If you’ve been prescribed Roaccutane (isotretinoin) for severe acne, you’re probably wondering when you’ll start seeing results. The journey with this powerful medication is unique for everyone, but understanding the typical timeline can help set realistic expectations and keep you motivated through the treatment.

The Short Answer

Most people begin noticing improvements between 8 to 12 weeks, though significant clearing often takes 4 to 6 months. A complete course typically lasts 16 to 24 weeks, depending on your dosage and response to treatment.

What to Expect: A Week-by-Week Guide

Weeks 1-4: The Initial Phase

During the first month, you might not see much improvement in your acne. In fact, many people experience what’s called the “purge” or initial breakout, where acne temporarily worsens before it gets better. This happens because Roaccutane speeds up skin cell turnover, bringing underlying spots to the surface more quickly.

What you might notice:

Increased skin dryness, particularly on the lips and face
Possible initial flare-up of existing acne
Mild redness or sensitivity
Need to start using moisturiser regularly

Don’t be discouraged if your skin looks worse during this period. It’s a normal part of the process and indicates the medication is working at a deeper level.

Weeks 5-8: The Transition Period

By week 6 to 8, most people notice their skin beginning to settle. New breakouts may start to slow down, though you’ll likely still be dealing with existing spots and marks.

What you might notice:

Fewer new spots appearing
Existing acne beginning to heal
Increased dryness throughout the body
Possible dry eyes or nosebleeds
Skin becoming more sensitive to the sun

This is when maintaining a solid skincare routine becomes crucial. Gentle cleansing, regular moisturising, and daily SPF are essential.

Weeks 9-16: Visible Improvements

This is typically when the magic starts to happen. Most people see substantial clearing during this period, with a noticeable reduction in both the frequency and severity of breakouts.

What you might notice:

Significantly fewer breakouts
Smoother skin texture
Reduced oil production
Existing spots healing faster
Increased confidence as results become visible

Your dermatologist will monitor your progress during this time and may adjust your dosage based on how your skin responds and any side effects you’re experiencing.

Weeks 17-24: The Final Stretch

In the last phase of treatment, your skin continues to improve and stabilise. Many people achieve nearly complete clearance by the end of their course.

What you might notice:

Minimal to no new breakouts
Clear, smooth complexion
Reduced scarring visibility (though dedicated scar treatments may still be needed)
Continued dryness that will gradually improve after stopping treatment

Factors That Influence Timeline

Several factors can affect how quickly Roaccutane works for you:

Dosage: Higher cumulative doses often lead to better long-term results but may take longer to reach. Your dermatologist calculates the ideal cumulative dose based on your body weight.

Acne severity: Those with more severe acne may need longer treatment courses to achieve full clearance.

Individual response: Everyone’s body metabolises medication differently, which affects both efficacy and side effects.

Consistency: Taking your medication as prescribed, ideally with fatty foods to improve absorption, ensures optimal results.

Managing Expectations

It’s important to remember that Roaccutane is playing the long game. Whilst some treatments promise quick fixes, isotretinoin works to fundamentally change how your skin behaves, often providing lasting results after treatment ends.

The waiting period can feel frustrating, especially during the initial purge, but most people find the results well worth the patience. Studies show that approximately 85% of people who complete a full course experience long-term clearance or significant improvement.

When to Speak to Your Dermatologist

Whilst the timelines above are typical, you should contact your dermatologist if:

Your acne becomes significantly worse after the first 2 months
You experience severe side effects that affect your quality of life
You see no improvement whatsoever after 3 to 4 months
You have concerns about the emotional or physical side effects

Your dermatologist can adjust your treatment plan, provide additional support, or investigate whether other factors might be affecting your progress.

Life After Roaccutane

Once you’ve completed your course, your skin will continue to improve for several months as your sebaceous glands remain suppressed. The dryness and other side effects gradually subside, typically within a few weeks of finishing treatment.

For most people, the results are long-lasting. Some may experience a mild relapse and require a second course, but many enjoy clear skin for years or even permanently after treatment.