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Accutane (Isotretinoin)

Isotretinoin (Accutane) is primarily used to treat bad cases of cystic acne, and to help the skin more rapidly renew itself. In addition, it is used in rare cases for certain skin cancers and skin diseases. It is a type of retinoid, which is naturally found in the body in small amounts. In the USA, it's a prescription drug, but it is sold over the counter without a prescription in many countries.

Bodybuilders who use anabolic steroids have utilized accutane to counteract the negative effects of steroids on their skin; especially, the acne related side effects.

isotretinoin chemical structure

Fig 1. Isotretinoin Chemical Structure

Table of Contents

What is acne and What causes it?

Acne is a chronic skin condition, which can manifest itself in black/whiteheads, greasy skin and pimples. Teenagers going through hormonal changes may experience reduced self esteem and anxiety due to these effects. Acne is most common during teenage years, as androgens and testosterone levels are increasing.

80% of the cases are genetic; however, there is some evidence that diet and lifestyle choices (especially smoking) will increase the severity of the condition.

Acne is most common on parts of the skin that have a lot of oil glands, such as the face, chest and back.

When natural treatments fail, accutane becomes the last resort to help combat acne issues.


Isotretinoin was developed by Hoffmann-La Roche in 1982, building on the discovery that vitamin A can inhibit sebum production at toxic dosages. Dr. Gary Peck received the inventor's award from the US Department of Commerce for his discovery of its use for treatment of cystic acne.

In Feb of 2002, Roche's patents expired and now there are other brand names for isotretinoin. Since there have been numerous medical lawsuits, in 2009 Roche decided to drop their Accutane brand in the USA. It is now sold under roaccutane outside of the US, and, within the US, there are different generic names through different companies.

roche accutane

Fig 2. Roche Accutane

How it Works

Accutane works as an isomer of Vitamin A, which reduces the amount of oil released by the oil glands in the skin; this will make it difficult for acne to form and reduce it significantly. Nearly all patients achieve clearing of acne during a course, with 90% reporting 'excellent' results with higher dosages. Those that choose to dose low will have results with diminished side effects, but run the risk of recurrence.


Since chances of acne are increased with anabolic steroid use, and bodybuilding requires looking good (especially physique competitors), many athletes who have failed to conquer their acne with natural remedies will turn to accutane.

It is the androgenic increases associated with steroids that will trigger increased acne. This is especially true for those genetically prone to the condition. Also, the hormonal changes can trigger acne as well, such as increased testosterone levels.

Side Effects

High doses of accutane will result in vitamin A toxicity, which will result in both permanent and temporary side effects.

Permanent and temporary side effects such as :

  • Stunted growth: The FDA, in 2010, stated the drug may stop bone growth in teenagers still growing.
  • Inflammatory bowel disease: Some studies have linked this drug to causing Crohn's disease.
  • Eye changes: Decreased night vision and dry eyes have been reported.
  • Other issues like skin problems, hyperostosis, and birth defects (in pregnant women) have been reported.
  • Psychological effects, particularly depression, seems to be a common, but that has yet to be proven in studies.
roaccutane roche

Fig 3. Roaccutane by Roche


Among bodybuilders, the dosage should be conservative. Once a day dose of 10-20mgs for 6-8 weeks maximum should work fine. Among the general public fighting acne, a dosage of 50-150mg per day may be prescribed by their physician. It is a good idea to take the drug with a large meal. In addition, it may be necessary to use multiple courses of treatment.


Want to read about Accutane on our forums? check out these threads:


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Written by
Steve Smi (Also known as Steve Smith), has over 12 years of experience in the bodybuilding and fitness industry. He's the co-Host of the popular Evolutionary Radio Podcast - over 500,000 listens! He has been a personal trainer and writer for the last 10 years with over 1000 articles written. He's been a moderator on forums for over 10 years. Steve holds the following certifications and records: NASM Personal Trainer NASM Fitness Nutrition Specialist Florida Local Powerlifting champion Top writer for 2019 Fitness rated

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