Isotretinoin (Accutane) is a drug which is used by physicians to treat extreme acne. This is a retinoid, similar to vitamin A, which is a class of medicines.
According to the British Association of Dermatologists, about 90 percent of people taking an Accutane course find their acne dramatically improves although it can worsen in the short term.
Accutane has an number of side effects, including severe ones. According to the Food and Drug Administration (FDA), people should be taking isotretinoin only under close supervision of a health care professional.
This report would take a look at some of Accutane’s side effects. This will also look at the long-term adverse effects of the drug, and offer recommendations on when to seek a doctor’s advice.
Side effects of Accutane
People will undergo blood tests before taking Accutane, and at regular intervals thereafter, to check their liver and kidney function as well as their fat and cholesterol levels.
Some common Accutane side-effects include:
- dry, cracking, or peeling skin
- dry or inflamed eyes
- chapped lips
- a dry nose, perhaps with nosebleeds
- headaches
- aches and pains
Patients who take Accutane will also have increased exposure to UV light and they can use sun protection as much as possible to avoid direct sunlight.
Current guidance says people taking Accutane should also stop waxing or even performing cosmetic skin procedures when taking the medication and afterwards for 6 months. It is for preventing scarring.
However, after using Accutane or products containing isotretinoin one 2017 review found no evidence to support delaying cosmetic procedures. That said, it is only with the advice of an experienced doctor that people should perform such procedures.
When talking about Accutane people sometimes mention weight gain or weight loss. The FDA does not currently list the change in weight as a side effect of this drug, though.
Risks in pregnancy
It is very important that anyone who is pregnant, planning to become pregnant or who may accidentally become pregnant should not take Accutane.
This is because Accutane may cause:
- miscarriage
- congenital disabilities
- premature labor
- death in babies
These are serious and not rare results. For example, the Genetic and Rare Disease Information Center says that if they are exposed to retinoids during pregnancy, around 20–35 percent of fetuses may develop malformations.
Different countries have put in place different regulatory procedures to prevent fetal exposure to this drug, including asking people to use two methods of contraception during and after retinoid therapy, and routine pregnancy tests.
In 2006 the United States adopted iPLEDGE in an attempt to eliminate fetal isotretinoin exposure through a limited distribution program.
A 2019 analysis reported that although there has been a decrease in the number of pregnancy complications, miscarriages and fetal abnormalities in people taking isotretinoin since then, they still do occur.
Anyone who breastfeeds does not take Accutane, either.
Allergic reactions
Many people can get an allergic reaction to the Accutane ingredients.
Cholesterol and Fat
Accutane can also increase blood cholesterol levels and body fat levels. Doctors can track these by regular blood tests.
Blood cells: Red and white
Taking Accutane can contribute to reduced red and white blood cell counts. Over 1 in 10 people taking Accutane may experience anemia.
Long-term side effects
The following sections will go into more detail on Accutane ‘s potential long-term side effects.
Sexual function and fertility
Accutane appears to have no effect on fertility. Scientists have, however, found a link between Accutane and sexual side effects, like:
- erectile dysfunction
- loss of libido
- genital numbness
Mental health problems
There are some serious mental health issues associated with Accutane.
For example, Accutane may cause:
- depression
- psychosis
- suicidal thoughts
Such serious but uncommon side effects can also occur after Accutane is stopped by an individual, so follow-up treatment is important.
Neurological problems
Accutane taking will increase the pressure within the brain of a human. It may result in total loss of sight and, occasionally, death.
Damage to internal organs
A further potential side effect of Accutane is organ damage. Accutane can cause injury to:
- pancreas
- bowel
- esophagus
- liver
Bone, muscle, and joint problems
Accutane may affect the:
- bones
- muscles
- ligaments
- joints
When taking this drug people should discuss every workout they do with their doctor.
Accutane can halt long bone growth in still growing teenagers.
Blood sugar and diabetes
Accutane can raise blood sugar levels and, rarely, contribute to diabetes.
Vision problems
People can experience a (sometimes permanent) loss of night vision and other serious eye problems from taking Accutane.
The drug will also make it uncomfortable to wear contact lenses and after treatment, the discomfort will continue.
Serious skin problems
As well as the more normal, mild skin side effects, people with the use of Accutane have reported serious skin conditions.
These include:
- erythema multiforme
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
Side effects after stopping the drug
Many of the long-term side effects can linger until an person stops taking Accutane. This may also cause lasting complications, such as scarring, loss of vision or damage to the internal organ.
According to one 2018 review, some people have had sexual side effects appearing or becoming significantly worse after they stopped treatment.
Meanwhile, a 2010 study found an increased risk of suicide for up to six months after treatment with Accutane ended. Before treatment began, however, the risk of attempting suicide was greater. For this reason any potential risk due to Accutane can not be verified.
Interactions
People who are going to take Accutane will discuss any other drugs or herbal supplements they are taking with their doctor.
People taking Accutane will especially avoid:
- vitamin A supplements
- tetracycline antibiotics
- corticosteroids
- any other acne treatments
- alcohol (or keep it to a minimum)
- phenytoin (Dilantin)
- strong sunlight and sunbeds
- cosmetic skin procedures, such as waxing or laser treatment
Accutane will decrease the efficacy of progestin-only birth control pills, so people who take these should speak to their doctor. In the same way, taking St. John’s Wort may mean less successful birth control pills.
When to see a doctor
Patients who take Accutane will see a doctor if any of the mild side effects occur and cause problems to them.
Other signs can indicate serious condition. These include:
- symptoms of depression or psychosis
- indications of an increase in brain pressure, such as:
- bad headaches
- blurred vision
- dizziness
- nausea
- vomiting
- seizures
- stroke
- a severe rash that may blister or peel, sometimes with flu-like symptoms, conjunctivitis, or sores in the mouth, eyes, nose, or throat
- possible abdominal problems or organ damage symptoms, such as:
- nausea
- vomiting
- bad stomach pains
- diarrhea
- bleeding from the rectum
- chest or bowel pain
- the skin or whites of the eyes turning yellow
- dark urine or difficulty urinating
- muscle weakness and pain
- swelling or bruising on some areas of the body
- difficulty moving the arms and legs
- ringing in the ears or worsening hearing
- problems with vision or dry eyes that hurt
- an allergic reaction
- dark urine
When someone experiences these symptoms when taking Accutane, they should immediately avoid taking the drug, and call a doctor.
Those with back pain or joint pain should seek medical advice, too.
Anyone who breaks a bone should tell the doctor who treats them to take Accutane, too.
Summary
Accutane is an effective medication for extreme acne, but it does have some significant side effects, including mental health concerns and pregnancy-related complications.
Anyone who is considering taking this medicine should have a detailed discussion with their doctor about the risks and how they can be reduced.
