Benefits and Side Effects of Isotretinoin for Acne

Isotretinoin is a very effective acne treatment drug, but requires caution. Today, we'll tell you all about the benefits and side effects of isotretinoin.
Benefits and Side Effects of Isotretinoin for Acne

Written by Edith Sánchez

Last update: 27 May, 2022

Today, we’ll tell you more about the benefits and side effects of isotretinoin.

Isotretinoin is a drug that’s useful for the treatment of moderate to severe acne. It’s available in 10, 20 and, 40-milligram capsules and, according to estimates, is effective in up to 80% of cases.

The average treatment lasts 4 to 5 months. Doctors also sometimes prescribe Isotretinoin to treat other skin problems or even some types of cancer.

Despite its efficacy, it can produce significant side effects. For example, it causes birth defects, so pregnant women shouldn’t use it. At the same time, you should never use it simultaneously with vitamin A supplements.

Let’s take a closer look.

What’s isotretinoin for?

Although isotretinoin is useful for the treatment of various types of acne, doctors almost always prescribe it to treat a severe form called severe recalcitrant nodular acne. Doctors usually recommend it only when other approaches haven’t worked.

It’s one of the most effective medications against acne. Also, in some cases, doctors prescribe it to treat problems such as rosacea, hidrosadenitis suppurativa, folliculitis decalvans, chronic hand dermatitis, skin photoaging, and psoriasis. At the same time, professionals have recommended it for the treatment of some types of skin cancer since the 1980s.

What are its benefits for the body?

Isotretinoin is a drug that acts on several levels. It has a comedolytic action, meaning it prevents the formation of the clog that gives rise to comedones or blackheads. This causes a very significant improvement in the lesions that are already present and prevents the appearance of new ones.

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

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

A woman popping a pimple on her cheek.
Acne has different forms of presentation. Some are severe with multiple dermal lesions including comedos (clogged hair follicles).

The side effects of isotretinoin

The side effects of isotretinoin can be mild or severe. Among the former is increased dryness affecting the skin, lips, nose, and eyes. This leads to difficulties such as chapped lips, nosebleeds, and dry eyes.

These side effects almost always go away on their own. When they don’t, it’s important to consult a doctor. At the same time, this drug can also produce more serious reactions that we’ll look at below.

You may also be interested in: How to Use Turmeric to Treat Acne

Elevated cholesterol

This drug can raise blood cholesterol levels. This is more common in people who are overweight, have diabetes or metabolic syndrome, or consume alcohol. It’s best to follow up regularly with blood tests.

Muscle and joint problems

Patients have reported muscle and joint pain in people taking isotretinoin. In adolescents, it may stop the normal growth of long bones. It may also cause muscle weakness.

Pressure on the brain

Pressure on the brain isn’t a common effect, but it is very serious. It can lead to loss of vision and even death. It manifests itself through symptoms such as severe headache, dizziness, nausea, vomiting, and blurred vision. This condition should be treated as soon as possible.

Skin rash

Occasionally a rash appears that may be severe, although this is uncommon. It’s 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 of the skin

Organ damage and toxicity

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

Hearing problems

It’s possible, although uncommon, for this drug to cause reduced hearing or ringing in the ears. If this occurs, it’s important to see a doctor immediately.

Visual problems

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

Allergic reactions

This medicine causes moderate to severe allergic reactions. Sometimes there’s a rash, bruises on the legs, or red spots. If there are hives, swelling of the face, or difficulty breathing, then you need to go to the emergency room immediately.


This side effect of isotretinoin is also uncommon. In some people, it causes blood sugar problems that may lead to diabetes. It’s very important to be attentive to the symptoms and to discuss any doubts with your doctor.

Low red blood cell levels

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

Low white blood cell levels

Low levels of white blood cells increase the risk of infections. If a person is taking the drug and develops fever or infections more often, they should tell the doctor. In any case, this isn’t common.

Mental problems

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

Discover: Endogenous depression: symptoms, causes and treatment

Considerations before taking isotretinoin

A digital representation of an unborn fetus floating in amniotic fluid.
The side effects of isotretinoin include fetal malformations. Therefore, its use in female patients of childbearing age requires extreme precaution.

Every person should be informed in detail about the possible side effects of isotretinoin. In some cases, you may need to sign an informed consent form. The patient should tell the physician about any other drugs, supplements, or substances that they take regularly.

Several of the most serious effects of isotretinoin are related to pregnancy. A woman who’s pregnant or breastfeeding should not take this drug. Neither should anyone who plans to become pregnant. Miscarriage, premature birth, or malformation of the fetus could result.

If a woman takes the drug, she should be sure to use reliable contraceptive methods. In the case of men, the substance may remain in the semen and experts are unaware if this has any effect if it fertilizes a woman. Therefore, caution should be exercised in this regard.

A drug of caution

It should be noted that some of the adverse effects caused by isotretinoin are reversible, but others are not. Sometimes, the patient simply needs to stop taking the drug, while in other cases the damage is permanent.

Such a substance should be taken with excessive caution. The indications must be followed with precision, the prescribed tests must be performed, and the physician must be kept informed of any changes or concerns.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

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  • Santos-Pérez, M., et al. “Sospecha de diabetes mellitus por isotretinoína.” Farmacia Hospitalaria 37.4 (2013): 340-342.
  • Aranda Núñez, A. P. (2019). Estudio de la relación del esfuerzo de corte con la presión en aneurismas cerebrales y la predicción del riesgo de ruptura usando herramientas de inteligencia artificial basado en datos morfológicos, fluidodinámicos y estructurales.
  • Ramos, P. P., Argilagos, C. S., & Tejo, I. L. (2020). Uso de isotretinoína en pacientes con acné nódulo-quístico en el Hospital. Revista Cubana de Farmacia, 52(3), 1-15.
  • Gómez-Flores, Minerva, et al. “Declaración de posición conjunta. Uso de isotretinoína en acné común.” Revista Médica del Instituto Mexicano del Seguro Social 49.3 (2011): 281-288.
  • Concha, Elescano, and Ivy Marcela. “Cambios séricos de colesterol y transaminasas en pacientes tratados con isotretinoína Centro Médico Naval 2014-2015.” (2015).
  • Guzman Rojas, Patricia, et al. “Hepatitis autoinmune inducida por isotretionina.” Revista de Gastroenterología del Perú 36.1 (2016): 86-89.
  • Peña, Ruth Beatriz, Ángela Cadavid, and Walter Cardona Maya. “Posible relación entre el uso de isotretinoína y la presencia de globozoospermia.” Revista Cubana de Obstetricia y Ginecología 37.3 (2011): 428-430.
  • Vega Zuñiga, Julio Hugo. “Monitorización laboratorial para el uso de isotretinoina en el tratamiento del Acné.” (2017).

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.