Isotretinoin: What You Need to Know

Isotretinoin is a powerful oral medicine used for severe cystic acne and cases that did not respond to other treatments. It clears oil glands, shrinks acne lesions, and often leads to long-term remission. Because it's strong, you need a clear plan with your dermatologist before starting.

How it works and typical dosing

Isotretinoin reduces sebum production and changes skin cell behavior so pimples stop forming. Typical dosing is between 0.5 and 1 mg per kg of body weight daily, split into one or two doses, until a cumulative dose around 120 to 150 mg/kg is reached. Your doctor adjusts the dose based on side effects and response.

Side effects and monitoring

The most common side effects are dry skin, chapped lips, dry eyes, and nosebleeds. It can also raise blood fats and affect liver tests, so doctors order baseline and follow-up blood work - usually liver function and fasting lipids. Avoid vitamin A supplements while taking isotretinoin because combining them can cause toxicity. Don't use tetracycline antibiotics at the same time due to a risk of increased brain pressure.

Isotretinoin causes severe birth defects. People who can become pregnant must use two reliable forms of contraception, have negative pregnancy tests before starting and monthly while on treatment, and avoid pregnancy for at least one month after stopping. Follow your country's pregnancy prevention program closely.

Mood changes and rare reports of depression or suicidal thoughts have been linked to isotretinoin. While a direct cause is debated, check in with your doctor if you notice mood shifts, new anxiety, or thoughts of self-harm. Family support and regular follow-up help spot problems early.

Simple practical tips make treatment easier: use a gentle cleanser, a non-irritating moisturizer, and a humid lip balm. Wear sunscreen every day - your skin becomes more sun-sensitive. Avoid waxing facial hair while on treatment because the skin can peel or scar more easily.

Don't drink heavily while on isotretinoin; alcohol increases strain on the liver and can worsen triglyceride rises. Also, do not donate blood while taking isotretinoin and for at least one month after stopping to prevent exposing a pregnant person to the drug.

Isotretinoin is prescription-only. Beware of bargain online sellers that don't require a prescription. Work with a licensed dermatologist or pharmacist for safe dosing, monitoring, and follow-up. If you have questions about side effects, lab results, or contraception requirements, ask your health provider - it's the best way to stay safe and get results.

Typical course length is four to six months, but some people need more time or a lower maintenance dose. If you're trying to avoid scarring, start early and follow acne care routine your dermatologist recommends. Keep a simple diary of side effects and blood test dates - it helps during follow-ups. If cost or online options are tempting, confirm the pharmacy requires a prescription and is licensed.

Ask about generic isotretinoin if cost is an issue; generics are usually the same, less expensive and available locally too.