Isotretinoin: The truth about side effects
Dermatologists prescribe isotretinoin (also called Accutane®) to treat deep, painful acne cysts and nodules. When other treatment fails, this medication can diminish or clear severe acne and prevent new acne scars.
Side effects: What we know
If a person takes isotretinoin while pregnant, this medication can cause:
Severe birth defects
Miscarriage
Stillbirth
Prevent this side effect: To get a prescription for isotretinoin, a patient who can become pregnant must take two pregnancy tests to make sure they're not pregnant. Patients must also agree that while taking this medication, they will have a monthly pregnancy test and use two forms of birth control.
Dry skin, severely chapped lips
Nosebleeds
Dry, irritated eyes
Dry mouth
Treat these side effects: These will clear once you stop taking the medication. Until then, you can get relief with moisturizer, lip balm, and artificial tears. For nosebleeds, apply petroleum jelly just inside your nose. This helps keep the tissue moist, which can prevent nosebleeds.
When you take isotretinoin, you may become:
Extremely sensitive to the sun
Because isotretinoin effectively treats so many people with severe acne, many people are surprised by this possible side effect:
Acne worsens
Know that this side effect is temporary: When you start taking isotretinoin, acne can worsen for 1-2 months before it begins to clear. This happens with many other acne treatments.
While taking isotretinoin, you may develop:
Trouble seeing at night (night blindness)
Thinning hair
Muscle (or joint) pain
Understand that these side effects are temporary: These side effects tend to go away when you stop taking isotretinoin. Lost hair tends to grow back.
Other possible side effects: When taking isotretinoin, other concerning side effects may occur. These include:
Rash
Stomach problems
Unhealthy cholesterol levels
Uncommon side effects include:
Increasing pressure on the brain, which can lead to problems with your eyesight, permanent loss of eyesight, and, in rare cases, death.
Liver damage
Side effects: What we need to learn
While some people have reported the following serious side effects, we don't have enough evidence to know whether isotretinoin is linked to or can cause the following serious side effects:
Depression
Thoughts of committing suicide
Inflammatory bowel disease (IBD)
When a patient with acne develops depression, dermatologists take this seriously. They are trained to spot warning signs that a patient could be depressed. Before prescribing isotretinoin, dermatologists also screen patients carefully for possible signs of depression and thoughts of suicide. This helps them determine if the medication is a good option for you.
Researchers have also studied the connection between acne and IBD. While some studies suggest that taking isotretinoin may increase the risk of developing IBD, other studies have not found this to be true.
To find out whether this medication can cause IBD, researchers continue to study this possible side effect. This research takes time. Researchers have to account for many considerations. For example, it's possible that the genes which increase your risk of having severe acne also increase your risk of developing IBD, and this has to be carefully considered.
Dermatologists monitor each patient
Before prescribing isotretinoin, your dermatologist will talk with you about your acne and give you information about isotretinoin. This can help you decide whether this medication is right for you.
If you and your dermatologist decide that isotretinoin is the right treatment, your dermatologist will watch for warning signs of side effects. You will meet with your dermatologist every 30 days. This allows your dermatologist to check in with you to see how you’re doing. If all is well, your dermatologist can write another 30-day prescription for isotretinoin.
Writing a new prescription every 30 days is a safeguard that helps protect your health. In the United States, isotretinoin can only be prescribed for 30 days. To get another prescription, you need to check in with your dermatologist.
During your check-ins, tell your dermatologist how you feel, even if it seems unrelated to taking isotretinoin.
Other side effects, aside from the ones listed above, are possible.
Your dermatologist can help you sort out what’s happening.
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References
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Last updated: 12/3/20