Isotretinoin – Patient Information Sheet

What is isotretinoin?

Isotretinoin (formerly known as Accutane) is a vitamin-A–derived medication used to treat severe or persistent acne that has not responded to other treatments. It works by reducing oil (sebum) production and inflammation.

Indications

  • Moderate–severe or treatment-resistant acne
  • Off-label use for other skin conditions at your dermatologist’s discretion

Do NOT take isotretinoin if you:

  • Are pregnant, planning pregnancy, or breastfeeding
  • Have liver disease
  • Have high triglycerides
  • Have an allergy to isotretinoin or soya oil
  • Have impaired night vision

Pregnancy & contraception (critical)

Isotretinoin must not be used during pregnancy.
It causes severe birth defects.

  • Pregnancy must be avoided during treatment and for 1 month after stopping
  • Two forms of effective contraception are required if you are of child-bearing potential

Drug interactions

  • Tell your doctor about all medications and supplements
  • Stop tetracyclines (e.g. doxycycline, minocycline)
  • Avoid vitamin A supplements

Common side effects

  • Dry lips, skin, eyes
  • Nosebleeds
  • Muscle or joint aches
  • Sun sensitivity

Rare but serious side effects (seek medical advice urgently)

  • Mood changes or depression
  • Severe headache, blurred vision, dizziness
  • Severe abdominal or chest pain
  • Shortness of breath
  • Allergic reactions
  • Hair thinning

Monitoring

Regular blood tests may be required to monitor:

  • Liver function
  • Cholesterol and triglycerides
  • Blood counts

Dosing plan

  • 10 mg every second day for 2 weeks
  • Then 10 mg daily, until your review in 6-8 weeks where the dose will be adjusted based on response and side effects.
  • Take with food, any time of day
  • Typical course: 12–18 months

Precautions

  • Avoid alcohol
  • Avoid excessive sun exposure; use sunscreen daily
  • No blood donation
  • No waxing, aggressive exfoliation, or ablative laser treatments
  • Avoid strenuous new exercise routines
  • Do not take vitamin A supplements

Skincare while on isotretinoin

Cleanse (twice daily)

Gentle, non-foaming cleanser
Examples: CeraVe Hydrating Cleanser, QV Gentle Wash, Cetaphil Gentle Cleanser

Moisturise

Apply liberally and reapply as needed
Examples: CeraVe Cream, QV Face Moisturiser, La Roche-Posay Effaclar H, Avène Hydrance

Sun protection (daily)

SPF 30+ broad-spectrum sunscreen
Examples: La Roche-Posay Anthelios, Avène Aqua Fluid, Cetaphil, SunSense

Lips

Apply frequently
Examples: Dermal Therapy Lip Balm, La Roche-Posay Cicaplast Lèvres, Propaira Zinc lip balm

Avoid

  • Scrubs, alcohol-based products
  • Benzoyl peroxide, AHAs, BHAs (unless advised)

Additional care

  • Short, lukewarm showers
  • Artificial tears for dry eyes
  • Saline spray or Nozoil for dry nose
  • Avoid picking acne (use pimple patches if needed)

Expectations

  • Acne may take weeks to months to improve
  • Dryness is expected and manageable
  • Consistency is key

If you experience concerning side effects or have questions at any time, please contact your dermatologist.

For personal use only. Intended for the patients of Dr Anes Yang. Please refer to the disclaimer.

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