Side effects of Accutane

 
Sad Accutane acne patient

Accutane (isotretinoin) Overview

Accutane (also called isotretinoin) is the most effective acne treatment available. Like all medicines, it can cause side effects. Social media sometimes makes these side effects sound worse or more common than they really are. Most side effects are mild and can be managed with simple, over-the-counter treatments while your skin clears up on Accutane. Learn more about Purging below.


Accutane’s (isotretinoin) Side Effects

A study of over 3,500 people taking Accutane found the most common side effects and how often they happen. Dry eyes and dry skin are very common—almost everyone gets them while on Accutane, so you should expect it.

IMPORTANT: If you are having any mood issues - depression, suicidal thoughts, anger issues, etc - STOP Accutane immediately and call your dermatologist.

Below, I list each side effect in order of how common it is, with tips on how to treat them. Click on any side effect to jump to the treatment advice:


Dry Lips

Managing Dry, Cracked or Peeling Lips on Accutane

  • Use a thick, plain moisturizer like Vaseline or Aquaphor several times a day.

  • If your lips are peeling, try a urea-based lip balm (Flexitol).

  • At bedtime, apply a thick layer—no one will see you while you sleep!

  • Don’t lick your lips—saliva can make dryness worse.

  • If your lips are red or irritated, use Dr. Dan’s Cortibalm or FixMySkin, which have hydrocortisone in them.


Dry Skin

Managing Dry Skin on Accutane


Facial Redness

Managing Facial Redness on Accutane


Nosebleeds

Managing Nosebleeds on Accutane


Muscle Aches

Managing Muscle Aches on Accutane


Itchy Skin

Managing Itchy Skin on Accutane


Peeling Skin

Managing Peeling Skin on Accutane


Purging

Managing Purging on Accutane

Some people notice their acne gets worse right after starting Accutane. This is sometimes called “purging,” and it can be confusing. Before social media, only about 1 in 20 patients told me their acne flared up at the start. Even then, it usually was better by their one-month checkup. Now, it seems like almost everyone online talks about purging. But there’s no strong research to show how often it really happens or how long it lasts. In my experience, about 10–20% of people have a small flare-up in the first few weeks. It usually starts to improve by the end of the first month.


Headaches

Managing Headaches on Accutane

Mild headaches are common on Accutane and usually due to not drinking enough water.

  • Hydrate more: Drink at least 2 liters of water per day.

  • Get more sleep—aim for 8 hours a night.

  • Use pain relievers like acetaminophen or ibuprofen (Advil tastes better but costs more).

    • These can usually be taken together for one dose to relieve a headache.

  • NOTE: Headaches usually improve over time as the body adjusts to Accutane.

Rare but Serious: Benign Intracranial Hypertension (BIH)also called pseudotumor cerebri

Stop Accutane right away and call your dermatologist or go to the ER if you have:

  • A severe or constant headache, especially if worse when lying down.

  • Headache with blurred or double vision.

  • Headache with nausea or vomiting.


Joint Pain

Managing Joint Pain on Accutane

Joint pain is common on Accutane and can be due to not drinking enough water.

  • Hydrate more: Drink at least 2 liters of water per day.

  • Get more sleep—aim for 8 hours a night.

  • Use pain relievers like acetaminophen or ibuprofen (Advil tastes better but costs more).

    • These can usually be taken together for one dose to relieve joint pain.


Eczema (Dermatitis)

Managing Eczema on Accutane


Accutane dry eyes

Dry Eyes

Managing Dry Eyes on Accutane


Hair Loss

Managing Hair Loss on Accutane

Accutane can cause hair shedding called telogen effluvium. The good news: it’s temporary, and hair usually grows back on its own without treatment. In the meantime:

  • Be gentle: Avoid tight hairstyles, harsh brushing, and heat styling.

  • Eat well: A whole-food, plant-based diet gives your body what it needs to regrow hair. A multivitamin can help—I recommend Flintstones Chewables with Extra Iron.

  • Manage stress: Stress can make shedding worse. Try to get good sleep, exercise, take breaks, and talk to someone if you’re feeling overwhelmed.

  • Be patient: Shedding usually stops in 3 months, and full regrowth may take 6–12 months.


Sun sensitivity

Managing Sun Sensitivity on Accutane


What if your Accutane side effects are too much?

If you're having problems on Accutane, stop taking it and contact your dermatologist. This is especially important if you’re feeling depressed or having mood issues. You may need a lower dose of Accutane or a prescription cream. If over-the-counter treatments are not working, look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.


DISCLAIMER

The statements expressed and content of this website are not intended to be a substitute for professional medical advice. Readers should seek their own professional counsel for any medical condition or before starting or altering any treatment, exercise, or dietary plan. Please see our full disclaimer here.

 
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