Isotretinoin Side Effects: What You Need to Know Before Starting Treatment

When you hear isotretinoin, a powerful oral medication used to treat severe acne that hasn’t responded to other treatments. Also known as Accutane, it’s one of the most effective tools for clearing stubborn acne—but it’s not without risks. Many people see dramatic results in just a few months, but the side effects are real, and they’re not always mild. You might hear stories about it being a miracle cure, but what you don’t hear as often are the daily struggles: cracked lips, dry eyes, nosebleeds, and even changes in mood. These aren’t rare exceptions—they’re common enough that your doctor should talk to you about them before you start.

One of the most frequent issues is dry skin, a direct result of isotretinoin reducing oil production in the skin. It’s not just about feeling tight—it can lead to peeling, itching, and even painful fissures around the mouth and fingertips. Most people need to use heavy moisturizers and lip balms daily, and even then, it’s a constant battle. Then there’s mood changes, including depression, anxiety, and in rare cases, suicidal thoughts. The link isn’t proven for everyone, but enough cases have been reported that doctors now screen patients before prescribing. If you’ve ever struggled with depression, this isn’t a drug to take lightly. Other side effects like joint pain, elevated cholesterol, and liver enzyme changes show up on blood tests, which is why regular check-ins aren’t optional—they’re required.

Isotretinoin doesn’t just affect your skin—it affects your whole body. You might notice your eyes feel gritty, or your nose gets dry and bleeds easily. Some people report increased sensitivity to the sun, so sunscreen isn’t optional. Even something as simple as wearing contact lenses can become uncomfortable. These aren’t just inconveniences; they’re signs your body is reacting to a strong drug. The good news? Most of these side effects go away after you stop taking it. But while you’re on it, you need to be proactive. Talk to your doctor about what’s normal and what’s not. Keep track of how you’re feeling—not just physically, but emotionally. And never ignore a change in your mood or behavior.

What you’ll find below are real, practical posts from people who’ve been through it—some with minimal issues, others who faced serious challenges. You’ll read about how to manage dry skin with the right products, what blood tests to ask for, how to spot early signs of mood changes, and why some people switch to alternatives like topical retinoids or antibiotics. This isn’t a list of scare stories—it’s a collection of honest experiences to help you make smarter choices. Whether you’re considering isotretinoin or already on it, the info here can help you stay safe and know what to expect.