Does Isotretinoin give lasting results for acne?

Question

Hello doctor,

I am 32 and have been dealing with persistent acne and pigmentation on my cheeks for almost three years. My recent hormone report showed slightly high testosterone levels, and my dermatologist suggested starting Tretinoin cream along with chemical peels. I am worried about the skin purging phase and possible irritation.

Are there better alternatives for sensitive skin that work gradually?
Do oral options like Isotretinoin provide longer-lasting results, and how safe are they for liver health?
Can diet changes or supplements like zinc and omega-3s make a real difference in improving acne and hyperpigmentation control?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Tretinoin (topical retinoid for acne and pigmentation) is very effective but can be harsh, especially on sensitive skin. Better alternatives include:

Adapalene is a similar but often less irritating retinoid available over-the-counter or by prescription.
Azelaic Acid is excellent for both acne and pigmentation, and very well-tolerated.
Low-strength formulas starting with a low concentration of Tretinoin and using it every other night can reduce purging and irritation.

However, please consult a dermatologist before starting any of these.

Oral Isotretinoin is the closest thing to a permanent cure for many people and offers long-lasting results. It is safe for the liver in most patients when monitored with regular blood tests (LFTs – liver function tests).

The main concerns include severe dryness and the well-known risk of birth defects, requiring strict contraception.

Diet and supplements also play a supportive role. Evidence shows that reducing dairy and high-sugar foods may help some individuals.

Supplements like zinc have good evidence for reducing inflammation and acne, while Omega-3 may also help by lowering inflammation. These support treatment but do not replace it.

If you follow the suggested instructions, you should get relief. However, I strongly advise discussing your treatment plan with your dermatologist in person for clarification.

I hope this helps.

Thank you.