I've been accepted for Roaccutane. Would I be foolish to turn it down?

[RoseandBubbles]

I am mid forties and have suffered with acne since puberty. During my teens and twenties it was largely controlled by Dianette. In my first pregnancy I had great skin, not so lucky second time around.

I'm very fair. My skin is oily but dry. My skin marks incredibly easily and the redness/scarring bothers me as much as the acne which can be painful at times. Until a few years ago it was largely confined to my chin/around my mouth, but in the past few years I've developed Rosacea across my cheeks. It's mainly just red and bumpy, I don't tend to get pustules and some days it is more visible than others.

Towards the end of last year/beginning of 2026 I was desperate to try Roaccutane. I had my Dermatology appointment last week and would have been prescribed it had I been taking contraception (we use condoms whilst my DH is waiting for a vasectomy). So I was sent away to get some contraception and then will be given another appointment. In the meantime I've been on Lymecycline for a month (previously used 10 years ago, worked well at first then effectiveness dwindled) and Skinoren which I've also previously used.

I don't know if I want to try Roaccutane anymore. The dermatologist said my issues are almost certainly hormonal (I agree) and in which case when I go through menopause I would most likely need Spironolactone to manage my acne.
I'm not sure if all the trade offs are worth it. There are no guarantees it will work for me and if it does, it might only be for a limited time. I wear contact lenses and was told I wouldn't be able to wear them anymore. My contact lenses are hugely important to me. It wasn't fun having acne, braces and glasses as a teen so lenses made a huge difference. I know I will dry out like a crisp and night driving will likely be an issue for me. I already avoid it unless I need to.

But then there's the thought of what if. What if it does work and the side effects aren't bad for me? From posts I've read on here some people just seem to need to use lip balm more regularly. If you were me, what would you do?

My sister took it and it changed her life. No reason why you cant try it and if you dont like the side effects you can always come off it.
My eyes are so dry naturally I cant wear lenses. I just choose attractive frames that suit my face and if its a special occasion I walk around blind and hope I dont fall down the stairs 😄

I had it decades ago when I was 21, I’m now 52. The dryness was perfectly manageable. I mainly just used Vaseline as a moisturiser and that was it. I do have severe dry eyes but no idea if it’s related or just another joyous part of aging. You could decide against it and then end up with dry eyes and not able to wear your lenses anyway. I have no regrets I found it truly a miracle drug

I had it for a year (in my 40s) - was great ! And I wore my contact lenses no problem

I have been in a fairly similar boat (my skin sounds much like yours although my main problem now seems to be - I think - spots caused by folliculitis), although I haven't got as far as actually asking for Roaccutane.

At my worst times I'd have bitten your hand off for it BUT currently I'm managing things with Soolantra (I bought it online but my GP will prescribe it for me now that my derm has written to ask them to), Inkey List Oat Cleansing Balm, intermittent Hibiscrub washes, niacinamide and LRP moisturiser. My face is pretty clear at the mo - my spots appear on the side of my neck - so I'm just sort of managing it but I completely understand how you feel and I wish I could give you the answer!

I had really bad adult acne in my 30s
mostly on my neck and chin area
it was awful & with a client facing job, acne wrecked my confidence. I just wanted to hide away, I was so miserable.
roaccutane worked where nothing else did
A last resort
my skin cleared up and has been good ever since - now 45
I coped with the dry skin ok - lanolin nipple cream is an excellent moisturiser for cracked lips, dry skin
I didn’t finish my course because my skin responded quickly

I took it 6 years ago, at 45. Really changed my life.

Just remember the sunscreen.

I took it and it changed my life for the better.

I have never been more confident.

Sunscreen is a MUST...

I had nosebleeds every day in the shower and became anaemic.

I took it when I was 17/18 and I've very rarely had a spot since.

Seeing as you also have rosacea, I would absolutely try Metronidazole first. Worked for me.

I had it in my early 30s and can not recommend it enough! Some of the side effects are a pain dry lips, stiff joints on a morning) others are fab (my normal greasy hair was perfect and didn’t need washing as much!).
I’m entering my 40s now and hormonal spots are back but nothing like I was before Roaccutane.

Oh and just to add I still wore my contact lens without issue. I bought drops to prepare myself but didn’t need them.

Please do your research fully on this drug. The GP tried to prescribe me this and I was mortified when I looked into it. I’m now using CBD ointment that’s worked wonders for me. It’s completely personal choice of course and I’m sure for some it’s had amazing results.

I had similar issues to you. Oily skin, fair, scarring and pigment marks after acne as much as an issue as the acne. Struggled with acne throughout my adult life, for periods AHAs and retinol helped a bit.

During the pandemic it got much worse - I do get pustules. I went to a dermatologist fully expecting to be proscribed roaccutane, and he said: you have rosacea. I was skeptical, I didn't get the redness, didn't believe it could cause the deep large pustules I experienced.

He asked about what was going on, when he found out I was working from home in a cold room heated with air heaters, and that I'd spent a long time settling my son at nursery wearing face masks for hours he explained that circumstantial stuff, and stress (my job was massively impacted by the pandemic) made it all flare up.

he suggested soolantra, finecea, oral antibiotics. I said I wasn't sure about the anti-biotics - I've been on them too much and have IBS as a result (and I believe excessive antibiotics as a child and teenager has likely disrupted my gut microbiome and made my skin worse.

Anyway, he said: start with soolantra and fineaca and see how you do.

OMG is has been life changing. Cleared up my skin within 4 weeks. The acne scars are also much improved. That was four years ago and I've not looked back. I only ever saw the dermatologist once - my GP is happy for me to have soolantra and fineaca on prescription, though occasionally I buy extra from a private pharmacy to make sure I always have some in hand (and I go through the soolantra faster).

I have to find a good cleanser (I like the yellow byoma one or Beauty Pie happy face). I occasionally use an acid cleanser or gentle retinol (less that once a week). I've realised I was using those things too much and it was making my rosacea worse not better.

Soolantra is the game changer for me. I use it at night, every other night like clockwork. The off night I usually use fineaca, sometimes something else like a gentle retinol or a moisurizer (if my skin is feeling dry).

I wish I'd sought help from a dermatologist years ago. I regret how much of my adult life I have spent feeling self conscious about and trying to manage or over up my bad skin - though I am glad now I've not had roccutane.

I'm grateful now for the oily skin - I am nearly 50 and look much younger despite my natural fairness. And I guess learning about skincare made me understand the importance of SPF early and I've worn it daily in all seasons since my 20s, which is now paying off.

I have dry eyes too, and already struggle with too bright sunlight (I've read that can be a feature of rosacea) and also night vision.

Have you tried the soolantra finaeca alternating nightly? If not I suggest you ask to try that first, and give it a good three months, and then see where you are?

Good luck!

I'm currently taking it, here's the thread I started when I began it:
https://www.mumsnet.com/talk/style_and_beauty/5364144-ive-just-started-roaccutane

My acne isn't hormonal, but certainly worsens at my totm...Like you I have oily but dry skin, a little rosacea and also a history of dry eyes.

I've increased my dose twice, now taking 40mg per day - my skin looks amazing!

The dryness is a bugger, but I've found a routine which works for me and I'm managing it really well. I'm continuing it for the foreseeable, if I miss a few doses both my rosacea kicks in again and acne returns a bit but certainly the acne is improving each time.

I also use intensive eyedrops for my eyes but don't need them nearly as much as I'd expected.

Honestly I wish I'd done this years ago. If it doesn't work for you, you can stop.

Soolantra's also been very effective for me @CatsRock . I have heard of Fineaca though, what does that do?

I do similar to you - retinol around three times a week and either Vit C or glycolic acid once a week too. I like Beauty Pie Japan fusion or Curel foaming wash (very gentle).

Got it for my daughter for acne after a consultation with a private dermatologist and then i saw something about the side effects on the internet (periods and reporoductive health). i discussed it with the consultant and have decided daughter won't take it unless it is the absolute last resort. Amazing drug but I think you need to be aware of the side effects.

Have you tried tretinoin? I had similar acne + glasses and Dianette was a miracle for me. Pregnancy helped (2 boys) but in between was rough.
I'm peri now and use tret and niacinaminde through skin and me and very happy with my skin. My DSis tried roaccutane a few years back and couldn't tolerate (liver function). She's on tret now. Worth a try if you haven't?

Was a game-changer for my teen (in a good way). Did cause dry skin so she was glad when the time came to stop but by that time it had made a huge difference to her skin (and confidence)

Roaccutane can be prescribed as a longer lower dose course if you are worried about side effects. I've had it a few times over the last 30 years (I'm unlucky in that my acne always comes back) and have tolerated it better than long term antibiotics.

Roaccutane was life changing for me. My acne was hormonal but it’s sorted me right out. It’s been 10+ years and I started to get the odd spot on my chin again on my period a couple of years ago, but tret is managing it now. I’d put my children on it in a heart beat if they start suffering with it.

And just to say I requested to reduce the dose to a longer period of time and the side effects became much more manageable.

My son took it and it was brilliant. No side effects at all.

You need people to keep a very close eye on you from a mental health perspective. The physical symptoms were fine. I look back now and realise mentally it was very bad. But I had no. As in zero.

I resorted to it in my 30s. Game changer. I had terrible cystic acne. I still get some acne in late 40s, but nothing like. Don’t recall any side effects other than dry skin/ lips

I have been wondering about Soolantra and it's probably why I'm so hesitant about Roaccutane. I don't know a great deal about Soolantra but I have seen images that people have shared and their results look very impressive.
I fear I have oversteered things by saying I wanted to try Roaccutane to my GP who then referred to me Dermatology who haven't questioned it and I'm now on this path.

I had roaccutane in my 20s and wore contact lenses. No issues. Amazingly though I did take it at the same time as a 3 month backpacking trip around central America which is - in an ideal world - the best thing you can do on this drug! So humid there so you don't suffer so much from dryness. Anyway it fixed my problems.

If there's an issue with using it due to contraception, I recommend finding a Catholic hospital. My hospital were happy to give me it provided I did a pregnancy test; I can't take hormonal contraceptive as they give me crazy side effects. Plus I was early 20s and had no intention of having a baby.