Stories about treating — and learning to embrace — our adult acne.
Photo-Illustration: The Cut; Photo courtesyCarol Lee
In January 2026, Kendall Jenner publicly denied the nose-job allegations that had followed her for years. Instead, she claimed that Accutane (also known as isotretinoin), a popular oral retinoid used to treat severe acne, had shrunk her nose. Other public figures, including Alix Earle, have also claimed that the medication changed the appearance of their noses, causing interest in the so-called “Accutane nose job” to skyrocket.
According to board-certified dermatologist Dr. Mona Gohara, the term is a misnomer, since the retinoid doesn’t actually affect bone or cartilage the way a surgical rhinoplasty does. However, it does treat acne by shrinking sebaceous glands and reducing oil production. “The nose has a high density of these glands, so when they quiet down, the skin can look less thick, less shiny, and less congested,” Dr. Gohara says. “Think of it like deflating a puffy jacket — the structure underneath is the same, but it looks sleeker.” Dr. Chelsea Hoffman, another board-certified dermatologist, adds that “clearing active acne and associated inflammation on the nose reduces swelling that may have been contributing to a bulkier nasal appearance.” Some doctors, like board-certified dermatologist Dr. Shereene Idriss, even prescribe Accutane to individuals who have undergone nose jobs to mitigate oil levels and help with swelling.
But be warned — due to its long list of side effects, isotretinoin is often seen as the last resort for those with acne. Patients are likely to experience dry skin, lips, and eyes, and some report aching muscles and joints, thinning hair, headaches, and changes in mood. Rarer, more significant risks include severe birth defects if the medication is used during pregnancy, blurred vision, and changes in cholesterol levels or liver enzymes. “Serious side effects are less common, but they are part of why this medication needs to be monitored carefully,” says board-certified dermatologist Dr. Kate Kleydman.
The Cut’s beauty writer Carol Lee got on Accutane at 22 years old after dealing with acne for over a decade. At the tail end of her treatment, she noticed that her nose had started looking different. Here, Lee explains why she took the medication and how it felt to see her face change in more ways than she’d anticipated.
I had no idea Accutane would change my nose. I had harbored insecurities about it here and there but never enough to fantasize about a rhinoplasty — even though a relative did suggest that I get one when I was 8. (Not surprising, if you’re familiar with South Korean plastic-surgery culture.) And I do remember asking my mom once or twice why I couldn’t have inherited her small, svelte nose, which my aunt once called “the best nose in our family.”
But by high school, I was dealing with debilitating acne, and that was all I could think about. I woke up at 5 a.m. every morning to plaster over the red, inflamed bumps with thick layers of foundation and powder before racing to catch the school bus. I didn’t care about my nose anymore — in fact, I liked it. But because of the pimples splattered across my face, I rarely saw the features beneath them. I couldn’t stand to look in the mirror without makeup on. When I did, I bargained with myself. I vowed that I would love my face with all my heart if only my blemishes would go away.
But they didn’t leave without a fight. Acne was my constant companion for nearly a decade, and I had at least one — if not dozens of — pimples on my face every single day from age 12 to 22. I didn’t feel like I could meet new people, put myself in new situations, or even go to early morning classes without makeup on. When I was at sleepovers, I’d sneak into the bathroom to reapply concealer after we had all washed our faces. I was hyperaware of every sensation in my skin and could anticipate a breakout a day or two before it appeared. Just by touching the spot, I knew exactly whether it would be a surface-level whitehead or a cystic pimple, and I could predict how long it would stay. Call me the acne forecaster. There were stretches of time when my skin looked more clear than others, but it was never 100 percent clear. After a few years, I couldn’t remember what it felt like to have clear skin and to not feel bumps under my fingers when I washed my face.
By 2022, my skin was the worst it had ever been. The texture was off the charts, and I was breaking out all over my face. No area was safe. My face felt angry and inflamed at all times, like it was screaming for my attention. Some pimples were tiny, and others large, deep, and painful. Every night, I knew that another one, if not a whole litter of them, would make its shining debut by the time I woke up. A little present to look forward to each morning.
I don’t remember my skin-care routine at the time, but I also had a feeling that this wasn’t something I could will away with the help of an over-the-counter toner or serum or ten-step Korean skin-care routine. I had also started my first-ever full-time job, which meant that I had my own adult money and health insurance, and I was willing to pay anything to find a treatment.
Lee’s skin with makeup in August 2022.
Photo: Carol Lee
So a week before my 22nd birthday, I visited a dermatologist for the first time in July 2022. He took one look at my skin and immediately told me that I needed to go on Accutane. I had heard horror stories about the medication before. But I also knew that the situation must be dire for him to have recommended it, and I was buoyed by the hope that it would cure me, once and for all.
I came back to the doctor’s office a month after my consultation, and he prescribed me my first dose of isotretinoin (the generic name for Accutane). As part of the process, I had to sign an abstinence pledge (the other option is to use two forms of birth control) to ensure that I wouldn’t get pregnant while on the medication. I also had to visit my dermatologist once a month for check-ins, during which they took my blood to monitor liver function and lipid panels as well as my urine to double-check that I wasn’t pregnant. I also took quizzes that tested me on things like the purpose of a condom and whether or not the pull-out method works. Before I hit my deductible, each visit cost me around $400 dollars, and the medication ranged from about $40 to $120 every month. I was able to afford this only because I was maxing out my HSA, and my employer at the time provided a yearly contribution of a few hundred dollars.
From left: Lee in September 2022. Photo: Carol LeeLee in December 2022. Photo: Carol Lee
From top: Lee in September 2022. Photo: Carol LeeLee in December 2022. Photo: Carol Lee
When I look back on my progress pictures from that time, I can see an almost immediate improvement by September after a brief moment where it got worse. By December, the majority of my breakouts were gone, and I didn’t see any new ones pop up. But to be safe, my doctor kept me on the medication until April 2023 for a total of eight months. As expected, I experienced severe dryness all over my body, which manifested in near-daily nosebleeds, rips at the corners of my lips, and a slight achiness in my joints — although I did relish only having to wash my hair about once a week instead of every day. La Roche-Posay’s Lipikar AP+ cream and Dr. Dan’s CortiBalm lip balm were my saviors.
From left: Lee in August 2022. Photo: Carol LeeLee in July 2023. Photo: Carol Lee
From top: Lee in August 2022. Photo: Carol LeeLee in July 2023. Photo: Carol Lee
I was so relieved to watch my skin heal that I didn’t notice my nose getting smaller. But as a certified Reddit fanatic, I was on those forums weekly, drinking in others’ transformations and reading their testimonies. Some of those posts mentioned “nose shrinkage,” and I got curious — and to my surprise, my monthly selfies had captured the slow progression of my own Accutane nose job. My nose, once swollen and highly irritated, now had a slightly more refined tip, and you could see the shape of the underlying cartilage. There were no differences in how it felt or functioned, but when I showed my friends my before-and-after photos, even they pointed out the evolution in how it looked.
Lee in January 2025.
Photo: Carol Lee
I had no beef with my old nose. Even if I hadn’t done Accutane, I don’t think it would ever have occurred to change my nose in any way. But I do love my “new” one, even though it’s technically the one I was born with — just without all that inflammation. This was, as my beloved Bob Ross would put it, a happy accident. But isotretinoin isn’t a guaranteed way to get a smaller nose, so I’d never recommend that someone get on it just to attempt a nonsurgical “nose job.” However, if my acne ever cropped back up, I would 100 percent do Accutane again, despite the months of cracking skin and bloody noses that may plague me once more. I haven’t experienced a single true pimple in the past three years, and most people who see my bare face now are surprised to hear that I ever had such severe acne. (Every time someone tells me that I have perfect skin, I can’t help but confess my past, as if I’ve come into my fortune by illegal means.) Clear skin is priceless to me, and there is not a single day I take it for granted.