Experts say the acne drug definitely won't give you a "free nose job."

By Korin Miller
May 20, 2021
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Accutane has been hailed as a miracle drug for people with severe acne. But a growing number of people on TikTok claim that they also got a "free nose job" from using the medication.

Tiktok-Can-Accutane-Shrink-Your-Nose
Credit: Getty Images / Photo Illustration by Jo Imperio for Health

Plenty have shared before and after photos of themselves with what they say are more streamlined, shrunken noses. It seems like the whole thing started with Alejandro Vera (@m0ldaviteking_), who told the story of how he mentioned to his sister's boyfriend that she got a free nose job from using Accutane. "Did you know my sisters—both my sisters and I—got free nose jobs back in 2016?" he said. "Yeah, we were on Accutane. That sh*t shrinks your nose."

Cue: Tons of other TikTok users stitching Vera's experience with their own. "Not medical advice but if you wanted a nose job, go on accutane instead!!" said Rooz Divsalar (aka @1rzdd).

Another TikTokker known as @zahlidowdd shared a series of photos of herself over time with a seemingly smaller nose. "It all makes sense now," she said. And according to user @prizzilla, the medication gave her "more than just a skin glow up."

So what's going on here, exactly? Dermatologists weigh in on why you shouldn't sign up for Accutane, just to get a "free nose job."

What is Accutane?

Accutane, aka isotretinoin, is a powerful medication used to treat a particular type of severe acne known as recalcitrant nodular acne, according to the US National Library of Medicine's MedlinePlus resource. Patients may be prescribed Accutane when other treatments, like antibiotics, haven't helped. Accutane is a retinoid, and it works by slowing the production of certain natural substances that can cause acne.

Accutane "also shrinks the sebaceous—oil producing—glands," board-certified dermatologist Ife J. Rodney, MD, founding director of Eternal Dermatology Aesthetics, tells Health.

Accutane is an oral medication, and you take it by mouth twice a day with meals for up to five months at a time.

So, can Accutane shrink your nose?

The short answer: No. "Unfortunately, Accutane cannot actually shrink your nose," Dr. Rodney says.

However, Accutane could, in theory, make your nose look smaller under certain conditions. "Accutane may make the nose look less bulbous because of its effect on the oil glands in that area," Joshua Zeichner, MD, director of Cosmetic & Clinical Research in Dermatology at Mount Sinai Hospital, tells Health. "We know that the nose has among the highest concentration and most active oil glands on the body." So, in theory, if you shrink the oil glands in your nose when you're on Accutane, it could make your nose look smaller.

There's this to consider, though, per New York City dermatologist Doris Day, MD: You'd only see a change if you had large, overactive sebaceous glands in the first place. "Most people don't," she tells Health.

And even if you did have overactive sebaceous glands in your nose, Dr. Day says that Accutane isn't going to change the actual shape your nose. "You wouldn't suddenly have a sharper, more sculpted nose," she says. Dr. Rodney agrees, calling the free nose job claims "a bit of an exaggeration." (Accutane has not yet responded to Health's request for comment as of publication.)

Overall, doctors don't recommend going on Accutane in hopes of getting a smaller nose.

"Accutane is my favorite drug for people who are the right candidates, but it has side effects and has to be given carefully and for limited amounts of time," Dr. Day says. "It's not a drug to be taken lightly."

Accutane has a long list of potential side effects, ranging from skin dryness to more serious issues like birth defects. The American Academy of Dermatology (AAD) specifically lists out the following as potential side effects of Accutane:

  • Dry skin, severely chapped lips
  • Nosebleeds
  • Dry, irritated eyes
  • Dry mouth
  • Extreme sun sensitivity
  • Temporarily worsening acne
  • Trouble seeing at night
  • Thinning hair
  • Muscle or joint pain
  • Rash
  • Stomach problems
  • Unhealthy cholesterol levels
  • Liver damage

In pregnant women, the AAD says, Accutane can cause severe birth defects, miscarriage, and stillbirth, which is why people who can get pregnant must take two pregnancy tests before going on the medication and must agree that they will take a monthly pregnancy test and use two forms of birth control while on Accutane.

"There is a very strict program called iPledge where patient, doctor, and pharmacist must all sign off on using the drug, knowing its risks," Dr. Rodney says. "Everyone must agree that the patient is the only one allowed to use Accutane, only at the prescribed dosage." Basically, this is not a medication you can just pick up over the counter and start taking at will.

If you're on Accutane and you noticed a subtle change in your nose—and you wanted it to look different—then you can just credit those shrinking oil glands and call it a day. But otherwise, it's best to skip this hack.

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