Isotretinoin, formerly known as the brand Accutane, is a highly effective acne treatment. But, like all medications, it can cause side effects. Common isotretinoin side effects include dry skin and joint pain.
Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Experiencing severe acne, no matter your age, can be challenging. Maybe you’ve tried the hands-off approach to no avail. Or you’ve given every cream, cleanser, strip, and light a go — with little success.
When other acne treatments don’t work, many dermatologists turn to medications — specifically, isotretinoin.
You may know this best by its former brand name, Accutane. It’s a form of vitamin A that’s been shown to combat severe acne. It’s thought to work by reducing how much oil your skin produces, slowing down the growth of skin cells that can clog pores. This creates an unfit environment for acne-causing bacteria to thrive.
But just because it can be very effective doesn’t mean every dermatologist will prescribe it to everyone. It can have some strong side effects, ranging from mild, like dry skin, to more severe, such as affecting pregnancies.
With that in mind, it’s good to know some of the common side effects of isotretinoin and how to manage them.
Need a prescription or refill? You can get discreet and expert on-demand care in as little as 15 minutes with no video or appointment required. For $25, answer a few questions online and get a treatment plan from a board certified healthcare professional. Get started here.
100% online care
Treatment plans in 15 minutes or less for 40+ conditions.
According to the National Institutes of Health (NIH), the most common side effects of isotretinoin (Absorica) involve dryness. In fact, dry, chapped lips affect up to 90% of people taking this drug. Other similar effects include:
sun sensitivity
dry skin
dry mouth
It can also dry out the nasal membranes, which can lead to more nosebleeds. This usually isn’t anything to worry about. You can manage nasal dryness by applying petroleum jelly inside your nose or using a nasal spray.
Isotretinoin can also dry out your eyes. That can be especially uncomfortable if you wear contact lenses. Using artificial tear drops can help keep your eyes moist and lower the risk of infection, according to the American Academy of Dermatology (AAD).
This side effect should go away when you finish your course of medication, which usually lasts 15–20 weeks. But until then, there are some strategies you can use to manage dryness.
Making sure you stay hydrated by drinking plenty of water is key. The AAD also recommends that you use moisturizers and petroleum jelly to help with dry skin and lips. The association also reiterates the importance of practicing sun safety to help avoid the negative effects of increased sun sensitivity.
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
Free prescription coupons
Seriously … free. Explore prices that beat the competition 70% of the time.
Taking isotretinoin while pregnant can cause severe fetal development issues, pregnancy loss, and stillbirth. In fact, it has a black box warning from the Food and Drug Administration (FDA). This is a warning on the medication to inform people and healthcare professionals of a very serious adverse effect.
According to the AAD, if you’re of reproductive age, you will need to take two pregnancy tests to show you’re not pregnant before a doctor can prescribe the medication. You’ll also have to take monthly pregnancy tests and use two forms of birth control for as long as you’re taking the medication.
3. Joint and muscle pain
Experts estimate that body aches and pains affect 20% of people taking isotretinoin: A small 2020 study found that 66 of the 94 participants on the medication experienced lower back pain.
Researchers don’t quite know why this happens but it may have to do with isotretinoin’s effects on cells that line joints. If you have any joint or muscle pain while taking isotretinoin, consider speaking with a doctor. Note that the pain should go away once you stop the medication.
4. Headaches
According to the American Osteopathic College of Dermatology (AOCD), 5% of people who take isotretinoin get headaches. Some of these headaches are not a concern, but the medication can also increase the pressure in your head. In rare cases, this may lead to vision loss or serious brain issues.
Consider speaking with a doctor right away if you have:
persistent headaches
blurred vision
dizziness
nausea
vomiting
seizures
5. Worsening acne
Sometimes, acne symptoms can worsen before getting better. This can be the case with isotretinoin.
At the beginning of treatment, it’s possible you may notice more breakouts, and your acne may seem worse than before. This is common, but know that it’s usually temporary. The AAD notes it can be around 1–2 months before your skin starts to clear up.
6. Thinning hair
According to the AOCD, 10% of people experience thinning hair while taking isotretinoin. The same effects that help curb acne, such as slowing cell growth and oil production, may also affect hair growth. This is especially true if you’re taking a very high dose. As with joint pain, this side effect should stop once you stop the medication.
7. Depression
Some people may experience depression while taking isotretinoin, but more research is necessary into whether the depression is due to the medication.
According to some research, acne alone is often linked with an increased risk of depressive symptoms, and treating it can actually reduce these symptoms.
Isotretinoin benefits
While these side effects may seem daunting, it’s important to remember that they go away after your course of treatment. Also, dryness — the most manageable side effect — is typically the most common reaction.
The main benefit of isotretinoin treatment is its effectiveness.
After a round of treatment, or 2 pills a day for 4–5 months, 85% of people who try isotretinoin have clear skin.
Most of those people won’t need any more treatment for their acne, although some may need a second round of isotretinoin.
Research also finds that treating acne can improve your quality of life by lowering symptoms of depression and distress.
Summary
Isotretinoin, formerly known as Accutane, is a strong medication to treat acne. It’s known for having very common side effects.
Some of these side effects can be mild, but they include dry skin and lips, worsening acne before it improves, and joint pain. These usually go away after finishing treatment. Note that you should not take isotretinoin if you’re pregnant, as it can cause pregnancy loss, stillbirth, or fetal development issues.
Alongside the above side effects, it’s important to remember that isotretinoin is very effective. Treating your acne might improve your overall quality of life. If you have any concerns about side effects, you can speak with a healthcare professional.
Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.
