ULTIMATE ACCUTANE SURVIVAL GUIDE (Proven Studies To Get You Through)

Here is your ultimate Accutane survival guide backed up with reliable, proven scientific studies. Accutane is a tough treatment to undergo. You will definitely need to change products in your routine to cope. Your skin will become extremely dry, flaky, and sore. Your lips may crack back and trying to put makeup on is a nightmare. But with these tips and tricks, you will find it easier to deal with. Here is your ultimate Accutane survival guide backed up with reliable, proven scientific studies.

Why Do You Need to Change Your Routine When on Accutane?

Accutane interferes with the function of the sebaceous glands in the body. These are structures that secrete oil (1). It not only has an effect on the size of the gland, but also the amount of sebum (oil) that is produced. 

By reducing the production of oil throughout the body, Accutane directly inhibits one of the contributing factors to acne formation; When oil and dead skin cells clog hair follicles, this leads to an inflammatory infection, causing acne bumps. Through this steep reduction in oil production, your skin will be much less susceptible to clogged pores. However, you will experience extreme dryness and flaking, and it is often paired with cheilitis, or inflammation of the lips (1). Due to these changes in the body, your regular skin care products and habits, such as your moisturizer or how many times you cleanse the skin, will need to change to cope with these new effects. See below for top tips to help you through your Accutane journey.

1. No More Harsh Acne Treatments

Accutane is usually the last defense against stubborn, persistent, and/or severe acne. It is likely that you may be currently on a multitude of acne treatments already, such as benzoyl peroxide, salicylic acid, or retinoids. Due to the drying nature of these acne treatments, it is important that you scale back on their use once you begin your course of Accutane. They will only add more dryness and irritation to the skin, making your flaking worse, and impair your skin barrier (2). 

It has been shown that consistent use of barrier repairing ingredients strengthen the skin’s ability to fight against inflammation and dehydrated skin. Instead of harsh treatments, look at incorporating high quality skincare products to your routine to cushion the effects of Accutane. To note, high quality does not mean expensive. Your local drugstore is filled with products that incorporate skin-loving ingredients such as ceramides, niacinamide, and hyaluronic acid. 

  • Ceramides are a key component to the stratum corneum, or outer layer of the skin. Even one application of a cream containing ceramides was shown to increase skin hydration and decrease transepidermal water loss over a 24 hour period leading to an increase in skin barrier function (3). Try the CeraVe Moisturizing Cream. It is a tried and true fragrance-free moisturizer that includes ceramides and is great for sensitive skin. 
  • Niacinamide is a type of B vitamin that has shown incredible benefits to the skin when applied topically. Niacinamide repairs damaged skin cells and also interferes with the transport of pigment-forming structures, promoting lightening of pigmentation or dark spots on the skin (4). The most important characteristic of niacinamide is that it improves barrier function by increasing ceramides in the skin (5). This is a much needed ingredient in your skincare routine during your course of Accutane.
  • Hyaluronic acid (HA) is another star ingredient that prevents water loss from the skin. When applied topically, it can bind to water molecules and help the skin retain moisture (6). It is abundant in the dermis (tissue beneath the outer layer of the skin) and regulates water balance and stabilizes skin structures (6). It is thought to play a role in anti-aging by ensuring skin is moisturized. Try the Neutrogena Hydro Boost Hyaluronic Acid Serum. To note, it is very important to use a good moisturizer on top of serums containing HA. This will ensure that the water retained by the HA will stay on the skin, rather than evaporate into the air.  

2. Find a Gentle Cleanser and Gentle Body Wash

The plethora of cleansers on the market makes it a difficult choice as to what cleanser you should be using. Let’s narrow your options down. 

First, it is best to choose a fragrance-free cleanser. Fragrance in skincare can cause irritation, contact dermatitis, and allergic reactions (7). By choosing a fragrance-free cleanser, you reduce your chance of having dry and irritated skin, which is important when you are on Accutane. 

Next, find a cleanser that suits your skin’s needs, based on whether you have oily, dry, or combination skin. Since you are on Accutane, your skin condition will be dry and flaky. It’s best to choose a hydrating cleanser or a gentle foaming cleanser. 

Most importantly, look at the ingredients. Cleansers contain surfactants, which are cleansing agents that can be very harsh on the skin. Surfactants can stay in the stratum corneum, or outer layer of the skin, and disrupt the integrity of the skin barrier (8). The combination of a mild surfactant and biologically compatible skin lipids has been shown to reduce barrier damage when cleansing (9). Look for mild surfactants such as sodium cocoyl isethionate in combination with fatty acids such as stearic acid. Sodium N-cocoyl glycinate is another mild surfactant that not only foams into a creamy lather, but is less likely to impair skin barrier function (9). Stay away from cleansers containing sodium lauryl sulfate, as this is a harsh surfactant  that can cause irritation, redness, an increase in transepidermal water loss, and dryness (10). 

3. Say NO To Scrubs and Put Down The Loofah!

The use of facial scrubs, otherwise known as a type of physical exfoliation will only cause damage to the skin. Physical exfoliation involves the act of scrubbing your skin, either with a cloth, abrasive loofah, brush, or other equipment, or with a product that includes hard particles, such as walnut shells, sugar or sea salt. So, what’s the issue? The problem with physical exfoliators is that they do not provide uniform exfoliation of the skin. Often, certain areas of the face will be focused on more, thus leading to irritated skin. Depending on how abrasive the scrub is, you may also damage the skin, causing redness, inflammation, and increased dryness. During your course of Accutane, you do not want to further aggravate your skin. This will only cause more soreness, dryness and flaking. For the duration of your treatment, it is best to stay away from physical exfoliation and chemical exfoliation as well.

4. Fuel Your Body From The Inside Out

And so the saying goes, you are what you eat. There is definitely some truth to this. Since Accutane is notorious for drying out your skin, it is worth implementing foods in your diet that promote healthy, hydrated skin. 

Omega-3 Fatty Acids

The ingestion of oils that contain a high amount of omega-3 fatty acids has been shown to increase skin barrier function. For example, consumption of docosahexaenoic acid (DHA), a type of omega-3 fatty acid, decreased skin inflammation (11). Further, daily ingestion of flaxseed oil was shown to increase skin hydration, improve scaling of the skin, and reduce TEWL. Similar results were seen with consumption of hempseed oil, leading to a decrease in skin dryness (11). 

β-Carotene

β-Carotene is a type of vitamin A that is found in many foods including carrots, pumpkin, sweet potatoes and mangos. It has been shown to reduce redness in the skin caused by UV light, and thus exhibits photoprotective effects when administered orally (12). It may also play a role in reversing photoaging, although more research is needed on this subject (13). 

Vitamin E

Vitamin E is available in vegetables and oils, such as sunflower and safflower oil. It is an antioxidant that can prevent oxidative damage of cell membranes. It also helps reinforce collagen structures in the skin, which promotes anti-aging effects (14). It has also been shown to decrease the time it takes for wound healing when combined with zinc and vitamin C (15). Vitamin E is important for keeping your skin healthy and better able to cope with the harsh effects of Accutane. 

Probiotics

Although there isn’t a ton of research on the effects of probiotics on skin barrier function, it is worth mentioning. Oral supplementation with Lactobacillus plantarum has been shown to increase skin hydration and decrease TEWL (16). Also, consumption of Lactococcus lacti promoted an increase in skin hydration as well. In addition, oral administration of Lactobacillus reuteri in animals showed a decrease in inflammation surrounding the follicles in the skin, which may play a key role in reducing the formation of acne (17). These benefits are worth incorporating probiotics into your diet by eating foods such as yogurt, sauerkraut, and kimchi.

5. Nourish Your Hair 

Dry skin also means having a dry scalp. This can lead to weakened and damaged hair, which can affect hair growth and the overall appearance of the hair. To help mitigate these side effects, here are a couple of hair tips to abide by:

Use Fragrance-Free Gentle Shampoo

As mentioned earlier, fragrance in cosmetics can cause contact dermatitis and other irritating, allergic reactions on the skin, and this includes the scalp (18). It is best to choose a shampoo that is fragrance-free to reduce scalp irritation and itching. In addition, it is worth looking at the types of surfactant used in your shampoo. While anionic detergents, such as ingredients ending with lauryl sulfate or laureth sulfate, can thoroughly clean sebum and hair products from the hair, these are incredibly harsh on the scalp and hair itself (19). It is best to look for amphoteric detergents, such as cocamidopropyl betaine, which can be found in baby shampoos for example. 

Reduce Heat on Hair

Using heat on the hair, such as with a hair dryer, can lead to rough and dry hair (20). The outer layer of the hair shaft, known as the cuticle, was shown to develop cracks after being treated with heat (20). Thermal treatments have also been shown to degrade tryptophan in the hair, which is an amino acid that plays a role in pigmentation, therefore changing hair colour and increasing hair damage (21). To prevent hair damage, holding your blow dryer at a distance of 15 cm was shown to induce less hair damage (21). 

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Most importantly, be patient. Acne treatments take time to work, and being stressed over the timeline of improvement will only make things worse. And remember, relapsing after Accutane may happen and is okay. You will find a treatment that works for you.

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References

  1. Pile HD, Sadiq NM. Isotretinoin. [Updated 2021 May 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:  https://www.ncbi.nlm.nih.gov/books/NBK525949/?report=classic
  2. Del Rosso JQ. The role of the vehicle in combination acne therapy. Cutis. 2005 Aug;76(2 Suppl):15-8. PMID: 16164152. 
  3. Spada F, Barnes TM, Greive KA. Skin hydration is significantly increased by a cream formulated to mimic the skin’s own natural moisturizing systems. Clin Cosmet Investig Dermatol. 2018 Oct 15;11:491-497. doi: 10.2147/CCID.S177697. PMID: 30410378; PMCID: PMC6197824.
  4. Zhen AX, Piao MJ, Kang KA, Fernando PDSM, Kang HK, Koh YS, Yi JM, Hyun JW. Niacinamide Protects Skin Cells from Oxidative Stress Induced by Particulate Matter. Biomol Ther (Seoul). 2019 Jul 5;27(6):562-569. doi: 10.4062/biomolther.2019.061. Epub ahead of print. PMID: 31272139; PMCID: PMC6824628.
  5. Levin J, Momin SB. How much do we really know about our favorite cosmeceutical ingredients? J Clin Aesthet Dermatol. 2010 Feb;3(2):22-41. PMID: 20725560; PMCID: PMC2921764. 
  6. Papakonstantinou E, Roth M, Karakiulakis G. Hyaluronic acid: A key molecule in skin aging. Dermatoendocrinol. 2012 Jul 1;4(3):253-8. doi: 10.4161/derm.21923. PMID: 23467280; PMCID: PMC3583886.
  7. Panico A, Serio F, Bagordo F, Grassi T, Idolo A, DE Giorgi M, Guido M, Congedo M, DE Donno A. Skin safety and health prevention: an overview of chemicals in cosmetic products. J Prev Med Hyg. 2019 Mar 29;60(1):E50-E57. doi: 10.15167/2421-4248/jpmh2019.60.1.1080. PMID: 31041411; PMCID: PMC6477564. 
  8. Walters RM, Mao G, Gunn ET, Hornby S. Cleansing formulations that respect skin barrier integrity. Dermatol Res Pract. 2012;2012:495917. doi: 10.1155/2012/495917. Epub 2012 Aug 13. PMID: 22927835; PMCID: PMC3425021. 
  9. Regan J, Mollica LM, Ananthapadmanabhan KP. A Novel Glycinate-based Body Wash: Clinical Investigation Into Ultra-mildness, Effective Conditioning, and Improved Consumer Benefits. J Clin Aesthet Dermatol. 2013 Jun;6(6):23-30. PMID: 23882306; PMCID: PMC3718747. 
  10. Branco N, Lee I, Zhai H, Maibach HI. Long-term repetitive sodium lauryl sulfate-induced irritation of the skin: an in vivo study. Contact Dermatitis. 2005 Nov;53(5):278-84. doi: 10.1111/j.0105-1873.2005.00703.x. PMID: 16283906. 
  11. Parke MA, Perez-Sanchez A, Zamil DH, Katta R. Diet and Skin Barrier: The Role of Dietary Interventions on Skin Barrier Function. Dermatol Pract Concept. 2021 Jan 29;11(1):e2021132. doi: 10.5826/dpc.1101a132. PMID: 33614213; PMCID: PMC7875671. 
  12. Schagen SK, Zampeli VA, Makrantonaki E, Zouboulis CC. Discovering the link between nutrition and skin aging. Dermatoendocrinol. 2012 Jul 1;4(3):298-307. doi: 10.4161/derm.22876. PMID: 23467449; PMCID: PMC3583891.).
  13. Balić A, Mokos M. Do We Utilize Our Knowledge of the Skin Protective Effects of Carotenoids Enough? Antioxidants (Basel). 2019 Jul 31;8(8):259. doi: 10.3390/antiox8080259. PMID: 31370257; PMCID: PMC6719967. 
  14. Schagen SK, Zampeli VA, Makrantonaki E, Zouboulis CC. Discovering the link between nutrition and skin aging. Dermatoendocrinol. 2012 Jul 1;4(3):298-307. doi: 10.4161/derm.22876. PMID: 23467449; PMCID: PMC3583891. 
  15. Keen MA, Hassan I. Vitamin E in dermatology. Indian Dermatol Online J. 2016 Jul-Aug;7(4):311-5. doi: 10.4103/2229-5178.185494. PMID: 27559512; PMCID: PMC4976416. 
  16. Parke MA, Perez-Sanchez A, Zamil DH, Katta R. Diet and Skin Barrier: The Role of Dietary Interventions on Skin Barrier Function. Dermatol Pract Concept. 2021 Jan 29;11(1):e2021132. doi: 10.5826/dpc.1101a132. PMID: 33614213; PMCID: PMC7875671. 
  17. Kober MM, Bowe WP. The effect of probiotics on immune regulation, acne, and photoaging. Int J Womens Dermatol. 2015 Apr 6;1(2):85-89. doi: 10.1016/j.ijwd.2015.02.001. PMID: 28491964; PMCID: PMC5418745.
  18. Panico A, Serio F, Bagordo F, Grassi T, Idolo A, DE Giorgi M, Guido M, Congedo M, DE Donno A. Skin safety and health prevention: an overview of chemicals in cosmetic products. J Prev Med Hyg. 2019 Mar 29;60(1):E50-E57. doi: 10.15167/2421-4248/jpmh2019.60.1.1080. PMID: 31041411; PMCID: PMC6477564.
  19. Draelos ZD. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. 2010 Jan;2(1):24-9. doi: 10.4103/0974-7753.66909. PMID: 21188020; PMCID: PMC3002407. 
  20. Lee Y, Kim YD, Hyun HJ, Pi LQ, Jin X, Lee WS. Hair shaft damage from heat and drying time of hair dryer. Ann Dermatol. 2011 Nov;23(4):455-62. doi: 10.5021/ad.2011.23.4.455. Epub 2011 Nov 3. PMID: 22148012; PMCID: PMC3229938. 
  21. Gavazzoni Dias MF. Hair cosmetics: an overview. Int J Trichology. 2015 Jan-Mar;7(1):2-15. doi: 10.4103/0974-7753.153450. PMID: 25878443; PMCID: PMC4387693. 

 

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