Side effects from using isotretinoin

Some severe cases of acne need extreme treatments! Even if you use good skincare! But acne medications has side effects. Learn more here.

Author Mads Timmermann

Mads has 14+ years of experience as a skin expert and has written/read this article.

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Question: “Side effects from using isotretinoin”

Hey Mads

My dermatologist believes I’m so severely plagued by acne that the only solution for me is Isotretinoin. I really have so many pimples. In particular, I experience a lot of huge bumps that never turn into yellow pimples, but just become huge “bumps” – and they really hurt.

The only problem is that I have heard many bad things about Isotretinoin. So what are the side effects and what should I be aware of?

I would be very happy if you could help me take a decision. I just want to get rid of my acne, it hurts a lot and I’ve really tried everything. Your skin care series has helped VERY much. In fact, the Danish Skin Care series is the only products that has ever helped. But Danish Skin Care does nothing against the huge big pimples that almost become bumps / horns on my skin :-(

My skin is so ugly and I have a constant pain in my skin. Right now I have 3 huge pimples in the forehead and I also think one more is on the way! I also have a lot of ordinary pimples but it’s far better than just a year ago because I’ve started using Danish Skin Care.

I hope you will help me.


Answer to: “Side effects from using isotretinoin”

Hi Ella

Its great hearing that you are happy with my products – and I am really glad to hear that they have helped you :-D

However, it sounds like you are really suffering from a severe degree of acne. And because of your description of the pimples that you get many of at the same time – but where Danish Skin Care does not really help – I’m pretty sure it’s got to be cysts. If you experience more than 2-3 cysts at once, you should immediately seek medical advice and start on a pill cure – so it is very nice that you have already talked to a dermatologist.

And I would certainly advise you to follow the recommendation from your dermatologist and get started with Isotretinoin. That’s the pill cure against pimples, which may be necessary for some people – after trying everything else.

And yes, even with skin care, we can do a lot today, but there are still some severe cases where there is definitely a need for medicine. Cysts is one of the cases, like violent acne breakouts may be. The medicine you can use is antibiotics or a harsh vitamin A cure, which isotretinoin is.

However, it should be added that Isotretinoin is a medicine used only for the treatment of really severe cases of pimples, acne or cysts, where you have unsuccessfully tried other treatments … which you already have, so that’s why your dermatologist is advising you to start taking Isotretinoin :-)

However, Isotretinoin can cause side effects like all other medicines. I will try to describe the various side effects of Isotretinoin below.

– Want to know more about Isotretinoin, please read here

Let me start by saying that the pills with the names Accutin and Actavis both contain Isotretinoin, as does Roaccutan. Roaccutan is no longer sold in Denmark.

The risk of side effects with Isotretinoin depends on the dose you take, but throughout the course of treatment, your dermatologist will constantly increase your dose because you will need more and more until your acne is cured. So with Isotretinoin you go through a gradual increase up to the maximum you need. Afterwards, the dermatologist will reduce the amount of pills, and this part of the treatment must continue over 6-12 months.

When the dose of Isotretinoin decreases – or you completely stop taking Isotretinoin pills, the side effects usually decrease or disappear completely.

The side effects of Isotretinoin usually disappear within two weeks after you completely stop taking the medicine, but of course there may be some serious side effects that will not disappear again. However, this only happens in really rare case of side effects.

Of course, if you want to start with Isotretinoin, I will definitely be up to you after reading the side effects. However, I would like to say, just as your dermatologist has already done that you need to start with Isotretinoin to get rid of your acne.


The most common side effects that most people experience are the skin and mucous membranes dry out.

The side effects It is especially dry lips, dry skin on the nose and dry eyes.

In addition, the following are also very common side effects that most will experience in conjunction with an Isotretinoin cure for pimples.

  • Joint and muscular pain, back pain.
  • Drowsiness and irritation of the eye, inflammation of the eyelid, inflammation of the conjunctiva of the eye.
  • Dry skin, skin scaling, itching, redness of the skin.
  • Increased amount of fat in the blood.
  • Blood deficiency and increased tendency for bleeding due to changes in blood composition.
  • Fragile skin with a risk of sore skin.
  • Inflammation of the skin and lips.


The common side effects of Isotretinoin, which according to the manufacturer are 10 in 100 treated with Isotretinoin, are:

  • Headache, hay fever.
  • Dry mucous membranes in the nose, nose bleed, nose and throat inflammation.
  • Blood in the urine.
  • Increased amount of cholesterol in the blood.
  • Increased sugar level in the blood.
  • Increased tendency for infections due to lack of white blood cells.

However, I would say that I have never heard of anyone who was on Isotretinoin who did not experience a headache. So I would probably think that headache is a very common side effect, just like fatigue and a need for much sleep it is.


  • The rare side effects of 10 out of 10,000 are:
  • Aggressiveness, anxiety, depression, mood swings.
  • Hair loss.
  • Severe allergic condition with rapid blood pressure drop, respiratory distress and possibly Cramps (anaphylactic shock).


The following side effects are the very rare side effects of Isotretinoin and occur in only 1 in 10,000, but you get them anyway. Note, however, that these are the very rare side effects, so do not panic about this series of side effects :-)

The very rare side effects from using Isotretinoin are:

  • Abnormal behavior, symptoms of mental illness, suicidal thoughts, suicide attempt and suicide.
  • Bacterial infections.
  • Changes in the lymphatic system.
  • Diabetes.
  • Increased pressure in the brain, cramps, drowsiness.
  • Cataracts, blurred vision, blurred cornea, corneal inflammation, fluid accumulation in the eye.
  • Color blindness, irritation of contact lenses, decreased night vision, increased sensitivity to light.
  • Impaired hearing.
  • Hoarseness, dry throat.
  • Cramps in the lung muscles – especially if you suffer from asthma.
  • Increased hairiness in women.
  • Increased sweating.
  • Crazy nails, nail infection.
  • Joint inflammation, ligament calcification and tendons, tendonitis, bone growth, bone enlargement, bone density decreased.
  • Inflammation of the blood vessels.
  • Inflammation of the colon and small intestine, bleeding in the gastrointestinal tract, bloody diarrhea.
  • Inflammation of the pancreas.
  • Hepatitis, which gives yellow skin and eyes.
  • Kidney inflammation.


In relation to the above side effects, there are also a number of limitations. So things that you must not – and should not – when you are in treatment with Isotretinoin. The first is that you should avoid sun and completely avoid the solarium! So no sunshine while you’re in treatment! Therefore, it’s also a good idea to start the treatment with Isotretinoin in the fall and continue through the winter, if you continue through the summer, you really need to take care of sunscreen and stay in the shadows!

For example, you will be getting tanned when you take Isotretinoin and other acne pills. It can cause problems if you are going on holiday or spending a lot of outdoor sports. Therefore, remember to use sunscreen and make sure to get a lot of shade.

Also note that sunscreen containing alcohol may lead to further skin drying. Therefore, choose all your skincare products without alcohol.


This point is really important!

Pregnant women must not use Isotretinoin! Neither should you attempt to become pregnant while taking Isotretinoin. In fact, as a woman, you should wait for at least 3 months after your treatment with Isotretinoin before you become pregnant.

For men, the same applies, you must not try to conceive a child with a woman while on Isotretinoin and you should wait at least one month after treatment ends before attempting to make children.

The above applies to all medicines containing Isotretinoin. Accutin, Actavis and Roaccutan are all preparations containing Isotretinoin and must not be used during pregnancy or at the same time attempting to become pregnant.

According to the National Board of Health, there have been several cases where children were born with severe malformations of the central nervous system and internal organs after their mothers and fathers had used Isotretinoin.


If you are taking Isotretinoin, do not donate blood. This applies throughout the treatment and at least two months after treatment. Therefore, do not give blood, lose blood or be blood donor while you are on Isotretinoin!


In any case, you should at least significantly lower your intake of alcohol. Isotretinoin is hard for the liver and your organs, that why you dermatologist during your treatment is constantly monitoring your blood, taking tests and checking your kidney. And alcohol is extremely hard for the liver, so not to add extra load on your system you should really avoid – or minimize your alcohol intake.

You should really minimize your alcohol intake while you are taking Isotretinoin because of your liver and your organs, but also for better results. Your dermatologist can only increase the dose of your Isotretinoin pills if your blood tests and kidney can help to break the pills. And if you drink alcohol at the same time, your liver may have trouble with this process.

Drinking alcohol reduces the chance of a really good result.

At the same time, the body is already very dry – from the very common side effects – and drinking alcohol on the body also has the effect. It will just cause your skin to become even more dry which you hardly want.

The many side effects that I have written above may seem very dissuasive when you are now considering whether you should start taking Isotretinoin. However, I think you should be aware of the side effects that may occur. Remember, however, that the vast majority of those treated with Isotretinoin only experience the very common side effects.

Remember: The most common side effects are only dryness of the skin and mucous membranes and perhaps headache.

Medications like Isotretinoin are also made available to the public only because studies have first shown that the benefits of taking the medicine in the vast majority of cases are greater than the disadvantages associated with side effects.

Also, it is also important to point out that you are only allowed by your dermatologist to get started with Isotretinoin if you have tried several different treatments and that your dermatologist really believes that Isotretinoin is the only solution for you skin problems.

And with your skin and your extent of cysts, I totally agree with your dermatologist. Isotretinoin is the solution for you to get rid of your severe acne problem. You have already used my Danish Skin Care series for a year and experienced good results, but just not good enough to remove it all.

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