Accutane was a brand name for an oral, anti-acne medication that is no longer being prescribed, but the active ingredient in it (isotretinoin) is now available as a generic. Accutane/isotretinoin has the potential to cure acne or at the very least make it go away for awhile. Once a round of isotretinoin is done, the acne may still return; however, if it does, it is rarely as bad as before.

Regrettably, isotretinoin is a difficult drug. There are lots of serious side effects such as elevated cholesterol, liver problems, loss of hair, unbelievably dry skin, birth defects if you get pregnant while taking it, depression (though that side effect is controversial), headaches, bloody nose, and on and on. But for me, my acne was even more difficult than all of those health risks, which is why, once I was fully informed about the risks, I still opted to take this medicine to help my acne.

Prior to Accutane, every morning for me was a living nightmare of having to look in the mirror to see what had happened to it overnight. It was agonizing and it was rarely good news. And then during the day I could feel eruptions developing as I touched my face or felt the small throbs where swollen bumps were growing. I even hated the word “pimple.” I found it embarrassing and insulting. I am sure anyone struggling with acne knows just how I felt, and how strong the desire for clear skin becomes.

When I finally decided to try Accutane it was with utter abandon. I would do anything to not have this struggle of seeing red, inflamed, white dotted lesions on my face.

When I started my prescription I noticed a difference within the first week. I’ll never forget the moment when I touched my face and felt nothing that I was so used to feeling. All I could feel was smooth skin! Much to my continued surprise, it remained that way for weeks. I had some of the side effects I was told about, including bloody nose, dry lips, and headaches. No one tested for liver function and cholesterol levels in those days and I was beyond getting pregnant so there is much I don’t know for what did or didn’t go wrong for me internally. What I do know is that it was the first time in my life since the age of 11 that I liked looking at myself in the mirror.

At the three month point I started experiencing hair loss and that freaked me out. As a result, I stopped taking the drug and, as expected, the hair loss stopped. The trade-off for stopping too soon to save my hair was my acne came back about two months later. I did a great deal of research and found that the dosage and timing was a big deal. A lower dose taken over a longer period of time seemed to be far better. I discussed this with a new physician and started another cycle of Accutane. Thankfully, it went much better the second time around.

Today, almost 17 years later, I still struggle with breakouts but nothing like I did before Accutane. I sometimes think I should have taken another treatment cycle but never did, not because of the risks, it was just that I never got around to it and I was happy enough with the results two rounds of Accutane provided.

Given everything known about isotretinoin/Accutane my only personal regret is that I waited so long to take it. I can only guess what my mornings would have been like in my 20s and early 30s had I taken the drug back then, and not wasted so much time and money on irritant-laden products that made matters worse not better. Like many of you, I just didn’t know any better and just kept buying product after product hoping something would work.

Everyone has to weigh the pros and cons of many things they do in life; for me, Accutane was a no-brainer. Whether you feel the same way is a decision only you can make, but if you decide to take isotretinoin, be certain you’re fully informed of the risks, particularly if you’re a woman of childbearing age.

A few months back headlines in the British news mentioned that an ad for mascara in a popular fashion magazine wasn’t a picture of the model wearing the advertised mascara but, horrors of horrors, she was really wearing false eyelashes. When a U.S. reporter called to ask for my opinion about this revelation my immediate reaction was, you’ve got to be kidding. I thought this can’t be the first time anyone noticed this! In the 30 years I’ve been part of the cosmetics industry I’m fairly certain I have never seen an ad for mascara where the model wasn’t wearing false eyelashes (at least individual false lashes, meticulously placed).

What I found jaw-dropping is that these reporters and editors thought this was newsworthy. How can this possibly be considered news of any kind? Have these reporters (all women) never really looked at an ad for a cosmetic that closely before? Are we so easily fooled by something this obvious? Talk about missing the elephant in the room! Next thing you know the news will be reporting on the revelation that pictures in magazines are extensively retouched via sophisticated computer programs or that the makeup on the model is rarely, if ever, the product or products being advertised. And any model over age 35 without a trace of visible wrinkles? Give me a break!

Respectfully, I know that on some level we know these ads are phony, but the desire to believe otherwise, to want the fantasy that a mere purchase of a mascara, foundation, or anti-wrinkle cream can truly alter our everyday appearance to the sublime is overwhelming for most women. That’s where our hope turns us into gullible, susceptible innocents at the mercy of the cosmetics industry. We’re ready to believe whatever they tell or show us. And don’t think you aren’t influenced, because you are. Those ads generate humongous sales or companies wouldn’t endlessly spend millions of dollars every month on myriad ads in major fashion magazines and on television to get your attention.

If you want to avoid getting sucked in the next time you pick up a fashion magazine or see an ad on television, here are the basics to remember:

1. Models and celebrities in fashion advertising are already gorgeous, with perfect skin and features. They can be enhanced but they started out with the bar already set above us mere mortals. Every model has been further transformed by talented makeup artists, hairstylists, stylists, and lighting experts.
2. Even after all the coifing, styling, makeup, posing, and the thousands of pictures taken so the best one can be selected, the picture is still extensively touched up to remove or drastically soften any flaws. I’ll never forget the time a model told me that she doesn’t look as good in real life as she does in pictures.
3. The women in hair dye ads do not get that color from the dye being advertised. Those highlights and flowing tresses took experts a great deal of time to achieve. The look was accomplished in a salon after hours of processing and styling, not in the model’s bathroom!
4. The women in the ads for shampoos and conditioners did not get their hair to look that way because of any shampoo or conditioner. It took lots of highlights, blow drying, flat ironing, curlers, styling products, and on and on to achieve the look that finally gets photographed for the ad.
5. Regardless of the claims asserted and the claims about what studies show, if it sounds too good to be true, it isn’t true. All cosmetic companies hire labs to create studies that prove their claims. My favorite example is ProActiv. Their results are stilted and embellished. The research on acne treatment does not support what they claim is true for their products (even Jessica Simpson on her own reality show said Accutane is what cured her acne!).
6. Wrinkle creams don’t replace plastic surgery, Botox, dermal injections, lasers, or light treatments, regardless of the name brand or who is selling the product (and it’s often a doctor who performs the real deal procedures, which is incredibly disingenuous).

There are many products out there that can make a noticeable difference in your appearance. But trying to live up to the images used to sell these products—expecting your results will be the same—is the stuff dreams are made of!