

Acne is a frustrating problem that affects both skin appearance and self-confidence, especially when pimples are stubborn and persistent despite using creams and antibiotics. This is where Roaccutane comes in—a powerful and highly effective treatment for severe and cystic acne. But before starting Roaccutane, it’s important to understand its effects on the skin, benefits, and potential side effects, so you can choose a safe approach and achieve the best results without complications.
What is Roaccutane?
Roaccutane is a medication from the retinoid family, derived from vitamin A, and is used to treat severe acne that has not improved with other treatments.
It works by:
Reducing oil production in the skin, which helps prevent clogged pores.
Significantly decreasing acne breakouts and skin inflammation.
⚠️ Roaccutane should be prescribed under strict medical supervision due to its potency and potential side effects.
Does Roaccutane cause weight gain?
Usually, it does not directly affect weight, although some people may notice slight changes in appetite during treatment.
Does Roaccutane cause hair loss?
Mild hair shedding may occur at the beginning of treatment for some individuals, but it is usually temporary and stops after finishing the medication.
Can I use makeup while on Roaccutane?
Yes, but it is best to use gentle, oil-free products and remove makeup carefully to maintain skin health.
Does Roaccutane require a special diet?
Not strictly, but it is advisable to avoid very fatty foods or high vitamin A supplements. Drinking plenty of water helps reduce skin dryness.
Can I take Roaccutane again after years?
Yes, in some cases, if acne recurs, a doctor may prescribe another course. The dose and duration depend on acne severity and skin response.
Does Roaccutane affect pregnancy immediately after stopping?
Women should continue using contraception for at least one month after finishing treatment to prevent potential harm to a developing fetus.
Is Roaccutane safe for children and teenagers?
It is generally used after puberty. Use in younger children is rare and requires careful medical supervision.
Can Roaccutane cause psychological issues?
In rare cases, some people may experience mood changes or depression. It is important to monitor mental health and inform the doctor if symptoms appear.
Duration of Roaccutane treatment
Follow your doctor’s instructions closely. Typically, treatment lasts 6 to 8 months, depending on acne severity.
Cosmetic products during treatment
Avoid heavy makeup or products that may clog pores. Always consult your doctor before trying new skin products.
Severe dry lips
Continue treatment and use a lip balm regularly. If dryness is severe, consult your doctor.
Do acne breakouts return after treatment?
Acne rarely returns after completing Roaccutane. If minor breakouts appear, a doctor may recommend topical treatments to maintain clear skin.
Initial follow-up: 3–4 weeks after starting to run blood tests and check progress.
Subsequent visits: Scheduled based on test results and doctor’s instructions.
Blood donation during Roaccutane
Not allowed during treatment and for at least one month after stopping.
Reason: If your blood is given to a pregnant woman, it could harm the fetus.
If one dose is missed: Take it as soon as you remember unless the next dose is near; do not take double doses.
If multiple doses are missed: Contact your doctor before continuing.
Tips to avoid forgetting doses: Set a daily alarm, keep pills in a visible spot, and follow your routine. Do not adjust doses on your own.
Before and during treatment: Regular blood tests are essential for safety:
Before starting:
Liver function tests (LFTs) to ensure liver health.
Cholesterol and triglycerides, as Roaccutane may raise them.
Pregnancy test for women.
Complete blood count if needed.
During treatment:
Liver function and lipid profile every 1–2 months.
Monthly pregnancy tests for women.
Monitor skin, lips, and eyes for dryness or irritation.
As needed:
Blood sugar or thyroid tests if there is medical history or new symptoms.
Additional tests if unusual side effects appear.
Roaccutane tablets contain the active ingredient and several excipients to ensure stability and proper absorption.
1. Active Ingredient
Isotretinoin – a pharmaceutical form of vitamin A, responsible for:
Reducing skin oil production, which decreases clogged pores.
Exfoliating the skin and preventing pore blockages.
Anti-inflammatory effects and reducing acne-causing bacteria.
Dosage strengths: Usually 10 mg, 20 mg, or 40 mg, depending on the doctor’s prescription.
2. Inactive (Auxiliary) Ingredients
Sunflower oil or soybean oil: Improves drug dissolution and absorption.
Glycerin or cellulose: Forms the capsule or outer shell.
Gelatin: Creates the soft, swallowable capsule.
Stabilizers or colorants: Maintain the shape and color of the capsule.
Roaccutane is a powerful treatment for severe, persistent acne, especially when other treatments like antibiotics or topical creams fail. Not everyone is suitable. Generally, it is recommended for:
Severe or stubborn acne cases
Nodular or cystic acne.
Cases that do not improve after trying antibiotics, retinoid creams, or benzoyl peroxide.
Adults and mature adolescents
Usually recommended after puberty, when the body’s hormonal balance is more stable.
Patients able to follow strict medical supervision
Roaccutane has strong side effects, including:
Severe dryness of skin and lips.
Liver issues and elevated blood lipids.
Sometimes eye or joint problems.
Regular blood tests and dermatology follow-ups are essential.
Women who are not pregnant or planning pregnancy
Roaccutane is highly teratogenic, harmful to the fetus even with short exposure.
Usually, two forms of contraception are recommended before, during, and after treatment, with regular pregnancy testing.
Roaccutane (Isotretinoin) comes in various forms and concentrations depending on the manufacturer and patient needs, but the active ingredient is the same: Isotretinoin.
By dosage strength
10 mg: Often for starting therapy, lightweight patients, or those sensitive to the drug.
20 mg: Most common for standard cases.
30–40 mg: For adults or severe cases, under strict medical supervision.
By manufacturer / brand name
Roaccutane: Most famous global brand.
Isotretinoin: Generic or alternative brand names.
Other brand names exist in different countries but contain the same active ingredient.
By formulation
Oral capsules: Most common, easy to swallow, usually soft or gelatin capsules.
Topical cream or gel: Often for early-stage or mild cases, but less effective than oral capsules.
Roaccutane targets the root causes of acne, not just the symptoms, which makes it more effective than traditional treatments. Its effects include:
Reducing sebum production
Acne bacteria thrive on skin oils.
Roaccutane significantly lowers oil levels, reducing bacterial activity.
Exfoliating skin and unclogging pores
Promotes natural skin exfoliation.
Prevents blackheads, whiteheads, and nodules.
Anti-inflammatory effect
Reduces redness and swelling around acne lesions.
Reducing acne-causing bacteria
Although not a direct antibiotic, it makes the skin less hospitable to Propionibacterium acnes.
Improvement usually begins after 3–4 months.
Some patients may experience initial worsening of acne before gradual improvement.
Standard treatment lasts 4–6 months to achieve clear results.
Scar improvement may take longer and sometimes requires additional treatment.
Improved skin appearance
Smoother, clearer skin with fewer acne lesions.
Reduced oiliness and smaller pores.
Improved scar appearance
Roaccutane does not remove existing scars but reduces their visibility.
Drier skin
Common side effect; moisturizers are recommended.
Less oil secretion
Reduces shine and prevents clogged pores.
Improved skin elasticity
Encourages skin cell renewal, making skin look healthier and younger.
Patient assessment before starting
Dermatologist evaluation to confirm need.
Baseline blood tests: liver function, lipids, pregnancy test (for women).
Review medical history and current medications.
Dosage determination
Based on body weight and acne severity.
Duration usually 4–6 months, sometimes up to a year.
Monitoring during treatment
Blood tests every 1–2 months.
Monitor skin, lips, and any side effects.
General instructions during treatment
Use moisturizers for skin and lips.
Avoid laser or strong chemical peels.
Women must use two contraceptive methods during and for 1 month after treatment.
After treatment
Most patients see long-lasting results.
Some may need a second course if acne recurs, usually milder.
Common and temporary:
Dry skin and lips, sometimes cracking.
Dry eyes or nose, occasional burning or mild bleeding.
Sun sensitivity, mild redness or itching.
Blood-related effects:
Temporary elevation in cholesterol and triglycerides.
Slight increase in liver enzymes.
Requires regular blood monitoring.
Rare and serious effects:
Bone or joint pain, especially with high doses.
Psychological effects: depression or mood changes (rare).
Eye problems: night vision issues, severe dryness.
Birth defects: highly teratogenic, strict contraception required.
Persistent dryness and sun sensitivity – mild ongoing dryness or lip cracking, increased sun sensitivity.
Neurological issues – rare intracranial hypertension, headaches, nausea, vision changes.
Psychological effects – rare depression or suicidal thoughts; close monitoring required.
Eye problems – dry eyes, irritation, corneal issues, night blindness, especially with contact lens use.
Liver and digestive issues – occasional liver enzyme elevation, possible inflammation, gastrointestinal effects on pancreas, esophagus, or liver.
Tips for Managing Side Effects While Taking Roaccutane (Isotretinoin)
Roaccutane is highly effective for treating severe acne, but it can cause several side effects. Here are the most important tips to manage them:
Dryness of the skin, lips, mouth, and nose is one of the most common side effects. To reduce it:
Apply moisturizers frequently to the body and affected areas.
Use oil-free moisturizers on the face, chest, and back.
Keep lips moisturized throughout the day.
Take short, cool showers and avoid harsh soaps; use emollients and gentle cleansers instead.
Avoid skin exfoliation or laser treatments during therapy and for up to 6 months after finishing.
Shave with a razor instead of waxing to minimize skin irritation.
For dry mouth: use sugar-free candies or gum, suck on ice chips, or use saliva substitutes.
For dry nose: use saline sprays and apply petroleum jelly inside the nasal passages.
Use lubricating eye drops or artificial tears, especially if wearing contact lenses.
Avoid driving or performing dangerous activities if vision is blurred or night vision is reduced.
Apply sunscreen daily and reapply every 4 hours.
Avoid direct sun exposure, especially between 11 a.m. and 3 p.m., and protect against strong winds or extremely cold weather.
Wear protective clothing and hats to reduce direct sunlight exposure.
Roaccutane is not suitable for everyone due to potential risks and side effects. Avoid it in the following cases:
Planning Pregnancy
Roaccutane is highly teratogenic and can cause severe birth defects.
Women should avoid Roaccutane at least 2 months before trying to conceive.
Breastfeeding
Roaccutane should be discontinued during breastfeeding to protect the baby from harmful effects.
Allergy to Roaccutane
Avoid if allergic to vitamin A, retinoids, or any component of the medication.
High Blood Lipid Levels
Patients with high triglycerides or cholesterol should avoid Roaccutane for health safety.
Vitamin A Overdose
Individuals with excessive vitamin A intake from diet or supplements should avoid Roaccutane.
Other Medical Conditions
Avoid Roaccutane if taking tetracycline antibiotics.
Not recommended for patients with severe liver disease.
Do not use Roaccutane after its expiration date.