Accutane (its generic name is isotretinoin) is a drug derived from vitamin A, and it is taken orally. It essentially stops the oil production in your sebaceous glands (the oil-producing structures of the skin) and literally shrinks these glands to the size of a baby’s. This prevents sebum (oil) from clogging the hair follicle, mixing with dead skin cells, rupturing the follicle wall, and creating pimples or cysts. Normal oil production resumes when treatment is completed and the sebaceous glands slowly begin to grow larger again, but never (or at least rarely) as large as they were before treatment.
“Because of its relatively rapid onset of action and its high efficacy with reducing more than 90% of the most severe inflammatory lesions, Accutane has a role as an effective treatment in patients with severe acne that is recalcitrant to other therapies” (Source: Journal of the American Academy of Dermatology, November 2001, Supplemental, pages 188-194).
In a large percentage of patients who complete a four – to six-month treatment with Accutane, acne is no longer considered to be clinically significant, though almost one-fifth of patients can have a recurrence of acne within the first two years (Source: Journal of Drugs in Dermatology, October 2008, pages 963-966). But generally the recurrence is milder than before treatment. Of course, a percentage of people still receive no benefit from taking Accutane, no matter how many treatments they take.
By the way, while dosage and duration depend on the severity of the patient’s acne, the treatments generally last 16 weeks. If a second treatment is necessary, an eight-week rest period is required between treatments. Interestingly, acne continues to improve even after the course of treatment is completed, although doctors do not know exactly why.
“[Accutane] is the treatment of choice for severe nodulocystic acne. It represents the sole agent that effectively addresses all of the pathophysiological factors in the production of acne” (Source: Seminars in Cutaneous Medical Surgery, September 2001, pages 162-165).