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Isotretinoin for Acne

Last Updated October 2023 | This article was created by familydoctor.org editorial staff and reviewed by Leisa Bailey, MD

Isotretinoin is a medicine used to treat very bad acne. It is usually used for cystic acne that did not get better after treatment with other medicines. It is important for you to take isotretinoin the right way. You should also know about the side effects of isotretinoin. Talk to your doctor if you have any questions about this medicine or if you have side effects when you take it.

Before taking isotretinoin, tell your doctor if you or anyone in your family has any of these conditions:

  • Diabetes
  • Asthma
  • Liver disease
  • Heart disease
  • Depression

You should also tell your doctor if you are allergic to any medicines, especially parabens (chemicals used in cosmetics, moisturizers, and isotretinoin). Be sure to tell your doctor if you are taking any other medicines, even over-the-counter medicines.

Path to improved health

Isotretinoin has been prescribed just for you. Don’t share it with other people. Keep it away from children. You should take isotretinoin with food. You don’t have to keep the medicine in the refrigerator but do keep it out of sunlight. Don’t keep it in a place that is very warm.

You may not give blood while you are taking this medicine or for at least 1 month after you stop taking it. You should also not have cosmetic procedures done to smooth your skin (such as waxing) while you are taking isotretinoin and for at least 6 months after you stop.

Isotretinoin is like vitamin A. So, while you are taking isotretinoin, you should not take vitamin A pills or multivitamins that contain vitamin A. You also should not take any antibiotics without talking to your doctor first.

What should I expect during isotretinoin treatment?

The dosage of isotretinoin is different for each person. During your treatment, your doctor may change your dosage. Be sure to take isotretinoin just the way your doctor tells you. If you miss one dose, don’t take extra the next time. You will probably take isotretinoin for 15 to 20 weeks.

Your acne may get worse when you first start using isotretinoin. This usually just lasts for a little while. If this happens to you, your doctor may have you use other medicines along with the isotretinoin in this stage.

Your doctor needs to check on you often. Be sure you keep all of your appointments with your doctor. They may check your cholesterol levels and your liver.

What should I expect after isotretinoin treatment?

Your skin might keep getting better even after you stop taking isotretinoin. Most of the side effects go away in a few days or weeks after you stop taking isotretinoin. If your side effects last for more than a few weeks after you stop taking this medicine, talk to your doctor.

Your acne may not get better the first time you use isotretinoin for 15 to 20 weeks. If you need to take isotretinoin again, you can start taking it again 5 months after your first treatment is over.

Things to consider

Does isotretinoin have any side effects?

During treatment, you may have some of the following side effects. These side effects usually go away when you stop taking isotretinoin:

  • Dry skin and lips—your doctor can suggest lotions or creams to use
  • Fragile (easily injured) skin, itching or rash
  • Increased sensitivity to the sun (easily sunburned)
  • Peeling skin on your palms and soles
  • Thinning hair
  • Dry, red eyes (you may find that you can’t wear your contact lenses during treatment)
  • Nosebleeds
  • Bleeding gums
  • Pain in your muscles
  • Vision problems such as decreased night vision

A few people have even more serious side effects. If these problems aren’t treated, they could last even after you stop taking isotretinoin. If you have any of the side effects listed below, stop taking isotretinoin and check with your doctor right away:

  • Headaches, nausea, vomiting, or blurred vision
  • Depression or changes in your mood, such as feelings of sadness or irritability
  • Unusual tiredness or lack of appetite
  • Severe stomach pain, diarrhea, or bleeding from your rectum
  • Very dry eyes
  • A yellow color in your skin or eyes, and dark yellow urine

Are there special concerns for girls and women?

You must not take isotretinoin if you are pregnant or if there is any chance you might get pregnant while taking this medicine.

Isotretinoin causes severe birth defects, including:

  • Malformation of the head and face
  • Intellectual disability
  • Severe internal defects of the brain, heart, glands, and nervous system

It can also cause miscarriage, premature birth, or death of the fetus.

In order to prevent pregnancy, you must use 2 forms of birth control at the same time for at least 1 month before you start taking isotretinoin. You must continue using 2 forms of birth control during the entire time you are taking this medicine. Keep using 2 forms of birth control for 1 month after you stop taking isotretinoin.

Your doctor will make sure you are not pregnant before you start taking isotretinoin. They will check again every month while you are taking it. You will be asked to read and sign a consent form to show that you understand the dangers of birth defects and that you agree to use 2 forms of birth control. If your period is late, stop taking isotretinoin and call your doctor right away.

Questions for your doctor

  • Can I take isotretinoin for mild acne?
  • Will isotretinoin keep my acne from scarring?
  • Is it possible that isotretinoin won’t work for me?
  • Will my acne return when I stop taking isotretinoin?
  • When can expect the drug to start working?


National Institutes of Health, MedlinePlus: Isotretinoin

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