Isotretinoin is a drug used to treat severe acne that hasn’t responded to other treatments. It may be prescribed for other uses, including other skin problems and certain kinds of cancer.
This drug is a vitamin A derivative (retinoid), so your body reacts to it in a similar way that it does to vitamin A. Because vitamin A can build up in your tissues, it can quickly become a problem. You shouldn’t take vitamin A supplements while taking isotretinoin.
It can do a good job of clearing up your skin, but there are some potential side effects. Most of these fade within a few weeks after you stop taking it.
The dose is tailored to each person, and treatment usually lasts four to five months. It’s important that you never take more than prescribed.
Isotretinoin is available in a variety of brand names, including Absorica, Amnesteem, Claravis, Myorisan, and Sotret. The original brand, Accutane, is no longer on the market.
Read on to learn about the effects of isotretinoin on the body.
Skin and Hair
Since isotretinoin is designed to treat severe acne, it has a visible effect on the skin. The medication can be very effective in treating severe acne because it targets:
- clogged pores
- oil production
Unfortunately, when you first start using it, your acne may get worse before it gets better.
Some of the more common side effects include dry skin and chapped lips. You may also have dry nasal passages, which can make your nose bleed.
While taking isotretinoin, your skin will be more sensitive to the sun, so be sure to use sun protection. Don’t use any type of indoor tanning device.
Some people develop fragile skin, rash, or peeling skin on the palms and soles. You may notice a faint yellowing of your skin. Thinning hair is a possibility.
Because your skin can become so fragile, hair removal techniques like waxing, dermabrasion, or laser treatments can lead to scarring. Wait until you’ve been off isotretinoin for six months before having any of these procedures.
Your skin may keep improving for a time after you’ve finished the medication.
Isotretinoin is dangerous for unborn babies.
Women of childbearing years should take a pregnancy test before starting this medication. You should also use an effective form of birth control, plus a backup method.
You shouldn’t get pregnant for four weeks after you stop taking it. If you do get pregnant, stop taking the medication and tell your doctor right away.
Taking isotretinoin during pregnancy can cause miscarriage, death of the fetus, or premature birth. It can also lead to severe birth defects such as:
- small or missing ears
- hearing loss
- small eyes, which is called microphthalmia
- missing eyes
- a small or missing thymus gland, which is responsible for making white blood cells
- a cleft palate
- congenital heart defects
It can also cause a buildup of fluid and pressure on the brain called hydrocephalus. This can lead to intellectual disabilities.
Babies may be born with an underdeveloped brain and small head, which is called microcephaly. This can lead to intellectual and developmental disabilities.
Men who take isotretinoin may have some of the drug in their semen. It’s not clear if that can cause birth defects. It’s also unclear whether the drug passes to your baby through breast milk. You shouldn’t breastfeed while taking it.
Anyone who plans on taking isotretinoin must register with iPLEDGE. The FDA-approved restricted distribution program is designed to inform people about the risks of birth defects and to prevent pregnancy while taking the drug.
Central Nervous System
Isotretinoin can affect your central nervous system. Some potential side effects include headaches and tiredness.
You may have dry eyes or have trouble seeing in the dark. Some people have ringing in the ears or hearing loss. In some cases, hearing loss can become permanent.
Isotretinoin can cause increased pressure in your brain, which is a life-threatening condition. Symptoms of increasing brain pressure include:
- severe headache
- blurred vision
Some people go through mood changes, such as irritability or sadness.
There’s a potential for serious mental health problems, including depression, psychosis, and suicidal thoughts. Warning signs include emotional outbursts, withdrawal, and seeing or hearing things that aren’t real. Get medical help immediately if you have any of these symptoms.
Any medication can cause an allergic reaction. Symptoms include hives, swelling of the mouth or face, or breathing problems. You should see your doctors if you think you’re having an allergic reaction to your medication.
Digestive and Excretory Systems
Isotretinoin can cause problems all along the digestive tract. Some side effects include:
- bleeding gums
- a lack of appetite
- stomach pain
- bowel pain
- dark urine
- rectal bleeding
These symptoms could indicate damage to your:
Your doctor may need to monitor your liver and cholesterol levels while you’re taking this medication.
Blood, Bones, and Muscles
While taking isotretinoin, your red and white blood cell counts may decrease. Symptoms include feeling faint and having difficulty breathing.
Isotretinoin can build up in your bloodstream. You may develop problems with blood sugar and lipid levels.
Because of the danger to pregnant women, you shouldn’t donate blood while taking this medication or for a full month after you stop taking it.
The side effects of isotretinoin can also include pain in the: