Side effects

The side effects of oral isotretinoin are significant and require detailed discussion with the patient to ensure full understanding of the implications of taking the drugs. Because one of the therapeutic benefits of isotretinoin is as a drying agent, patients will experience dry skin, chapped lips, dry eyes and a dry mouth. Secondary skin infections with S. aureus can also occur and should be treated with oral antibiotics or antiseptics (depending on the level of infection). Less frequently patients may experience muscle and back aches and mild headaches, although these usually resolve as the treatment progresses. Nosebleeds and skin fragility may occur. There may be a rise in serum lipid levels. Certain symptoms should be taken very seriously and warrant discontinuation of the treatment immediately. These include:

• severe headache
• decreased night vision
• signs of adverse psychiatric events

Generally, the unwanted side effects will resolve once treatment is discontinued.

Both brands of isotretinoin available in Britain contain soya oil. Some patients with peanut allergy may have cross-reactivity with soya and this needs to be discussed. The capsules that encase the active ingredients contain gelatine which may make taking the tablets unacceptable to someone on a vegetarian diet.