Accutane: It’s one of the most singularly contentious words in the skin-care conversation, both feared and praised. That’s because the drug is both potent and potentially dangerous — and just happens to be the savior for those with severe cystic acne.

Accutane is the brand name for a drug called isotretinoin — a vitamin A-derivative. It was approved in 1982 for the treatment of severe acne that is unresponsive to conventional methods like topical medication and oral antibiotics. In 2009, the company behind Accutane pulled the drug from the market for unspecific economic reasons. So while we still call isotretinoin drugs Accutane, that actual name-brand drug does not exist anymore. Instead, you can be prescribed Absorica, Claravis, Myorisan, Amnesteem, or Zenatane. According to dermatologist Dennis Gross, MD, isotretinoin is the "closest thing to a cure [for acne that] we have."

“What Accutane is doing is destroying the [oil] glands that cause acne," says Dr. Gross. He explains that in people with acne, 80 to 90% of the oil glands on the face are healthy and functioning. But 10 to 20% are “sick” and overproducing oil. Accutane targets the cells where acne keeps coming back over and over again and kills them off.

Now, all of this sounds very straightforward and sensible. However, it’s not that simple. Bring up the drug to anyone who had or has acne, and you’re bound to get a response of either, “It changed my life,” or, “Oh my god, do NOT go on that poison.” With possible side effects that range from depression to birth defects, it's understandable why people have such a visceral reaction to it. I, however, am not one of those people. After a year and a half of suffering through the most brutal cystic acne my face had ever come up against, I didn't hesitate when Dr. Gross brought up the drug.

But besides the “don’t get pregnant — no, seriously, don’t” caution you hear repeatedly, I knew very little about what being on Accutane actually entails. With that in mind, I put together a diary documenting my experience, with all the nitty, very gritty, and sometimes TMI tidbits that everyone thinking about Accutane should absolutely know.