Isotretinoin is part of a group of drugs closely related to vitamin A called retinoids. Isotretinoin is licensed and commonly used to treat moderate to severe acne, especially when there is a risk of scarring. A dermatologist may occasionally use isotretinoin to treat other skin conditions, such as purulent hydradenitis and rosacea.
Most people who have used the drug (about 9 out of 10) see significant improvement in their acne with isotretinoin alone at 16-24 weeks, although during the first few weeks of treatment, acne may worsen before it begins to improve. A small number of patients continue to have milder (albeit improved) rashes after isotretinoin, which can be controlled with conventional treatments such as antibiotics.
With the following prescriptions, the dose of isotretinoin may be adjusted depending on how well you deal with the side effects and how well you respond to the medication. Most patients take 20 to 80mg of isotretinoin every day, and the course usually lasts 16 to 24 weeks. At the lower doses in this range, which are often better tolerated, the course can last longer than 24 weeks. Your acne may continue to improve for up to 8 weeks after treatment.
Since isotretinoin is best absorbed into the body with food containing some kind of dietary fat, it should ideally be taken after a meal or snack with milk and not on an empty stomach. The capsules must be swallowed whole and must not be crushed.
While you are taking isotretinoin and for six months after you stop taking isotretinoin, your skin will be thinner than usual; depilation, epilation, dermabrasion and laser treatments should be avoided. Shaving is usually tolerable, but it is recommended that you use a moisturizer afterwards.
Isotretinoin can increase your skin's sensitivity to the sun. Therefore, you should avoid direct exposure to the sun while taking this drug. If necessary, you should use a sunscreen product with a high protection factor of at least Sun Protection Factor 30. You should also avoid visiting a tanning bed.
Muscles and joints can hurt, especially after exercise. Temporary hair thinning can sometimes occur. Isotretinoin can affect your vision, in particular your ability to see at night, and people whose work requires good night vision, such as drivers and those who drive a heavy vehicle, should be treated with extreme caution. If you have difficulty seeing at night, you should avoid driving and / or operating heavy equipment.
Pilots will not be able to continue their work while taking isotretinoin and should discuss this with their employer before starting medication. These changes in vision can be permanent in extremely rare cases.
Elevated blood fat and mild liver inflammation may occur, but are usually not clinically relevant; they will be monitored by blood tests during the course of treatment. If you have had liver or kidney problems or have high cholesterol or diabetes, you should discuss this with your doctor before starting treatment.
Most drugs can be safely taken with isotretinoin, but some medicines can react with it. Medications to avoid while taking isotretinoin include:
This is not a complete list and it is important that you always consult a specialist if you are taking any medication other than isotretinoin.
