The Accutane side effects you should know about
Constant breakouts and deep, painful bumps and cysts. Dealing with severe acne, no matter your age, can be tough. Maybe you’ve tried the hands-off approach, to no avail. Or you’ve given every cream, cleanser, strip and light a spin — with little success.
When other acne treatments fail, many dermatologists turn to isotretinoin. You may know this medication 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.
Today, isotretinoin is sold under other brand names, such as Absorica®, Claravis® and Zenatane™. But the name change hasn’t affected its results.
After a round of treatment (or 2 pills a day for 4 to 5 months), 85% of people who try isotretinoin have clear skin, according to the American Academy of Dermatology (AAD). And between 40% to 60% of those people won’t need treatment for their acne at all after that. Some may need a second round of isotretinoin treatment within 2 years of their first. The rest may still need to use other acne treatments, such as Differin®. (Use our search tool to find free coupons for Differin and thousands of other medications.)
With such great results, why don’t dermatologists just prescribe isotretinoin to everyone and call it a day? While the medication is effective, it can also have strong side effects. Some, such as dry skin, are merely annoying. Others can be much more serious.
With that in mind, it’s good to know some of the common side effects of isotretinoin — and how to manage them.
Dry, peeling skin
At about the 1-month mark, your skin can start to peel and feel very dry, says Purvisha Patel, MD. She’s a board-certified dermatologist and founder of Advanced Dermatology & Skin Cancer Associates, based in the Memphis, Tennessee, area.
To help, Dr. Patel recommends taking an oral vitamin E tablet or applying vitamin E oil to your skin to nourish and protect it. “Drinking at least 6 glasses of water a day and using a moisturizer also can help,” she says.
Your skin will also be more sensitive to sun damage. So be sure to use protection. Here are our favorite products.
Sometimes, things get worse before they get better. And that can be the case with isotretinoin.
During the first 3 weeks or so of treatment, your acne might get worse, according to the Mayo Clinic. That’s helpful to know up front so that you don’t feel discouraged if it happens. This reaction is your body purging dead skin cells and other debris, which causes inflammation. The good news: This effect should be temporary, and your skin should start to improve after 1 or 2 months.
Chapped lips are also very common while taking isotretinoin. Applying Vaseline (or any petroleum-jelly-based ointment) can ease the dryness, Dr. Patel says.
Isotretinoin can also dry out the nasal membranes, which can lead to more nosebleeds. The American Osteopathic College of Dermatology (AOCD) recommends using Ayr® Saline Nasal Gel to keep your nose moist.
Eyelid and eye irritation
Isotretinoin can dry out your eyes, too. That can be especially uncomfortable for people who wear contact lenses. Using artificial tear drops can help keep your eyes moist and lower the risk of infection, according to the AAD.
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Joint and muscle pain
Experts estimate that body aches and pains impact about 20% of people taking isotretinoin. In fact, a small study published in BMC Musculoskeletal Disorders found that 66 of the 94 participants on the medicine experienced lower back pain.
Why this happens isn’t really known. But it may have to do with isotretinoin’s impact on cells that line joints. If you have any joint or muscle pain while on isotretinoin, tell your doctor. The positive part is that the pain should go away once you stop taking the medication.
According to the AOCD, about 10% of people experience thinning hair while on isotretinoin. The same effects that help curb acne, such as slowing cell growth and oil production, may hinder hair growth, too. That’s especially true if you’re on a very high dose. As with joint pain, this side effect should stop once you’re off the medication.
About 5% of people who take isotretinoin get headaches, according to the AOCD. Some of these headaches are not a big deal, but the medication can also increase the pressure in your head. In rare cases it may lead to vision loss or serious brain problems, the Mayo Clinic warns.
Tell your doctor right away if you have persistent headaches, blurred vision, dizziness, nausea, vomiting or seizures.
Pregnancy birth defects
Taking isotretinoin while pregnant can cause severe birth defects, miscarriage and stillbirth.
If you’re of reproductive age, you have to take 2 pregnancy tests to show you’re not pregnant before you can be prescribed the medication, according to the AAD. You’ll also have to take monthly pregnancy tests and use 2 forms of birth control for as long as you’re taking the medication.
Due to the potential for serious side effects, isotretinoin is prescribed for only 30 days at a time. That way, your dermatologist can watch things closely before prescribing the next batch.
It can take a bit of time to find the right dosage for you. But if you’ve struggled with severe acne — and have the battle scars to show for it — isotretinoin could be a life-changing medication.
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Success rates and side effects of isotretinoin: American Academy of Dermatology
Precautions while using isotretinoin: Mayo Clinic
Common isotretinoin side effects: American Osteopathic College of Dermatology
Study on isotretinoin and body pain: BMC Musculoskeletal Disorders (2020). “Analysis of musculoskeletal side effects of oral Isotretinoin treatment: a cross-sectional study”