A simple zit often just seems like an inconvenience, until that zit turns into deep cystic acne, destroying your self-confidence like an insecure prom queen. Odds are, if you’ve struggled with acne like this, then you are familiar with the miracle medication Accutane. Accutane is very much a last resort, when every acne cream, wash, or pill cannot seem to eradicate those breakouts. In cases such as these, when a patient cannot achieve their desired complexion, their dermatologists may finally suggest the wonder drug. But how does it work?

Accutane, also known as isotretinoin, belongs to a family of retinoids, which derive your body of Vitamin A. Deriving the body of Vitamin A decreases the size of your sebaceous glands, giving your skin a chance to renew itself and start removing old cells that haven’t been treated yet. This not only removes the bacteria from your skin, but decreases your chance of getting white and blackheads. Several doses are taken regularly by mouth over a course of (on average) six to eight months . Most patients notice that their acne will get worse at first, because all those backed up cells and bacteria come to the surface in order to detox the skin. The pimples don’t necessarily increase in number, they just seem to become more painful and red. But don’t let this discourage you, because overtime your skin will fully replenish and the scarring will gradually begin to fade, leaving a gorgeous face with an even-toned glow.

But there are still many, many side effects and sacrifices that are made when you decide to go on Accutane. One of the more serious ones is the risk of birth defects. If a woman becomes pregnant while on Accutane, the baby may be born with possible heart and facial defects, like cleft palates or congenital heart disease, intellectual disabilities, or even an underdeveloped central nervous system. Because of this, female patients must take a monthly pregnancy test before and after beginning their Accutane doses. Skin also becomes very dry and sensitive, due to the lack of vitamin A in your bodies system. Oil production in your skin pretty much comes to a halt, leading to cracked and peeling skin, lips, eyes, thinning hair and sometimes even nosebleeds. There have also been a history of psychological effects, demonstrated by personality changes, irritability, or depression, though Accutane cases such as these have been rare.

But despite the risks mentioned, Accutane is a God-send. Once you reach the end of your treatment, the results will blow you away. Your blemishes will disappear right before your eyes, and they won’t be back. Accutane is truly acne’s worst enemy; it will rescue you from a lifetime of insecurity.