How Should Skin Care Be Taken During and After Roaccutane (Isotretinoin) Treatment?

Posted on by Ersin Koseoglu

Although Roaccutane treatment gives very effective results, it can cause very serious negative effects on the skin and body. You should get to know Roaccutane a little more closely in order to take care of your skin during and after Roaccutane treatment and to do your skin care properly for a better skin. In this study, we tried to explain the effects and side effects of Roaccutane and the steps you can pay attention to in skin care.

The use of retinoids in the treatment of dermatological diseases is one of the most exciting developments in recent years.

When Roaccutane (Isotretinoin) is used, the oil production of the skin is reduced by 90% or more. When the skin oil decreases, the environment where bacteria can feed and multiply naturally decreases and acne formation is prevented in this way. This can provide long-term and permanent improvements in the treatment of various lumps and cysts. But it also has many side effects. For example, it is known to cause visual impairment in the dark, pressure on the skull, and liver problems. It can cause dryness, itching, rash on the face. It can cause dryness around the mouth, lips, nose, around the eyes and in the eyes. Nosebleeds are also common among those who use the drug. We have tried to examine them in detail below. In addition, we tried to convey what should be considered during and after Roaccutane treatment in order to minimize the side effects.

How Should Skin Care Be Taken During and After Roaccutane (Isotretinoin) Treatment?

During Roaccutene treatment, many changes occur in the skin as the oil production of the skin decreases by 90% or more. It can turn into dry, easily inflamed allergic skin. Exfoliation can also be observed. Cleaners with gentle ingredients should be preferred for skin cleaning and the skin should not be irritated with harsh (SLES, SLS, Sulfates) ingredients. In addition, ingredients such as essences and ethyl alcohol that trigger skin dryness and cause allergic reactions should be avoided.

As a cleansing gel: You can choose AHA/BHA Exfoliating Gentle Cleansing Gel. It is a creamy and very gentle cleanser, it does not irritate the skin.

After cleansing the skin, a well-formulated tonic with a moisturizing effect should be applied, and then the skin should be moistened with serum and moisturizer. Broad spectrum sunscreen should not be neglected during the day and should be renewed every 2 hours. Moisture masks should not be neglected in weekly maintenance.

We recommend that you use a pure Cyrene Hyaluronic Acid Intensifier containing hyaluron, prebiotics and ceramides as a serum to avoid concerns such as sensitization and dryness on your skin. You can minimize the damage caused by Roaccutane to your skin with this serum. You can use it before moisturizer day and night. It is a very good serum containing pure Hyaluronic acid.

Developed with probiotic technology as a moisturizer Cyrene Skin Rescue Moisturiser is suitable for you. Prebiotics help the skin to continue its healthy functions by regulating the skin microbiome. In addition, by supporting the good bacteria in the skin microflora, they help to destroy the bad (pathogenic) bacteria that cause sensitivity etc.

We recommend you to use Cyrene Invisible Physical Sunscreen, which is designed especially for sensitive skin, contains 100% mineral filter, does not contain chemical filters and harmful ingredients for the skin, and does not react with the skin.

You can benefit from the help of our experts in the creation of your skin care routine and in the selection of products specific to you.

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Although Roaccutane (Isotretinoin) side effects have been minimized, undesirable side effects such as mucocutaneous side effects, elevation in serum lipid levels and teratogenicity (factors or substances that cause congenital deformities in the offspring as a result of passing from the mother to the baby's circulation through the placenta) still exist. continues [1].

As can be seen from the studies conducted by Peck et al., the superiority of Roaccutane (Isotretinoin) has been confirmed in the treatment of severe nodulocystic acne that relapses after conventional treatments [2].

Systemic Roaccutane (Isotretinoin) is the only drug that is effective on all factors involved in the pathogenesis of Acne Vulgaris. It both provides effective improvement in acne lesions and prolongs the time for the disease symptoms to fade.

  • Reduces the size of sebaceous glands (Sebum production glands) and sebum production. During treatment, sebum production is reduced by 90% or more.
  • Normalizes follicular keratinization, prevents the formation of new comedones.
  • Indirectly inhibits the growth of P. acnes by changing the follicular environment.
  • It shows anti-inflammatory effect.

After discontinuation of Roaccutane (Isotretinoin) treatment, sebum production and P. acnes levels that decreased during the treatment may increase again. It is a potent inhibitor of enzyme reactions required in retinoic acid and hydroxysteroid metabolism, particularly androgen and estrogen metabolism [3,4].

Roaccutane was originally only approved for the treatment of severe, persistent nodular acne. However, when the use of between 1993 and 2000 was examined, it decreased from 63% to 46% in severe acne, while the rate increased from 31% to 49% in mild and moderate acne [5].

Oral Roaccutane (Isotretinoin) therapy is very effective in severe nodulocystic acne and in most cases responds to 4-6 months of treatment [2,6,7,8].

Oral Roaccutane (Isotretinoin) is the first choice in the treatment of severe acne. Usually, the response may not be evident even 1-2 months after starting treatment. Similarly, its effect may still persist a few months after treatment is discontinued [9].

Roaccutane (Isotretinoin) Side Effects

Before using Roaccutane (Isotretinoin), possible side effects should be carefully studied and understood. To summarize:

Teratogenicity: Causing congenital deformities in the offspring as a result of the possibility of miscarriage in pregnant women or the transfer from the mother to the circulation of the offspring through the placenta.

Ocular: Decreased night vision, Dry eyes, Stapyhylococcus aureus infections

Bone: Osteophyte (local protrusion-like bone growth or ridge in bones) formations, Osteoporotic changes in long bones, Premature closure of epiphyses.

Lipid metabolism: Hypercholesterolemia (Excess cholesterol in the blood), Hypertriglyceridemia (Increased triglyceride level in the blood).

Hepatic: Elevated transaminases, Rarely toxic hepatitis.

Neurological: Depression - suicidal ideation

Muscle: Myopathy (Muscle disease).

Gastrointestinal: Exacerbation in inflammatory bowel diseases, Pancreatitis (due to triglycerides).


One of the biggest and most serious problems that Roaccutane (Isotretinoin) can cause is Teratogenicity. Unfortunately, we cannot find studies and researches about this in Turkey, but there are very detailed archives in the USA.

According to US sources, 3.6 million women become pregnant every year and 45% of these pregnancies are unintended. Pregnancy occurs in 3 out of every 1000 patients using Roaccutane (Isotretinoin) in the USA. 91% of these patients reported that they were warned that the drug may cause congenital damage if used during pregnancy (Roche Accutane Drug Safety Database 1991-1998).

Female patients should be absolutely sure that they are not pregnant before Roaccutane (Isotretinoin) treatment, and they should not become pregnant during the treatment and until 1 month after the end of the treatment. After this period, every expectant mother can conceive and give birth to healthy babies. At this stage, there is no difference between a mother who has used isotretinoin and a mother who has not used it.

FDA has over two thousand cases of pregnancy while using Roaccutane (Isotretinoin) since 1982. Most of these pregnancies ended in miscarriage. Although some of the babies born were healthy, more than 160 babies were born with birth defects according to FDA data [15].

The second most serious problem that Roaccutane (Isotretinoin) can cause is depression. After effective treatment of acne with Roaccutane (Isotretinoin), the psychosocial problems associated with acne also improve in many cases. However, in some patients with depression, there is no improvement in depression with treatment. This may be due to many factors such as ineffective fighting strategies, acne scars (blemishes), Roaccutane treatment [16].

Hazan et al., in their study published in 1983, reported that 5.5% of patients using Roaccutane (Isotretinoin) had symptoms of depression [17].

In a study published in 1999, the relationship of 6 drugs (isotretinoin, minocycline, tetracycline, doxycycline, diane and oxytetracycline) used in the treatment of acne vulgaris with suicide, suicide attempt and suicidal ideation was investigated. In this study, a total of 1830 psychiatric side effects reported worldwide until 1999 were reached, and it was determined that 59.8% of them were due to Roaccutane (Isotretinoin). It has been reported that 47 suicides and 56 suicidal thoughts were associated with Roaccutane (Isotretinoin) use [18, 19, 20].

Roaccutane (Isotretinoin) must affect brain functions in order to cause depression. This topic was published in 2005 by Bremner et al. In patients treated with Roaccutane (Isotretinoin) and antibiotics, brain functions were measured with fluorodeoxyglucose positron emission tomography before and 4 months after the treatment. ].

Other side effects of Roaccutane (Isotretinoin) may include drying of the skin and mucous membranes, nosebleeds, hoarseness, eye inflammation, reversible corneal opacity, and contact lens intolerance [22,23].

Dermatological side effects are exanthema (skin flushing and symptomatic skin eruptions), itching, facial redness/dermatitis, sweating, pyogenic granuloma (tubules with pus), nail degeneration, increased lump formation, thinning of hair strands and reversible hair loss, can be counted as hair growth and hyperpigmentation

Muscle pain, joint pain, hyperostosis (overgrowth or development of bone tissue) and tendonitis may develop in the skeletal-musculoskeletal system. Sensory disorders may include visual disturbances, photophobia, dark adaptation disorders (decreased night vision), cataracts, corneal inflammation, and hearing impairment at certain frequencies in isolated cases [24, 25, 26].

If you need help with your skin care routine WhatsApp Support by contacting us from our experts you can get help.


  1. Acne Vulgariste Oral Isotretinoin Treatment, Cengizhan Erdem, Turkey Clinics J Int Med Sci 2006;2(30):36-43
  2. Peck GL et al., Prolonged remissions of eystic and conglobate acne with 13-cis-retinoic acid. N Engl J Med 1979; 300: 329-333
  3. Bershad S, Poulin YP, Berson DS, Sabean J. Brodeli RT, Shalita AR, Kakita L, Tanghetti E, Leyden J, Webster GF, Miller BH. Topical retinoids in the treatment of acne vulgaris. Cutis 1999; 64 (Suppl 2): ​​8-20
  4. Blaner WS. Cellular metabolism and actions of 13-cis-retinoic acid. J Am Acad Dermatol 2001; 45: 129-135.
  5. Chivot M. Residual acne lesions after treatment. Ann Dermatol Venereol 1996; 123: 594-600
  6. Leyden JJ. The role of isotretinoin in the treatment of acne: personal observations. J Am Acad Dermatal 1998; 39: 45-49
  7. Pochi PE. 13-cis retinoic acid in severe acne. N Engl J Med 1979; 300: 369-380
  8. Jones OH, Blanc D, Cunliffe WJ. 13-c;s retinoic acid and acne. Lancet 1980; 2: 1048-1049
  9. Goulden V, Layton AM, Cunliffe WJ, Current indications for isotretinoin as a treatment for acne vulgaris. Dermatology 1995; 1gO: 284-287
  10. Di GiovannaJj. Systemic retinoid therapy. Dermatol Elin 2001; 19: 161-167
  11. Geiger JM, Hommel L, Harms MI Saurat JH. Oral l3-cis retinDie acid is superior to 9-cis retinoic acid in sebosuppression in human beings. J Am Acad Dermatol 1996; 34: 513-51
  12. Cunliffe WJ, Norris JFB. Isotretinoin: an explanation for its long term benefit. Dermatologica 1987; 175 (Suppl1): 133-137
  13. Layton AM, Knaggs H, Taylor J, Cunliffe WJ. Isotretinoin for acne vulgaris-10 years later: a safe and successful treatment. Br J Dermatol 1993; 129: 292-296
  14. Strauss JS, Leyden Jj, Lucky AW, Lookingbill DP, Drake LA, Hanifin JM et al. A randomized trial of the efficacy of a new micronized formulation versus a standard formulation of isotretinoin in patients with severe recalcitrant nodular acne. J Am Acad Dermatol 2001; 45: 187-195
  15. Mitchell AA, Van Bennekom CM, Louik C. A pregnancy-prevention program in women of childbearing age receiving isotretinoin. N Engl J Med 1995; 333: 101-106
  16. Kellet SC, Gawkrodger DJ,The psychological and emotional impact of acne and the effect of treatment with isotretinoin. Br J Dermatol 1999; 140: 273-282
  17. Hazen PG, Carney JF, Walker AE, Stewart JJ. Depression a side effect of 13-cis-retinoic acid therapy. J Am Acad Dermatol 1983; 9: 278279
  18. Middelkoop T. Roaccutane (Isotretinoin) and the risk of suicide: case report and a review of the Literature and pharmacovigilance reports. J Pharmacy Practice 1999; 7: 374-378
  19. Jick SS, Kremers HM, Vasilakis-Scaramozza C. Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide. Arch Dermatol 2000; 136: 1231-1236.
  20. Jacobs DG, Deutsch NL, Brewer M. Suicide, depression, and isotretinoin: is there a causal Iink? J Am Acad Dermatol 2001; 4S: 168-175
  21. Bremner JD, Fani N.Functional brain imaging alterations in acne patients treated with isotretinoin Am J Psychiatry 2005; 162: 983-991
  22. Nguyen E-Q H, Wolverton SE. Systemic retinoids. At Comprehensive Dermatoiogic Drug Therapy. Ed. Wolverton SE. Philadelphia, W. B. Saunders Company, 2001; 269-310
  23. Stainforth JM, Layton AM, Taylor JP, Cunliffe WJ. Isotretinoin for the treatment of acne vulgaris: which factors mav predict the need for more than one course? J Dermatol 1993; 129: 297-301.
  24. Harms M, Masouye I, Radeff B.The relapses of cystic acne after isotretinoin treatment are age-related: a long-term Follow-up study. Dermatologica 1986; 172:148-153
  25. White GM, Recurrence rates after one course of isotretinoin. Arch Dermatol 1998; 134: 376-378
  26. Cunliffe WJ, Layton A, Knaggs HE. Retinoids: 10 years ten. Ed. Saurat J H. Basel, Karger, 1991; 274-280