You may have read about various side-effects and stories about isotretinoin on the Internet.
Below is a list of the most serious, important and common side-effects related to isotretinoin.
Serious side-effects
Birth defects
Isotretinoin can cause severe malformations to an unborn child/foetus.
This is the most important and serious side-effect of isotretinoin.
Females must not fall pregnant while on isotretinoin and for one month after stopping.
Sexually active females must be vigilant about the use of two methods of contraception at all times during, and one month after stopping treatment with isotretinoin.
Females must have a blood test to confirm the absence of pregnancy before treatment is started.
Headaches
Persistent morning headaches with nausea or vomiting is a concerning symptom. You must seek medical attention if this occurs.
Side-effects you will likely experience
Dryness and cracking of your lips
You will need to use lip balm throughout the day. It’s best to have a few tubes of lip balm in your bag, bathroom, car, work/school, etc.
Dryness, fragility and irritation of your skin
You may find that your skin becomes more dry than usual. If you have eczema, this may worsen. It will be important for you to moisturise at least twice a day while you are on treatment. Avoid soap and use soap substitutes instead. Avoid hot showers and do not spend more than five minutes in the shower.
Wounds may take longer to heal while you are on isotretinoin.
Waxing, tattoos, piercings, laser and other cosmetic skin treatments should be avoided.
Elective surgical procedures should be post-poned, or treatment with isotretinoin post-poned for a time after surgery.
Sun sensitivity
You will be more sensitive to the harmful effects of the sun while you are on isotretinoin. This means that it will take less time for you to burn under the sun and the sunburn will be more severe and last longer than usual. If you are taking isotretinoin during the warmer months, you must avoid direct sun exposure. It is important that you wear sunscreen when you are in the sun as well as sun protective clothing. This includes wearing a hat and long sleeves.
Other side-effects you may experience
Nose bleeds
Isotretinoin can cause dryness inside your nose which may lead to nose bleeds. If this occurs, it is best to use Vaseline inside your nostrils regularly.
Dryness of eyes
If you develop dryness inside your eyes, you can use artificial tears that can be purchased from a pharmacy. Should this continue to be a problem, please let us know. This side-effect may interfere with the ability to wear contact lenses.
Flare of acne
Your acne may worsen for a few weeks before it starts to improve. This is especially the case if your acne is severe to begin with or you have many whiteheads (closed comedones).
Muscle aches & Fatigue
A minority of patients will experience mild muscle aches and pains.
Some patients may experience fatigue with isotretinoin.
Liver and cholesterol problems
Isotretinoin can sometimes stress the liver which can lead to increased cholesterol and changes in your liver function tests. This is monitored with blood tests during your treatment.
It is important that you do not drink excessive amounts of alcohol during your treatment.
Side-effects that are less common
Visual disturbance
Approximately 2-4% of patients may experience decreased night vision. In rare circumstances, this may become permanent.
You should discuss your treatment in detail with us if you plan on becoming a pilot or wish to join the airforce or army.
Be extra cautious while driving a vehicle at night or if you operate heavy machinery at night.
Other side-effects that may be induced by isotretinoin
Depression & mood changes. There is varied opinion whether isotretinoin really causes depression. The greater consensus is that in most patients, isotretinoin helps relieve anxiety and depressive symptoms that is often attributed to having severe acne. Nevertheless, there have been a few reports of isotretinoin causing depression which resolves when isotretinoin is stopped. It is therefore important that you notify your family members, as well as the clinic and your local doctor if you do develop any signs of depression.
Signs of depression include:
▪ Feeling sad or having crying spells
▪ Losing interest in activities once enjoyed
▪ Sleeping too much or having trouble sleeping
▪ Changes in appetite or bodyweight
▪ Having trouble concentrating
▪ Withdrawing from friends or family
▪ Lacking in energy
▪ Feelings of worthlessness or inappropriate guilt.
Hair loss. It is reported that isotretinoin can cause alopecia (hair loss), however, this is not commonly seen in practice.
Auditory issues. Uncommonly, isotretinoin has been reported to cause temporary hearing loss or hearing impairment.