The following information is provided as educational material for those that have been prescribed isotretinoin (Roaccutane / Accutane).
Isotretinoin (Roaccutane) Information - what you need to know
What is isotretinoin?
Isotretinoin is a medicine that is used to treat severe acne. It is related to vitamin A and works by reducing the amount of oil that your skin produces, reducing the number of blackheads and whiteheads) and cysts and reducing skin scarring.
How do I take isotretinoin?
You should take isotretinoin with food to help your body absorb them better. If you miss a dose, do not double the dose the next day.
Isotretinoin can take a few weeks or even months to work, so you may not see results right away. You will be on isotretinoin for 6-24 months. It's important to keep taking isotretinoin as prescribed, even if you don't see results right away.
What to expect when taking isotretinoin?
Flare of acne – occasionally acne may get worse in the first 4-8 weeks before it starts to improve, and additional treatment may be necessary. In very rare cases, a flare can last 3-6 months.
Dry skin and lips – this is the most common side effect and can happen all over the body, but particularly affects the lips, nose, and eye. To help with dry skin use a soap-free wash, moisturiser twice a day and lip balm 10 times a day. Lubricating eye drops are helpful for dry eyes. Avoid other anti-acne creams and treatments (unless advised by the dermatologist).
Sun sensitivity - it is important to wear protective clothing, a hat, and sunglasses, as well as use a broad-spectrum SPF 50+ sunscreen.
Is Isotretinoin safe?
Isotretinoin is a safe medicine when it is taken as prescribed by your doctor. However, it can have some serious side effects if it is not taken correctly. Isotretinoin can cause very severe birth defects if it is taken by pregnant women or if you accidentally fall pregnant. It can also cause liver function abnormalities and elevated cholesterol in some people.
To make sure that you are safe while taking isotretinoin, you must:
Use two forms of birth control to prevent pregnancy throughout treatment and for 1 month after treatment has finished (e.g. oral contraceptive pill and condom).
Get regular blood tests to check liver function and cholesterol levels
Avoid drinking excessive alcohol (>2 drinks) while taking isotretinoin
Avoid donating blood
Avoid waxing, ablative laser treatment, chemical peels and non-emergency surgery (unless advised by the dermatologist).
Avoid any other form of vitamin A
Avoid breast feeding
Other rare but serious side effects include:
Severe headaches with blurred vision/double vision
Vomiting, diarrhoea and bleeding from the bowel.
If you have any of the above side effects, stop the medication immediately and contact your doctor.
Other less common side effects include:
Hair thinning - usually temporary and regrows after treatment is stopped
Muscle aches and joint pains after physical activity
Facial redness and flushing
Ingrown nail (paronychia)
There have been reports of mood change and depression in people taking isotretinoin. However no studies to date have established a causal relationship between isotretinoin and depression. Recent studies show that generally patients feel better on Isotretinoin as their acne improves (1). Any changes in mood should be reported to the treating dermatologist.
Conclusion
Isotretinoin is a medicine that can help to clear up severe acne. While it can have some side effects, it is generally safe when taken as prescribed by your doctor. Most side effects are not severe and improve after treatment is stopped. If you have any questions or concerns about taking isotretinoin, be sure to talk to your doctor.