Isotretinoin for acne: benefits and side effects

Isotretinoin is a drug used to treat moderate or severe acne. It is available in capsules of 10, 20 and 40 milligrams and is estimated to be effective in up to 80% of cases. The average treatment lasts between 4 and 5 months.

Isotretinoin is also sometimes prescribed to treat other skin problems or some types of cancer. Despite its efficacy, it has been associated with considerable side and adverse effects. It causes birth defects and that is why pregnant women should not consume it. It is also not used simultaneously with vitamin A supplements.

What is isotretinoin used for?

Although isotretinoin can be used to treat various types of acne, it is almost always prescribed to treat a severe form called severe recalcitrant nodular acne. It is usually prescribed when other approaches have not worked.

It is one of the most effective drugs against acne. Likewise, in some cases it is indicated to treat problems such as rosacea, hidradenitis suppurativa, decalvante folliculitis, chronic hand dermatitis, skin photoaging and psoriasis. On the other hand, it is used to treat some types of skin cancer since the 1980s.

What benefits does it have for the body?

Isotretinoin is a drug that works on several levels. Has comedolytic action, that is, it prevents the formation of the plug that gives rise to comedones or pimples. This causes a very significant improvement in the lesions that are already present and prevents the appearance of new ones.

This drug inhibits the growth of a bacteria called Propionibacterium acnes. The microorganism is naturally found on the skin, but its spread causes various infections, including acne.

Likewise, isotretinoin has anti-inflammatory action. One of its main benefits is that it decreases the production of sebum. This makes it very effective against various skin problems.

Acne has different forms of presentation. Some are severe with multiple skin lesions including comedones.

Isotretinoin side effects

The side effects of isotretinoin can be mild or severe. Among the former is the increase in dryness that affects the skin, lips, nose and eyes. This leads to difficulties like chapped lips, nosebleeds, and dry eyes.

These side effects almost always go away on their own. When this is not the case, the doctor should be consulted. On the other hand, the drug has also been associated with other more serious reactions that we will see below.

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High cholesterol

The drug may raise blood cholesterol levels. This is more common in people who are overweight, have diabetes, have metabolic syndrome, or who use alcohol. The most convenient thing is to do a regular follow-up with blood tests.

Muscle and joint problems

Joint and muscle pain have been reported in people taking isotretinoin. In adolescents it could stop normal growth of long bones. Likewise, it can cause muscle weakness.

Pressure on the brain

Pressure on the brain is not a common effect, but it is a very serious one. Can lead to vision loss and even death. It manifests itself through symptoms such as a very severe headache, dizziness, nausea, vomiting, and blurred vision. This condition must be addressed as soon as possible.


Sometimes a rash appears that can be serious, although this is rare. It is considered a medical emergency and may be accompanied by the following symptoms:

  • Blisters on the arms, legs or face.
  • Sores in the eyes, nose, mouth, or throat.
  • Peeling on the skin.

Organ damage and toxicity

Isotretinoin can damage organs such as the liver, pancreas, intestine, and esophagus. This is rare. Symptoms such as digestive bleeding, yellowing of the skin, diarrhea, dark urine, or very severe pain in the abdomen are warning signs.

Hearing problems

It is possible, although rare, that this drug cause reduced hearing or ringing in the ears. If this occurs it is important to see a doctor immediately.

Visual problems

The medicine can cause dry eyes, but also an unusual amount of tears in the eyes. Likewise, sometimes causes blurred vision, double vision, or tunnel vision. It may be more difficult to see in the dark.

Allergic reactions

This medicine causes moderate or severe allergic reactions. Sometimes there is a rash, bruises on the legs, or red spots. If there are hives, swelling of the face or difficulty breathing, it is necessary to go to the emergency room.


This side effect of isotretinoin is also not common. In some people it causes blood sugar problems that can lead to diabetes. You have to be attentive to the symptoms and ask any questions about them.

Low levels of red blood cells

This medicine can reduce the level of red blood cells and lead to diseases such as anemia. The main symptoms are weakness, tiredness, dizziness, pale skin, and cold hands and feet.

Low levels of white blood cells

Low levels of white blood cells increase the risk of infections. If a person is taking the medicine and has a fever or infections more often, they should tell the doctor. In any case, it is not common for this to happen.

Mental problems

Isotretinoin can cause serious mental health problems. It can lead to depression, suicidal thoughts, and even psychosis or loss of contact with reality. If there are noticeable changes in mood or behavior, it is necessary to consult a doctor.

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Considerations before taking isotretinoin

Fetal malformations caused by the drug make it necessary to consider the precaution of use in female patients of childbearing age.

Everyone should be fully informed about the risks of taking isotretinoin. In some cases it is necessary to sign an informed consent. The patient must inform the doctor about any other drug, supplement or substance that he ingests on a regular basis.

Several of the most serious effects are related to pregnancy. A pregnant or nursing woman should not take this medicine. Neither should anyone planning to become pregnant. It could cause an abortion, a birth before term or malformations in the fetus.

If a woman takes the drug, she must ensure that she is using reliable contraception. In the case of men, the substance can remain in the semen and it is not known if this has effects in case you impregnate a woman. Therefore, caution prevails in this regard.

A care medicine

It should be taken into account that some of the side effects caused by isotretinoin are reversible, but others do not. Sometimes just stopping the drug is enough, while in other cases the damage is definitive.

A substance like this should be taken with extreme caution. Follow the instructions to the letter, perform the prescribed tests, and keep your doctor informed of any changes or concerns.