Skin care while on isotretinoin

Isotretinoin (Roaccutane, Oratane and other brands) is a very effective treatment for acne. It works by shrinking the oil glands, so almost everyone gets dryness. With good daily care, this is usually easy to manage.

Lips

Dry, cracked lips affect nearly everyone.

• Apply a lip balm or ointment (such as petroleum jelly or a paraffin-based lip balm) often: every 1 to 2 hours, and thickly at night.
• Keep a lip balm in your pocket, bag, car and by the bed.
• Avoid licking your lips. It makes them drier.

Face and body

• Wash with a gentle, soap-free cleanser. Avoid scrubs and exfoliants.
• Apply a fragrance-free moisturiser twice a day, and after showering.
• Keep showers short and lukewarm.
• If you get dry, itchy patches (often on the hands, arms or legs), apply moisturiser more often. Let us know if it does not settle.
• Stop other acne treatments such as benzoyl peroxide, retinoid creams, acids and toners, unless we have told you to keep using them.

Sun protection

Your skin burns more easily on isotretinoin.

• Use SPF 50+ sunscreen every day on exposed skin, and reapply when outdoors.
• Wear a hat and sunglasses, and seek shade in the middle of the day.

Eyes

• Dry or gritty eyes are common. Use lubricating eye drops (artificial tears) as needed.
• Contact lenses may become uncomfortable. You may need to wear glasses more often.
• Night vision can be reduced in some people. Take care when driving at night, and tell us if you notice this.

Nose

• A dry nose and small nosebleeds are common.
• Apply a little petroleum jelly inside each nostril at night, or use a saline nasal spray.

Avoid during treatment and for 6 months afterwards

Your skin is more fragile and heals more slowly. To avoid scarring, avoid:

• Waxing (shaving is fine)
• Laser treatments, chemical peels and dermabrasion
• New tattoos and piercings

Other important safety information

• Pregnancy: isotretinoin causes severe birth defects. If you could become pregnant, you must not be pregnant during treatment, or for 1 month after stopping. We will discuss contraception and pregnancy testing with you.
• Mood: tell us and someone close to you straight away if you feel low, anxious or irritable, or have any thoughts of self-harm. In an emergency, call 000. You can also call Lifeline on 13 11 14.
• Do not donate blood during treatment or for 1 month after stopping.
• Do not take vitamin A supplements, or tetracycline antibiotics (such as doxycycline) unless we have prescribed them.
• Alcohol: keep it to a minimum. Isotretinoin can affect your liver and blood fats, which we check with blood tests.
• Exercise: muscle and joint aches can happen, especially with hard exercise. Build up gradually.
• Your acne may flare in the first month. This is normal and settles as treatment continues.

When to contact us

• Low mood, anxiety or any thoughts of self-harm
• Severe headache, blurred vision, or nausea and vomiting
• Severe stomach pain
• A rash that is spreading, blistering or peeling
• Dryness or cracking that is not improving with the tips above