The Side Effects of Accutane: What’s Common and What’s Not

Author: Dr. Bobby Buka

This is a serious medication and it requires blood monitoring every month. A typical course duration of therapy of Accutane is about four months, but it’s all weight-based. So depending on how heavy you are will determine how long your Accutane therapy course will be.

The side effects that I commonly see in my practice are very dry skin, dry eyes, dry mouth, and dry mucus membranes. In my patients who are really active, like marathon runners, they will notice some joint pain.

Besides the dryness and the joint pain in really active patients, there are really severe side effects that you’ll notice when you review materials prior to taking Isotretinoin. Although these side effects are rare, some of the more serious ones include the raising of fats in your blood called hyperlipidemia, a drop in your red and white blood cell counts called leukopenia, and a raising of your liver enzymes or liver inflammation called transaminitis. Luckily, these side effects are rare, as well as some of the other cosmetic side effects that are rare, like hair loss, which has been reported in patients taking Accutane.

The most important side effect of Accutane is the horrific incidents of pregnancy while you’re on that medication. There’s no question that fetuses exposed to Accutane in maternal circulation have severe side effects: limb abnormalities and central nervous system abnormalities. That’s why doctors make such a huge deal out of protecting our patients from pregnancy while on Accutane, which requires two forms of birth control for the entire time, if you’re a woman.

There have been some more recent reports linking Accutane to the unmasking of inflammatory bowel disease, so if you have a history in your family of either ulcerative colitis or Crohn’s disease, that’s something to be aware of. But, we have probably over 1,000 prescriptions for Accutane that we’ve written, and whereas we do see a lot of dryness with this medication, we’ve seen relatively few of the more serious side effects reported in our patient population.

You’ll notice improvement of your acne almost right away. In severe acne cases, it may get a little worse before it gets better. But most everybody gets better right away, with the peak benefit between months two and three.

Accutane does nothing for acne scarring. After a therapeutic course of Accutane, we will typically circle back to address any redness or scars, or texture abnormalities of scars, using our CO2 laser or our chemical peels.

It’s really important that your skin does not undergo any trauma while you’re on Accutane, because your body’s ability to heal itself, the skin included, is hindered while you’re on Isotretinoin.This means that you should not have surgeries, unless they are urgent, while you’re on Accutane.

Accutane is a systemic medication used for severe recalcitrant nodular cystic acne. It can be used at any age, even in children, if a nodular cystic acne is significant enough. For more questions on the side effects of Accutane, please contact Dr. Bobby Buka today.