If you’ve ever struggled with stubborn pimples or painful cystic acne, chances are you’ve come across Accutane as a potential treatment option. And while you’re probably well aware that it can help clear up persistent breakouts, the popular prescription medication is rumored to have another, unexpected side effect: “shrinking” your nose.
Yes, you did read that right. And there are photos on social media which seem to confirm this phenomenon. In a viral video with more than 9 million views, for example, one TikToker insists Accutane delivered a “nose job in [her] sleep” and presents a teenage selfie as evidence. (Though to be fair, she also admits she didn’t know how to use makeup to contour her face back then.)
Dermatologists we spoke to said that these claims are, at best, exaggerated and, to be honest, BS.
First, what is the Accutane treatment?
Just in case you don’t already know, Accutane (or isotretinoin) is a super potent oral retinoid meant to improve severe and persistent acne. It’s usually a last-resort option for folks who haven’t responded to other less aggressive treatments like antibiotics or prescription-strength topical solutions, such as benzoyl peroxide or salicylic acid.
Acne is a complex condition (which is why it’s so hard to treat). In essence, Accutane works by reducing excess sebum, a thick, oily substance naturally produced by your skin’s sebaceous glands (found underneath your hair follicles). Ife R. Rodney, MD is a board-certified dermatologist in Maryland and the founder of Eternal Dermatology. She tells SELF how too much sebum can clog up your pores, causing breakouts.
“As a result, [Accutane is] a great and pretty popular option for treating persistent acne and minimizing redness or inflammation,” Dr. Rodney says. But like any prescription medication, it comes with the risk of unpleasant (and for some, intolerable) side effects—which we’ll get into in a minute.
Does Accutane shrink the nose?
No. Let’s backtrack to the drug’s ability to reduce sebum production. Your nose is home to a large number of sebaceous cells. (Yep, we’re talking about those teeny-tiny holes you’ve probably squeezed at.) Because of Accutane’s oil-minimizing effect, your skin might become less congested or greasy-feeling after taking it, Joshua Zeichner, MD, the director of cosmetic and clinical research at Mount Sinai Hospital’s Department of Dermatology in New York City, tells SELF.
“By decreasing oil production, Accutane will shrink the glands themselves—including the ones on your nose. That’s why this area tends to show a great level of improvement when taking the medication,” Dr. Zeichner says. That, along with “a decrease in swelling and inflammation,” may result in the tip of your nose looking ever-so-slightly smaller, he says.
This effect is far less dramatic than many TikTokers make it out to be. One possible reason why some of those before-and-after “Accutane nose job” pics look so dramatic is that many people start the medication to address hormonal acne during their teen years—a time when your whole face (not just your nose) looks different than it will post-puberty. No matter if you’re taking Accutane or otherwise, your face will continue to develop as you grow into adulthood.