What are the side effects of isotretinoin (roaccutane)?
Isotretinoin can cause severe fetal malformation and therefore it must not be taken by pregnant women. Women at risk of pregnancy should use two independent methods of contraception for 1 month prior to treatment, throughout the course of treatment and for 3 months after completing the course of treatment.
Other common side effects include:
- Dry lips: Almost all patients will experience this, the frequent use of a lip moisturiser - such as vaseline - is usually sufficient.
- Dry skin: Isotretinoin will dry the skin, which can lead to the development of dermatitis. Following a dedicated skincare routine during treatment can help manage this dryness.
- Increased sensitivity of your skin to sunlight
- Temporary hair thinning
- Muscle ache and delayed recovery from exercise - this can be an issue for those competing in sports at a high level
Rare side effects include:
- Liver inflammation (hepatitis): This is an uncommon but recognized side effect. Blood tests are performed before starting treatment and after approximately 2 months of treatment in order that it can be picked up early.
- Disturbance of the fats (lipids) in the blood: This is rare in otherwise healthy individuals and is monitored with blood tests.
- Mood disturbance: Isotretinoin has been associated with low mood and depression and there have been several cases of suicide whilst patients are taking isotretinoin.
It is difficult to known to what extent depression and low mood are the result of the treatment with isotretinoin particularly since acne itself can cause low mood, however if you have suffered from depression you will be required to see a psychiatrist who can assess the safety of isotretinoin prior to commencing treatment.
If you experience low mood whilst taking isotretinoin you must immediately stop taking it and seek advice from a doctor.
Inflammatory bowel disease: A link has been proposed between treatment with isotretinoin and the development of inflammatory bowel diseases such as ulcerative colitis and Chron's disease, however the evidence in this area remains inconclusive.
The British association of Dermatologists has produced a very helpful information leaflet that lists some additional rare side effects that may occur and provides additional information relating to treatment with isotretinoin and it is very important that you have read this and discussed any questions that you might have with your dermatologist prior to starting treatment.
It is important to appreciate that despite the possible side effects listed above, the majority of patients tolerate treatment with isotretinoin well experiencing only dry skin and lips and find it to be a safe and effective treatment. Nevertheless, due to this potential for side effects it can only be prescribed under the supervision of a consultant dermatologist.
How can I help
I see patients in person in central London. An in person consultation allows me to examine the skin directly including features that are difficult to capture in a photograph such as 3-dimensional changes and textural change. This is the better option where the diagnosis is uncertain, where previous treatment has not been effective, or where a procedure is being considered. For more straightforward conditions such as acne and rosacea a remote consultation with clear photographs can be a good option.
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