Starting Accutane (isotretinoin) can feel like a big step. It often clears stubborn acne, but the drug comes with real side effects you should know about before you begin. This page breaks down the common reactions, the serious risks to watch for, and practical ways to manage symptoms while staying safe.
The most predictable effects are dryness: chapped lips, dry skin, dry eyes, and nosebleeds. Use heavy lip balm, fragrance-free moisturizer, and preservative-free eye drops daily. Many people also notice increased sensitivity to sunlight and faster skin peeling — sunscreen and gentle cleansers help a lot.
Muscle and joint aches are not rare, especially if you exercise a lot. Headaches, fatigue, and temporary changes in vision (like night-vision issues) can happen. A smaller number of people report hair thinning while on treatment, which usually reverses after stopping the drug.
Some side effects are uncommon but important: severe stomach pain, intense headaches, vision changes, or unusual bruising/bleeding. If you get any of these, contact your prescriber right away.
Accutane is highly teratogenic — it can cause serious birth defects. If you can become pregnant, expect strict rules: reliable contraception starting before treatment, monthly pregnancy tests during treatment, and usually one after stopping. Don’t stop contraception without checking with your prescriber.
Liver function and blood lipids can rise on isotretinoin. Doctors order baseline blood tests and repeat checks during treatment. Avoid high-dose vitamin A supplements and limit alcohol: both raise the risk to your liver and can boost triglycerides.
Mood changes and depression are reported by some people. While most users don’t have psychiatric problems, you should tell your doctor about new or worsening depression, anxiety, or thoughts of self-harm right away. Never ignore sudden mood shifts.
Other practical rules: don’t donate blood while on treatment and for a period after stopping, because of the pregnancy risk if a transfusion reaches someone pregnant. Avoid waxing or strong laser treatments on your face while skin is fragile — ask your dermatologist for timing.
How to make the treatment easier day to day: keep a routine for lip balm and moisturizer, use gentle skincare (no harsh scrubs or alcohol toners), wear SPF 30+ daily, and stay hydrated. Plan workouts and rest for muscle aches, and choose soft contact lenses or switch to glasses if your eyes get too dry.
Accutane can be life-changing for severe acne, but safe use means understanding risks, following monitoring plans, and speaking up about new symptoms. If anything worries you, contact your healthcare provider or reach out through our Contact Us page for more guidance. Your doctor is the best person to tailor advice to your situation.
