What is isotretinoin and how does it work?
Isotretinoin treatment is based on the oral and prescription use of a vitamin A-related retinoid drug. It reduces the skin's oil production and affects the processes involved in the development of acne. It is not a vitamin supplement; it should not be started on your own.[1][2]
Who is suitable for isotretinoin treatment?
Isotretinoin is generally considered, after expert evaluation, for severe acne that has not responded adequately to other suitable treatments or in cases where there is a risk of permanent scarring. It is not an automatic starting option for mild acne. The consultation takes into account the duration of previous treatments, the location and severity of the acne, scarring or psychological effects, and the individual's health status. The suitability of the medication cannot be determined solely by looking at acne photos on the internet.[2][3]
What should be told to the doctor before treatment?
Share any acne medications you have used previously, known medical conditions, mental health history, allergies, and any medications and supplements you are currently taking. Pregnancy, breastfeeding, or pregnancy plans must be discussed beforehand. Bringing your test results and the names of any skin care products you use will facilitate the consultation. The physician will assess the risks, determine the necessary tests and follow-up plan; treatment will only begin after a personal assessment.[1][2]
How are the daily dose and duration of treatment determined?
Dosage is determined by the physician based on the person's weight, response to the medication, and side effects. The mg value on a capsule is not the same as the total daily dose. If the daily dose changes, previous days are not counted as the new dose. In some patients, a lower dose or a change in the treatment plan may be considered depending on tolerance. A number calculated from the internet should not be used to change the number of capsules in the prescription.[2][3]
What is cumulative dose?
The cumulative dose is the total amount of medication actually taken during the course of treatment; when expressed in mg/kg, the total amount is related to weight. For example, taking 20 mg daily for 30 days would be 600 mg for that period; this is not a prescription example. NICE refers to a total range of 120–150 mg/kg for the decision and allows for the assessment of early termination in case of an appropriate response. The target does not replace individual assessment.[3]
How long does the treatment last and when does it take effect?
The product information states that a typical course of treatment is 16–24 weeks; dose reduction or interruption of treatment may alter the duration. Temporary worsening may occur in the initial period; this does not happen to everyone. Improvement may continue after the end of treatment. New lesions, side effects, and blood tests are evaluated together at follow-up appointments. Report any significant worsening to your doctor; do not determine the end date solely based on a calculator or another patient's experience.[2]
Side Effects and Blood Tests
Dry lips and skin, dry eyes or nose, and muscle and joint pain may occur. Since changes in blood lipids and liver enzymes may occur, the physician will evaluate appropriate tests at the outset and during follow-up. Changes in test results do not mean that every person has permanent organ damage; the decision is made according to the level of the results and the individual's condition. Report any severe or persistent symptoms to the healthcare team.[1][2]
What can be done about dryness and skin sensitivity?
For dry lips and skin, regular moisturizer and lip balm can help. Opt for a gentle cleanser; if dry eyes or nose bother you, consult your doctor or pharmacist about appropriate support products. Use shade, clothing, and sunscreen to protect yourself from the sun. Do not use irritating products, waxing, or skin treatments without consulting your dermatologist.[1][4]
Can Mood and Sexual Function Be Affected?
Symptoms related to mental and sexual function have been reported; the causal role of the medication is not certain in every report. Nevertheless, it is important to take new or worsening symptoms seriously and discuss them with the treatment team. Some complaints have also been reported to persist after treatment. Seek immediate help if you have thoughts of self-harm, severe mood changes, or feel unsafe. Share your previous mental health history before starting treatment.[1][6]
What symptoms require immediate help?
Stop taking the medication and seek immediate medical attention if you experience severe headache with blurred vision, severe abdominal pain, jaundice, or a widespread blistering rash. Seek immediate help if you experience difficulty breathing, swelling of the face or throat, or thoughts of self-harm.[1][2]
Pregnancy, Breastfeeding, and Post-Treatment Contraception
Isotretinoin can cause serious birth defects and pregnancy loss during pregnancy; it should not be used during pregnancy or breastfeeding. Individuals who may be pregnant should discuss contraception and pregnancy testing with their doctor before treatment. The source product information includes conditions for effective contraception at least one month before treatment, during treatment, and at least one month after the last dose; local product information and individual circumstances should also be verified. If pregnancy is suspected, discontinue the medication and contact a doctor immediately.[2][5]
Having Children in Men and Partner Pregnancy
The UK Roaccutane product information states that at therapeutic doses, sperm count, motility or morphology are not affected; the amount of sperm that passes from men using the drug to their partner via semen is not at a level associated with any expected harmful effects on the fetus. However, discuss your plans for having children and any concerns about the treatment with your doctor. This information does not permit anyone who is pregnant or who might become pregnant to use the drug; do not share your medication with anyone.[2]
Which medications, supplements, and procedures should be discussed?
Vitamin A supplements and tetracycline antibiotics should not be used with isotretinoin. Inform your prescribing physician about your other medications and supplements. Do not self-administer irritating peels and acne products; plan treatments such as waxing and laser with your dermatologist. Protect yourself from intense sun exposure. Do not donate blood during and for one month after treatment; follow your product's instructions for more detailed application.[1][2]
Discuss your alcohol use and exercise routine with your doctor; intense exercise can worsen muscle and joint problems. If significant muscle weakness is accompanied by dark urine, stop exercising and seek immediate medical attention.[1][2]
What is the difference between Roaccutane, Zoretanin, Aknetrent, and Acnegen?
Roaccutane, Zoretanin, Aknetrent, and Acnegen are among the brands of oral medications containing isotretinoin.[5] The fact that they contain the same active ingredient does not mean that all capsule doses or excipients are the same. A brand name alone does not indicate that a medication is more effective or safer for everyone. Do not change your medication or number of capsules yourself; confirm the brand change, prescription, and current instructions for use with your doctor or pharmacist.
Can acne reappear after treatment?
Yes, acne may recur in some people; isotretinoin does not guarantee permanent cure for everyone. The fact that improvement may continue after the completion of treatment makes it important that a new course of treatment be decided upon with expert evaluation. Do not restart on your own with the remaining capsules. The type of recurring lesions, previous response and other possible treatments will be evaluated with your doctor.[2]
For appointments and informationClinic contact informationYou can review the page.
This text is for general information only; it does not replace a personal prescription, examination, or the current instructions for use of your medication.
Sources
[1] NHS, Isotretinoin:https://www.nhs.uk/medicines/isotretinoin-roaccutane/
[2] Roaccutane, product information (United Kingdom; does not replace Turkish product information):https://www.medicines.org.uk/emc/product/100634/smpc
[3] NICE, acne recommendations:https://www.nice.org.uk/guidance/ng198/chapter/Recommendations
[4] American Academy of Dermatology, side effects and skin care:https://www.aad.org/public/diseases/acne/derm-treat/isotretinoin/side-effects
[5] TITCK, isotretinoin risk management materials:https://www.titck.gov.tr/dinamikmodul/111
[6] MHRA, psychiatric and sexual side effects review:https://www.gov.uk/guidance/isotretinoin-an-expert-review-of-suspected-psychiatric-and-sexual-side-effects
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