Accutane, also known as isotretinoin, is a powerful medication primarily used to treat severe acne that has not responded to other treatments. It reduces the size and oil production of sebaceous glands and influences skin cell turnover. This mechanism often leads to various skin-related side effects, making it important to understand what to expect.
Common Skin Changes
One of the most frequently observed effects of Accutane is widespread skin dryness, often appearing as flaky, red, and sometimes itchy patches, particularly on the face, hands, and around the mouth. This dryness can sometimes resemble eczema due to the scaly, irritated appearance. The medication reduces the skin’s natural oil production, which can lead to a parched feel and visible flaking as the outer layers of skin shed more rapidly.
The lips are especially susceptible to dryness and often become severely chapped, cracked, and peeled, a condition known as cheilitis. This can range from mild discomfort to painful fissures at the corners of the mouth. The skin can also become noticeably thinner and more fragile, increasing its susceptibility to easy bruising, tearing, or peeling, especially with minor trauma or procedures like waxing.
Individuals taking Accutane experience increased sensitivity to sunlight, known as photosensitivity. This means the skin can burn more quickly and severely with sun exposure, even on cloudy days, due to the medication reducing the thickness of the outermost skin layer.
Identifying Severe Skin Reactions
While many skin changes on Accutane are manageable, certain severe reactions, though rare, require immediate medical attention. One such concern is widespread redness and peeling that extends beyond localized dryness, potentially covering large areas of the body. This goes beyond typical flaking and can be a sign of a more serious issue.
The appearance of blisters or target lesions signals a serious reaction. Blisters are fluid-filled sacs on the skin, while target lesions are distinct, round lesions with multiple concentric rings, resembling a bullseye. These can appear on the skin and also on mucous membranes, such as inside the mouth, around the eyes, or in the genital area.
Severe, persistent itching accompanied by the formation of hives or welts is another concerning symptom. Unlike the mild itchiness associated with dry skin, these manifest as raised, red, itchy bumps that can appear suddenly and spread across the body. The development of any unusual, deep, or painful sores that do not heal warrants prompt medical evaluation.
When to Contact Your Doctor
It is important to contact your doctor if you experience persistent or worsening common symptoms that become unmanageable despite at-home care. This includes dryness, cracking, or irritation that significantly impacts your daily life. Any signs of severe reactions, such as widespread redness, blistering, target lesions, severe hives, or painful sores, warrant immediate medical consultation.
You should also seek prompt medical advice if you notice any signs of skin infection. These can include increased pain, swelling, warmth, or the presence of pus in any skin lesions. Any new, unexpected, or alarming changes in your skin that cause concern should be discussed with your healthcare provider.
Caring for Your Skin While on Accutane
Managing skin side effects on Accutane involves consistent and gentle care. Frequent and generous application of thick, emollient moisturizers is highly recommended for the face, body, and lips. Opt for fragrance-free, non-comedogenic products to avoid further irritation or clogged pores. Petroleum jelly-based lip balms are particularly effective for chapped lips.
Sun protection is very important due to increased photosensitivity. Daily use of a broad-spectrum sunscreen with an SPF of 30 or higher is advised, along with wearing protective clothing and seeking shade when outdoors. When cleansing your skin, use mild, non-foaming cleansers and avoid harsh scrubbing or abrasive products that can strip the skin of its natural oils.
It is generally recommended to avoid other acne treatments, such as topical retinoids or benzoyl peroxide, and harsh skincare products unless specifically directed by your doctor. These can exacerbate the dryness and irritation caused by Accutane. Maintaining good hydration by drinking plenty of water can also support overall skin health during treatment.