently, depending on individual circumstances, the use of an additional anti-inflammatory medicine may become necessary to calm the inflammation if a significant “Accutane purge” occurs.

At the Advanced Acne Institute, we use a combination of a cautious starting regimen and careful monitoring in the beginning of treatment in an attempt to identify early evidence of an “Accutane purge” in order to take early steps to prevent it from fully developing.

Our proactive approach has been a very helpful strategy for managing and limiting the risk of developing a full-blown “Accutane purge.”

While there is no guaranteed method to completely prevent a “purge” from taking place, careful monitoring during the first few weeks of Accutane treatment together with early intervention if signs of an acne flare are observed can help to significantly limit the extent of a “purge” as well as provide helpful reassurance to calm a patient’s anxiety over the possibility of developing an initial period of increased acne breakouts.

In conclusion, the “Accutane purge” is often misunderstood and can be a source of significant anxiety for acne sufferers and can even prevent the consideration of Accutane as a potential treatment option. Having a better understanding and clearing up misconceptions of the “Accutane purge” is important when weighing the pros and cons and risks and benefits of Accutane treatment.

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.

Contact Us
Call Us Text Us
Skip to content